I just spent two hours working on complete horseshit.

[LuckyCharms]

I keep impeccable records. Always have.

I have a medical flex plan that I track to the penny and cross reference to several worksheets because I can't trust the people who administer such things. I have caught the administrators of my flex plans making dumb shit errors to the tune of a few thousand dollars over the past many years. Of course, these errors were not in my favor. Double postings, math errors that a well designed system should catch, etc. If I did not catch these simple errors performed by them, I would be harmed by a pretty substantial dollar amount.

I started doing this shit for some recent medical bills at about 4AM today.

And I gradually started fuming about the amount of time I am wasting on this completely fucked up "health care system" that we have here.

I am not smart enough to convey in writing the laughable steps that I have to take on a semi-weekly basis just to sort out my medical insurance problems/problems with reimbursement on my medical flex plans, screwed up bills from doctors, etc.

This is quite a health care financing and delivery system we have in this country. You have to be smart and aggressive (well, I'm not smart, but I make up for it by being aggressive) just to make sure that some insurance company, or some "flex plan administrator" is not sticking their fucking hands in your pockets. Just what you need when you may not be feeling well in the first place.

The people responsible for opposing single payer, and the people responsible for striving to eliminate Obamacare, and the greedy fuckers who have allowed insurance companies to advertise themselves as "health companies", and the people who spread misinformation about "socialized medicine" because they are too stupid to understand such things so they try to keep this country locked into the most fucked up piece of dogshit health care system that could ever be dreamed up...should be strung up by their fucking balls with hot razor wire (NOT LITERALLY OF COURSE YOU FUCKED-UP LURKING NARCS).

[True Blue American]

1. Be sure and vote

Democratic!

[dalton99a]

2. USA! USA!

HSBC survey (2014)

[FakeNoose]

12. Wow! All I can say is, at least we're not Ireland

[Midnightwalk]

29. Ireland jumped out to me too

Apparently they’ve increased spending a lot but it’s hard for me to figure out why. There is a mix of oublic and private insurance but it isn’t clear to mr how much if the increase is driven by private insurance vs the government trying to improve delivery.

From Wikipedia

In 2010 Ireland spent €2,862 per capita on health, compared to a European Union average of €2,172 per capita,[2] of this spending approximately 79% was government expenditure.[3] In 2017 spending was the seventh highest in the OECD: $5,500 per head.[4]

...........

The 2008 Health Consumer Powerhouse Euro Health Consumer Index report ranked Ireland's public healthcare system 11th out of 31 European countries.[26] This is an improvement on the 2007 report which ranked Ireland 16th out of 29 countries,[27] and a drastic improvement on the 2006 report, in which Ireland was ranked 26th out of 26 countries.[28]

The strange part is they got their improvement by 2008. In 2010 their costs were in line with ither OECD countries but by 2017 they almost doubled.

Seems like a failure we should understand but I don’t see any analysis on what happened.

[GoneOffShore]

40. Interesting because I'm in France and covered under that system.

I'm paying about 200€ a month for a mutuelle(top up insurance) and feel pretty good about it.

[Scarsdale]

3. Best healthcare in the world, asccording to the entitled

politicians in D.C. Bullsh*t. Donations from the healthcare professionals, insurance companies are keeping us from REAL healthcare reform. Every other westernized country has decent healthcare, except this country. Why? Greedy politicians, that is why. A national healthcare plan would make a tremendous difference to this country. Employers would not have to concern themselves with covering their employees (or not). People could change jobs with no worries about healthcare. Imagine being able to see a doctor, without having to make sure you can afford it? This country is backwards when it comes to healthcare. Oh, and elections, too. Look WHAT we have in the WH, screwing up the 4th of July right now.

[Ohioboy]

4. Thank you for your post. I know what you mean.

I don't have time to go into all the ways I've been screwed around by insurance companies. You are right that you have to watch them every minute, and it's a lot of work and time, work and time you'll never be paid for or get back.

[cilla4progress]

5. Yep

and yep.

It is galling.

I see the suffering the for-profit health system imposes on my low-income clients. Deferrring needed procedures to alleviate pain.. it is sadistic, torture.

