Planning on dropping Health Insurance. Change my mind.

[bruceha2000]

Why the rush to pay off the home loan? It痴 probably your largest tax write off.

Not any more. Not with a standard deduction for single people moved up to $12K with the tax law that was passed last year.

 

[D2Cat]

BrokeFarmerJohn, I have to commend you on selling the bull. You had no use for him if you only had steers!

 

[Streetcar]

Why get unsecured loan or borrow against 401 ,if you refinance your house or get equity loan

 

[thekkfan]

We don't need health insurance for everyone.

What we NEED is healthcare costs regulations. You should be able to go to the doctor, get a normal bill like you do for anything else, and be able to simply pay it. Same for medications.

It's funny learning at my previous career how the gov't regulates phone, cable, utilities rate increases, but does nothing where the fatcat money lies.... gas, oil, healthcare.

 

[ultrarunner]

The funny thing is Hospitals are closing all around the country... must not be all that lucrative a business.

What other business is regulated to provide care to all without regard to payment?

Some would argue regulation is very much a part of the problem...

 

[thekkfan]

None around here. Must be the overpopulating in your area of the country and cannot financially sustain the influx..?

Dunno. :confused3:

 

[Oaktree]

The funny thing is Hospitals are closing all around the country... must not be all that lucrative a business.

What other business is regulated to provide care to all without regard to payment?

Some would argue regulation is very much a part of the problem...

Good points.
As a healthcare industry insider, what thoughts do you have regarding improving care while keeping prices under control? Other countries seem to manage it.

I don't like excessive regulation either, but some industries seem to bring it upon themselves.

We don't need health insurance for everyone.

What we NEED is healthcare costs regulations. You should be able to go to the doctor, get a normal bill like you do for anything else, and be able to simply pay it. Same for medications..

At the very least, we need some transparency regarding pricing. Why can't a hospital bill (or to a lesser extent, a doctor's visit) be all-inclusive instead of getting a bill from the hospital, plus another one from the doctor, another for the anesthesiologist, still another for the pathology lab and all sorts of really vague items on the bill that even the billing dept. can't explain? I get that some of these specialists are independent contractors, but why can't the hospital pay them and include all costs in one bill?

A little bit of open-ness regarding fees would be nice too so you have an idea what to expect going in, maybe tests, procedures, add-ons that could be eliminated up front to keep costs low. Every other industry seems to be able to do this.

As far as medication goes, same thing. There is no excuse for a given drug to have a several hundred % range in price from one pharmacy to another for the exact same drug.

We need some accountability here, and that's sorely lacking. Hospitals and pharmacies seem to be able to charge whatever they want and their attitude is take it or leave it.

From what I can see Obamacare® did very little to address any of these issues, just added more bureaucracy to the mix.

 

[ultrarunner]

I believe pro-active patients would help a lot.

Many only care what their portion is if any... some will almost brag saying my last hospital stay was 80k and I only had to pay $250 or some small amount.

There is a total disconnect between the consumer and cost. I know of no other purchase where so many are uninterested in cost... of course there are those that do the leg work... they contact all parties prior as they want pricing in writing and not afraid to shop or bargain for elective procedures...

Also... and this is a pet peeve of mine is the "Price" varies greatly... contract or no contract, in network, emergency etc... price requested prior to service vs we will find out when the bills start arriving.

My brother did all the right things for his surgery... at the last minute the anesthesiologist in net work was not available... as in 20 minutes prior but another was substituted... out of network... when it was all said and done... my brother was expected to pay $3100 for out of network and none of this was disclosed... his Doc was called away on a emergency... medical ambush is what I call it.

Brother refused... then the collection calls started coming... each collection letter and call was returned to the Doctors residence... amazing what happens when no one gets back to you and the customer is ringing your door bell....

Surgery typically will have a minimum of 3 components to the bill... facility, anesthesia and surgeon... there are cases facilities simply no longer do because reimbursements do not cover the cost... especially if additional supplies are needed.

Some facilities will work with patients and high volume docs... say 4 cases with one being Medi-Cal in the mix... this way the average tend to work out better.

An informed consumer is the first defense... as is managing expectations.

I have quite a few Doctor and Nurse friends in Austria... Austria is known for having excellent medical training and quite pro active when it comes to the young, expectant mothers and those with a long productive work life ahead...

My Vienna Docs said procedures routine in America for elderly simply are not going to happen in the State system... transplants, cancer routines with very expensive drugs... etc...

Also, Docs there do not worry about lawyers... and employees all have basic coverage...

But... just because it works well for most... there are those that can afford it go elsewhere to have treatment they are not eligible for in Austria... in full disclosure... the gap is narrowing... but was quite extreme even 20 or more years ago.

