New ICE Vehicles Banned in California by 2035

[Tomm]

Originally Posted by Irace86.2.0

I don’t have first had experience of government insurance. I work for a hospital and am on private insurance that is an EPO (half way between a HMO and PPO). I have been under-insured and uninsured in my life. I’ve had bad experiences with private insurance and not being insured.

I obviously see the benefits from healthcare expansion through the ACA first hand from patients. I deal with the VA hospital and clinics, as well as, medical and medicare and medicaid insurance. I have family using different types of insurance from government, medicare and private. I know of bad experiences, but I don’t know their overall opinion.

I see waste from restrictions like VA patients need to be transferred to the VA for admition, so they get two bills now. I see the same for HMO/capitated patients that have to be transferred and double charged.

These types of anecdotal stories really aren’t guaranteed to be representative. I’d like to think my experiences aren’t bias and would reflect most experiences, but I can’t guarantee that, which is why we rely on other metrics. I probably have thousands of stories from patients, so there is a lot to share. In general, I see that coverage is an obstacle for receiving the best care, and insurance causes a lot of waste, while passing the buck to patients with higher premiums or refusing to pay for something.

Because I work for a Catholic hospital system, my insurance reflects their values, so even though most insurance companies would jump at the opportunity to pay for an abortion or pay for a vasectomy, they don’t allow it. In fact, if it wasn’t for the ACA mandating they pay for birth control, we would have to pay that out of pocket. That wouldn’t be the end of the world, but it highlights the issues. Per diem employees get 15% extra pay to offset the lack of healthcare and lack of other benefits, but full time employees either accept the healthcare plan, or they get nothing, so if I wanted to get on my wife’s insurance then I wouldn’t get 15% and the hospital gets to pocket the premiums they don’t have to pay for me. Odd because I would rather have the cash or have taxes taken than feel like I’m getting less contributions than my coworkers just because I chose her plan. Because of that, we have a problem maintaining full time staff and maintaining staffing levels. I’m regressing and ranting.

The system needs improvements.

I’m aware of you feel about, I just want to know how someone who has actually enrolled in ACA feels ab their service.

[Tomm]

Originally Posted by Dadhawk

Frankly I don't trust the surveys to mean much. I'm a good example. I've been on some form of health insurance for 40 years. During that time, my use of the system has been only for routine care as I've never had a major health event. So, for the most part I am satisfied with the insurance I have because it has always covered my needs.

The problem is, my opinion shouldn't matter because why would I have a bad opinion of the system?

Exactly. My experience with the public option has been nothing but the typical military rigamarole - just another head of cattle in the chute. It’s to the point that I’m willing to pay the copay and deductible for better service rather than get it free from the VA. Even while I was active duty, I paid extra so my wife and kids didn’t have to go to the same doctors I did.

[ZDan]

Another thing to consider: you may be thrilled with your employer-provided insurance, but if you get sick enough to lose your job, guess what...

They will gladly take your money for years and decades, but if something really serious happens you are selectively removed, as most employers will just let people go if they are too sick to produce for them.

[Irace86.2.0]

Originally Posted by TylerLieberman

Lol another thread gone off topic

To recap, California mandating EVs => statements about California having too many regulations => conversation about the benefits of more regulations versus less regulations => focusing on one category—healthcare.

Healthcare is one of those subjects that radiates with everyone. It affects everyone. It is a subject that is harder to apply normal economic/capitalistic principles. If I say I have a pill that can save your life then what is that worth to you? It is harder than quantifying a car or phone or TV. It is harder to quantify than the price for a hair cut, for an Uber ride or to have someone install a turbo kit on your car. If radiation could save your wife from cancer then what is that worth to you? If your child needs an emergency appendectomy for a ruptured appendix then what is that worth to you? If you have a hard time pricing out these items then congratulations you or whoever reading this is human. That is why healthcare is different. People will pay anything to have more time alive and with their loved ones and for their health, when it matters like this. This is why everyone has a vested interest in this conversation, and why we can’t treat it like any other industry. Healthcare at the hospital level and all the way to the pharmaceutical level requires a different approach.

FWIW, the EV mandate is likely not necessary or going to happen, but it may encourage more development, investment and planning, which may accelerate us getting there even faster. I think we might get there through public interest that fast without the mandate, assuming there are the already planned investments in green utilities to support such a transition. In another 5-10 years, EVs will be cheaper and just be a better vehicle for the masses. The enthusiasts aside of course, but even some of them will change their tune.

[Tomm]

Originally Posted by ZDan

Another thing to consider: you may be thrilled with your employer-provided insurance, but if you get sick enough to lose your job, guess what...

They will gladly take your money for years and decades, but if something really serious happens you are selectively removed, as most employers will just let people go if they are too sick to produce for them.

A lot of big companies have medical leave buckets that are employee donation oriented which require a certain number of hours of leave to be donated to be a member in case something like this happens. Kind of like insurance for leave. It’s a cool new thing.

[Irace86.2.0]

Originally Posted by Tomm

I’m aware of you feel about, I just want to know how someone who has actually enrolled in ACA feels ab their service.