[Farmer-Rick]

6. How come errors like this always go in favor of the rich corporations?

I actually caught an error my bank made. It was only $11.00 but it went in favor of the pharmacy that got double payment.

On the other hand, using my government sponsored health insurance Tri Care. They caught an overpayment and sent me my money back. Government health insurance should be provided to everyone just for this reason alone.

When there is a profit motive, there is a cheating motive.

[Ligyron]

17. Tri Care is great.

You are fortunate to have what many can only dream of. Our new healthcare system should be based on the VA model w Tri Care.

[Farmer-Rick]

32. Yes, it is pretty good

But honestly my wife was on Medicare for life (she passed away) and it was better.

Everyone deserves health care and insurance and those who prevent it are horrible cruel people.

[vlyons]

7. Yes totally fucked up

I get radiation every day, and every day, the people at the hospital greet me by name. So they all know who I am. And every day, the technician asks my birthdate. I asked her if she thought it had changed since yesterday. Or if she thought an imposter was desperate to use my name to get zapped with radiation. It's all so stupid.

[area51]

8. Please support

comprehensive Medicare for All and contact Speaker Pelosi and ask her to support it.

[onlyadream]

9. We had a flexible spending account

And hubby was laid off...when I put in for reimbursement I was told he didn’t exist in their records. I had to prove it with paycheck stubs showing the payments! It took many hours to set it straight and, from that moment, I was done with FSAs.

[El Mimbreno]

10. Like so many things today...

there's always a catch or a scam or just a screwup. Check this:

MD: You need surgery for a deviated septum.

Insurance: We need to see a CT scan first. Scan approved at facility X.

Insurance: Surgery approved, payment for scan denied - non-participating facility. You owe them $1800.

Us: Can't afford surgery after paying for scan.

[panader0]

11. Don't get sick and if you do, die quickly.

kidding of course.
I'm lucky that I'm so poor that the great state of Arizona gives me free
health care. Well, almost. Also lucky that at 68 I'm relatively healthy.
Except maybe in the mind. I'll have to check to see if that's covered.

[ehrnst]

13. Single payer is used by very few countries to achieve Universal Health Care. Most use hybrid payers.

To attack anyone at all who points out that Single Payer took decades to get up to speed in the few countries where it is used, or to point out the problems with Bernie Sanders' timeline and cost estimates as "greedy fuckers" isn't factual or productive.

We are working towards universal health care as the goal. If we can get there faster with a multi-payer plan, with some private elements like the vast majority of the rest of the industrialized world, that would be preferable than a bill that will likely meet the same fate as the requirement for Medicaid expansion did. If the 2010 SCOTUS struck down the ACA's mandate that states expand Medicaid to more poor people, even if the Federal Government paid for it, how do you think the current SCOTUS will rule on the inevitable challenge to a law that requires the expansion of Medicare AND Medicaid to everyone? Look at how the GOP was able to kneecap some of the many parts of the ACA.

We should not make mistake that anti-choicers make, by dismissing/demonizing health care policy experts as "shills of the Planned Parenthood and the abortion industry" who say that getting rid of Planned Parenthood will not stop abortions, and in fact, may increase their numbers and make them more dangerous. Their first goal stopped being to reduce abortion, and became "punishing the greedy doctors and those promiscuous women" rejecting any strategy, no matter how effective, that doesn't eliminate Planned Parenthood and criminalize providers.

(No, I'm not comparing Planned Parenthood to private insurance providers. I'm comparing the tribal thinking that the "solution" has become dogma, and demonizes anyone who points out the problems in that "solution" as heretics, "stupid," and/or "greedy bastards."

There are ways to get affordable health care to more people that would be quicker and more efficient than a bill that can't deliver what it promises, as per non-partisan, self-funded health care policy think tanks and experts.

I will believe those experts over a political promise any day.

I understand your anger. I have only in the last 15 years gotten out of horrific debt because of medical bills as an uninsured person just out of college who landed in the hospital for two weeks with two bleeding ulcers, then again 3 years later for a week for the very same.

Yes, our health care system is fucked up. Like the issue of emancipation, there may not be a solution that doesn't create more problems in other aspects of health care and the economy, or hurt other people. It's a 'wicked problem" that defies a single simple answer, no matter what the intentions of a politician who promises one.

