In 2010, I had good union health insurance. Obamacare was the law of the land. In November that yr my 1yo son was struck by a careless driver in a crosswalk. After two surgeries and a night in intensive care, he died.
— Michelle DuBarry (@DuBarryPie) February 23, 2020
I googled FMLA and learned I wouldn't qualify b/c I hadn't been at my job for a year. If I lost my job we would both be without insurance. Without my income, there was no way we could afford $1K/month COBRA.
— Michelle DuBarry (@DuBarryPie) February 23, 2020
My husband who was also injured in the crash, was refused treatment by his primary care doc b/c she didn't accept payment from auto insurance and his health insurer wouldn't pay til we exhausted our auto insurance.
— Michelle DuBarry (@DuBarryPie) February 23, 2020
We ended up with around $5K in out-of-pocket expenses and our health insurer paid $175K. Eventually, we'd receive a settlement from the at-fault driver. For a minute, we thought we might be OK financially.
— Michelle DuBarry (@DuBarryPie) February 23, 2020
(Side Note: It took me 8 yrs but in 2019 I initiated and passed a bill making this practice illegal in OR. It remains legal in many states.)
— Michelle DuBarry (@DuBarryPie) February 23, 2020
Through all this, my husband and I both were suffering from PTSD. We had jobs, a mortgage. All of it hung in the balance. In a humane system, we could grieve without having to navigate an insurance juggernaut, without worrying about being thrust into debt and poverty.
— Michelle DuBarry (@DuBarryPie) February 23, 2020
Every one of us lives in a body that is going to fail. Sometimes it happens suddenly, catastrophically. Do you want to fight with insurers when this happens? Do you want to sort through a mountain of bills when you lose someone you love, when your grief is raw?
— Michelle DuBarry (@DuBarryPie) February 23, 2020
I believe change is coming. I am ready to fight for other families, for #MedicareForAll, and to elect @BernieSanders president. Sending solidarity and love to all who are suffering under this awful system. ❤️?
— Michelle DuBarry (@DuBarryPie) February 23, 2020
I don’t know how someone can be as strong as this woman. I know how it feels to have a child in the hospital, but ours survived. I can’t imagine combining that with financial ruin. Michelle has two first graders now, and this is her website.
Starfish
There are Republicans on Twitter insisting that we have the best healthcare, and it just does not ring true. Most people are on stupid high deductible plans.
There has been no time when if you liked your insurance you can keep it unless you are on Medicare or Medicaid. Everyone else is switching insurance with a job.
Dorothy A. Winsor
I always roll my eyes when a politician says people love their private insurance. Maybe if they’ve never had to use it.
Baud
@Dorothy A. Winsor:
I’ve always had job based coverage and have never had the issues that many others have had.
Now I don’t “love” my insurance company, and I would never stand on the way of health reforms that expand coverage, including M4A, but people who are afraid of being left worse off are a real voting bloc.
PenAndKey
@Starfish: I currently pay $600/mo for my insurance premiums and hope to never have to actually go to the hospital because my family out of pocket max for the year is $8k and we simply don’t have that sort of money. In an ideal world we would, or we’d live in a country that has a sane healthcare system, but that’s not America in the present day.
And this isn’t even getting into the insanity of living in a country where your employer dictates your insurance. Half the reason I took my current job was because I commuted to work and, because of the distance, only one of two hospitals where I live was covered by my work insurance. And the one that was covered? It’s a Mayo “affiliate” and not worth the name.
So I’m effectively paying a minimum of $7,200/year just to have access to an insurance network that covers my hospital. Actually using it? I’d take being taxed for a universal coverage plan over this monstrosity of a system any day.
Because seriously, how many of us work for corporate America not because it’s our dream, but because we need the insurance? How many of us don’t start our dream small businesses because there’s not a realistic alternative to the employer provided insurance racket? As far as I’m concerned half the reason our healthcare system is so entrenched is because it’s a method, like NDAs and union busting, to limit the ability of employees to say ‘enough is enough’ and leave for a better job or strike out on their own.
Cheryl Rofer
I’m not sure how to read this. The writer is a former insurance executive who decided he was doing evil, so he is predisposed to seeing the world in terms of insurance. But I’ve wondered what it is about Bernie that people love, and maybe this is it.
RobertDSC-Mac Mini
She blew it by endorsing an irresponsible 78 year old with a history of acute heart trouble. Her story is one of the reasons why universal coverage is so important, but the clown she endorsed won’t get us there.
PenAndKey
@Cheryl Rofer: I don’t have the skillset to weigh the details (that’s why I rely on people like David), but I can safely say that I would crawl over a field of broken glass to vote for someone who actually had a chance at implementing a universal non-employer-tied healthcare system in this country. And no, that’s not an exaggeration. If that’s what it took I’d do it today. If not for me, than for my children. I never want them to have to make their life and career decisions based on the question of “how do I get healthcare if I do X?”. That’s how people get trapped in jobs they hate and how they skip out on things like annual checkups because they’re too afraid of bad news. That’s not a decision citizens of a proper first world country should ever need to consider.
I have my issues with Wilmer’s diehards but I certainly understand how the message is appealing.
chopper
@Cheryl Rofer:
M4A is hugely popular? someone tell that to warren’s poll numbers. unless i guess they mean ‘M4A with no actual details”.
Eric U.
people are justifiably worried that they will lose their existing healthcare and get screwed by whatever government program is supposed to replace it. And the implementation of the ACA didn’t help at all. Democrats barely learned from the Clintoncare debacle in the ’90s. I know a lot of the ACA problems were there because they had to placate lieberman, but I still wonder what would have happened if it wasn’t so complicated.
Baud
@chopper:
TBH, 6 in 10 of Democratic primary voters isn’t a great stat. In fact, there are better polls of M4A’s popularity that are more impressive.
Citizen Alan
To be honest, I’m not that impressed by 60% support for M4A in the democratic primaries of to pro Bernie States. What’s the national approval and disapproval rating for M4A?
Baud
@Citizen Alan: C’mon, man.
PenAndKey
@chopper: Warren’s numbers are down because the media is giving her the Hillary treatment and ghosting her when they can’t. Do you really think it’s a coincidence that the person most in favor of realistically upsetting and regulating the current system started getting bad to non-existent media coverage right when she was at her strongest and looking like a realistic primary winner? Her policies aren’t the problem. The influence campaign that’s been or is being effectively waged against her is.
Starfish
@chopper: One of the top issues for all people is “healthcare.” What about healthcare? We are doing bandaids in my state to control insulin costs, but it is probably not enough.
hueyplong
Can’t help but notice that no GOPer ever has to give “details” about anything being campaigned on, ever.
Our side, on the other hand, has to prove beyond a reasonable doubt that no Republican will be inconvenienced.
What Have The Romans Ever Done for Us
I got hit by a car in August of last year while biking to work. It was the driver’s fault – I was going straight down a two-way street (southbound) she was coming north, and she made a left turn right into me. I did not run a stop sign or anything, she just completely failed to yield to oncoming traffic before making her left turn. I was not seriously injured despite her not even stopping until I was on top of her hood. I hit the windshield and cracked it in two place (with the back of my head in one spot, thank God for bike helmets) and left two dents in her hood, then rolled off and hit the pavement. My bike was totaled.
I never lost consciousness and was basically more or less fine, but it was really traumatic and I did go to the ER to make sure I was OK. They X rayed my ankle (which was bruised but not broken thankfully) and did a head and neck CT which came back fine. Her auto insurance is supposedly paying for the entire thing…but…they apparently don’t pay out a cent until the claim is closed. So if you wonder why physicians groups, physical therapists, etc. don’t take auto insurance its because if you need several months of treatment and therapy, they will be waiting several months to get paid. Ditto if you need years of therapy, presumably.
My back tightened up after the accident and I finally got it checked out by an orthopedist in November. He didn’t see anything wrong so prescribed PT – this was post-Thanksgiving and I decided to wait to get treatment until after the Christmas holidays as it would have meant interrupting my course of treatment for over a week while I went home to Michigan. So, the ER has still not been paid because I’m still getting treatment. The PT office would not take auto insurance so the bills are being paid by my BCBS policy. Which is fine as my out of pocket expenses are not that extreme but at some point presumably I or they should get money from the auto insurance company. But, it’s just complete bullshit that auto insurance companies of at fault drivers can hold off for months and months on paying off claims. I’m sure it’s legal but it shouldn’t be.
Meanwhile I’m the one getting threatening letters from the hospital even though I gave them the claim info. Like, go after rhymes with dearie insurance. They owe you the money, not me, and you know that. I could pay the $1,000 bill but I shouldn’t have to when the accident was their driver’s fault. Now I’m worried BCBS is going to come after me personally for reimbusement but there’s no reason that they couldn’t work it out with rhymes with dearie insurance without me being involved. Luckily I’m in a financial situation where it wouldn’t hurt too much to reimburse them for it all and wait for dearie to pay out but it’s the principle…I shouldn’t have to do that! They should be paying their bills! And not waiting for months to do it.
Nelle
Like many of you, I have binder full of horror stories about insurance challenges. But what really startled me was the peace of mind living under a national health system overseas. Plus so much more time. Plus the freedom to change jobs or start a business. No real paperwork. My friends there found that letting people die because they didn’t have money was barbarism at its worst and if that was a mark if a “Christian” country, they wanted nothing to do with that barbaric religion.