Do you mean do people like their version of Kaiser or Blue Cross insurance through the ACA market in terms of coverage, deductibles and premiums?

Some states didn't set up their own exchanges. Some insurance providers wanted the ACA to fail. Some state’s governors didn’t support the ACA. California set up their exchanges:

California has an individual mandate as of 2020, and state-based premium subsidies for enrollees earning up to 600% of the poverty level. Average rate increase for 2021 is the lowest in CoveredCA history.

Premium increases across the 11 Covered California insurers averaged less than 1% for 2020 (new individual mandate is keeping premiums stable).

More than 1.5 million people are enrolled in individual plans through Covered California

For 2019, the average rate hike was 8.7%, but would have been only 5% without the federal mandate penalty elimination.

https://www.healthinsurance.org/cali...ance-exchange/

The ACA was suppose to be the start—not some final solution. Single-payer is likely the final solution, but even if that is a state decision like California might do, states were suppose to adapt the programs to their specific markets. We see the difference in states that went all in. More have coverage. Outcomes are better. Costs are more controlled.

[TylerLieberman]

Originally Posted by Irace86.2.0

To recap, California mandating EVs => statements about California having too many regulations => conversation about the benefits of more regulations versus less regulations => focusing on one category—healthcare.

Healthcare is one of those subjects that radiates with everyone. It affects everyone. It is a subject that is harder to apply normal economic/capitalistic principles. If I say I have a pill that can save your life then what is that worth to you? It is harder than quantifying a car or phone or TV. It is harder to quantify than the price for a hair cut, for an Uber ride or to have someone install a turbo kit on your car. If radiation could save your wife from cancer then what is that worth to you? If your child needs an emergency appendectomy for a ruptured appendix then what is that worth to you? If you have a hard time pricing out these items then congratulations you or whoever reading this is human. That is why healthcare is different. People will pay anything to have more time alive and with their loved ones and for their health, when it matters like this. This is why everyone has a vested interest in this conversation, and why we can’t treat it like any other industry. Healthcare at the hospital level and all the way to the pharmaceutical level requires a different approach.

FWIW, the EV mandate is likely not necessary or going to happen, but it may encourage more development, investment and planning, which may accelerate us getting there even faster. I think we might get there through public interest that fast without the mandate, assuming there are the already planned investments in green utilities to support such a transition. In another 5-10 years, EVs will be cheaper and just be a better vehicle for the masses. The enthusiasts aside of course, but even some of them will change their tune.

Cool story. Two thumbs up.

[Irace86.2.0]

Originally Posted by Tomm

It’s not that I don’t trust Gallup it’s that I don’t believe it is an accurate representation of the truth. Go visit of a VA hospital and tell me that 78% of that lobby is happy with their service.

You are confusing VA insurance with VA medical services.

[Tomm]

Originally Posted by Irace86.2.0

Do you mean do people like their version of Kaiser or Blue Cross insurance through the ACA market in terms of coverage, deductibles and premiums?

Some states didn't set up their own exchanges. Some insurance providers wanted the ACA to fail. Some state’s governors didn’t support the ACA. California set up their exchanges:



https://www.healthinsurance.org/cali...ance-exchange/

The ACA was suppose to be the start—not some final solution. Single-payer is likely the final solution, but even if that is a state decision like California might do, states were suppose to adapt the programs to their specific markets. We see the difference in states that went all in. More have coverage. Outcomes are better. Costs are more controlled.

Honestly, I’m just looking for anyone that enrolled, at all. I’m not picky. I’m hesitant to listen to rationales until after I hear from someone who had it and heard their opinions.

[ZDan]

Originally Posted by Tomm

A lot of big companies have medical leave buckets that are employee donation oriented which require a certain number of hours of leave to be donated to be a member in case something like this happens. Kind of like insurance for leave. It’s a cool new thing.

That most people don't have access to...

[Tomm]

Originally Posted by Irace86.2.0

You are confusing VA insurance with VA medical services.

Well I’ve never used VA insurance without the VA medical. I’m not sure you can unless you have specialty care that the VA can’t handle - a rarity.

I don’t even think I’ve interacted with them. All of your insurance info is on file because it’s all taken care of in house.

[Tomm]

Originally Posted by ZDan

That most people don't have access to...

. . . Social security disability . . .

. . . Unemployment . . .

There are options.

[ZDan]

Originally Posted by Tomm

. . . Social security disability . . .

. . . Unemployment . . .

There are options.

That's funny, because apparently about 30 million have no coverage...

[Dadhawk]

Originally Posted by Tomm

Honestly, I’m just looking for anyone that enrolled, at all. I’m not picky. I’m hesitant to listen to rationales until after I hear from someone who had it and heard their opinions.

I'm not enrolled but one of my adult sons uses AHA. It's a high deductible plan that includes dental. The plan closely matches the one I have through work in terms of benefits, although his out of pocket is higher as are his deductibles, it is administered by United Healthcare (under a different brand name), and is cheaper than what I get through my employer. He uses the same Doctors my wife and I use. He gets a minor subsidy because of his income level.

Anyone can go to healthcare.gov and look through the available plans if you are really interested in them.