Bill Huizenga says people must be responsible for own health care costs

[GMDino]

http://www.mlive.com/news/grand-rapids/index.ssf/2016/12/sons_broken_arm_bill_huizenga.html

Quote:While the Affordable Care Act put in place under President Obama is credited with giving 20 million Americans health insurance, it has been criticized for driving up insurance rates and adding regulations that interfere with the doctor-patient relationship.


President-elect Donald Trump and Republican leaders are eager to begin "repealing and replacing" the sweeping healthcare law. After blasting the ACA throughout his campaign, Trump now says he wants to keep provisions that prevent insurance companies from denying policies based on pre-existing conditions, and allow children up to the age of 26 to remain on their parents' policies. He still wants to do away with the mandate requiring everyone to have health insurance.

"There's definitely going to be changes in the health care delivery system," said U.S. Rep. Bill Huizenga, R-Zeeland. "We can't just continue to squeeze providers to say this is how we are going to save money. It's forcing health care providers ... into some very different actions that in most people's opinion is unhealthy."

Instead, Huizenga says more responsibility needs to shift to the shoulders of patients to reduce costs. One way to do that is having them pay a bigger share of their medical expenses by increasing their insurance deductibles and incentivizing them to use HSAs, health savings accounts, to sock away pre-tax money to pay medical bills.

"At some point or another we have to be responsible or have a part of the responsibility of what is going on," Huizenga said. "Way too often, people pull out their insurance card and they say 'I don't know the difference or cost between an X-ray or an MRI or CT Scan.' I might make a little different decision if I did know (what) some of those costs were and those costs came back to me."

The father of five offered a personal example of how this shift might play out. He says his youngest son fell and injured his arm. Not sure if it was sprained or broken, he and his wife decided to wait until the next morning to take the 10-year-old to the doctor's office, instead of going to the emergency room that night. The arm was broken.

"We took every precaution but decided to go in the next morning (because of) the cost difference," Huizenga said. "If he had been more seriously injured, we would have taken him in. ... When it (comes to) those type of things, do you keep your child home from school and take him the next morning to the doctor because of a cold or a flu, versus take him into the emergency room? If you don't have a cost difference, you'll make different decisions."

See?  It's OUR fault for the rising cost because we use the services we are paying for!

Stupid people!  You should wait until the next day to make sure that are in broken, or that inability to breathe is a cold or pneumonia!

Why are wasting the money of those poor providers?!?!  


All seriousness aside "repeal and replace" is starting to sound more like "Screw you...you'll pay what we say and if you're lucky you'll be ble to afford some care if any."

[oncemoreuntothejimbreech]

(12-20-2016, 08:45 AM)GMDino Wrote: http://www.mlive.com/news/grand-rapids/index.ssf/2016/12/sons_broken_arm_bill_huizenga.html



See?  It's OUR fault for the rising cost because we use the services we are paying for!

Stupid people!  You should wait until the next day to make sure that are in broken, or that inability to breathe is a cold or pneumonia!

Why are wasting the money of those poor providers?!?!  


All seriousness aside "repeal and replace" is starting to sound more like "Screw you...you'll pay what we say and if you're lucky you'll be ble to afford some care if any."

I just don't get it.  Everything he mentioned, both pro and con, are already in place.  He didn't mention a single idea which is new.  He seems to suggest we need to get rid of Obamacare because it 'forces healthcare providers to do what many consider unhealthy' without providing any examples and shift the cost to the patients.  Those are a couple of Obamacare's biggest criticisms!  Obamacare was intended as a safety net for the uninsured.  It was never meant as a Cadillac plan. Which means in order for monthly premiums to be affordable for most, they pay higher copays with larger deductibles.  So usually they are paying out of pocket until they reach their deductible.  Huizenga basically just proposed replacing Obamacare with Obamacare.

Because the reimbursement rates are so poor, many doctors won't accept it.  (Medicaid reimburses as little as nine cents on the dollar.) So it forces providers to do what many consider unhealthy.  I've ran into the same problem with employer sponsored insurance forcing me to order tests I don't need before I can order the test I do need thus increasing the overall cost to the patient.  So again, Huizenga basically just proposed replacing Obamacare with Obamacare.