[KY_EnviroGuy]

19. K&R. Agree, and thank you for that clarity.

I think the result we would like to see will require the eventual dismantling and rebuilding of a huge complex industry, many parts of which should never have been allowed to happen. Changes will have to come very slow and methodical to avoid disturbances in existing care and avoid massive wrong-headed political backlash.

The existing system is far too complex, with layer after layer they've added to increase profits and to insure it survives any effort to simplify it with government-sponsored programs. The sick, the poor, the disabled and seniors are paying the price every day for this greed and complexity. I see it happening real-time with family and friends.

We Americans are proficient at building complex things that seem to be a good idea at the time, but not so good at reversing course and rebuilding for the good of all the people.

KY......

[KY_EnviroGuy]

14. A clear result of an unfettered laissez-faire version of capitalism.

The greedy pigs of the healthcare industry have added layer after layer of costs to even basic essential care to the point that hardly anyone can understand it. That's especially true for seniors like me.

When I was a kid, all payments and paperwork was handled at the doctor's office and all records were stored there, and health insurance was very simple. Then they went to external billing (a layer) and external record keeping (a layer) and then most all doctors became associated with some major hospital (about 10 new layers) rather than being independent.

Next, the insurance companies started being extremely picky about paying things a doctor recommended or prescribed which adds more complexity for hospitals, specialists and pharmacies. Now, insurance companies act as if they want to be your doctor.

What an outrageous racket and a shame for the rest of the world to see......

[uponit7771]

15. After getting a brain injury that sent me into seizures medical bills were a nightmare ...

... you'd think there would be a service for the sick to keep them straight

[Honeycombe8]

16. Is this for a business? Or you have multiple ins. plans just for yourself?

Why do you have multiple plans? What is a "flex plan"?

When you do find errors, you mean the ins. co. actually corrects them? I've never had luck getting an ins. co. to "correct" anything. A low level clerk just says, "I don't know why that's so." That's it. When you have an individual policy, you have no power whatsoever. Obamacare acting like individuals are groups of insureds makes no sense....it works to the detriment of the public. You pay for all sorts of stuff you don't need or want, because it's like a "group" policy, but the price isn't a "group" price, and the insured has no power like a group does.

The latest was one time when I had a supposedly free preventive exam (to get the bloodwork done). The ins. co. charged me about $60 for it. I called to ask why, because the ACA dictates that preventives are free. She said she didn't know. She said there must be a code in the records. I ask "what code?" She said she doesn't know. I call dr's office and ask. They tell me there is no code that's different from the way they normally code preventive exams. So because I was an individual, with an individual policy, without any leverage like a group, and no ability to change ins. cos. (that was the only co. that sold ACA individual policies in my area), I simply had to pay whatever they told me. Unless I wanted to sue in a small claims court somewhere.

I'm lucky to have had excellent health all my life, so haven't had to track ins. co. payments or anything. Now I'm on Medicare, which will hopefully be better, since I'll be getting medical conditions as I age. Unless I just drop dead one day.

[LuckyCharms]

18. Answers:

1) No, not for a business. I have individual medical insurance for myself.

2) I just have one insurance plan. The "flex plan" I am referring to is as follows:

3) Flex Plan = "Flexible Spending Account" that has nothing to do with actual medical insurance...it is separate and distinct from insurance. In a nutshell, with a flexible spending account, money is withdrawn from your paycheck to fund the account. There is a yearly maximum that you can contribute to the spending account...in my case (probably all cases), I think it is $2,600.

The money withdrawn from your paycheck for this spending account reduces your taxable income by the amount you put into the account. Therefore, your income taxes are reduced.

So you start with a balance of money in this spending account. There is a company that administers this fund of money for you. You then submit to this company your medical bills, usually after you pay them. Let's say you submit a medical bill for $100. The plan administrator will reduce your fund balance by $100, and then send you a check for that amount.

A flexible spending account is a way to put money aside for upcoming medical bills while reducing your income tax burden. The problem is that sometimes the plan administrator uses systems that can't seen to do simple math when they offset your fund balance by the amount of money they reimburse you for your medical bill.