Baud
@What Have The Romans Ever Done for Us: Yikes. Glad it wasn’t much worse.
I fear of riding bikes in the city.
Nelle
Like many of you, I have binder full of horror stories about insurance challenges. But what really startled me was the peace of mind living under a national health system overseas. Plus so much more time. Plus the freedom to change jobs or start a business. No real paperwork. My friends there found that letting people die because they didn’t have money was barbarism at its worst and if that was a mark if a “Christian” country, they wanted nothing to do with that barbaric religion.
Chyron HR
So now that Bernie’s won Nevada, M4A is back to being a real thing, not just a campaign slogan you’re not supposed to take seriously? Okay.
daveNYC
@RobertDSC-Mac Mini: Thing is, talking about Universal Coverage means nothing for her situation because she already has coverage. This isn’t a story about someone with no insurance getting crushed by medical bills, this is someone who had pretty good insurance getting crushed by medical bills.
PenAndKey
@Nelle: “But what really startled me was the peace of mind living under a national health system overseas. Plus so much more time. Plus the freedom to change jobs or start a business. No real paperwork.”
I’ve already said it, but this needs to be said again and again until the message sticks. I didn’t realize how much employer insurance sucks until after I had a family and realized I was trapped in a job that was physically destroying my body for years because it was the only place I could guarantee I’d have insurance to pay for my premature son’s potential ongoing medical complications through the recession. I also have friends who live outside of Toronto who really opened my eyes to how obscene our system here in the US is. Not one of them has to rely on their employer for insurance, and at this point in our lives half of them have their own small business doing photography or artisan crafts. If they had to rely on their boss for health coverage none of those businesses would exist right now.
@daveNYC: And isn’t that the worst part? Everyone talks about “healthcare coverage”. Coverage isn’t the problem any more than available treatments making the incurable actually curable. No, access is the problem. All the coverage in the world means nothing if you can’t actually access and utilize the care options that purportedly exist unless you’re wealthy.
zhena gogolia
Oh, groan. I guess I’m going to have to leave BJ. Dealing with the sanctification of Sanders is going to be hard enough in general without this.
Ohio Mom
In a week, I enter the promised land of Medicare For All 65 and Over.
What I think I will like best is knowing it will always be there for me, pre-existing conditions and all. Though it is a little pricier than I expected, and choosing among the Gap and drug plans was a headache. I don’t know how addled frail oldsters manage to continue to navigate those two parts.
What I’d really like is traditional Medicaid for All. Ohio Son has that (because he has autism and his mother was assertive about getting him signed up). It’s free and it has always paid for everything, no questions asked, even when it comes to non-generic medicines.
The older I get, the clearer it is to me that we live in a perfectly awful country. It’s only because many countries are even worse that we have people who want to emigrate here.
Chris Johnson
I’d like to see the whole industry banished. You have to be wealthy enough to be able to legally challenge them to get any sort of decent treatment.
My neighbor ran over my HOUSE, obliterating a third of the porch and putting me at risk of what was left, collapsing. The insurance people came and saw that I didn’t have enough resources to take them on, and lowballed their settlement so much that I could not get ANY work done, not even the lowball estimates, with winter coming on and fuel oil bills dropping in my lap. And that was it: I paid for heat, continued to be able to pay my bills, and my porch is still completely destroyed. And everybody who could be giving me trouble about it, who’ve heard this story, aren’t doing a thing to harm me… because they understand how badly I was screwed, and that there was nothing I could do.
And that ain’t even health insurance: that was a neighbor RUNNING OVER MY HOUSE WITH HER CAR, at fault, and making no effort to fight it.
Last snowfall I helped her shovel off her driveway and get the snow off her new car. The aftermath of all that wasn’t her fault.
PenAndKey
@zhena gogolia: Then leave. I can’t stand his fans, and his lack of policy specifics is irritating, but if you think bitching about our current system is “sanctification of Sanders” you’re obviously too insulated from the healthcare concerns of most of the country to take it seriously.
Not all of us are that lucky, and if I have to coalition-build with the Bernie-Bros to try and change it? If he actually wins the primary and that’s the reality of the situation? Then that’s what I’ll do.
Hell, I’m voting for Warren in the WI primary, but if Sanders ends up winning I won’t even hesitate to vote for him. I’d vote for a rabid squirrel if that’s what was heading the Dem ticket. What I won’t do though? Pretend that his message about how screwed up our healthcare system is doesn’t resonate with people.
What Have The Romans Ever Done for Us
@Baud: I was amazed it wasn’t worse but am thankful. I have gone back to riding. I live in our Nation’s capital and they have been really good about installing biking infrastructure throughout the city. My commute really is not dangerous as these things go – I have bike lanes for most of the way it takes me to get to the Metropolitan Branch trail, which has no car traffic, and that takes me down to just north of Union Station where I pick up a bike lane that is separated from traffic by a physical barrier. When that runs out I’m basically at the U.S. Capitol complex, which has very little car traffic because there are barriers that keep all cars but those with security clearance out. Then it’s a few blocks further south (again with bike lanes) to work. Round trip is about 19 miles so it’s a good workout. So long as the cars respect the bike lanes my only real hazard is people turning. Unfortunately people turn.
In this case I could have been a pedestrian crossing the street and it would have happened anyway. I have no idea what the driver was looking at. She did stop and there were two nearby pedestrians that also stopped to help, one of whom called 911.
The main thing is it’s ridiculous that auto insurance, that people pay premiums on, for just this situation fails to pay out in a timely manner. They should have some legal obligation to pay out as fast as health insurance companies do for necessary medical care. If they did that doctors and other health care providers wouldn’t be refusing them.
Chris Johnson
@zhena gogolia: If this doesn’t resonate with you, maybe you’re not a Democrat.
(which is not, in fairness, a requirement for posting on Balloon Juice. You can be whatever you want, and people will figure out what you are. You might not like the result, but it’ll happen)
bemused
@Dorothy A. Winsor:
I remember when a teaparty type republican won a house seat and was angry and shocked about the news at their orientation that they would not get on government health care plan immediately. He was apoplectic! Oh woe, what were he and his family of several children going to do?
What Have The Romans Ever Done for Us
Also, while the city isn’t entirely safe I feel safer there than on winding country roads. You get side swiped on one of those at speed and it could be a while before anyone sees you lying there, if ever. At least in a city traffic is generally not moving that fast and there are lots of witnesses and bystanders who can help you.
Baud
@What Have The Romans Ever Done for Us:
For two cars colliding, your car insurance should pay fairly quickly and then get the money from the other auto insurance company. I don’t know about car/bike collisions though.
arrieve
My story is a little different, but, I think, pertinent. As many of you know, I got sick in Rwanda in 2018 with an unidentified infection. I was hospitalized there, treated with antibiotics, and seemed to be recovering. Back in New York I became suddenly sick again (as in taken to the ER in an ambulance with a suspected heart attack sudden) and found myself in the cardiac unit for several days with a secondary viral infection that affected my heart. I am mostly recovered — my heart is about twenty beats per minute slower than it was before I got sick but I’ve adjusted — but I had months of doctors, hospitalizations, and every cardiac test imaginable. The twist to my story is that it was almost all covered. I had retired before leaving for Africa, but stayed on my employer’s health plan, and it turned out, I had excellent coverage. I paid $1000 on a $50K hospital bill, plus a few co-pays for specialists. I paid nothing for the stress test or the angiogram or the CT scans. But in our insane system, there’s no way of knowing how good your coverage is until you actually need to use it. I could have owed tens of thousands of dollars and wouldn’t have had any idea until the bills started coming in. And this is why the arguments about being an educated consumer are such bullshit. You don’t know and can’t find out how much anything costs, and when you’re sick and vulnerable all you care about is getting better.
What Have The Romans Ever Done for Us
@Baud: I think it’s different but I should have gotten my car insurance company involved in retrospect. There is a way to get bills paid earlier if you’re a pedestrian and I did eventually figure that out. But then they screwed up and only paid part of the ER bill, not the whole thing. Also I think the cap on that payout is like $1,500 which in today’s day and age is pretty much not going to pay for anything but the “we checked you out and you’re OK” ER visit. I mean, mine was over $1,400 and that’s all they did for me.
Ohio Mom
Zhena @23: Oh don’t leave, I’ll miss you! You’re smart and funny and always on target. Just be careful about whose posts you read. You can skip the ones by front-pagers who we know are not Bernie-haters.
A couple who are among my oldest, dearest friends are Bernie-ites. I can’t stand it. I’m not calling them as often as I usually do. I can’t help but feel personally slighted and insulted, even though I know their crazy unrealistic incorrigible idealism has nothing to do with me.
Avalune
@Dorothy A. Winsor: I scream at the TV “NO ONE LOVES THEIR HEALTH INSURANCE! No one!”
Anyone who loves their health insurance is either wealthy so it doesn’t matter or hasn’t had the pleasure of using it yet.
Cacti
On 60 minutes, Bernie can’t help but defend his dead boo Fidel Castro:
“It’s simply unfair to say everything is bad” about the Cuban revolution.
PenAndKey
@Ohio Mom: I’d rather they not leave either. Like you said, they’re a great contributor to the site and a valid voice in the discussion. And most of the time I’d agree with them. On this topic, though? Our healthcare system is screwed, and it actively screws everyone who’s not making money in it. My entire life trajectory after graduating high school has been dictated by my access to employer provided healthcare and the threat of losing it. To say I want to see the current system burn to the ground would be putting it lightly.
