High Deductible Plan Too Expensive?

In the same boat as some other comments. Summing up the annual premium for family plan this year is staggering. Honestly, I understand why insurance companies are cranking up deductibles and max-out-of pockets in the marketplace. The pre-existing condition portion of ACA was such a bold, ethical, idealistic requirement. But it is very much doomed to fail. They should have delayed that part for 5 to 10 years. It crushed the insurance companies when you could select a gold plan, max-out-of pocket of $3,000 in 2014 knowing your family member had cancer and would be getting treatments costing over $250,000 or more! Completely unsustainable, and definitely occurred, and how could you really blame anyone for taking advantage of that deal. What a small price to save a life!!!! Well, we already knew life had a price, but ACA has surely provided a prime example to uphold the idiom.

The cost of healthcare is high, but so are the demands of the American people. Things are pretty nice in our hospitals, and the average Doctor knows a thing or two about keeping people alive by managing or stabilizing patients. And then you can always get a second opinion if you’re willing to call upon research institutions that are on the cutting edge. There really are incredible medical opportunities in the US, and really good practices, and they make a lot of money. It takes a lot of education (and therefore a lot of money these days) to become a Doctor, and there wouldn’t be much incentive to grind through that gauntlet if it wasn’t for high-pay and benefits. In many ways it is a thankless job and not much like the medical dramas on TV (The life of a policeman is rarely so glamorous either…) Medical devices are expensive because it takes a lot of money to build devices/monitors that are dependable and made to function with minuscule failure rates (Law Number XV: The last 10 percent of performance generates one-third of the cost and two-thirds of the problems.) Much, much cheaper to make consumer products in the post-modern age of planned obsolescence with the kicker of overseas anonymity/paper-trail invisibility, which people are accustomed to. High-end medical devices are really precise! People also really dump on Big Pharma without realizing how much money is spent on sunk cost endeavors before viable treatments are realized. Literally needles in haystacks, and all I see is complaints about how costly the needles are. Even when drugs are discovered, the maintenance costs of manufacturing labs required to churn out batches of high tolerance uniformity is greatly overlooked by these complainers.

The reality is American workers are not paid as many REAL American dollars as they were before. A very well-planned Inflation is how this is accomplished. Also income tax is taken from not only the wealthy, but even your middle of the road wage earners. Imagine if we had to pay our taxes to the US Gov’t every pay period like a bill, say a utility bill or rent. Think of it that way, and then read what the founders of the US thought about that… But with American workers purchasing power slowly and tediously eroding, fewer working class actually have enough to invest. So probably best to stay single so you can work, work, work to pay that little bit more interest to the banks, and also so you can just put that much more into the market for the big banks to play with.

Can we afford the high cost of life, if life is somewhat like it was for the serfs in the fields?

I am an independent who has voted for Republicans, Democrats, and Libertarians in the past. However, I will NEVER EVER vote for another Democrat again because of how badly they have screwed up healthcare in this country. I am a healthy, self employed, working citizen, making close to $100k a year, and I will tell you that having health insurance is getting to the point where it is no longer financially feasible for me. My insurance costs for me alone are close to $9000 a year; add my $6,500 deductible to this, and I’m out of pocket over $15,000 a year before I see any benefits, plus I still have to cover a sizable chunk of any expenses over those costs. So what do I get with my upsized insurance mandated by the Affordable Care Act? A free checkup every year – for which I used to pay under $50 for with my old, very affordable health insurance.

I have no doubt that Obama will be judged by history to be the worst president ever just because of the ACA. The problem was never health insurance, it was health care costs. Honestly, how stupid do you have to be to try to solve the problem of affordable health care by mandating that everyone needs to purchase a product from a third party that does not provide health care and in fact actually ADDS TO THE COST of health care? And then to add to that stupidity, also require that health insurer’s policy must cover offer free birth control, 60 days of addiction treatment, and an annual checkup as part of the base policy? For those of you who think health insurance is the answer, please try to use your brain for just a few seconds: your insurance company inserts themselves into the transaction between you and your doctor, or the hospital; they insure the doctor gets paid, but the insurance company takes money for their services as well. And for those of you who want to point out that the insurance company negotiates lower rates with the doctors and hospitals, that is just another display of stupidity: the rates would be far lower if the insurance companies did not have their own interests at the forefront of all transactions.

