Hobo Jungle

[Rufus T. Firefly]

The only thing I can suggest is to take charge of your own circumstances, treat the medical people you interface with as your employees rather than trust them to tell you what you should comply with, and manage your affairs for yourself.

Educate yourself and listen to your own body. The days of the trustworthy doctor being on your side are now over in the USA. It is up to you to take charge of your health and, if the health care professional of choice doesn't want to hear you, run (do not walk) to the nearest exit. You can't trust the profession, but you can trust the individual who might earn that trust.

With considerable effort, you might able to find a doctor that will listen to you.

Unfortunately, the insurance game drives the assembly line medical office this days and finds some one that you actually talk to is exceedingly difficult. Medicine is now a volume business and we are all "billable units".

I had to go through 3 MD's at the practice I go to to find one that would actually listen to me. And, of course she departed which irritated me (and both of my children as well) to no end. Just when you find one that's decent, they evaporate.

The Hippocratic ideal has been replaced with collective greed, untrammelled even by law as the only code of ethical behaviour, as the business model. Until law brings them to heel, it's up to you to find those you can trust and to maintain a relationship of the employer with those few you can find who merit any trust whatsoever.

It's not altogether the greed ofhe doctor's office, but more of how the entire system is set up to the benefit of the insurance companies and how all that is regulated - realy does demand an assembly line volume business to optimize operations which then sacrifices actually getting to see a doctor at all!

As far as the legalists (that would be lawyers and politicians of any stripe) I can't help you there.

Now there's where I think Shakespeare summed it up fairly nicely in Henry The Sixth, Part 2 Act 4, scene 2. And, since politicians seem to cross-populate into that profession, all the better! And, I'm in favor of starting in PA with all those affiliated with banks in Philly.

[healey36]

To me, the ultimate travesty is that there are folks out there who are paid to be "patient advocates"...you pay them in a feeble attempt to avoid being hosed by their health-care brethren.

After having listened for years to my two doctor brother in-laws, I too am convinced that the industry is hopelesly off the rails. I have ocasionally read through brochures for medical conventions that they attend or are invited to, paying close attention to the topics covered by the speakers. I am convinced that if one wants to learn all of the intricasies of sheltering one's income, minimizing taxes, offshoring cash, owning property, how to be a non-profit, etc., don't go to a certified accountants or financial planners seminar, go instead to a medical convention.

[rogruth]

So far I have been well pleased with the GP we use in our little town.
His recommended specialists have,for the most part,been very good.
Of course that is only my opinion and it is based on following their
"orders" we usually get well.

It still gets harder all of the time.

[Rufus T. Firefly]

To me, the ultimate travesty is that there are folks out there who are paid to be "patient advocates"...you pay them in a feeble attempt to avoid being hosed by their health-care brethren.

Hmmmm..... All of the patient advocates that I interact with are cancer survivors and approach borderline fanatical about getting therapy, treatments, etc available to cancer patients. Paid? Most work for legitimate non-profits that fund a lot of research better than the Gov't does.....

I've not run into your brand of "patient advocates".

After having listened for years to my two doctor brother in-laws, I too am convinced that the industry is hopelesly off the rails. I have ocasionally read through brochures for medical conventions that they attend or are invited to, paying close attention to the topics covered by the speakers. I am convinced that if one wants to learn all of the intricasies of sheltering one's income, minimizing taxes, offshoring cash, owning property, how to be a non-profit, etc., don't go to a certified accountants or financial planners seminar, go instead to a medical convention.

That's true of all professional organizations and I belong to 2 professional societies (used to be 4, but the dues got costly, and attending conventions got old....). To be honest, everybody should have some understanding of how to shelter one's income, minimize taxes, understand owning property, etc. just to survive in this world as it's currently structured. A little ignorance does a lot of damage.

[Rufus T. Firefly]

So far I have been well pleased with the GP we use in our little town.
His recommended specialists have,for the most part,been very good.
Of course that is only my opinion and it is based on following their
"orders" we usually get well.

It still gets harder all of the time.