The phrase “vote blue no matter who” that so many of us have heard for months? That’s coalition building. Sometimes we don’t get our preferred candidate, and if that’s how things shake out I’ll be at the front of the line demanding, vocally, that Sanders follows through with his campaign rhetoric. What’s the alternative, Trump? Yeah, no. I’ll take what is likely mostly empty promises over an actively malicious dictator, thanks.
Leto
This mirrors what happened to me in most ways. Finding out about the differences between auto-insurance and medical insurance, trying to figure out who pays for what, all the while coping with the new reality of your shattered body as you lay in the hospital bed… like @arrieve: stated, all you care about is getting better. All your family cares about is you getting better. In a humane system that’s all you’d need to worry about. We also had to deal with the fact that our insurance company came after my settlement (the one meant to compensate for my new medical realities), lawyers were involved, I’m still fighting to get my retirements sorted and started, the fact that I’m never working in any meaningful way again, as well as most of the things that defined/motivated me I’ll never be able to do again.
In a humane system, I/we would only have to worry about some of those things but here we are. It’s part of the reason I support EW and M4A/universal coverage.
Cacti
@Chris Johnson: Is making vaguely threatening comments online to female posters something you usually do, bro?
zhena gogolia
@Chris Johnson:
Her story resonates with me. That is why I would like us to have a DEMOCRATIC candidate who can win and actually do something about it. (Which requires winning Congress, which is not likely with Sanders.)
I have been a Democrat for many decades. Fuck you all. Bye.
PenAndKey
@Cacti: Zhena said that this conversation was the sort that they’d have to leave BJ over. Chris then said that if that’s the case, they may not be a Democrat in the first place, that being on isn’t a requirement for posting here, and that if that’s the case they may not like their treatment. And, based on #40, it was enough to drive her off the site. That’s too bad and I hope she returns, but I’d hardly call it a threat.
Emotions are running high this election, but I’d hardly classify their exchange as more than a heated disagreement, if that.
Ohio Mom
PenAndKey @37: I’m broken glass all the away, will definitely vote and canvass for nominated Sanders even though I am sure it will be a replay of Mondale and Dukakis.
But I would just as well not start gushing over Bernie a moment before I have to. I’m assuming Zhena is in the same place.
Cacti
@PenAndKey: Hello new person. Who the hell are you?
gvg
Of course we have already pointed out how Medicare 4 all isn’t what people imagine, however I have to say the insurance I had was great. I was healthy and had an insurance plan with a good reputation for years. I had always wondered if it would be good when I actually got sick because of all the stories I heard over the years. (Avmed, state of Florida group) Well 6 years ago I discovered I had cancer. My treatment had few problems. 1 delayed approval for an optional genetic screen I knew I might have to pay for, but they did pay after only a small delay I didn’t even have to call about. I had $40 copays for specialists as opposed to 20 for regular doctors. $100 surgery fee once. I was miserable and tried to sleep as much as I could so I am grateful I didn’t have to call the insurance company after the beginning when I checked to see what I needed to do. Basically no problems, so yes I appreciated them. It also helped that my large employer took it in stride instead of what I hear about other companies.
A couple of years ago, my employer changed companies. The new one Aetna has a good reputation also though just a shade less good in consumer reports, but I won’t know till I really need it. Also their was a contract dispute and now one of the hospitals around here is out of network. Its not the biggest one though, that I went to before. Still, I am probably OK, especially compared to others.
My year of cancer didn’t cost me enough to make it worth my while to itemize that year. Standard deductible was better for my taxes-and I had been doing some expensive dental work before the cancer.
On the one hand,when you have something that works, you don’t want to change, hence my unease at the insurance company change. On the other, the whole time I was going through this, I was thinking about other people who weren’t as lucky. The doctors offices have permanent employees whose job is to help patients get grants and bill relief on treatments and prescriptions. That sends a message to me. I’ll also say it’s always been a factor in my choosing and staying at this job, that I had good state health insurance. I rather like my job so I am not suffering, But even when I was in college, students talked about health insurance as a job choice factor and even considered it in choices of major.
We should have better choices, Sanders is not up to the job.
PenAndKey
@Cacti: New my ass. Google my name on the site and try again. We’ve been over this before.
@Ohio Mom: I actually had a discussion with my father shortly after the Nevada results started coming in to just that effect. I fully expect that we’re seeing Dukakis 2.0. That doesn’t change the fact that the alternative is Trump. I can only control my own vote. If my primary choice doesn’t win? I’ll vote for whoever does, even it means siding with the Bros.
download my app in the app store mistermix
I had to step away after posting this but wanted to comment on the 6/10 Democratic voters supporting M4A or 6/10 supporting public option: I think you’ll get the same numbers for almost any positively-worded change in the current insurance system. People hate it and running against it is smart politics. I’m skeptical that Warren’s fall in the polls was solely because of M4A details, and I agree with AOC on this:
frosty
@Ohio Mom: We just went on Medicare when I retired in January. Three months of trying to figure it out and then giving up on Medicare Advantage when it became clear that living in one state when your doctors are in another can’t be done. We went with Medigap and it costs us almost $2K a year more.
Speaking of which, anybody that says Medicare is free and means you don’t have private insurance is full of crap. It’s a kludge and we should do better.
My 24-year old student needed insurance when I dropped employer coverage. He qualified for Medicaid which was relatively a breeze to navigate. Publicly funded private insurance with choices for companies and doctors. Seems like a good way to go for me. Feck M4A at least as currently constituted.
Cheryl Rofer
Even Republicans want decent health care without the insurance hassle, although they don’t like M4A.
RinaX
That’s an awful story. I’m still not voting for Bernie in the primary. As a Floridian, I’m depressingly aware of how the margins make a difference. That’s my concern regardless of anyone’s healthcare platform. It was the margins that cost us in 2016 and screwed Florida in 2018 when we had a good candidate. I’m not sure any of the current candidates are enough to close those one to four percent margins that keep costing sane people. However, Bernie’s the one I’m the least confident about.
Cacti
@PenAndKey: Sorry new person. I don’t remember you or Chris Johnson.
Seems a common trait among the leftier than thou nyms that pop up here.
Cheryl Rofer
@download my app in the app store mistermix:
I think this is key to getting as many votes as possible for a landslide in November, on many issues.
Cheryl Rofer
@Cacti: They’ve both been around for a while.
gvg
@Avalune: No, some of the companies aren’t ass*. It is luck and it shouldn’t be but my company when I had cancer was great. So it is true some people love their insurance companies. The problem is also we can’t control which company we have access to. Among other things.
Cacti
Well that’s a drastic departure from everything she’s said about ideologically impure Democrats to date.
PenAndKey
@Cheryl Rofer: That’s the power of propaganda. The same people are a big part of why the joke about “Keep the government out of my medicare!” started up when the ACA was first being debated. I blame Fox and Facebook.
@Cacti: You know, I don’t care if you don’t recognize me. I’ll discuss any on-topic subject you wish in any thread we interact with. If you want to imply that I’m an outside agitator have at it, because I know I’ve been here for years under various names and the regulars here have known me by this name for months. I don’t know all the regulars here, and I don’t expect you to either.
Betty Cracker
@What Have The Romans Ever Done for Us: Wow, glad you weren’t more seriously injured! A similar thing happened to our daughter last year, and we’re still fighting the goddamned insurance company over it.
frosty
@zhena gogolia: Oh hell, don’t leave!
Barbara
@Dorothy A. Winsor: Politicians love their private insurance because they work for the largest “power buyer” in the state/nation, and get the best rates and generally avoid the harshest kinds of policies, e.g., high deductibles.
What Have The Romans Ever Done for Us
@Avalune: This is true. I have some of the best private insurance there is (BCBS for Federal Employees) and I don’t love it. I’m glad I have it but even for me it’s not entirely clear that I’d be better or worse off under some more comprehensive universal coverage – medicare for all – heavily regulated private subsidized insurance – whatever. Maybe my co pays would be higher, but then maybe my monthly out of pocket premiums go down. Unless I have full information about what medical services I will need in the future and how my current insurance would stack up against the new system, I could be better off or worse off.
But, I’m pretty confident I wouldn’t be so much worse off under the alternate system that it would really materially affect my comprehensive financial situation or my quality of life in any real way. That’s what I don’t understand about people worried about losing their private insurance…even the best private insurance isn’t going to be all that much better, and maybe no better at all, than whatever replaces it.
Betty Cracker
@RinaX: Fellow Floridian, and I agree: a Sanders nomination will almost certainly put Florida out of reach. Scaremongering about socialism is more effective here than possibly any other state in the country. That said, I’m not sure any Democrat could flip Florida blue under the current circumstances. The GOP has been really effective at suppressing the vote.
chopper
@PenAndKey:
i don’t think it’s a coincidence that warren’s numbers took a shit right after she released a detailed M4A plan that got scrutinized.
download my app in the app store mistermix
@Cacti: No it isn’t. She was the first one to say “calm down” to Sanders supporters on the night of the Iowa primary. She’s been a strong advocate for her cause and will be an uniting force in the party. You could learn many things from her about politics.