Another problem is that these spending accounts are nothing more that a band-aid attempted fix to what should instead be a simple and straightforward solution to your personal health care financing.

[Honeycombe8]

21. Oh, yeah. I remember what FSA is.

That's not your insurance. That's a benefit for working people w/employer-provided insurance, to set aside some costs in a special account, that can be used to offset out of pocket medical expenses.

I'ts a working person's version of the HSA, it seemed to me. The ACA actually cut that benefit. Didn't make any difference to me, since I never used the FSA program.

[MarvinGardens]

23. FSA are still around in some workplace plans.

So ACA did not eliminate them. However, unlike HSAs, every FSA plan I've seen had a "use it or lose it" provision. You have to spend your entire contribution within the year, or by April 15th of the next year, or you lose it. To me, that's absolutely outrageous and wrong, so I have never participated in an FSA.

[Honeycombe8]

25. I remember that. That's mainly why I didn't participate.

I was healthy, so not likely to use whatever I was allowed to put into FSA (you could only use it for certain things, like daycare costs, prescription meds, etc.). And I couldn't roll it forward for a future med expense. i think I participated the first year my firm had it, and I lost that money.

[druidity33]

28. I have an FSA plan...

I put in $500 dollars a year because that's the maximum amount that rolls over to the following year. We usually use it up (it's a family plan), but when we haven't i see it there when the new plan year starts. That's when we get glasses. Also, my plan allows for a debit card, so i only have to submit claims when the MD isn't in network. It even lets me use the card for prescriptions and med supplies at the pharmacy.

[LuckyCharms]

30. Mine works fine for prescriptions...

But whenever I try to use my debit card to pay a co-pay at the doctors office, the charge will go through, but the flex administrator will always come back to me requesting more detail to make sure the charge is IRS compliant. So for anything other than scripts, I just submit it online, manually, after I pay it with a regular credit card. I am then reimbursed with a direct deposit...and the reported fund balance remaining is incorrect probably a third of the time, because the administrator has a bad habit of deducting charges twice, which then necessitates an email and follow-up.

Also, there is no "network" for my spending plan. All they care about is that the charge is valid for FSA purposes, and that it is IRS compliant. I can see any doctor. My FSA is in no way tied to my insurance. Insurance presents a whole different set of problems, including "networks".

[Lars39]

31. I use durable medical stuff, so we put in all we're allowed.

We wait until we have EOBS because they started hassling us for the minor stuff. We don’t even use the debit card.

[Ohiogal]

20. I feel your pain, Lucky

Seems like Every ...Single ... Time... we get a statement from our health insurance it requires multiple phone calls and at least an hour.’s time on the phone trying to speak to a person in order to understand the charges or fight the charges.

I often wonder what happens to elderly, frail, people, who don’t have the ability or understanding to do all this shit. They’re probably taken to the cleaners over their medical bills. You really have to stay on top of it if you don’t want to get fleeced. Our health insurance system in this country is a fucking disgrace.

[MarvinGardens]

22. Sounds like Blue Cross.

I've had them at various times, and they always pulled that crap. It superficially looks like sloppy incompetence, but it always goes in their favor. In the computer age, how could you possibly process a claim as if I am in lower tier coverage, when I am in the higher tier coverage? Luckily, where I work now, I had a choice. So I dropped them and went with more expensive insurance offered by a union. More expensive on paper, but you know what? They actually pay claims, exactly as they are supposed to, every time. So there is no more wasted time on the phone, writing angry letters and filling out forms. I get that time back, and it's worth every penny.

If more people just had choices, like I do, it would be an improvement. Before we try single payer, I'd like to see a system where we buy our health insurance the way we buy car insurance, with some ground rules of course. They have to cover preexisting conditions, there is a minimum level of coverage that all plans must provide, and everyone has to carry it. Like the ACA exchanges, but for everyone. It's ridiculous that so many Americans are locked into a single insurance company because of where they work. For many, the status quo vs single payer argument is monopoly vs monopoly. Many workers are stuck in a local monopoly with their employer based coverage, and single payer will replace it with a national monopoly. So people think, "my current coverage is the devil I know. And I could always go work somewhere else, or convince my HR department to offer something else. But if we get single-payer and it sucks, what recourse do I have?"