If you really wanted to solve this problem, you would need to understand the problem and work to attack it in a logical manner. So what is the problem? Health care costs are high. Why? There are many, many reasons. Here are the some of the biggest reasons:
1) Malpractice insurance / malpractice lawsuits / malpractice awards
2) The U.S. has just under two doctors for every 1000 people (and bear in mind that among these doctors never see sick patients at all; they are in purely admin roles). A 2014 Survey of American Physicians found that 85% of physicians reported that they are over-extended, and that only 19% said they have time to see more patients.
3) The vast majority of these doctors are not allowed to practice medicine, per se. They are allowed to do testing and diagnosis, but when it comes to prescribing treatment, they have little to no discretion; they MUST follow treatment guidelines mandated by insurance company actuaries based on past treatment resolution rates.

Given these facts, how does requiring people to purchase health insurance fix anything? It doesn’t, of course. It only increases costs.

To fix the system, you need to have a multi-pronged approach, and sadly, I do not believe Donald Trump and the Republican majority currently elected have the courage to tackle this problem in a manner that makes sense. The backlash in terms of campaign and PAC contributions from lawyers and insurance companies would be staggering. Ift is far easier to say something like ‘we need to open up healthcare insurance across state lines’ than to deal with the multi-headed monster that is this problem. But here, in my opinion, is what it would take to start to fixing this:
A) There needs to be huge changes in malpractice law; awards need to be limited, and serious financial consequences need to be applied to complainants AND THEIR COUNSEL for bringing losing malpractice actions before a court of law.
B) The number of doctors in this country needs to be increased. We need some sort of program that puts students through medical school, and forgives that debt over a period of years for their service in an area where health care professionals are already strained. Create a doctor, pay them a decent wage for 7 years while they serve out the terms of their agreement in an inner city hospital or some rural area, and after that time, they owe the program nothing and can move on. (As an aside, go talk to some doctors. I promise you it will not take you very long to find several who are very unhappy with their jobs and wish they could do something else, but they have huge student loans that they need to repay, and they need to keep their jobs in order to stay afloat. There is a reason the suicide rate among physicians is double the rate of the general population.)
C) Let doctors doctor. Part of the solution needs to be getting the insurance companies out of the doctor’s way. I’m all about data, and believe that there is a lot to be said for playing the percentages, particularly when it comes to things like poker. But poker involves 52 cards – all of which are known, understood, and cannot change. Even with the use of wild cares, there is a finite number of possible outcomes for every round of poker. Medicine deals with people, and there is no way that any amount of data can determine the best treatment option for each and every person. Don’t misunderstand me here: the insurance companies’ data is valuable, and we still need this data, but we need to allow doctors the use of their discretion and training to determine how to best treat a particular patient. Given the huge advances in technology and our ability to access and update information at almost real time, this approach should increase both patient care and doctor morale.

Oh – and I think everyone in power who voted for the Affordable Care Act should be required to be covered only by plans offered on the government exchange.

I receive social security and have Obamacare but my premium and deductible is so high I cannot afford it. I am a widow and live from month to month. Can I find a cheaper premium at this time since it has passed the date to change my mind.

ACA keeps saying you get “FREE” services. Free care only means free screenings for those leading unhealthy lifestyles. Out of the list of services for adults only colonoscopy (over 50), chol screen, blood pressure, mammogram and pap smear benefit healthy lifestyles. The long list of others benefit the smokers, drinkers, promiscuous, unhealthy eaters and pregnant women. It’s a pretty expensive “free” pap smear and I can check my BP at the drug store. Why should I pay for others bad choices??? I still need to pay a ton toward a deductible if I do need to go to the doctor. I’ll pay around $7000 in premiums and deductibles before my insurance kicks in. How is that insurance? I’ll pass.

I’m a single parent of one. I make more money than most ($100K); unfortunately $20K of that goes to taxes and $35K goes to student loan ($20K in interest alone!). I live very conservatively. For about 18 months I’ve been looking into health insurance but each time I go to the exchange website I just can’t stomach the costs. The cheapest plan (an HMO??) for my child and I is $350/month with a $5000/person deductible. The cheapest EPO is $375/mo with $6000/person deduct. The cheapest PPO is $475/mo with $5200/person deduct. These prices are just stupid. With all the living expenses, licenses fees and professional insurances I already cover, paying these prices for health insurance is beyond reasonable. Obamacare was the dumbest idea and worse written law to come out of this administration.

Obamacare sucks. Im in the same situation and my monthly premium would be the same price as my rent. Incredible!!!