JMS
Yes, this is a horrible situation, but it does lead to some policy questions that we don’t hear about or talk about much. Insurance other than primary health insurance can pay for health claims. If we reform the health insurance system, will anything change with regard to claims paid by auto insurance or workers’ comp, for example? If everyone can get medical care regardless, is there even a marketplace for liability as related to healthcare costs? I’m not assuming someone will be able to wave a wand and clear that up. Will people be able to sue for medical costs in the new system if there are fewer costs? Other countries must have ways of dealing with this so I’m not saying it’s some kind of roadblock but it’s just interesting that I haven’t heard anyone talk about it.
Leto
@gvg: That seems to be the most common trait with everything American: luck. If you’re lucky then you have X, otherwise welcome to Y club. I’d like to take the luck out of one of our systems.
chopper
@What Have The Romans Ever Done for Us:
i’m in the same boat. BC/BS for feds is good for private insurance, but it aint the ‘gold plated cadillac’ people say it is. it’s more like a gold-colored corolla, used.
Leto
@What Have The Romans Ever Done for Us:
That’s what we have and it’s our exact same feeling. You bring up a lot of good points; glad you’re still with us to do that.
PenAndKey
@chopper: That may be, but I honestly put it down more toward the tonal shift in coverage she was experiencing around the same time. She went from being treated like a dark horse candidate and “flavor of the week” personality to being mocked for being prepared almost at the drop of a hat. If I were a betting man I’d point to her poll numbers and policy positions pissing off people who didn’t like what she was proposing.
Quite frankly I don’t see the analysis of her proposal being what shifted things away from her. They had already started to shift before she released her first draft.
gvg
@What Have The Romans Ever Done for Us: I suspect you should have gotten your auto insurance involved but I wouldn’t have thought of it for a bike accident. I have been rear ended several times over the decades and one time my auto insurance company told me that because the truck that hit me was commercially insured, I should make the claim through them, and let them fight with the at fault persons insurance. They told me that “for whatever reason” commercial insurance always paid very slow and I would wait months for approval to get my car fixed, where as if I claimed through them, I would be out my deductible until they finally got the claim through, but I would get my car fixed fast. They were right. Other times I claimed through the other persons insurance and had no problems.
Years later I had another accident where the at fault person was renting a car and getting insurance through them. That would make it commercial too but also the way the rental company acted at the scene made me suspect they had lied about having insurance. I told my company I thought it would never get paid and claimed through them. I have not gotten my deductible back and it’s been more than a year.
O. Felix Culpa
I am most decidedly NOT a Bernie fan – but I resonate with the description of our deeply flawed mostly employer-based insurance system. As the former CFO of several small to medium-sized nonprofit organizations, I had to negotiate our health insurance coverage annually. We wanted to do well by our employees (of which, of course, I was one), but we had a weak bargaining position due to our size. The prices went up every year while the coverage those higher prices bought shrank every year. It sucked.
Also, it is reasonable and necessary to discuss the problems with our “system” and desired solutions. I think M4A is problematic for a host of reasons that have been covered many times over on this blog, but I understand why many people gravitate toward it…and I understand the hesitation that some feel about change, which could lead to worse outcomes for some, especially during transition. But we have to tackle this problem, which will affect EVERYONE directly or indirectly at some point, unless they happen to be a 1%-er
ETA: What Leto said at #64 about luck. No one should have to rely on fickle fortuna for medical care for themselves or their loved ones.
What Have The Romans Ever Done for Us
@Betty Cracker: What are people paying for is what I want to know? You write check after check to those shysters and then when it’s time for them to pay out it’s a tooth and nail fight.
I’m very thankful that I wasn’t seriously injured and that even if I had to pay out the entirety of the associated bills I would still be OK financially. But, excuse the shouting IT SHOULD NOT BE THIS HARD TO GET MONEY OUT OF A GIANT CORPORATION THAT HAS THE MONEY, KNOWS IT OWES IT TO YOU, BUT JUST DOESN’T FEEL LIKE GIVING IT TO YOU.
Cacti
Yes, her insinuating Nancy Pelosi is a racist was a highly unifying event.
Of the rest of the party against her.
Baud
@What Have The Romans Ever Done for Us:
In terms of out of pocket costs and covered conditions, maybe that’s true. I don’t believe, however, that you can totally change how health care is financed in this country and not affect the relationship between patients and providers. A lot of people will be required to adjust from what they are used to.
Barbara
@Cheryl Rofer: I can’t say too much about this kind of thing because it’s an occupational hazard. But the schizophrenia between trying to placate appeals to lower costs without actually doing anything that directly forces the issue is on full display in the legislation that is trying to get to a full vote in the Senate on lowering prescription drug costs. The Senate could potentially pass that legislation but it will not get majority Republican support unless the only provision that actually addresses pricing (and really, just inflationary price increases) is stripped from the bill (at which point, it will receive zero Democratic votes). “I want lower costs but I won’t do anything that would actually create conditions for lower costs” is basically the default Republican position, which means that wringing hands over costs but opposing M4A is not surprising at all. I don’t think M4A is a great idea not because I have ideological opposition, but because I think there are better ideas, and also, people seem to think that M4A fences out insurers, when more than 40% of Medicare beneficiaries are enrolled in an MA plan, and 100% of beneficiaries receiving drug coverage are enrolled in a private insurance plan.
Chyron HR
@PenAndKey:
That’s… one of the signs of being a troll.
What Have The Romans Ever Done for Us
@gvg: I think in DC bicyclists are treated like pedestrians which is why there is a special process for getting bills paid by the insurance of the person at fault. When it looked like one of the bills was being referred to collections I contacted the main adjuster and she sent me to the other person who handles the quicker payout for pedestrian claims. They had to verify that bike riders are eligible which they are.
What Have The Romans Ever Done for Us
@Baud: That could be an issue. I’m not sure that many people have kenned it yet though. I think most of them are worried about their out of pocket stuff. But I could be wrong about that as it’s not something I have considered. My wife is an NP who does her own billing and she’s praying for single payer just to make the paperwork a lot, lot simpler.
tobie
This woman’s story is appalling. Full stop. It’s why people want the healthcare system fixed. The devil is in the details. I actually think we will move to a single payer system eventually but the transition to it is everything. If you announce in advance that in 2 years, 4 years, or 10 years, you’re going to end group plans, however, you put the 149 million people on group plans at risk. Claims will be slow-walked or denied and then contested in court. Rosa DeLauro and Jan Schakowsky found a brilliant way of dealing with this problem in Medicare for America. I’m surprised the plan hasn’t gotten more attention.
Barbara
@JMS: I am sure the ATLA will try hard to preserve this aspect of liability insurance, however, you raise a really good point. If universal care exists, why bother with all the friction and transactional costs associated with allocating responsibility for who pays for what part of it? Well, partly it’s because all care systems, even those that are universal, have limits on services, and it is possible that certain types of services will fall through the cracks. At any rate, I have been singing this song for a long time. Sometimes a principle makes sense only in theory: “The person responsible for the accident should pay the costs,” makes sense in theory, but when you add the costs and complexity associated with affixing responsibility, it makes a lot less sense in practice. Medicare Secondary Payer has established an incredibly burdensome infrastructure to try to capture a sliver of costs to the system associated with payers that are deemed to be “primary” by Congress.
Baud
@tobie:
I’m afraid the only two accepted options are M4A and keeping the status quo.
Another Scott
@daveNYC: Her story is a big argument for single payer. My J has horror stories about an at-fault driver’s auto insurance vs BCBS as well.
But an interim solution is to “simply” change the state/federal laws about who pays what when multiple insurance companies are involved, and who has rights to go after settlement payments, etc. Even that would be a bloody battle because so many players and so much money is at stake.
Grr…
Cheers,
Scott.
PenAndKey
@Chyron HR: Oh FFS, it’s also, as has repeatedly been discussed every time some yahoo accuses me of being a troll, the sign of someone who checks out of the site for months at a time and simply can’t remember their old nyms. To my knowledge I’ve had two and I’d love to know what the hell they were. In the grand scheme of my life, and the number of games and sites I’ve been on under various names, that’s nothing. I’ve reached out to various front-pagers to ask if they can do a email search through the comment archives, because I know that’s one of the metrics a self-hosted wordpress install database back-end tracks, but nobody has ever done so. I will gladly append my name to include my old ones if someone ever tracks down what they are. Until then, I’m keeping the one people recognize me as.
Now quit derailing the discussion.
Chris Johnson
@Cacti: But you’re not a Democrat either. You’re some kind of working troll, and very persistent at that. And I had to give up being a Bernie Bro because I was misguided and wrong, so now apparently we are not on the same real side?
Mnemosyne
Don’t have time to read the whole thread right now, but this is your daily reminder that we would be MUCH further down the road towards universal coverage if John Roberts had not ripped the heart out of PPACA by deciding that Medicaid expansion by the states should be voluntary.
And yet Obama and the Democrats get the blame for that, because people are fucking stupid and never blame Republicans for their open sabotage.
The Moar You Know
@Cacti: He’s right, but Christ, even I’m not stupid enough to say it in public. He’s just like Trump, can’t keep his fucking dumb mouth shut and keeps saying the stupid shit with the outdoor voice.