If it works for you, you've probably found one that's right for you!

More than a decade ago I had a Doc that I could call, tell him what was wrong with me, and he'd call in the prescription that I wanted and not waste everybody's time with an office visit. If I couldn't diagnose it myself, he'd have me in his office the same day that I called. Sadly, I outlived him.

[sarge]

Healey's brand of patient advocates are everywhere. The most obvious are the lawyer groups who are the commercials on the telly about pelvic mesh, asbestos, this pill gone bad, "Call 1-800-Bad-Drug".

Then there are the ones who fill in the forms to Social Security for those who are either bewildered or lying about being "disabled". "We handle all forms, appeals, and representations; pay nothing until your benefits start". They make money hand over fist taking crass advantage of the bewildered and enabling the liars and cheats. No wonder the country can't afford its obligations to those who actually worked all their lives and paid into the Social Security system.

Here's a piece of intellectual heresy. Any thinking man who runs for office calling himself a conservative and standing on the plank of fiscal responsibility/fraud reduction would call for a NHS just to get these slime and the insurance companies out of the pockets of the taxpayer, the sick and truly disabled. Think of the ratcheting up of just the adverts from the fraudsters that's going on now as we actually proceed further with the Affordable Care Act. The feeding frenzy continues, meanwhile that poor thinking intellectually honest conservative would never get in because he wouldn't have ha'penny in his PAC account unless he sold his convictions. You sell your soul to pass the Lobby and take a seat.

Even if he was rich enough to fund himself, he'd never get the votes anyway. Unfortunately, the true party of the USA (the Lawyers) has already implemented its propaganda such that the honest right-winger sees red when anyone mentions a NHS and will fight it tooth and nail as demonic socialism rather than bringing an industry gone amok to heel. Meanwhile the honest left-winger believes in recent events as somehow socially progressive and sings the ACA to the heavens without knowing it actually further enables the looting, and the Triumvirate marches ever onward in lockstep with the Politicians/Lawyers of both political parties, laughing and cleaning out the coffers both public and private.

It's brilliant.

[Rufus T. Firefly]

Healey's brand of patient advocates are everywhere. The most obvious are the lawyer groups who are the commercials on the telly about pelvic mesh, asbestos, this pill gone bad, "Call 1-800-Bad-Drug".

Not what I file under "patient advocate" at all -- "ambulance chasers" is what we used to call them. Really tarring the good work that real patient advocates do by lumping these thieves under that label.

Then there are the ones who fill in the forms to Social Security for those who are either bewildered or lying about being "disabled". "We handle all forms, appeals, and representations; pay nothing until your benefits start". They make money hand over fist taking crass advantage of the bewildered and enabling the liars and cheats. No wonder the country can't afford its obligations to those who actually worked all their lives and paid into the Social Security system.

Again, not what I file under "patient advocate". What we used to call "confidence men" and "flim-flam men" - see also: con artists, grifters, scam artist....

Here's a piece of intellectual heresy. Any thinking man who runs for office calling himself a conservative and standing on the plank of fiscal responsibility/fraud reduction would call for a NHS just to get these slime and the insurance companies out of the pockets of the taxpayer, the sick and truly disabled. Think of the ratcheting up of just the adverts from the fraudsters that's going on now as we actually proceed further with the Affordable Care Act. The feeding frenzy continues, meanwhile that poor thinking intellectually honest conservative would never get in because he wouldn't have ha'penny in his PAC account unless he sold his convictions. You sell your soul to pass the Lobby and take a seat.

Maybe it's more hypocrisy that heresy? "...a conservative and standing on the plank of fiscal responsibility/fraud reduction...." -- precious few such individuals exist, I haven't seen any sign of real fiscal responsibility in a rather long time....

