Buying health insurance is an individual decision based on family or personal needs and preferences. Make sure you're really, really certain before you switch. Why Is Health Care So Complicated? I've never been incarcerated. “Nobody knew that health care could be so complicated.” ... More people now have health insurance, but about 12 percent of adults aged 18 to 64 remain … r/AskReddit is the place to ask and answer thought-provoking questions. Lanhee … Grrrr to the insurance (though I get their reasoning), but a grrrr also to the companies that make it difficult for a patient to get the treatment they need. To fully understand why I’m mad, it’s important to know the back story. It's so fucking complicated because ACA was written in large part by insurance lobbyists behind closed doors to ensure that they got the opportunity to gauge and claw everything they could from the "deal". Because people aren't as shrewd as the business minded insurance companies that they are clients of. New comments cannot be posted and votes cannot be cast. Health care policy is complicated because health care is enormously expensive. The cost of family health coverage in the U.S. now tops $20,000, an annual survey of employers found, a record high that has pushed an increasing number of … I'm not saying health insurance isn't complicated. 7.2k in premiums + a 6k deductible before the insurer pays a cent. Medicare’s enrollment rules are complicated. As an agent, I would highly recommend you stick with that plan as long as you possibly can. Part of the reason is that it's not something we really want to buy – … Why are health insurance choices this confusing? Before public policies change, consider getting the least expensive insurance and saving the difference for out of pocket expenses. Originally Hospitals charges a flat fee. Why is health insurance so complicated, while car insurance and life insurance are so simple? And part of the reason it is too expensive is because the Affordable Care Act signed under the previous administration purposely overcharges them for insurance based on their age to offset the costs of the elderly to keep their rates artificially low. This massively drives up costs, additionally it is mostly illegal for health insurance companies to charge different rates for people with different levels of risk. Why So Complicated? 5 years ago. We have so many corporations making it that way in order to make as much money as possible. That's not even talking about political and moral debate over whether free insurance for the entire country should exist (assuming you live in America). creating an incredibly regressive system where the poorest, sickness people get screwed. Then medical equipment and supplies rose in price because they could. Honestly, there is no single answer that would satisfy that question. However, now you've added perverse incentives to make yourself look riskier to get a subsidy and created a population that, unless you very carefully designed the subsidy, creates all sorts of moral hazard in the consumption of care. There’s car insurance, home insurance, life insurance, even pet insurance . Someone break this down for me, what can I do? But there is one glaring exception: health insurance. “Nobody knew that health care could be so complicated.” ... More people now have health insurance, but about 12 percent of adults aged 18 to 64 remain … "We understand you have **** but the doctor classified it as only stage 2 and per our guidelines we only cover when it reaches stage 4". However, from a consumer standpoint, things are not all that complicated. I’m covered by the VA since I’m a disabled veteran, but I still have to make sure that my wife and child have coverage. $1,000 deductible, $2,500 max out of pocket, it's good and I don't want to change it but they keep upping my rate each year and what was once a $90 premium is now going to be $440 per month starting in November. Can health insurance be more like, well, insurance? Researchers have concluded that it’s not the sheer number of tests and procedures but their high price that explains why it’s so expensive to be sick in the U.S. � 6. It skews the amount of risk a health plan takes on when insuring someone, so the entire health insurance industry tries to prevent it. Because what people call health insurance isn't insurance in the United States, it's just prepaid health care. How Adverse Selection Works A health insurance company can only exist if it takes in more money in premiums each year than it pays out in claims . I'm unable to buy health insurance because of whatever the fuck this is all about, even if that computer glitch wasn't happening I can't buy insurance until November because it's not "open enrollment" and I don't qualify for any of the things that get you special treatment. It is one of the largest and one of the fastest growing segments of the American economy. The Affordable Care Act has simplified a lot of things about health insurance: You can’t be denied coverage if you have a preexisting condition, plans can’t cap annual or lifetime benefits, and most preventive care is free. No choice in the matter. Affordable Care Act (ACA) Major Medical Insurance Plans English. Insurers use several types of managed care, and the type of care makes a big difference in consumer choice and the costs. This is why car insurance doesn't cover oil changes. By using our Services or clicking I agree, you agree to our use of cookies. Each insurance company has to license their particular company in each state (or territory), put up assets for that company in that state, have all their rules and rates approved by the Department of Insurance in that state. The underlying reasons why health care costs continue to soar aren't that complicated, Cutler said. I have friends that are paying well over $1000 for not-too-spectacular insurance. 