Rina99
@Betty Cracker:
Exactly. I’m not flipping out over doomsday landslide scenarios. Bernie as the nominee likely puts Florida and other close states back in the GOP column on November 3rd. That’s all Trump needs.
download my app in the app store mistermix
@PenAndKey: Seconded. Commenters new and old who contribute to the community are welcomed, and the trollish behavior that I see here is questioning the legitimacy of two who I’ve seen here for quite some time, just because a couple of you don’t agree with what they posted.
tobie
@Baud: I don’t know if it has to be binary. Yes, there are campaign promises of various sorts but should we have the good fortune to retain the House, take the Senate and regain the White House, the legislative process will get to work. It will be interesting to see then what can become law…
For now, though, in campaign mode, we seem stuck with a binary choice.
By the way: I read somewhere that only 4% of eligible voters participated in Sat’s caucus. If that’s true, I’m not inclined to extrapolate anything from the entrance polls. The sample’s too self-selecting.
Rina99
@Mnemosyne: John Robert’s screwed over a number of my family members with that move.
Chyron HR
@Chris Johnson:
Yes, of course, NOBODY is a Democrat now except Bernie Sanders and his supporters.
Baud
@tobie:
Yeah, the only reason things are they way they are is because of the fragmentation of the non-Sanders candidates. But that may be all Sanders needs.
PenAndKey
@download my app in the app store mistermix: It happens. Heck, I’ve been called out on making that sort of accusation against someone who was acting like a particularly egregious troll but was really just having a bad day. At this point I don’t make the accusation and ignore those who do.
Cacti
@Chris Johnson: The supporter of the only non-Democrat in the race who tells everyone else that they’re not a Democrat.
Self-awareness isn’t your strong suit, is it?
But please, continue to enlighten us with facile class reductionist arguments about the “real reason for racism”, according to bourgeois white dudes.
PenAndKey
@Baud: In heavily contested elections it often is.
@Cacti: Are you going to contribute anything meaningful or are you just going to spend all day attacking anyone who doesn’t vociferously attack Sanders and his supporters the entire thread?
Baud
@PenAndKey: The other aspect that aids Sanders is the 15% cutoff for delegates.
John Cole
@Cacti:
Who the fuck annointed you hall monitor. You need to calm down today.
Cacti
Too many decades of reflexively defending the world’s communist regimes.
Chris Johnson
@John Cole: Don’t worry too much about it, John. Same old same old, not really any different. Some of the guys are on me like white and rice, but I did provoke ’em. Just another Monday on your blog :)
Chris Johnson
@Cacti: …Warren?
PenAndKey
@John Cole: I’m just going to disengage from them for the day. Emotions are high and it’s not worth the strife on a Monday.
Betty Cracker
@Rina99: Sanders is definitely a riskier nominee than some of the other choices, IMO, but I think we can win with any of the current top-tier candidates, including Sanders. I’m still hoping Warren can pull off a come back. We shall see.
Ohio Mom
Frosty @47: The thing I don’t think is made clear enough about Advantage plans is that they like young, relatively healthy subscribers a lot more than old, frail and medically-involved ones.
And a lot of the time, if you need to leave your Advantage plan for whatever reason and you have serious medical issues, it can be hard to find an affordable gap plan. At that point, the gap insurance plans can and will hold your pre-existing conditions against you.
That’s what convinced me to avoid Advantage plans. They are a lot more affordable in the beginning, but maybe not later. A lot of people on tight budgets must get screwed over when they go for the low, low price of an Advantage plan and then get really sick years later.
lee
That is seriously fucked up that your insurance company can come after the ‘pain and suffering’ part of your settlement.
Barbara
@Ohio Mom: There are NO gap plans for Medicare Advantage. Medigap is solely for those who are not enrolled in a Medicare Advantage plan.
Of course MA plans like having beneficiaries enroll when they first become eligible for Medicare, one, because they are healthier, and two, because that means they will have them for a longer period of time. Medigap plans are the same way, except that they get to underwrite when you decide you want one after your first year of coverage. MA plans never get to underwrite, so premiums are uniform.
Cacti
Respectfully disagree. You can’t unwind an authoritarian regime from the authoritarian aspects.
There are numerous real world examples of countries that have achieved significant advancements in education, healthcare, etc., without also devolving into a police state in the process.
Cacti
Has no path to the nomination as long as Bernie’s in the race, and the only thing removing him would be another infarction.
CliosFanboy
Oh man, I dealt with them after I was rear-ended by another driver who had them as their insurer. What a dishonest painintheass company!!!!
Tenar Arha
@Betty Cracker: not even with the recent referendum, the federal stay on the fines & fees, & the fast tracking in blue-r districts?
Mnemosyne
Also, too, wait until the 2016 Jill Stein voters and the non-voters find out that the Supreme Court can cancel executive orders made by the president. Surprise, bitches! I guess that “trying to hold you hostage over the Supreme Court” was more important than you gave us credit for.
Nah, who am I kidding. They’ll just blame Democrats for everything. Again.
Betty Cracker
@Tenar Arha: As I understand it, it’s unclear at this point whether the federal stay on fees and fines will be resolved in time to affect this year’s election. Right now, it applies to the plaintiffs in that case only and the governor is appealing to ruling. I’m hoping the fast-tracking in blue districts come back to bite Republicans on the ass, but the data on that is still out too. The bigger lift will be helping people get ID and overcoming the many other obstacles, such as voter purges, early voting restrictions, etc
ETA: I also should add that Sanders would start off behind the 8-ball in Florida regardless of the ruling, IMO. Scaremongering over socialism works here, and the state’s population skews old. That said, anything could happen!
schrodingers_cat
OT: Delhi is burning right now there is pogrom underway.
Tenar Arha
@Betty Cracker: Maybe I should save this for the next constructive action thread, but do you have a favorite Florida voter ID organization?
schrodingers_cat
Delhi is a warzone. Please retweet because this is being ignored by the Indian media which is focused on the photo-ops of the two bigots.
Tenar Arha
@schrodingers_cat: Sorry to hear this. I’m thinking of you, and hoping those you love & care for are somewhere safe right now.
Felanius Kootea
ZG’s issue with Bernie is that she thinks he’s a Russian asset. Not everyone agrees. I can see how having that belief would cause one to view his ascent in the primaries as an existential threat.
I just think Putin believes Bernie will be the candidate most likely to create chaos on the Dem side and the Dem least likely to engage with the rest of the world if he manages to be elected. That works for Putin and for many dictators around the world.
The healthcare situation in the US is a national embarrassment and tragedy. I can understand why people think that tinkering around the edges of Obamacare isn’t enough. Unfortunately, Democrats alone can’t bring the comprehensive change that’s needed. I wish more people in the national media would discuss this issue in a nuanced way. I am for Medicare for all in principle but have observed politics long enough to know that the versions being touted on the campaign trail will be watered down if either proponent gets elected. We may end up with Obamacare plus public option if Bernie or Warren get elected. I think they both know that too, no matter how passionate their supporters get. But we have to improve things no matter how slow progress is. With all the handwringing about Medicare for All on the Dem side, no one mentions that the Republican plan is still to repeal Obamacare and the Supreme Court will rule on this after the election! All the Dem candidates should be pointing this out.
Given that only a fraction of the delegates needed have been committed, I’m going to work as hard as I can to get my candidate elected in the primaries. I’ve already voted for her in California.
Betty Cracker
@Tenar Arha: VoteRiders is doing great work here and everywhere else. For for felon voter rights restoration specifically, the Florida Rights Restoration Coalition did a lot of work to get the initiative on the ballot and is crowdfunding fee payments.
schrodingers_cat
@Tenar Arha:My family is from Mumbai but husband kitteh has a cousin who lives there. This is happening in Delhi’s Muslim neighborhoods so their family is most likely safe.
Jill
@Starfish: I used to have great insurance on my last job — the job that almost put me in a hospital from a nervous breakdown. But having that great insurance tied me to a job that was killing me. It got me through my husband’s cancer, brain surgery, stroke, and death without putting me in the poorhouse, but it came close to destroying me.
Now I am on an ACA plan that costs me $800/month with a $6900 deductible, and I can ONLY go to UNC doctors. And this is what they call “choice.”
Peale
@chopper: Yep. 6 in 10 means 4 in 10 against. That’s a wedge issue. 0% of republicans favor single payor. 40% of our most devoted voters going to caucuses don’t want it.
catclub
My experience was from about 16 years ago. Same effect of nobody wants to pay because somebody else might be liable. However, when I did get a settlement, they basically took all of my medical expenses and multiplied by some number larger than 1 for the settlement. And therefore it would have paid me to have MORE medical expenses – and be sure I had reported ALL of my expenses (I missed one large one – they were less aggressive going to demanding payment because they knew a settlement was likely coming.)
Good luck with your case.
TC
Bbb, but, but Bernie is against Unions and their health plans! Yeah, that line of attack worked out well for the corporate Dems and the union bosses in NV, didn’t it? Fuck ’em, I say.
Barbara
@Jill: There is a lot wrong with U.S. healthcare, and this is emblematic. I would reassure all people, however, that lack of choice among doctors is probably the least of their worries in the American health care system. It’s not that all doctors are equal, probably far from it, but in general, you as a consumer don’t have many tools to identify the good ones from the bad, unless they are really bad, and even payers with reams and reams of data struggle to identify factors that meaningfully distinguish doctors from each other. If you are going to doctors associated with a premier training institution, as UNC is, at the very least, you will avoid one of the worst features of medicine, and that is the tendency of doctors not to progress too far beyond what they learned during training, whenever their training occurred.