Even if he was rich enough to fund himself, he'd never get the votes anyway. Unfortunately, the true party of the USA (the Lawyers) has already implemented its propaganda such that the honest right-winger sees red when anyone mentions a NHS and will fight it tooth and nail as demonic socialism rather than bringing an industry gone amok to heel. Meanwhile the honest left-winger believes in recent events as somehow socially progressive and sings the ACA to the heavens without knowing it actually further enables the looting, and the Triumvirate marches ever onward in lockstep with the Politicians/Lawyers of both political parties, laughing and cleaning out the coffers both public and private.

It's brilliant.

More pathetically sad actually.

[sarge]

Maybe it's more hypocrisy that heresy? "...a conservative and standing on the plank of fiscal responsibility/fraud reduction...." -- precious few such individuals exist, I haven't seen any sign of real fiscal responsibility in a rather long time....

The heresy is on my part.
Regarding the fiscal responsibility bit, I believe many actually do exist, but they will never become any more than concerned citizens. They cannot join the ranks of the politicians because (as we all know) fiscal responsibility doesn't pay.

More pathetically sad actually.

But you have to admit, what a bunch of geniuses to be able to pervert the Grand Experiment so successfully, drain the coffers into their pockets or the pockets of their employers, and have the citizenry (no matter right or left) actually believe their interests are being somehow represented at the same time.

[Rufus T. Firefly]

Maybe it's more hypocrisy that heresy? "...a conservative and standing on the plank of fiscal responsibility/fraud reduction...." -- precious few such individuals exist, I haven't seen any sign of real fiscal responsibility in a rather long time....

The heresy is on my part.
Regarding the fiscal responsibility bit, I believe many actually do exist, but they will never become any more than concerned citizens. They cannot join the ranks of the politicians because (as we all know) fiscal responsibility doesn't pay.

Oh, I agree that they exist, but not as politicians. Once upon there were a good number of such in the ranks, but they have just about all faded away replaced by those adhering to the "Mine, Mine, Mine" mantra.

More pathetically sad actually.

But you have to admit, what a bunch of geniuses to be able to pervert the Grand Experiment so successfully, drain the coffers into their pockets or the pockets of their employers, and have the citizenry (no matter right or left) actually believe their interests are being somehow represented at the same time.

Doesn't take that much genius to take advantage of a population that willing goes along like sheep to the slaughter. It's not as if they're so clever that no one is aware of the great scam. But, then there is also the great majority that just want to believe what they are told by their respective representative parties - the great blind believers....

[rogruth]

The Health Care usually referred to as Obama-Care is very confusing to me.
My wife and I are retired teachers,have health care through the Georgia retirement system that is combined with Medicare and its drug insurance program.
After many years of being able to choose between United or another system,don't remember the name,the state chose Georgia Blue Cross/Blue Sheild for
its retirement system members.The only choice that we had was the amount we would pay and that determines our coverage.Other than the deductible being
a little higher it seems to be OK.My point in the above is that I really have not had much,if any,contact with the Affordable Health Care Plan.

I understand that EVERYONE must now sign up for some health insurance or will be fined [taxed] next year.Some in our area think that that fine [tax] will then provide some form of minimal health care for them.Does it?If it does I see why some are reluctant to get insurance.What about those that do not pay income tax?

I would appreciate any help in understanding this.Why do I ask on a model train forum?Simple.I think I will get straight answers here.If some do choose to
answer.I don't think I can get straight answers from a web site about this health care because,IMHO,they will be biased to one side or the other. I hope I have not asked something that will degenerate into a political argument.

[J. S. Bach]

I think that some may think that the "fine/tax" might be less than their premiums would be.

[webenda]

I understand that EVERYONE must now sign up for some health insurance or will be fined [taxed] next year. Some in our area think that that fine [tax] will then provide some form of minimal health care for them. Does it?

No, the uninsured will not receive a healthcare insurance card by paying the fine.

The uninsured will have to get medical attention the way they did it before the Affordable Care Act, i.e., locate a hospital that will not turn them away for having no insurance.

Reference: http://housedocs.house.gov/energycommerce/ppacacon.pdf

If it does I see why some are reluctant to get insurance.

Generally, nobody likes to be told what to do.

What about those that do not pay income tax?

They will be required to file a tax return to pay the fine.