In my region... a not for profit hospital corp GAVE away a modern, seismic Hospital to the county... and it was not because of utilization because the census was high... it was because such a large percentage of patients had no insurance or were under insured...

Now the county has it and keeps asking for more funding to cover patients not insured.

We also had a stellar Catholic Hospital that service a real need for a variety of things... the Nuns said they could not and would not be a part of mandated "Family" planning... they pulled out and left...

This hospital is struggling but because the need is great... other Hospitals or competitors have stepped up with Million Dollar grants lest these patients show up on their doorstep...

 

[bruceha2000]

...
I told myself I would not end up in his situation so I watched my finances like a hawk. The retirement and investing game, I don’t know anything about, haven’t had the money for it yet.

The 401k loan, I knew had to be paid off if I ever left my job or would have to pay a early withdraw free etc. wasn’t as keen on the not making as much money as the loan is open. I just figured the loss would be less with that loan vs a higher interest loan.

I highly commend you for getting your financial house in order especially since you didn't have a good role model to teach you. BTW, divorce is the worst financial plan ever, that is why your dad lost the house. What he did with all the other money he should have had is unknown and sad. Had he invested it or paid off the house or what ever, he would be in far better shape.

I thought the max was percentage based for some reason and not numerically valued. Learn something new every day.

That makes it a GOOD day!

...
It's funny learning at my previous career how the gov't regulates phone, cable, utilities rate increases, but does nothing where the fatcat money lies.... gas, oil, healthcare.

They do something for gas and oil, they subsidize the suppliers.

 

[MossRoad]

I believe pro-active patients would help a lot.

Many only care what their portion is if any... some will almost brag saying my last hospital stay was 80k and I only had to pay $250 or some small amount.

There is a total disconnect between the consumer and cost. I know of no other purchase where so many are uninterested in cost... of course there are those that do the leg work... they contact all parties prior as they want pricing in writing and not afraid to shop or bargain for elective procedures...

Also... and this is a pet peeve of mine is the "Price" varies greatly... contract or no contract, in network, emergency etc... price requested prior to service vs we will find out when the bills start arriving.

My brother did all the right things for his surgery... at the last minute the anesthesiologist in net work was not available... as in 20 minutes prior but another was substituted... out of network... when it was all said and done... my brother was expected to pay $3100 for out of network and none of this was disclosed... his Doc was called away on a emergency... medical ambush is what I call it.

Brother refused... then the collection calls started coming... each collection letter and call was returned to the Doctors residence... amazing what happens when no one gets back to you and the customer is ringing your door bell....

Surgery typically will have a minimum of 3 components to the bill... facility, anesthesia and surgeon... there are cases facilities simply no longer do because reimbursements do not cover the cost... especially if additional supplies are needed.

Some facilities will work with patients and high volume docs... say 4 cases with one being Medi-Cal in the mix... this way the average tend to work out better.

An informed consumer is the first defense... as is managing expectations.

I have quite a few Doctor and Nurse friends in Austria... Austria is known for having excellent medical training and quite pro active when it comes to the young, expectant mothers and those with a long productive work life ahead...

My Vienna Docs said procedures routine in America for elderly simply are not going to happen in the State system... transplants, cancer routines with very expensive drugs... etc...

Also, Docs there do not worry about lawyers... and employees all have basic coverage...

But... just because it works well for most... there are those that can afford it go elsewhere to have treatment they are not eligible for in Austria... in full disclosure... the gap is narrowing... but was quite extreme even 20 or more years ago.

In my region... a not for profit hospital corp GAVE away a modern, seismic Hospital to the county... and it was not because of utilization because the census was high... it was because such a large percentage of patients had no insurance or were under insured...

Now the county has it and keeps asking for more funding to cover patients not insured.

We also had a stellar Catholic Hospital that service a real need for a variety of things... the Nuns said they could not and would not be a part of mandated "Family" planning... they pulled out and left...

This hospital is struggling but because the need is great... other Hospitals or competitors have stepped up with Million Dollar grants lest these patients show up on their doorstep...

We had two major hospitals in South Bend. One was a Catholic hospital (I was born there). About 7-8 years ago, they built a new hospital in the next town over and moved there. They paid to have their old hospital torn down and the site prepped for the local Catholic high school to build a new building on the old hospital site at no cost to the high school. All free. As I mentioned before, they moved because too many low-income people live here and don't pay their bills. It's only about 5 miles as the crow flies, but a world away from the people that need affordable care and assistance the most. Very hipocritical for an institution that's supposed to be all about helping the needy. It's all about the money.