FlipYrWhig
I still think the turning point toward national health care is going to have to be when businesses decide they just don’t want to handle health care benefits anymore.
Also, I hope eventually to gather more support for my own reform plan: Nurse Practitioners For All.
schrodingers_cat
4 people have died in state sponsored violence in Delhi today. This is our future if the Orange king is reelected.
Felanius Kootea
@TC: If Bernie is the nominee, he’s going to need all Democrats voting for him. That includes “corporate Dems” and “union bosses” in all states of the union. Let’s see how he does in the remaining non-caucus states in the primary. Reserve your FUs for Republicans.
jonas
The fundamental problem with our healthcare system is not just how it’s paid for (via private insurance), but how much it costs. Health insurance is so evil/expensive because they have to pay the outrageous prices charged by doctors, hospitals, and other service providers while also maximizing their bottom line. So if single payer, or M4A, or whatever is eventually implemented, that gets rid of the private insurance middleman (mostly). But the tough policy question is not just how to cover everyone, but how to get those costs down. Otherwise M4A doesn’t even begin to be sustainable. I have a sinking feeling that the rough shoal this whole venture will eventually break upon is getting these stakeholders to take a massive paycut. Not that that’s not possible — anything’s possible I suppose — but I’m having a tough time imagining it in our current reality.
Ksmiami
@daveNYC: it’s the overarching profit-driven medical care that’s the issue in this country – like sure we have some advanced procedures etc but the reality is it’s a racket.
Chyron HR
@TC:
It is absolutely wild that you guys have convinced yourself that you’re going to show up in Milwaukee with 33% of the delegates and order the other 66% of us to get out of “your” party.
joel hanes
I am sorry to have to report that the net effect of all the Anderson/Mayhew articles explaining the workings of for-profit health insurance has been to make me viscerally hate the moral obscenity that is for-profit health insurance.
Llelldorin
The original posts make it really clear where a lot of Trump and Sanders support is coming from. There are a lot of people in that kind of position. The smarter ones start looking for a candidate who’s promising to set fire to the whole system, because the usual Democratic party moderation doesn’t really appeal when you’ve just lost everything. The stupider ones (and dear God, are there a lot of them) assume that they must have been screwed by minorities somehow, because who else could possibly be to blame, and go running to Trump to put them in their place.
Leto
@joel hanes: agreed. Even when I don’t follow everything, the visceral hatred that I have just burns on through.
Llelldorin
@jonas: At the very least, you’d have to tie it to some sort of forgiveness for medical school loans, because young doctors can’t really take a pay cut while leaving enormous medical school debt intact.
Of course, that somewhat drastically increases the number of stakeholders to include the banks and the federal Department of Education.
Mnemosyne
@joel hanes:
As jonas just pointed out above, it ain’t just for-profit insurance that’s the problem. We have for-profit hospitals, too, and they’re going to fight tooth and nail to keep all of their profits. Tenet is not going to magically divest themselves and turn all of their hospitals and clinics into M4A locations, and Trump’s judges sure aren’t going to enforce any laws that force them to do it. What now?
Mnemosyne
@Llelldorin:
The “smarter” ones are still directing their fire at the wrong people since they decided in 2016 that judges don’t matter and the real problem with PPACA is that Democrats didn’t want it enough.
Republicans keep stabbing us in the back. Maybe we should prioritize getting rid of them before we start primarying Democrats in safe seats? Just an idea …
Barbara
@jonas: Yep. This is it. Medicare probably underpays (though I am very skeptical of hospital claims about their true costs), which is one way it manages to be cost effective, but the U.S. pays more for every kind of service than anywhere else in the world. One man’s outrageous costs is another man’s comfortable living.
FlipYrWhig
@Mnemosyne: That’s why there should be a dramatic increase in funding for medical training, thereby avoiding that spiral where people who want to be doctors then have to become the best compensated kind of doctors to pay off the debts they incurred becoming doctors in the first place. And some of that stems from the elitism and Veblen-good pricing of med schools. That’s another component I’d like to see politicians work on disrupting.
Ohio Mom
Barbara @103: I wasn’t clear enough. I meant if an Advantage plan subscriber wants to leave after a number of years and participate in traditional Medicare — say you were just diagnosed with cancer and don’t like your oncologist, but he/she is the only one on your plan, you might want to choice traditional Medicare provides. But now your medical history would make your Medigap policy choices very expensive (since you are way past your first year on Medicare).
At least, that is how I understand it — I know you know way more than me, please correct me if I’m wrong. I have several pre-existing conditions that are in good control right now but of course that may not always be true in the decades ahead. That made Advantage plans an easy No for me.
joel hanes
@Mnemosyne:
reminder that … John Roberts had not ripped the heart out of PPACA
Thanks, Mnem.
Reminders from the goddess of remembrance seem particularly apt.
joel hanes
@Chris Johnson:
There are reasons that the canonical metaphor for the Balloon Juice commentariat is “jackals”, and vicious backbiting is one of those reasons.
This place has been, for me, a perfect venue for further training in my life-long tactic of walking away from fights.
Llelldorin
@Mnemosyne: I’m not sure we can treat the Sanders voters as a single uniform block. The numbers vary from poll to poll, but it looks like the overwhelming majority of Sanders voters went on to vote for Clinton.
I’m assuming that the two populations bleed into each other a bit at the margins, giving us the True Genius Bernie Bro squads back in 2016 (together with a bunch of other groups—the “remember when being a misogynist liberal was a thing?” squad and the “We should be addressing universal issues like my problems and not special interest nonsense like your problems” crowd).
PJ
@download my app in the app store mistermix: AOC is wrong on this – the worst that can happen is that Bernie is the nominee and Democrats lose the House, and the ACA is abolished.
But what’s particularly galling about this admission by AOC, and similar ones by Sanders’ surrogates made in response to the Culinary Union’s desire to keep their insurance, is that, for a year prior, his surrogates and followers have been castigating any politician or person who suggested a public option or other intermediate options on the way to universal coverage (instead of Bernie’s M4All, accomplished immediately by his finger-pointing and rallies), making accusations that they are literally being killed by anyone who doesn’t support Sanders’ non-existent plan. It turns out that, in this respect, they can admit Bernie is just another politician who will have to get his healthcare plan through Congress. In all other respects, however, Bernie remains the miracle worker who will get us all to the promised land.
I am curious how you can be justifiably skeptical about all kinds of Republican BS, but get all dewy-eyed over AOC and Sanders’ vague promises.
Barbara
@Ohio Mom: Nope, this is definitely true. Medigap can underwrite, although there have been proposals to abolish this aspect of Medigap, because it deters a lot of people from trying Medicare Advantage plans, which is what policy experts really want people to do.
different-church-lady
@Cheryl Rofer:
Sure they do. They just don’t want it badly enough to do something, like, vote for people who would actually get it for them.
J R in WV
@Chris Johnson:
And maybe you, Chris, are an ass towards everyone around you. That’s what I see from here, and you, personally, are not helping anyone with anything.
Welcome to the world of pastry criticism!
different-church-lady
@Chris Johnson: You know who else isn’t a democrat?
Ohio Mom
Barbara @141: What’s the policy preference for Advantage plans? I thought they were in part give-aways to private insurance, and I admit I am always suspicious of any effort to privatize public programs.
?BillinGlendaleCA
@Mnemosyne:
Now that’s just crazy talk. //
Wolvesvalley
Testing whether duplicate comment posts.
Wolvesvalley
@Wolvesvalley: WordPress objected to duplicate comment.
Mnemosyne
@Llelldorin:
Trump needed less than 80,000 votes in three key states to win the Electoral College even though he badly lost the popular vote. Voters on the margins had outsized control over the outcome in 2016, which is why I’m still pissed at them. They could have helped us stop this disaster, and they didn’t want to sully their hands with our dirty practical politics.
Llelldorin
@Mnemosyne: I’m still mostly furious with the media for treating “Trump is utterly, manifestly unfit to be president” and “Clinton once ran Mac OS X Server” as equivalent stories, but I suppose there’s hate enough in my heart for them too.
Mnemosyne
@PJ:
That’s what made it clear that “Medicare For All” is a shibboleth, not an actual policy. Harris and Warren both made the mistake of thinking it was a policy to be debated and not an article of faith to be accepted, and it hurt their campaigns in a major way. Treating M4A as anything other than a sacred object — trying to turn it into policy — was blasphemy that had to be punished.
janesays
@PenAndKey: This time a zillion.
J R in WV
@gvg:
The car rental business is possibly more crooked than the health care biz. We arranged a trip through AAA some time back, and evidently they have some kind of agreement with Hertz. Worst experience renting a car… the young woman (must have been on commission, and ethics free) insisted on renting us a Mercedes. I was not willing to rent a Benz under any circumstances.
Eventually I told them I was walking the half-mile to the Enterprise shop if they didn’t do what I wanted. Pissed me off.
In AZ when I fly out, I need a 4×4 truck because of the remoteness of our small house / camp and my need to move firewood to ehat with. Not cheap to rent. I always buy the insurance waiver too, because driving on back country roads is more dangerous than on pavement. No questions asked when I show up with a dirty new Ram truck. Arizona pin stripes / aka streaky marks from the shrubbery you drive through, also not an issue.
Mnemosyne
@janesays:
Sanders isn’t going to fix it, because “Medicare For All” is an article of faith, not a policy. He literally has NO PLAN to fix anything.