We don’t need fricken “tips and tricks.” Do you not realize that Americans like me can not afford medical services?? And I found this answer insulting, you basically told us you know we can’t afford the actual care, but hey, when your kidneys go, we got one hell of a catastrophic plan. That first “a” in ACA was supposed to stand for “affordable” not “a$$-reaming.” Insurance co’s now have us by the short and curlies, and I am absolutely terrified. What’s worse is as I am researching each plan, I can’t find any that even cover some of my medications. My husband’s plan drops spouses in couple of months and I honestly do not know how we are gonna make it.

I am sickened by the way health insurance operates now. My husband & I both work full time jobs, hardly ever get sick and our deductible is $3000.00 and then the insurance pays 90% on top of the high premiums we have have to pay to have this lower deductible. I am 10 weeks pregnant and am paying $400 every doctors visit to go towards my deductible. That’s high! Not to mention any lab work done is based on a 75%/25% scale. You tell me how this is fair to people who work hard for their money but lazy asses can get everything for free after paying a small premium every month.

Obamacare is useless. I am making $16000 a year. They say I have to pay premium 250$ a month. I am a fit and strong man. The last time I saw a doctor was 2009, 7 years ago. I never need insurance in my life. So, instead of pay this stupid 250 $ a month, I will just pay my $700 fee on my tax refund each year. is much better. Obamacare suck !!!

This is absolutely ridiculous. My family is in a similar boat. Prior to the change in the laws, our deductible was $1500.00 per person with a $350.00 monthly premium. Now that the law has changed, our premium is over $500.00 per month with a $4,000.00 per person deductible for 2015 and is slated to increase to $6000.00 per person in 2016!! We would have to pay over $6000.00 per year in premiums and additional $6,000.00 per year before 1 person in my family would have coverage. In order for all of us to have met our deductible we would have to pay $12,000.00 for the group in addition to $6,000.00 yearly premium. Thats $18,000.00 PER YEAR before the insurance kicks in!!!!!! Who benefits in this scenario? Certainly not my family! We also make too much to qualify for assistance and an HSA is out of the question for us.. it would actually cost us more per monthly premium in addition to trying to come up with the money to fund the account. This is affordable care? I was well able to pay for my premiums, deductibles and out of pocket expenses prior to the changing of the bill but not now. Now, I dont want to go to the doctor, my daughter needs braces and dental isnt covered in that mess I described above, my husband and daughter both wear glasses and vision isnt covered in that mess I described above. This is beyond tolerable. No use in saying at least I have coverage, because I would actually have more money in my pocket if I didnt… About $18,000.00 per year more. Lets just call this what this is… a TAX. I get no benefits from my “coverage”.

So your answer to high health cost is SAVE SOME MONEY TO PAY FOR HEALTH COSTS! Just brilliant! Why didn’t I think of that!

Here’s an idea, if you want to be a millionaire, first, get a million dollars, and then….

Terrible illogical fallacy based answer. Mddle-class singles and families would consider a $6,000+ “low” obamacare deductible to be a “high” deductible. As a single individual on a teacher’s $32k annual salary, I’d have to put at least $10k (31.5%) of my “before tax” annual income into an HSA/FSA to reduce my income enough to qualify for a subsidy/tax credit. And I’d have to pay out of pocket for my prescription: approx $960/yr. And eye care: approx $250/yr. Approx Obamacare monthly health premium with $75 estimated tax credit applied monthly: $180.

Totals:
Salary reduction to qualify for tax credit: $10k (31.5% of annual gross from $32k to $22k).
Out-of-pocket *basic* health expenses: $1210.
Estimated annual health care premium: $2100.
Total est. annual health care cost: $10,310.

Effectively, to receive any discounts/subsidy/tax credit I have to reduce my annual take home salary by $10k to “save” $960.

Absolutely ridiculous!

If I don’t take a 31.5% salary reduction, then my monthly healthcare premium will be $233-255/month. My annual health care costs will be estimated $4006-4270.
Roughly 13% of my annual $32k salary will be spent on healthcare. And this is still too much, way too much.

Subsidy or not, on any Obamacare plan, when and if I need a diagnostic test it won’t fall under “preventive” care or “screening,” and I’ll get a whopping bill for say an x-ay or ultrasound.

So, NO, NO, NO! This answer absolutely does *not* help middle-income families.

Reduction of “gross income” by contributing to HSA/FSA accounts does not add up – advising those who fall into the “Obamacare Gap” to “utilize the HSA/FSA tax reduction strategy” signifies idiocy in basic accounting and budgeting.

Obamacare is crippling middle America. I can’t afford to spend 13% of my salary on healthcare let alone $31%.