U.S. Politics: Hairpiece In the Middle East Part 2

[Tijgy]

34 minutes ago, Fragile Bird said:

There may be 10,000 protesters in the streets in Belgium tonight to greet Trump. That should be an interesting change for his entourage, who were so pleased by the lack of protesters in Saudi Arabia.

I actually want Trump out of my country; and it has only been two hours. 

My train was delayed thanks to him and my rest was ruined by the protesters against him (they made a lot of noise (yelling and singing). 

 

[OldGimletEye]

16 minutes ago, Tijgy said:

I actually want Trump out of my country; and it has only been two hours. 

I'd say that putting up with him for two hours takes a lot of patience.
I would have thrown a fit after about 10 minutes. LOL.

[BloodRider]

18 hours ago, Cas Stark said:

Well, thanks to ACA, now everyone who wants insurance can get it, or so I have heard.  LOL.

My doctor doesn't take the crap exchange insurance that I am mandated to purchase now...the one that isn't cheap and has a deductable threshold of several thousand dollars.  But, thankfully he still gives me the 70% discount.  

Is it crap because your Dr. told you it was?  How do you know it is crap?

[Cas Stark]

8 minutes ago, BloodRider said:

Is it crap because your Dr. told you it was?  How do you know it is crap?

I know it is crap based on the massively high deductable that my 'silver' plan has, which means that in order actually get any insurance coverage I have to spend around six thousand+ out of my own pocket....which is more than my annual medical costs in pretty much every year of my life except the one where I had surgery.  So, it's a financial drain unless I either don't use any services, so am only out the premiums, or develop a major health issue that will cost more than $6K.  My PCP supported ACA as better than nothing, even though he doesn't accept the insurance.

ETA...there is also the awesome stress factor that god forbid, you should make more money in any given year than what you were making when you signed up that ACA will RETROACTIVELY raise your premiums, so at any time, should you make more money, you will be basically penalize and owe anywhere from a few hundred to several thousand, depending on what the subsidy might be.

[BloodRider]

27 minutes ago, Cas Stark said:

I know it is crap based on the massively high deductable that my 'silver' plan has, which means that in order actually get any insurance coverage I have to spend around six thousand+ out of my own pocket....which is more than my annual medical costs in pretty much every year of my life except the one where I had surgery.  So, it's a financial drain unless I either don't use any services, so am only out the premiums, or develop a major health issue that will cost more than $6K.  My PCP supported ACA as better than nothing, even though he doesn't accept the insurance.

ETA...there is also the awesome stress factor that god forbid, you should make more money in any given year than what you were making when you signed up that ACA will RETROACTIVELY raise your premiums, so at any time, should you make more money, you will be basically penalize and owe anywhere from a few hundred to several thousand, depending on what the subsidy might be.

Did you apply for the subsidies?  Sounds like you could get the subsidies.

[Cas Stark]

2 minutes ago, BloodRider said:

Did you apply for the subsidies?  Sounds like you could get the subsidies.

Yes, I have some subsidies, but they don't affect the deductable, at least in my understanding, they're for the premiums only.  Although since I have yet to actually use the insurance, I might be wrong.

[aceluby]

9 hours ago, ThinkerX said:

I should point out the discount for uninsured people here, at least, is income based, that maxes out at 70% off the price.  I am doing better money wise now than when I went that route before, so for me, the discount would probably be less. 

I would like to point out that discounts happen ALL THE TIME in healthcare, and has nothing to do with insured, uninsured, procedures, income... or really anything.  Insurers will get as much as 90% taken off the bill if the bill is paid quickly.  Many insurers have deals with hospitals/doctors with set payment terms.  Some are negotiated on a bill by bill basis.  Some will just keep not paying the huge bill until the doctor/hospital is willing to negotiate.  Early in my career I developed a website for an insurer to take a bill, do a line by line comparison of what was charged and what the insurer typically pays for the same thing, then calculate the proposed negotiated payment that the user would use to call up whoever was doing the billing.

So you're not really getting a 70% off deal because you're uninsured and are getting an income based cut.  You're getting that deal because that's still probably more than an insurance company is paying for the same procedure.  Medical bills are a negotiation starting point that serves to confuse people how the system actually works; while at the same time providing a great excuse to insurance companies for jacking up premiums.

"We need high premiums because of those skyrocketing costs.  They charge $10 for a band-aid!!!!!"

[aceluby]

27 minutes ago, Cas Stark said:

Yes, I have some subsidies, but they don't affect the deductable, at least in my understanding, they're for the premiums only.  Although since I have yet to actually use the insurance, I might be wrong.

If you aren't using the insurance and don't make enough so you qualify for subsidies, why aren't you just paying the penalty?  It has to be cheaper if you aren't taking advantage of the plan anyway.  This is what I'm not understanding about this whole thing.  Why sign up for the ACA at all if you didn't before and the only difference now is a relatively small penalty.

[Cas Stark]

34 minutes ago, aceluby said:

If you aren't using the insurance and don't make enough so you qualify for subsidies, why aren't you just paying the penalty?  It has to be cheaper if you aren't taking advantage of the plan anyway.  This is what I'm not understanding about this whole thing.  Why sign up for the ACA at all if you didn't before and the only difference now is a relatively small penalty.

My income went up last year and the penalty is now 2.5% of your yearly income if you don't sign up and can't claim any of the exemptions.

[drawkcabi]

3 hours ago, Manhole Eunuchsbane said:

Back to DipshitGate, Lieberman is no longer under consideration for the FBI Director gig.

http://thehill.com/homenews/administration/334889-lieberman-no-longer-considered-for-fbi-chief-report?utm_source=fark&utm_medium=website&utm_content=link&ICID=ref_fark

 

https://www.youtube.com/watch?v=TsiAfgzvfbM

 

[Manhole Eunuchsbane]

1 minute ago, drawkcabi said:

https://www.youtube.com/watch?v=TsiAfgzvfbM

 

PERFECT. Well played, sir. Well played.