Warren has a plan to make M4A work and she was punished for it by having supporters leave her in droves for Sanders, because they don’t actually want a fix. They want a slogan they can beat other people over the head with.
janesays
Is there no middle ground? Is it possible for someone not to be a Bernie Bro, and also not to be a Bernie hater? Is it possible to not be thrilled by his candidacy, to wish he hadn’t chosen to run, to prefer a different candidate and simultaneously to not view him as an existential, to not believe that his nomination guarantees a 40 state landslide, and to not despise him on a visceral level?
I’m one of those people. Bernie’s not my guy. I groaned when he jumped in the race. I did that with Biden, too. They’re both way, way too old to be doing this. I hope Bernie doesn’t win the nomination. I think he’s really terrible at playing with others. I think the rift between the executive and the legislative branches (even if Dems control both houses) is going to be the worst we’ve ever seen if he’s the president. His most vocal supporters are total assholes. I think it was shitty of him to not step aside much, much sooner in the 2016 election. I think he’s a cranky asshole. I fear he may not be able to win. If Elizabeth Warren is still in the race 15 days from now, I will be voting for her in my state’s primary. If she isn’t, I will vote for whoever the leading non-Bernie candidate is at that point, even if it’s Pete Buttigieg.
All that said… I don’t think Bernie Senders is evil. Narcissistic, egomaniacal, arrogant, pompous, self-righteous, sure. I agree in principle with most of his domestic policy ideas, even though I think it’s unrealistic to expect most of them to come to fruition anytime soon. If he wins the most pledged delegates, I think he should be the nominee, even if he doesn’t have an outright majority before the convention. I think if he goes into the convention with more delegates than any other candidate and loses the nomination because of superdelegate influence, I believe that will backfire catastrophically on us. If he’s the nominee, I will support him fully, and crawl over broken glass to do whatever I can to help him defeat Donald Trump (who I think really is an existential threat to the country). Should he become the nominee, I will chastise those who continue to paint him as a Russian puppet or generally disparage him in unconstructive ways (leveling non-vitriolic criticism of policy stances is perfectly fine), because that would be actively harmful to the cause of defeating Donald Trump in November.
That’s where I stand, and I don’t think there’s anything unreasonable about it.
janesays
@Mnemosyne: Umm, OK.
I’m really unclear what exactly any of that has to do with my liking PenAndKey’s comment #26. Do you think bitching about our healthcare system is the equivalent of “sanctification of Sanders”? Do you think any amount of support for him constitutes “sanctification”? If that woman’s story moved you and you got to the end where she supported Sanders and then decided, “fuck her”, well that’s just sad. Thinking she’s backing the wrong horse is fine. Thinking she’s a bad person – especially in light of the unimaginable tragedy she endured – because of who she’s chosen to support is extremely shitty.
I agree with you that Warren’s proposal for M4A is light years better than the vague platitudes coming from Sanders. It’s one of the many reasons why I believe she is the best and most qualified person running in this race, and why I would vastly prefer to see her as the nominee over anyone else, especially Bernie.
So… where are we in disagreement? Is it the fact that I don’t hate Bernie? Or that I think Democrats have an obligation to support the nominee no matter who it is – even if it’s Bernie Sanders?
texasdoc
@zhena gogolia: Please don’t leave. I enjoy your comments, though I disagree sometimes. And talking about “Medicare for all” isn’t sanctifying Sanders. We need more discussion about universal and accessible health coverage. A lot of people who talk about M4All, it seems to me, are using it as shorthand for universal affordable access. When you press for details, it becomes clear there are a lot of differences within that group, and that many of them don’t understand that there are costs for those on Medicare now.
janesays
@Betty Cracker:
Just speaking on Florida generally, I don’t think the situation is quite as dire as many think. Gillam and Nelson each lost by less than 1/2 of 1% of the vote. Trump won by 1.2% in 2016 – it was the 5th closest state in the entire country. The last three big losses in 2016 and 2018 probably feel overwhelming because in the end, a 0.13% loss (Bill Nelson) is going to have just as awful an impact (Sen. Rick Scott) as a 30 point loss. But I think Florida’s still a lot more purple than many people believe. Ohio is much closer to being completely out of play for Democrats than Florida, and Virginia and Colorado are both a lot more blue than Florida is red right now. I agree that Sanders would have a much tougher time winning there than a lot of other candidates because of the Cubano vote, but I don’t think Florida is unwinnable for Democrats in general.
WaterGirl
@zhena gogolia: I see a lot more of crucifixion of Sanders here than I do sanctification.
But clearly we have a mix of people, with opposing views. Some of those views are real, and some may be from people who want to sow discord.
Because if they can divide us, even here on BJ, they win. Please do not let them win.
EmbraceYourInnerCrone
@Ohio Mom: From the Medicare.gov website: Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are an “all in one” alternative to Original Medicare. They are offered by private companies approved by Medicare. If you join a Medicare Advantage Plan, you still have Medicare. These “bundled” plans include Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance), and usually Medicare prescription drug (Part D).
zhena gogolia
@texasdoc:
I obviously am addicted to BJ (there really is no alternative that I’ve found, everywhere else is even more Sanders-friendly). But I am in panicked despair that I will possibly be faced with a choice between two candidates backed and promoted by Putin in November 2020. I can’t be reasonable about it. I guess I know too much about Putin and what lies ahead of us. I can’t believe he conquered us without firing a shot.
Betty Cracker
@janesays: You’re probably right. What disturbs me about the state (well, one of the many, many things!) is that Trump’s approval rating has consistently been higher here than in most swing states. It’s been more or less an even split all along, no matter what. But, who knows what the future has in store? Things could change.
J R in WV
@Barbara:
When you say “Medigap can underwrite” You have lost me. What does “underwrite” mean in that context? I have no idea. Explain it to me like I was 12, please…
Joey Maloney
Sister Rail Gun of Warm Humanitarianism
@zhena gogolia: Putin is just the latest in a long list of people who have exploited the fractures in American society. And he wouldn’t have been able to do anything without the extensive groundwork others have put in place over the last 50 years or so.
Barbara
@J R in WV: They can price the product based on your health status
So, if you are leaving MA because you are newly diagnosed with cancer and want to go to a particular oncologist, but you want a Medigap product to pick up the cost sharing because Medicare has no limitation on out of pocket costs for the very substantial level of services you are going to undergo, you are going to find that those plans are very expensive for you
ETA: You have a few windows of opportunity to get Medigap without underwriting, when you become eligible for Medicare, and a few others. The problem for Medigap plans is that people who leave MA plans tend to do so just when they start using them a lot and perceive that they will have more freedom outside of such a plan.
Ohio Mom
Jane says @155: You and I are on the same page. I do not disagree with you at all.
I only told Zhena to be choosy about what threads she reads because I want her to stay as a commentator and she does not have the slack right now to read about Bernie.
I’ll read just about any thread, myself.
Who knows, maybe Zhena is right and Bernie is either a witting or unwitting Putin stooge. But since I can’t know that right now, I’m most likely voting for Warren (depends on results of Super Tuesday) and re-upping my membership in team broken glass.
janesays
@Baud: This is why I’ve been saying it would be much better if a few of the candidates drop out BEFORE Super Tuesday. Because if it’s a one-on-one race between Bernie and a not-Bernie candidate, the not-Bernie candidate is going to pick up delegates in every state. Right now, here’s what we’re looking at for Super Tuesday: Sanders is going to win delegates in probably every single state, and probably every other candidate is going to have a state or a few where they don;t win any delegates, because they’ll fall short of the 15% threshold. Warren won just shy of 13% of the vote in Nevada, but she’s going to get zero delegates out of that state. Bernie will get 18. And that scenario is going to play out in 13 different states next Tuesday, where various non-Bernie candidates will win 12-13% of the vote and have absolutely nothing to show for it.
California has 412 pledged delegates, and 144 of them are awarded based on statewide results. Right now, Bernie leads the polling at 27.9%, with Bloomberg in second at 14.7%, and Biden in third at 12.9%. If those numbers hold up, guess what happens? Bernie gets every single one of the delegates awarded based on statewide results – all 144 of them – because no other candidate reached 15%. I think some people don’t understand that the proportional allocation system isn’t in fact directly proportional. It’s possible for someone to win less than 30% of the vote and get 100% of the delegates in a contest where no other candidate hits 15%.
THAT is why I’ve been saying it is bad for every candidate to stay in this through Super Tuesday, if the goal is to beat Bernie Sanders.
Mnemosyne
@janesays:
This is the problem I have with Sanders: by insisting that a vague slogan of “Medicare For All” is the be-all and end-all of universal coverage, he’s basically poisoned the well for any discussion of what’s actually wrong with our system and how we go about fixing it.
The problem at the core of our system is PROFIT. Not just insurance companies — although they contribute a lot — but for-profit hospitals and for-profit health plans and for-profit physician groups. Expanding our existing Medicare system to all citizens and banning private insurance does jack shit to fix the problem of for-profit hospitals.
I would be happy to discuss how to fix our broken system, but anyone who thinks that shouting, “Medicare For All!” is going to do the trick isn’t going to be willing to talk about the hard choices that are going to have to be made as we try to create a better system over the objections of almost half of the states in the US.