[PoliWrangler]

24. Healthcare made easy

That's really the point of Single Payer, Medicare for All, Universal Health Care. Anyone who has experienced it in the EU or Canada already knows this. Probably millions in the US have experienced some similar frustrating situation but we do it individually, alone, divided from each other. There is strength in numbers, united we'll get better results. Good post LC.

[ehrnst]

26. There will be nothing "easy" about changing our baked in patchwork unregulated system,

let alone upending it to a single payer system.

Anyone who promises that it will be 'easy' and done in merely 8 years, affordably, with no negative impact on patient experience or the economy is ignoring what independent, self-funded health policy think tanks say.

Just as anyone who promises that shutting down Planned Parenthood, and redirect the taxpayer money that is reimbursed to them to make adoption free, will end abortion. It sounds very simple and appealing, especially to people who hate Planned Parenthood for "encouraging women to sleep around," but it's not going to work that way in reality. It also contradicts what non-partisan health policy experts say is the best way to reduce unplanned pregnancy leading to abortion.

[CrispyQ]

27. It's not enough that you're sick,

you have to watch your billing like a hawk, & even then, hope you have enough money to pay your regular bills & your med bills. Hmmmm, that seems STRESSFUL to me & isn't STRESS a number one killer? Seriously, at a time when you should be focused on your well-being, our country's "health care system" adds to the stress in your life.

I asked my rwnj cousin this once. For purely selfish reasons, why wouldn't you want the people you share your common space with, at grocery stores, at the library, in the park, to be as healthy as possible? Why would you risk the entire community's welfare for the cost of medical care for your fellow townspeople? He ignored me like he always does when I make him uncomfortable.

[Laelth]

33. Hear! Hear! k&r n/t

-Laelth

[lostnfound]

34. Yep. I have five possible payers..

FSA, health rewards card, insurance, self-pay, and pharma company copay assistance.

It’s completely impossible to know whether any bill is correct or complete, or whether I’ve met a deductible, etc.

[lostnfound]

35. We all waste time becoming proficient in multiple payer systems

People have to learn how to navigate insurance from one employer to the next, to COBRA, to Obamacare, to Medicare.

If they are lucky enough to have insurance.

[ehrnst]

36. "Waste time?" Most developed nations have multi payer systems for UHC.

[lostnfound]

37. I think you misunderstood me..complexity is burdensome. Many people can't cope.

Picture people with cognitive or emotional challenges. People with terminal illness. People whose kids are very sick yet they arejuggling work and caregiving.

Now picture them losing their job, having to learn about COBRA, THEN having to enroll in Obamacare: all the while getting bills from doctors, ER’s, hospitals, labs; paying their copays and deductibles and “coinsurance” and in some cases COBRA payments, applying for “copay assistance”, sending receipts in for FSA or healthy reward”, checking bills and more bills including debt collectors that may in fact be fraudulent, finding out which doctors are “on their plan”, filing appeals for denial of coverage...

The current system is too complicated.

[ehrnst]

38. Gotcha.

[lostnfound]

39. As you personally experienced, it's not mixed payer the way some other countries are, where..

You might have a $100 or $200 charge for your hospital visit in Europe. Here, the stakes are much higher.

Instead, it’s a system where you have a simple outpatient operation, a bill is generated for $30,000 which is sent through an opaque process to set one that the actual billed charges are $5000 of which you owe $1000 and they apply that to your deductible — or not, because they disallow some of the doctor’s charges who turn out to have been out of network...

A system where the kid who has a childhood cancer spends her twenties fighting and dying of breast cancer leaving tens of thousands of dollars of medical debt on her credit card...

A medicine that costs $8000 per month that you get billed for at $55 a month then $0 then $2000 per week while a shipment is delayed...and you file an appeal every two years to keep coverage.

Real life examples close to me.

[Phentex]

41. This is exactly what I experienced...

I think I posted about days spent trying to match up charges with services performed and the names of the practices, etc. It's extremely frustrating! I figure many people just give up trying and pay whatever they are told to pay.