I think that some may think that the "fine/tax" might be less than their premiums would be.

Let's investigate that. (This scenario applies to only to me.)

INSURANCE

My healthcare insurance costs $3,352.28/yr. It is broken down as follows: Medicare, $1,258.80/yr; United Healthcare Supplemental, $2,073.48/yr; Prescription Insurance, $20.00/yr.

NOTE--The supplemental seems high, but I pay no co-pay for anything. My brother has one of those free supplemental plans and tells me his co-pays are depleting his retirement savings.

FINES

For the first year of the new law, 2014, the fine for not having insurance is the lowest it will be. After that, it goes up steeply in 2015 and again in 2016.

In 2014: There are two ways the government calculates what you owe. You have to pay whichever amount is higher.
• One way is to charge you $95 for each adult and $47.50 for each child, but not more than $285 total per family.
• The other way is to fine you 1% of your family income. If your family makes $50,000 a year, the fine will be $500.

Yup, cheaper to pay the fine.

In 2015: There will still be two ways to calculate what you owe. You have to pay whichever amount is higher.
• One way is to charge you $325 for each adult and $162.50 for each child, but no more than $975 total per family.
• The other way is 2% of your family income. If your family makes $50,000 a year, the fine will be $1,000.

Yup, cheaper to pay the fine.

In 2016 and beyond: There will still be two ways to calculate what you owe. You have to pay whichever amount is higher.
• One way is to charge you $695 for each adult and $347.50 for each child, but no more than $2,085 per family.
• The other calculation is 2.5% of your family income. If your family makes $50,000 a year, the fine will be $1,250.

Yup, cheaper to pay the fine.

I will keep Medicare, my supplemental and Rx plans in 2014, not to avoid the 2014 fine payable in April, 2015, but because my doctor visits, tests and operations have exceeded the cost of health insurance for the last seventeen years.

Reference:
http://www.medicare.gov/medicare-and-yo ... rtant.html
http://www.webmd.com/health-insurance/i ... alties-aag
http://www.hhs.gov/healthcare/rights/law/index.html

[Mitch]

The government is bragging right now that 3 or 4 million people have signed up for healthcare, but insurance companies are saying that even though people look them up on the sites, they're certainly not all buying and some that have "bought" have not paid. The gov. is counting every hit on the site as a sign up. Currently, 6 million people who had health care have lost it, and now have to find a new policy at much higher premium with an exhorbitant deductible.
Insurance companies, by their very nature, are among the most greedy companies in the world. When this ACA came about, these companies had stars in their eyes about how much profit they could make when everyone had to have health insurance. Now it appears, (because the ultimate end result will be single payer, ie. the government) that the insurance industry will be complicit in their own demise.

[Rufus T. Firefly]

The Health Care usually referred to as Obama-Care is very confusing to me.

In part that's because there's a lot of disinformation and misinformation being presented as fact from just about every source that has an agenda or axe to grind.

...and now have to find a new policy at much higher premium with an exhorbitant deductible.

Not entirely accurate. A friend of mine just changed jobs from a rather large company down to a rather small company and the insurance offered by the new job was in a word, paltry. He opted out and signed up for ACA and was able to get the exact same insurance that he had back at the old company at the same price, and was able to also keep all of the same doctors, etc.

I suspect that the insurance that a good number have lost was probably best used if perforated, put on a roll, and then put to good use in the porcelain recycling center.

[rogruth]

Wayne & Rufus,

Thanks and that helps a lot.

If a person does not have income that is reported how will he/she be tracked to be fined?

When a person says that they "lost" their insurance I also get confused.
Was their insurance just cancelled?
Were they offered insurance but at higher premiums?
Insurance companies want to make money and it would seem to me that they would make an offer.

When our provider was changed and I got the Provider Directory from them most of our doctors were not listed.
The company told me that any doctor that accepted Medicaire was approved by them.
Since that answered my question I didn't ask what about if you did not have Medicaire.

What about illegal--oops,undocumented---no,those people that I don't know what to call anymore?