Problem is Obamacare affects less than 20% of us and it sounds like Huizenga wants to come up with an Obamacare replacement which will negatively impact the rest of us in the same way and for the same reasons he wants to get rid of Obamacare.  It's idiotic, but people will support him without understanding because all they hear is "get rid of Obamacare."

[Benton]

many people are too quick to go to the doctor. They've got insurance so they figure its free, or at least a free couple hours out of the office.

unfortunately, part of the reason insurance rates are high are uninsured using ers like doctors offices (since most practices wont see them). People needing just an antibiotic or bp check end up with a $1,500 bill that never gets paid, so the hospital or ready care passes that loss on to the paying consumer.

[oncemoreuntothejimbreech]

(12-20-2016, 10:56 AM)Benton Wrote: many people are too quick to go to the doctor. They've got insurance so they figure its free, or at least a free couple hours out of the office.

unfortunately, part of the reason insurance rates are high are uninsured using ers like doctors offices (since most practices wont see them). People needing just an antibiotic or bp check end up with a $1,500 bill that never gets paid, so the hospital or ready care passes that loss on to the paying consumer.

Many people do come to the doctor too quickly while some people wait too long. I don't think I have ever met a patient who believes a trip to the doctor is free because they have insurance, except when I was in the Army. 

Many times I have to ask the staff to track down costs for the patient (which vary from one policy to the next) so they can decide what they want which increases wait times for other patients. 

[GMDino]

(12-20-2016, 10:56 AM)Benton Wrote: many people are too quick to go to the doctor. They've got insurance so they figure its free, or at least a free couple hours out of the office.

unfortunately, part of the reason insurance rates are high are uninsured using ers like doctors offices (since most practices wont see them). People needing just an antibiotic or bp check end up with a $1,500 bill that never gets paid, so the hospital or ready care passes that loss on to the paying consumer.

But many also pay a copay and have a deductible and paid for the insurance to pay the doctor too.  And Hospitals trying to make it back on the insurance companies and people like you and me is also part of the problem.

Do some abuse the system?  Sure.

Do we throw the baby out with the bathwater because of it? I say no.

[oncemoreuntothejimbreech]

(12-20-2016, 11:04 AM)GMDino Wrote: But many also pay a copay and have a deductible and paid for the insurance to pay the doctor too.  And Hospitals trying to make it back on the insurance companies and people like you and me is also part of the problem.

Do some abuse the system?  Sure.

Do we throw the baby out with the bathwater because of it? I say no.

For the vast majority of patients I have encountered, they have some sort of cost share to visit the doctor.  In most clinical settings, if the patient can't pay, they aren't seen.  The exception being most major ERs due to the EMTALA law.

About the only exceptions I've noticed are the AFLAC policy holders who will come in with a trivial injury which they can easily take care of at home without being seen by a medical professional.  There are a few people who are looking to get out of school or work (your basic malingering), but they are a very small minority and the vast majority of work/school excuses are legitimate in my experience.

[*michaelsean*]

(12-20-2016, 11:04 AM)GMDino Wrote: But many also pay a copay and have a deductible and paid for the insurance to pay the doctor too.  And Hospitals trying to make it back on the insurance companies and people like you and me is also part of the problem.

Do some abuse the system?  Sure.

Do we throw the baby out with the bathwater because of it? I say no.

Deductibles usually aren't factored in with a Dr visit, at least not the ones I've had, but there are co-pays.  I think maybe insurance covers too much.  I mean if car insurance covered all maintenance on your car, it would skyrocket.  On the other hand,  you want people to be able to see their Dr without it being a financial burden.  I'm curious if not covering routine Dr visits would lower premiums meaningfully.  

[GMDino]

(12-20-2016, 11:39 AM)michaelsean Wrote: Deductibles usually aren't factored in with a Dr visit, at least not the ones I've had, but there are co-pays.  I think maybe insurance covers too much.  I mean if car insurance covered all maintenance on your car, it would skyrocket.  On the other hand,  you want people to be able to see their Dr without it being a financial burden.  I'm curious if not covering routine Dr visits would lower premiums meaningfully.  