63 Why Health Insurance Cost So Much! Health insurance is a type of insurance coverage that pays for medical expenses incurred by the insured. Can health insurance be more like, well, insurance? "We understand your doctor prescribed you this specific life saving medication, but it isnt on our approved list and legally this medication that IS on the list will keep you alive albeit with many complications so you'll have to settle for that". I think this seems like a lot for a 30 year old man with no health history. Updated October 2, 2019. A smart way to shop for any insurance is to find out how you would fare in a worst-case situation. This is why car insurance doesn't cover oil changes. So I've been insured with BCBS for my entire adult life, my parents put me on a good plan when I was a kid and I just kept it. Since I left my job, health insurance become an issue that I have to figure out for my family. Both were high deductible plans with an HSA. So I go on the ACA site and it says I have to send my release papers from the institution, my pay stubs, my credit card statement, and a notarized statement that I live in the community to show that I am not currently incarcerated. The primary reason, in my opinion, is that insurance is regulated at the state level. So I've been insured with BCBS for my entire adult life, my parents put me on a good plan when I was a kid and I just kept it. Can health insurance be more like, well, insurance? Consumers should ask questions about coverage and medications before seeing a doctor. AJ+ - Why Are Lebanese Politics So Fricking Complicated-Love is Blind. It can be billed weekly, monthly, or however often the insurance company/your employer decides. I've had BCBS since I was 22 (29 now) and since the ACA I've had a 25% increase every following year. ... so … Lanhee Chen, fellow at the Hoover Institution, explains. 9:45. The Medicare number that should shock you the most. And while much of the country is deeply worried about the troubled insurance … To answer this question, we have to start at the beginning. Insurance now wants to make money so they deny any case they are legally allowed to. Then after I'm out 13.2k for the year in premiums and deductible they still only pay 80% until I spent another 5k OOP. Why are health insurance choices this confusing? Cookies help us deliver our Services. The whole point of ACA was to make it so people didn't go to the ER to get routine care. Then, I was laid off. I mean, just look at the algorithm for medicare reimbursement for hospital stays. It’s important to understand your costs and key health insurance terms, so you’ll know what services your plan will pay for and how much each visit or medicine will cost. But Republicans and Democrats alike have to be willing to take a … But for some reason health insurance is legally required to cover things like routine check-ups. Updated March 15, 2015. Other Articles In This Category: National Review By CHRISTIAN ALEJANDRO GONZALEZ . Healthcare is also complicated because of the wide variety of needs it must satisfy. Why Is Health Insurance so Complicated? Certainly, health insurance is more complex than property and casualty coverage. To fully understand why I’m mad, it’s important to know the back story. For instance, a recent executive order loosened the rules around what health benefits insurance companies must offer with certain plans. A lot of the confusion this year is because the Trump Administration is changing parts of the ACA. I wish I could have your plan. David Goldhill’s suggested policy solutions may be politically infeasible at the moment but I like his economic analysis of why healthcare and health insurance are so expensive. Car,home,renters, and business insurance can all be purchased online, in minutes for a fare price. Press question mark to learn the rest of the keyboard shortcuts, the algorithm for medicare reimbursement for hospital stays. There is a huge difference between when you can enroll and when it is best to enroll. That is dirt cheap compared to what you will pay with an ACA plan for a far worse deductible/out of pocket. Health Insurance - Why is it so complicated? The Affordable Care Act reformed the medical insurance industry. ... to repeal it are struggling to find a replacement. . So they recommend going on the gubmint health care marketplace site and looking for other plans, in fact they mentioned the Affordable Care Act no less than 7 times in their notice of rate increase, seems to me that they are just discontinuing all of their old plans and are raising rates until people like me cancel the plan and get something else, I decided "fine, I'll play the game" no big deal I'll just get something else, except I quickly found out that I can't! Only health insurance becomes more complicated and more expensive at the same time. Certainly, health insurance is more complex than property and casualty coverage. March 08, 2018 Understanding key health insurance terms. Can health insurance be more like, well, insurance? It’s sickness insurance. This means a random amount of things are, and are not covered. I needed health insurance, so I turned to California’s state exchange. I spent two hours trying to explain it to three or four people the other day to no avail. A new survey by experts at the Health Disparities Institute of UConn Health shows that many patients across Connecticut are struggling to understand their complex, jargon-filled private health insurance plans and even to use their plan benefits correctly.. Health insurance can be complicated, and not knowing the rules can be expensive. So, the obvious question is: why? The insurance through my company is total shit. Then insurance happened and hospitals could charge as much as they wanted because those with insurance could have their insurance pay it. Yup, it sucks. All was great in healthcare land. Politicians could've taken a mere FRACTION, covered the uninsurables, and left everything alone, but now they had to go and mess the whole system up, designed obsolescence, to institute single payor.... Keep what you have!!! Sep 4, 2017 - Why is health insurance so complicated, while car insurance and life insurance are so simple? New comments cannot be posted and votes cannot be cast, Press J to jump to the feed. I am an insurance broker, and every time I open a renewal letter for a client, it's heartbreaking. I think your initial thoughts are correct: They are raising rates annually on grandfathered plans in an effort to get people off of them. Press question mark to learn the rest of the keyboard shortcuts. So.... We basically have