Obamacare just screwed me

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CottageFarm":3gv1zc8q said:
Kerley, I wasn't trying to imply that insurance is a gift, and I hope you didn't take it that way. It is a business contract.
Insurance, when provided by an employer, is a part of the compensation package. Employees trade wages for that insurance.
The problems with that are directly related to subsequent government regulations to require that same level of access to everyone, and since somebody had to pay for it, taxes and premiums began to rise substantially with each new regulation/burden placed on the system.
Hey I understood your post, No problem here. I just can't understand why people who planned their future and retirement have to pay for those that did not. I would think that the Gov. would leave things alone and start a special fund for those who need assistance rather than disrupt so many. I know I could afford $200. a year paid as a special tax to support such a program.
 
Melking, what kind of shot should cost 6k? That's the problem right there, doctors, drug companies and insurance companies are ripping us off.
 
kerley":1kxjfnrr said:
melking":1kxjfnrr said:
I am on Enbrel right now, and in 3 years I will turn 65. I was already told by my doctor that medicare will not cover it today but that he believes that the price will be low enough in three years that they will. I think it is $6,000 per shot and I take 1 a week, sometimes 2 a week for a month.
I don't think Medicare ever covered "EMBREL" but Blue Cross/Blue Shield under contract with "PERS" does until you turn 65 and then are forced by Federal Law to be on Medicare if you retire and draw Social Security. Then BC/BS pays 100% of the % that Medicare does not pay for.

Well hopefully, the medicine I take, ENBREL is a prescription medicine that can be self-injected. It is used to treat five long-term inflammatory diseases: moderate to severe rheumatoid arthritis (RA), adult chronic moderate to severe plaque psoriasis in patients who are candidates for systemic therapy or phototherapy, psoriatic arthritis, moderate to severe juvenile idiopathic arthritis (JIA), and ankylosing spondylitis (AS).
Will be covered because I will not get better and will have to take it or something like it the rest of my life.
 
melking":2wfte9tp said:
kerley":2wfte9tp said:
melking":2wfte9tp said:
I am on Enbrel right now, and in 3 years I will turn 65. I was already told by my doctor that medicare will not cover it today but that he believes that the price will be low enough in three years that they will. I think it is $6,000 per shot and I take 1 a week, sometimes 2 a week for a month.
I don't think Medicare ever covered "EMBREL" but Blue Cross/Blue Shield under contract with "PERS" does until you turn 65 and then are forced by Federal Law to be on Medicare if you retire and draw Social Security. Then BC/BS pays 100% of the % that Medicare does not pay for.

Well hopefully, the medicine I take, ENBREL is a prescription medicine that can be self-injected. It is used to treat five long-term inflammatory diseases: moderate to severe rheumatoid arthritis (RA), adult chronic moderate to severe plaque psoriasis in patients who are candidates for systemic therapy or phototherapy, psoriatic arthritis, moderate to severe juvenile idiopathic arthritis (JIA), and ankylosing spondylitis (AS).
Will be covered because I will not get better and will have to take it or something like it the rest of my life.
I think that is the Govs long term plan, no meds premature death, stops Social security and all meds cost and then they get a reward called inheritance tax. Obama could not have done this without the help of our Lazy Congress. I wonder if any of them read the bill before voting for it?
 
highgrit":23b9itfy said:
Melking, what kind of shot should cost 6k? That's the problem right there, doctors, drug companies and insurance companies are ripping us off.
My "EMBREL" cost the insurance about 5k for a 90 day supply shipped to my front door via ups and we have to sign for it.
 
highgrit":2l982uqb said:
Melking, what kind of shot should cost 6k? That's the problem right there, doctors, drug companies and insurance companies are ripping us off.

Enbrel is a "biologic"--not a traditional pharmaceutical preparation that can be scaled up readily. It's one of a few such drugs now on the market, mostly to treat chronic long-term conditions. Because they are so new, no "generics" are available yet, although it's my understanding that part of the ACA is focused on giving greater incentives to generic players to come up with "biosimilars" to these extremely expensive medications. Part of the problem, of course, is not only that they are sky-high per dose, but that they must typically be taken for the rest of one's life. (This, in comparison to antibiotics, many chemo drugs, etc).