[Mlle. Zabzie]

1 hour ago, Cas Stark said:

I know it is crap based on the massively high deductable that my 'silver' plan has, which means that in order actually get any insurance coverage I have to spend around six thousand+ out of my own pocket....which is more than my annual medical costs in pretty much every year of my life except the one where I had surgery.  So, it's a financial drain unless I either don't use any services, so am only out the premiums, or develop a major health issue that will cost more than $6K.  My PCP supported ACA as better than nothing, even though he doesn't accept the insurance.

ETA...there is also the awesome stress factor that god forbid, you should make more money in any given year than what you were making when you signed up that ACA will RETROACTIVELY raise your premiums, so at any time, should you make more money, you will be basically penalize and owe anywhere from a few hundred to several thousand, depending on what the subsidy might be.

Look, your post perfectly encapsulates a lot of what is wrong with the ACA.

1.  It is insurance, not a single payer system.  There are of course, deductibles and premiums.  I have never (thank goodness) hit my deductible on my plan (which is not an ACA plan, but it is a high deductible plan).  I've paired my high deductible plan with a HSA so that I have cash set aside tax free to be used to cover the expenses not covered by insurance.  But everything but annual checkups are pretty much out of pocket.  That's how it set up.  A single payer system would get you a different answer.

2.  The incentives are totally weird, particularly the way that the subsidies and penalties interact.

We will have single payer in my lifetime.  It's just a matter of when.

[Cas Stark]

8 minutes ago, Mlle. Zabzie said:

Look, your post perfectly encapsulates a lot of what is wrong with the ACA.

1.  It is insurance, not a single payer system.  There are of course, deductibles and premiums.  I have never (thank goodness) hit my deductible on my plan (which is not an ACA plan, but it is a high deductible plan).  I've paired my high deductible plan with a HSA so that I have cash set aside tax free to be used to cover the expenses not covered by insurance.  But everything but annual checkups are pretty much out of pocket.  That's how it set up.  A single payer system would get you a different answer.

2.  The incentives are totally weird, particularly the way that the subsidies and penalties interact.

We will have single payer in my lifetime.  It's just a matter of when.

I understand that if your income changes then your subsidies will change...but it is highly stressful, because as someone who is a freelancer, hence why no employer insurance, my income does vary sometimes hugely from year to year, but it's another unknown expense, and then who knows how long all that paperwork takes.  I have other issues w/ACA related mandates, like how the electronic system is MUCH worse than what existed before in terms of your records and prescriptions.  For single payer to not suck like the VA does, we would need massive, massive overhauling of everything.  Literally everything related to medicine in this country.  

[MerenthaClone]

Admittedly, the ACA sucks.  Terribly.  But for the vast majority of people in this country, it is far better than what we had before. 

e:  Also, the VA sucks for several reasons many of which are entirely unrelated to TriCare.  

[Kalbear]

Quote

like how the electronic system is MUCH worse than what existed before in terms of your records and prescriptions

Yeah, I don't buy this at all. Again that might be the case for you, but for most people it's far better. I get significantly faster test results, information requests, conversations with docs and nurses and shared information between primary and secondary care than I ever did before. Plus all the paperwork is done electronically and ahead of time, so I don't have to spend 15-30 minutes at the office filling out forms by hand. And I only have to do it once.

The most annoying thing to me personally is that children over 12 cannot be put into the system due to privacy concerns. That sucks. But otherwise the system is incredible.

[Manhole Eunuchsbane]

4 minutes ago, Kalbear said:

Yeah, I don't buy this at all. Again that might be the case for you, but for most people it's far better. I get significantly faster test results, information requests, conversations with docs and nurses and shared information between primary and secondary care than I ever did before. Plus all the paperwork is done electronically and ahead of time, so I don't have to spend 15-30 minutes at the office filling out forms by hand. And I only have to do it once.

The most annoying thing to me personally is that children over 12 cannot be put into the system due to privacy concerns. That sucks. But otherwise the system is incredible.

Agreed. The system we use now is superior to the old paper chart by an order of magnitude. The only downside really is the potential security risk.

[OldGimletEye]

10 minutes ago, MerenthaClone said:

Admittedly, the ACA sucks.  Terribly.  But for the vast majority of people in this country, it is far better than what we had before. 

e:  Also, the VA sucks for several reasons many of which are entirely unrelated to TriCare.  

The ACA is clunky. And it is what you get when single payer is  or was not politically viable.
The simple fix would just go to single payer, and then let insurance companies sell supplemental plans on top of that system.
I really dislike our employer based system and one of the problems is that the ACA was overlaid on top of that.
I agree that overall it's better, but we still have a way to go before we unfuck our healthcare situation.

[drawkcabi]

1 hour ago, Manhole Eunuchsbane said:

PERFECT. Well played, sir. Well played.

I knew of anybody on this board, you would be most appreciative of that.  

[aceluby]

1 hour ago, Cas Stark said:

My income went up last year and the penalty is now 2.5% of your yearly income if you don't sign up and can't claim any of the exemptions.

This still doesn't make sense to me.  If you qualify for subsidies like you claimed on a single plan the fee would be ~$100 a month.  If you're not using the plan, the plan is costing you more than that, and you didn't have insurance before because it's cheaper to pay out of pocket; wouldn't the fee be the cheaper option?

[Manhole Eunuchsbane]

6 minutes ago, drawkcabi said:

I knew of anybody on this board, you would be most appreciative of that.  

Know your audience. #1 in the Book of Rules.