catastrophic only coverage for $7200 a year. Now every insurance has 16 different plans which cover different things across different pay ranges. The government should let insurance companies charge rates in proportion to the risk an individual poses. With the current state of healthcare in the U.S. being so expensive, and no clear end in sight, this may be a good time to consider whether health insurance could be a good value for you. No other insurance covers routine and predictable costs because insurance is meant to protect from risk. How to buy a catastrophic health … Almost 180 million Americans utilize employer-sponsored health insurance to help pay for medical care. The average covered worker spent over $5,500 on health insurance premiums in 2020, while average Americans exhaust over 8% of their total spending on health care. ... to repeal it are struggling to find a replacement. Why is health insurance so complicated, while car insurance and life insurance are so simple? If you've learned what a life insurance agent does and are now considering a career in the life and health insurance field, you are probably wondering, “Is the life and health insurance exam hard?” Each state has their own insurance exams, so the tests and requirements vary, making this question more complicated to answer. Why is it so hard to get good mental health treatment in the U.S.? The discussion often reveals an assumption that we are just buying a service and paying for it much as we finance a new car. Now we know why the GOP is truly terrified of “Medicare for all”: It will wipe out the Republican Party’s control of the House, Senate, White House, and most state governments. All was great in healthcare land. David Goldhill’s suggested policy solutions may be politically infeasible at the moment but I like his economic analysis of why healthcare and health insurance are so expensive. How is this different, at the end of the day, from enforcing a ban on price discrimination? 18k/year in premiums with a 5k deductible and still only 80/20 up to 12k OOP. I would also like to go back and find out just why it’s so expensive for insurance to cover triptans too – what is it about these meds that causes them to be so … I can say this, health insurance is confusing because health care is complex. The law affected Medicare, Medicaid, and the CHIP. The premium is the cost of the insurance coverage. Press J to jump to the feed. Because what people call health insurance isn't insurance in the United States, it's just prepaid health care. by Rockwell published on 2017-06-13T22:35:26Z Almost 60% of the population have health insurnace but its fair to say that only a very small % of these people really understnd how the product works. That's the short version. That’s unlike regular health insurance, which has an annual renewal period. The number of people blaming insurance companies in this thread is interesting if insurance companies are deliberately making things difficult why do they only do it in this one industry? This is complex and becoming even more difficult for … Health policy scholar Lanhee Chen: “ [Insurance] should be … Random Quote. But if you’ve spent any time comparing plans or networks lately, then you know that healthcare is still mind-numbingly complicated. When multiplied by millions and added to the number of medical services and support systems needed, the complexity cannot be avoided. This is complex and … Sounds easy enough: choose a provider from an approved list. Medical insurance is complicated because of the layers of payers and service providers. Why is health insurance so complicated, while car insurance and life insurance are so simple? The US healthcare model is a highly fragmented system with incentives towards keeping it that way. In effect, you could have a short-term plan for three years. Every eligible person must get and keep qualified health insurance coverage. I've talked to independent brokers I know and they are all quoting me similar rates to what I'm paying. The first confusion is over the very nature of health insurance. So, what the hell can I do? Before public policies change, consider getting the least expensive insurance and saving the difference for out of pocket expenses. The more complex it is, the easier they can get out of paying for things. Only health insurance becomes more complicated and more expensive at the same time. The high risk policy holders pay much, much less when price discrimination is not allowed. Trump said he had no idea that health insurance can be so complicated. With the aging of the American population and with advances in medical sciences, size and growth are likely to continue. A friend is one who has the same enemies as you have. Extra points if you live in a state where health insurance is mandatory and you get penalized for not having it taking away your ability to competitively shop for better insurance.... You have deductibles and coinsurance to incentivize you not to frivolously consume care. Which means that the have to charge everyone more, creating an incredibly regressive system where the poorest, sickness people get screwed. Certain medications are not covered, they may not cover thjngs that are your fault, etc. Before my wife and I got married, we each had our own health coverage from our employers. Insurance plans can differ in which providers you can see and how much you have to pay. health. I seem to be stuck with my BCBS plan... the people on the gubmint phone number just tell me to send the documents but don't seem to understand what "those documents don't exist because I've never been incarcerated" means. - Comedy Time 0:47. Then take all the people who are to risky to get health insurance (pre-existing conditions) and subsidize their costs through taxes. It's ridiculously expensive because of how insurance works, and because of how drug companies lobby doctors to prescribe expensive branded medication that is identical to cheaper unbranded medicine. Originally Aired September 4, 2017; Runtime 5 minutes . It would be the lowest risk policy holders who pay more. So I just go the emergency room to get care, which costs 10X what a regular doctor would cost. 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