Separate and apart from the ACA, all insurance companies have been severely dialing back the past few years on what meds are covered. I have Blue Cross and can't get meds I need. (Well, I could pay out-of-pocket for $500/mo). The drugs have just gotten too pricey (in part because we "subsidize" the pharmaceutical R&D necessary to develop these drugs; many countries place direct limits on drug prices, leaving countries like the US that traditionally had a open checkbook to cover the massive costs of bringing a drug to market--and, of course, the huge profits and salaries on top).

In my view, we are in the middle of a sea change and it's hard to see where it ends up. Everyone blaming the doctors, lawyers, and what-not: No, sorry. WE are the "problem." We and our ever-strong desire for more health care, longer lives, better quality of life, etc. The stuff we have now (MRI's, high-tech gamma radiation, chemo, coronary bypass, organ transplants, etc etc) wasn't something our ancestors had to worry about paying for. Leeches, chicken soup, onion poultices (on your chest) and cigar smoke (blown in a child's ear to treat ear infection) were cheap.

Not only do we demand "MORE!" care, we don't even want to take minimal steps to take good preventive care of ourselves. A huge percentage of our collective health care dollars is going towards treating the "triad": high blood pressure, diabetes, high cholesterol--things many of us can prevent.

Another thing people who hate the ACA forget: when people don't have health insurance, they still get care, just at the ER, where it's more expensive. Because the ER can't turn people away once they're seriously ill, you and I pay for their care anyway. Yeah, I don't like it either. But them's the facts...
 
kerley":3c2oa4ja said:
CottageFarm":3c2oa4ja said:
Kerley, I wasn't trying to imply that insurance is a gift, and I hope you didn't take it that way. It is a business contract.
Insurance, when provided by an employer, is a part of the compensation package. Employees trade wages for that insurance.
The problems with that are directly related to subsequent government regulations to require that same level of access to everyone, and since somebody had to pay for it, taxes and premiums began to rise substantially with each new regulation/burden placed on the system.
Hey I understood your post, No problem here. I just can't understand why people who planned their future and retirement have to pay for those that did not. I would think that the Gov. would leave things alone and start a special fund for those who need assistance rather than disrupt so many. I know I could afford $200. a year paid as a special tax to support such a program.

You are hitting the nail on the head Kerley. I took a pay cut years ago to go with a company who had retirement packages including insurance after retirement, pensions, etc. Now that program is illegal.
 
Thanks boondocks, you are right on. I've been blessed with good health I guess. I have herniated disc's in my neck and lower back and take a blood pressure medicine daily. But since we canceled our health insurance in 1992, our family hasn't spent 10k total on health care and medicine. Insurance is a scam but when you need it you really need it. Sometimes it's a shame that the human race has found a way to get around natural selection. There is no doubt some people procreate that shouldn't. In nature only the strongest survive, and the best genes are passed on.
 
kerley":snf4bplw said:
CottageFarm":snf4bplw said:
Kerley, I wasn't trying to imply that insurance is a gift, and I hope you didn't take it that way. It is a business contract.
Insurance, when provided by an employer, is a part of the compensation package. Employees trade wages for that insurance.
The problems with that are directly related to subsequent government regulations to require that same level of access to everyone, and since somebody had to pay for it, taxes and premiums began to rise substantially with each new regulation/burden placed on the system.
Hey I understood your post, No problem here. I just can't understand why people who planned their future and retirement have to pay for those that did not. I would think that the Gov. would leave things alone and start a special fund for those who need assistance rather than disrupt so many. I know I could afford $200. a year paid as a special tax to support such a program.

You got that right play by the rules forty years and take it up the ass when you retire by the leaching liberal's.
I think we should turn a pack of shyt eating dogs loose in DC. After they got through eating all the liberals we could take care
of the dogs in a humane way versus them starving to death.
 
CottageFarm":3ok70lzg said:
The downside is that it will be replaced with Gov't run, single payer, universal care and the destruction will be complete.