And I do get very impatient when people complain about PPACA being a failure but don’t mention who deliberately kneecapped it: John Roberts. Not Obama, not Nancy Pelosi, not even Joe Lieberman. It was John Fucking Roberts. If we can’t even acknowledge that reality, how can we have a sensible conversation about how to fix what the Republicans broke?
Mnemosyne
@texasdoc:
Yep. And if you try to discuss those differences and what changes will need to be made to the existing Medicare system, the Twitter bros (not anyone here!) call you a murderer and say you hate poor people if you want to look at actual details of how to get a universal healthcare system to work.
I don’t think that there’s a single prominent Democrat who does NOT want universal healthcare. Every single one of the candidates running wants it! And yet they all get tarred by the Berniebros as wanting to kill poor people because they don’t mouth the phrase “Medicare For All.” It really pisses me off, in case you couldn’t tell. ?
Geminid
Medicare for All has good moral and economic arguments in it’s favor. My objections are political. Economist Robert Pollin lays out a good argument for M4A, but a lot of people are skeptical if not cynical about government, and you could sit these people down with Pollin for an hour and many would walk away saying “Sounds good. But I’ll believe that when I see it.” But if we could put public option through in 2021 they could “see it” as people and businesses around them opted in to a public plan. Then maybe we would transition to M4A by 2029. But this year I don’t think M4A is a winning issue. Defending the ACA is.
Betty Cracker
@Mnemosyne: I’ve been meaning to ask Dave A. what he thinks of “Medicare Pricing for All.” Have you heard of it? Basically, the idea is to make Medicare reimbursement rates universal, regardless of who provides coverage.
Ohio Mom
JR in WV @163: On the other hand (this explanation is subject to approval by Barbara) if you sign up for a Medigap plan (instead of an Advantage Plan) in the first year you are eligible for Medicare, your prior health history/pre-existing conditions are not held against you; you are charged the same rate you would be were you in perfect health.
The snag is if you leave an Advantage plan after the first year for a traditional Medicare/Medigap combo. Then “underwriting” (upping your premiums because you’re a bad risk) kicks in.
Just one example proving that choosing an approach to your Medicare coverage is not at all simple, and don’t get me started on the drug plan options…
joel hanes
@Mnemosyne:
Yes, hospitals and doctors charge a great deal in the US.
However, when I’m sick, I want to see a doctor, and when I need surgery, I want to be in a hospital. These are positive goods.
The entire premise of for-profit health insurance is to deny enough of the already-paid-for healthcare to the people who have paid for it to cover the insurance company’s operations staff, and management, and to richly reward the investors.
joel hanes
@Ohio Mom:
Fuck.
I wish I’d known this a year ago.
So I might be well-advised to stay in good health this first year of my retirement, and move to Medigap in fall, before my health deteriorates (knock wood).
joel hanes
@Betty Cracker:
Opining without any expertise of my own, I think we’d have to raise the Medicare reimbursement rates if we were going to attempt to make them universal.
Mnemosyne
@Betty Cracker:
I think Dave is much better qualified to answer that kind of question than me, because I am not good at math. What I would say is that if you think rural hospitals in red states are in financial trouble now, wait until they’re told that they can only get Medicare rates for their services.
Also, IIRC there are a lot of things that do not have Medicare codes, so the rates for things like childbirth will need to be hammered out. I don’t remember what the difference is between Medicare and Medicaid rates is, but I think there is a difference since Medicaid covers more stuff than Medicare.
And this is where I start clutching my head again, because if John Fucking Roberts had not decided to destroy the PPACA by removing the Medicaid expansion mandate, we would be SO much further down the road towards the MedicAID for All system that PPACA was the first step towards. ?
Ohio Mom
Zhena @161: It’s not over yet — things sometimes turn on a dime — but if you are right, how eerie will it be that Krushchev foretold our new condition?
Life will go on, I am optimistic right will prevail even if I might not live to see it. Not much consolation, I know. Just glad to hear you’re as addicted to this place as I am.
Mnemosyne
@joel hanes:
There is a synergy between for-profit hospitals and for-profit insurance that I think a lot of people don’t really understand or realize. If for-profit insurance is outlawed, for-profit hospitals will start closing because they’ve gone bankrupt, and a lot of areas of the country ONLY have for-profit hospitals.
France has figured out a way to have both universal coverage and private providers, so it’s certainly not impossible, but declaring health insurance illegal by fiat ain’t going to get us there.
Betty Cracker
@joel hanes: I believe the proposal I read did say that — reimbursement rates would have to go up, rural hospitals would have to be subsidized, etc. But it was an interesting idea on how to begin a transition.
J R in WV
I have a good friend who went to med school later in life than typical — he doesn’t have an undergraduate degree, started out as am EMT in an ambulance, then a Paramedic, then an ER orderly, then went to college to take premed classes, had great recommendations from many doctors he worked with, admitted to med school by acing all his pre-med requirements, but never completed all the undergrad requirements, like English Comp, poly sci etc.
Graduated with huge loan debt like most non-wealthy med school students, hundreds of thousands of dollars. Became an ER doc, which was what he enjoyed from the beginning. He paid off his educational debt in less than 4 or 5 years of medical practice, then started putting those funds into his retirement accounts.
I don’t have any problems with guys that save lives every day making the big bucks… but there has to be a happy middle ground somewhere!
Ohio Mom
Joel Hanes @175: Please get professional advice! I called my area Council on Aging and they hooked me up with a State-certified Medicare volunteer. Or write Anderson/Mayhew.
What I described is only one possible snag. Your situation might be very different than mine, with its own reasons for staying on the Advantage plan.
I have (stops to count) four potentially serious pre-existing conditions. I’m not the worst bet for an insurance company but I’m not a good one either.
Please note that my sister and BIL are very happy with their Advantage Plan. They are both very good at math/probability and fine print. My BIL is a retired CFO and my sister supervises and teaches volunteer tax advisors (via AARP). In other words, they knew what they were doing.
I assume they are carefully putting aside the money they are saving by going with the economical Advantage Plan against the day they may have to pay a premium for a Medigap policy. Or maybe that day won’t come for them.
This in the end is what having “choice” means: being your own actuary. Don’t assume your calculations will be the same as yours.
Good luck and Good Health!
janesays
@Mnemosyne: I agree with literally everything you posted there. I think PPACA has a lot of problems – mostly brought on by the Roberts Court – but I don’t think it’s nearly as bad as some make it out to be.
It is also worth noting that this woman’s story took place in 2010, well before all of the Obamacare provision kicked in, and 4 years before Marketplace coverage was available. I don’t doubt that her situation may still have been very dire had it happened in 2015 instead, but I think it’s at least possible it would have been less dire.
Ohio Mom
And to wrap up this thread, wasn’t it right-wing pundit Bill Kristal who darkly predicted that if the ACA was signed into law, that would be the end of Republicans ever holding the presidency? Ha!
And now he is a never-Trumper. Go figure.
joel hanes
@Mnemosyne:
declaring health insurance illegal by fiat ain’t going to get us there.
You’re right, and that’s not what I’m advocating.
I’d like to see a single-payer universal floor, better than current Medicare because less convoluted, and with somewhat higher reimbursements to providers to keep them solvent.
I think that those with too much money will always be able to purchase supplemental health insurance, and I don’t see anything wrong with that as long as the universal floor is comparable to the care in civilized nations.
Barbara
@janesays: The ACA did not become operational until 2014. Her situation has nothing to do with the ACA, and her story is dishonest in that regard, a fact that she almost certainly knows. And by the way, Medicare and Medicaid do the SAME THING with liability awards that private insurers do — especially Medicaid. She would still have lost most if not all of her recovery if she had been covered by Medicare.
LongHairedWeirdo
I’m not correcting you – but I wanted to call something out.
What she showed might not be what she’d call “strength”. For that reason, I often use the word “tough” for people who’ve survived a trauma. Why?
Well, some people feel so beat-down and hopeless, that they survive the hard way, i.e.: by “not dying”. Of course, everyone who survives accomplishes “not dying”, but a great many people feel that’s all they did – no strength, no heroics, just, “still alive”.
A person who goes through horrible situations, and is still alive at the end, is tough as fornicating nails, however strong they feel. (You know, nails have to be *really* tough to to be able to fornicate, because they tend to get pounded by actual *hammers*.)
If you say “strong” , and get some unexpected resistance/pushback, try “tough”. I’ve found it can be a safer word. This advice is worth twice what you paid for it, so long as you got it for free.
FlipYrWhig
@joel hanes: But in addition I think we need universal clinics too. It sounds silly but I mean it: Urgent Care for All!
brantl
@Cacti: You really are a pompous ass, you know that?
opiejeanne
@janesays: No. It’s like avocados. There is no middle ground on avocados.
opiejeanne
@zhena gogolia: Please don’t go. I enjoy your comments.
opiejeanne
@zhena gogolia: I feel the same. I look at the possibility of a Sanders nomination with horror and disgust, the way I look at Trump sitting in the People’s House.
E
@Citizen Alan: Who cares what the poll numbers say, quite frankly. Republicans passed a corporate tax cut that was supported by wha,t 23% of the population? They tried to repeal Obamacare when repeal was supported by what 30%? They oppose sensible gun control when 90% of the country supports it. Republicans don’t give a s*** what polls say. They push what they want and they get people to support it. Democrats have to learn to stop panicking about supporting a position because only 39.6% of the population starts supports it. Stop being afraid of your own shadow damn it.