Marketplace insurance tax return !!

[Kershaw]

It's bullshit because it all existed way before ACA. Blaming ACA for it is ridiculous. There should be transparency in the healthcare industry, they should list the cost of their procedures, visits, drug expenses, all that should be readily available. Absolutely. If you don't like your deductible, shop for another plan. That is literally what ACA is for, it's a marketplace for healthcare. I have AETNA (never used it in 4 years tbh, still pay for it) and I get at the end of the year an email to reenroll in my healthcare. I have 6 base plans to choose from that are highly customizable. That all happened because of ACA. Before that I had 2 options, hmo or ppo, both were set.

No one is going to choose to be poor to save a few thousand dollars on healthcare, that's also a ridiculous statement.

[Herr Faust Schinken]

My families insurance cost actually went down alot with covered Ca, we actually got a better plan with less copay with the same company that we had before before. They are also now covering a surgery that my mom need to have that they didn't before. I also have a sorta-preexisting condition where i haft to go and get a shot every 2 weeks the insurance company wouldn't have covered it before hand. Now i have no clue what the ACA looks like outside of CA, I've heard it was a royal pain in the ass for some people to sign up. But i just figured i would add my experience in.

[gwb72tii]

It's bullshit because it all existed way before ACA. Blaming ACA for it is ridiculous. There should be transparency in the healthcare industry, they should list the cost of their procedures, visits, drug expenses, all that should be readily available. Absolutely. If you don't like your deductible, shop for another plan. That is literally what ACA is for, it's a marketplace for healthcare. I have AETNA (never used it in 4 years tbh, still pay for it) and I get at the end of the year an email to reenroll in my healthcare. I have 6 base plans to choose from that are highly customizable. That all happened because of ACA. Before that I had 2 options, hmo or ppo, both were set.

No one is going to choose to be poor to save a few thousand dollars on healthcare, that's also a ridiculous statement.

take a deep breath and read carefully what i said.
I did not blame obamacare, i said obamacare resulted in all of us having to pay attention to cost because deductibles have gone up so you and i get to spend more of our money vs the insurance companys' money.
we've had the fed govt try to control costs from the top down as long as i've been paying taxes, by limiting reimbursement rates to docs. It hasn't worked because you and i, until now, haven't had to care because our damage was a copay, or a relatively small deductible.
my deductible went from $1200 to $5600. I care that i have to pay more for an MRI at multicare vs the local clinic because I'm writing the check. i'm spending my hard earned pay.
having the federal government involved makes it worse. its the least efficient way to try and solve healthcare costs.

[BraveUlysses]

The feds only limit reimbursement rates for medicare patients, not everyone on private plans.

[mrsleeve]

^

Correct and in many cases at less to FAR less than the actual COST of the procedure/treatment. So to in an attempt to compensate for this Providers massively up rate their over the counter cost charts to get Medicare to up the reimbursement rates.

[MrSlacker]

Yup didn't have insurance last year. Will just pay the penalty and call it a day.

[BraveUlysses]

^

Correct and in many cases at less to FAR less than the actual COST of the procedure/treatment. So to in an attempt to compensate for this Providers massively up rate their over the counter cost charts to get Medicare to up the reimbursement rates.

The how and why of what a hospital charges for any given procedure is all over the board, I'm not sure it has any basis in reality other than a money grab.

http://www.nytimes.com/2013/05/08/business/hospital-billing-varies-wildly-us-data-shows.html

A hospital in Livingston, N.J., charged $70,712 on average to implant a pacemaker, while a hospital in nearby Rahway, N.J., charged $101,945.

In Saint Augustine, Fla., one hospital typically billed nearly $40,000 to remove a gallbladder using minimally invasive surgery, while one in Orange Park, Fla., charged $91,000.

In one hospital in Dallas, the average bill for treating simple pneumonia was $14,610, while another there charged over $38,000.

Data being released for the first time by the government on Wednesday shows that hospitals charge Medicare wildly differing amounts — sometimes 10 to 20 times what Medicare typically reimburses — for the same procedure, raising questions about how hospitals determine prices and why they differ so widely.

The data for 3,300 hospitals, released by the federal Centers for Medicare and Medicaid Services, shows wide variations not only regionally but among hospitals in the same area or city.

Government officials said that some of the variation might reflect the fact that some patients were sicker or required longer hospitalization.

Nonetheless, the data is likely to intensify a long debate over the methods that hospitals use to determine their charges.

Medicare does not actually pay the amount a hospital charges but instead uses a system of standardized payments to reimburse hospitals for treating specific conditions. Private insurers do not pay the full charge either, but negotiate payments with hospitals for specific treatments. Since many patients are covered by Medicare or have private insurance, they are not directly affected by what hospitals charge.

Experts say it is likely that the people who can afford it least — those with little or no insurance — are getting hit with extremely high hospitals bills that may bear little connection to the cost of treatment.

[...]

The data showing the range of hospital bills does not explain why one hospital charges significantly more for a procedure than another one. And Medicare does pay slightly higher treatment rates to certain hospitals — like teaching facilities or hospitals in areas with high labor costs.

[...]

“There’s very little transparency out there about what doctors and hospitals are charging for services,” Mr. Zirkelbach said. “Much of the public policy focus has been on health insurance premiums and has largely ignored what hospitals and doctors are charging.”

and here's a really, really interesting map of which hospitals are charging at/below medicare rate, 1-2x medicare rates (look at florida) and more than 2x (mostly cali with another glut around philly/trenton/NYC)

[mrsleeve]

Its called a pricing matrix, and different providers use different ones, no different than car dealerships use on parts or service where some parts are marked up further than others, and that varies form dealer to dealer on some items.

Some Docs charge more for their time than others, some cater to a more up scale clientele. Some facilities may have more modern and NEW OR's or support facilities and there for cost more for the surgeons or docs to use them, or have more support staff in building during the procedure and for after care. The anesthesiologist cost can vary greatly from one to another. There are lots of factors that can vary the cost of a "routine procedure" Kinda like getting the wheel bearings done at the BMW store Vs the small independent shop.

Another reason some providers may have "retail costs" many many times that of the what a typical Medicare reimbursement might be, might be rate at which they have to treat patients that cant pay the bills and charge them off..... If there is a very high delinquency rate at a provider they might keep upping their retail rates in hope of covering some of those losses from those that actually pay namely the insurers and medicare

[Restoman]

I'll just say that with my employer managed health insurance it cost me around $11,000 plus I pulled an extra $800 into the flex account. Two adults and two kids most of the year. Baby at the end of 2015. So that was and is working off about $4000 in extra uncovered bills. Yay.

[gwb72tii]

My cost was $13,200 for two of us
I'm still waiting for the $2500/year savings from my older $6000/yr policy with the lower deductible Obama promised me as he looked at me square in the eye

[marshallnoise]

The whole system is smoke and mirrors and that is the issue. Hospitals can charge whatever they want, then take whatever cash they will get reimbursed for, write off the difference as a loss, never earn a dime of income and not pay taxes. Then no matter what plan you purchase, you wind up paying either more in premiums and less in out of pocket costs or vice versa. Its a fact.

Then the government comes in and basically pulls a Community Reinvestment Act and says they will guarantee health insurance companies clients and they can charge what they want.

Even before Obamacare, we didn't have a free market system. The difference was the states were regulating who could do business in their state and picked the winners and picked the losers.