I'm thinking that has been the plan all along. :(

Katherine
 
My sister had the same problem. Her insurance dropped her coverage. HOWEVER........after a few conversations with her Doctor, he found a way to get her covered again. He told her to call her insurance company and give them a certain code. She said the insurance company said they would be able to cover it under that code. Don't have any more details than that, but it might give you some ideas to discuss with your doctor. Hope this will help and good luck.
 
kerley":1hcb635t said:
melking":1hcb635t said:
I am on Enbrel right now, and in 3 years I will turn 65. I was already told by my doctor that medicare will not cover it today but that he believes that the price will be low enough in three years that they will. I think it is $6,000 per shot and I take 1 a week, sometimes 2 a we......................to take it or something like it the rest of my life.
I think that is the Govs long term plan, no meds premature death, stops Social security and all meds cost and then they get a reward called inheritance tax. Obama could not have done this without the help of our Lazy Congress. I wonder if any of them read the bill before voting for it?

The current 'federal estate tax' does not require a filing in 2014 until the estate net value reaches approximately $5,350,000 or so after all deductions. That means that a few of us on this board will not be increasing the federal government coffers upon our demise. The maximum net value hurdle has been steadily increased over the past 10 to 15 years.

Of course Congress could change that on a whim and begin reducing those limits but probably won't until the tax and spend party regains the house. More likely would be an executive order from the pen of the president reducing the estate net value limit. To your heirs, including the government that would change the calculus behind each marginal year of your life going forward. Your death this year would be worth more than your death next year. When that happens I would advise everyone eyeball those heirs a little more carefully. ;-)
 
This discussion is intersting hearing different people's personal experience and opinion. I work at a Children's Hospital in Australia. We just recently had a group of American academics from Harvard come over to run some workshops. They were raving about the positive impacts that Obamacare has had on the US health system. From this discussion it seems like it's quite complicated and not everyone is better off.

Andrew
 
keysbottles":wyw6h92f said:
townfarmer, how do folks in your country handle health care?

We have both a public and a private healthcare system. The public healthcare system is free and available to anyone. It's funded through tax dollars and run by both federal and state governments. Then there is the option of taking out private healthcare insurance. Private healthcare gives you the ability to choose your specialist and hospital, and there is less of a waiting times for non urgent surgury and procedures.

Our system like yours has many problems. Our public system is becoming more and more expensive to run and is financially crippling the country. For many people with private insurance they pay expensive monthly fees and still end up with gaps in their coverage. Heathcare here is also very political and when elections roll around it tends to dominate a lot of discussion.

Andrew
 
townfarmer":30xnd9a9 said:
We just recently had a group of American academics from Harvard come over to run some workshops. They were raving about the positive impacts that Obamacare has had on the US health system.
Andrew
I don't think their opinions surprises anyone here. "Obama is a graduate of Columbia University and Harvard Law School, where he served as president of the Harvard Law Review." You don't really expect a bunch of Harvard folks to do anything but heap praise on a fiasco named after their most famous alumni do ya?

(Anyone here attend Haahvad (or any other ivy league school of higher learning?)
 
HDRider":2ovsz9bb said:
How much does that medicine cost?

You might contact the manufacture to see if they will reduce your cost. It happens.

Yea, we tried that too. No dice unless we were living on the toke. So, we went to war with our retirement system--which, was attacked by many; and they agreed to provide coverage as is one more year (wrap account). Course, what the real issue is --they want to win the next election so, they'll keep lying til Hilary, or Moochelle or the two dysfunctional air heads (Pelosi, Reid)or any other mad dog, phychotic socialtist is re-elected. Remember, Comrade Bobama does whatever he wants. No one in Washington seems to have the cajones to stop him.
 
kerley":354kdwfw said:
HDRider":354kdwfw said:
How much does that medicine cost?

You might contact the manufacture to see if they will reduce your cost. It happens.

Yea, we tried that too. No dice unless we were living on the toke. So, we went to war with our retirement system--which, was attacked by many; and they agreed to provide coverage as is one more year (wrap account). Course, what the real issue is --they want to win the next election so, they'll keep lying til Hilary, or Moochelle or the two dysfunctional air heads (Pelosi, Reid)or any other mad dog, phychotic socialtist is re-elected. Remember, Comrade Bobama does whatever he wants. No one in Washington seems to have the cajones to stop him.

This is nothing more than a Marxist move.
Once they have everyone on obamacare the have complete control over our life.
This makes every American dependent on the government and under control of the politburo.
Unlimited unemployment, food stamps, public housing, health care is all about power,
sounds a lot like antebellum politics.
 

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