Nothing will lower premiums.  Gotta make that profit.

But that aside I'd rather pay a bit more for people to get routine maintenance then pay a lot more because people don't get things taken care of early and have to have more expensive treatments later. 

[oncemoreuntothejimbreech]

(12-20-2016, 11:39 AM)michaelsean Wrote: Deductibles usually aren't factored in with a Dr visit, at least not the ones I've had, but there are co-pays.  I think maybe insurance covers too much.  I mean if car insurance covered all maintenance on your car, it would skyrocket.  On the other hand,  you want people to be able to see their Dr without it being a financial burden.  I'm curious if not covering routine Dr visits would lower premiums meaningfully.  

Have you ever filled a prescription and asked, "Why does this cost so much?"  And heard, "You haven't met your deductible, yet."

Deductibles are factored into every visit.  If you're paying a co-pay that is because you have already met your deductible.

http://www.bcbsm.com/index/health-insurance-help/faqs/topics/how-health-insurance-works/deductibles-coinsurance-copays.html

Quote:Let's say your plan's deductible is $1,500. That means for most services, you'll pay 100 percent of your medical and pharmacy bills until the amount you pay reaches $1,500. After that, you share the cost with your plan by paying coinsurance and copays.

My biggest complaint regarding health insurance is the companies intentionally make it as complicated as possible so the average consumer doesn't understand what the hell is going on.  I have to deal with various plans from multiple providers from different states every week for the past 12 years and what I don't know about insurance greatly exceeds what I do know.  And I know more than the average consumer.

I had shoulder surgery last year.  I asked, "What are my total out of pocket expenses?"  I was told $1054.  Insurance would cover the rest.  I received one bill in excess of $3800.  That doesn't even include the bill for the anesthegiologist which was close to $1000.  When I called I was told I called the wrong place.  I had called the clinic and need to call the surgery center.  The "clinic" and the "surgery" center are under the same roof, same building, same doctors.  The clinic is in the front, surgery center in the back.  But, they each have separate billing departments and the clinic couldn't help me with surgery center billing questions and vice versa.  When I contacted the surgery center's billing department, I was told I was given an "estimate" and the total cost isn't always the same as the estimate.

To me, that's like asking, "How much to buy this truck?"

"Oh, $30,000."

Then getting a bill in the mail for $90,000.

And of course I was paying my monthly premiums and co-pays.

[*michaelsean*]

(12-20-2016, 12:24 PM)oncemoreuntothejimbreech Wrote: Have you ever filled a prescription and asked, "Why does this cost so much?"  And heard, "You haven't met your deductible, yet."

Deductibles are factored into every visit.  If you're paying a co-pay that is because you have already met your deductible.

http://www.bcbsm.com/index/health-insurance-help/faqs/topics/how-health-insurance-works/deductibles-coinsurance-copays.html
 

Not for me.  Regular Dr visits and prescriptions aren't affected by my deductible.  My son's MRI and surgery were.  

[Rotobeast]

(12-20-2016, 12:24 PM)oncemoreuntothejimbreech Wrote: Have you ever filled a prescription and asked, "Why does this cost so much?"  And heard, "You haven't met your deductible, yet."

Deductibles are factored into every visit.  If you're paying a co-pay that is because you have already met your deductible.

http://www.bcbsm.com/index/health-insurance-help/faqs/topics/how-health-insurance-works/deductibles-coinsurance-copays.html


My biggest complaint regarding health insurance is the companies intentionally make it as complicated as possible so the average consumer doesn't understand what the hell is going on.  I have to deal with various plans from multiple providers from different states every week for the past 12 years and what I don't know about insurance greatly exceeds what I do know.  And I know more than the average consumer.

I had shoulder surgery last year.  I asked, "What are my total out of pocket expenses?"  I was told $1054.  Insurance would cover the rest.  I received one bill in excess of $3800.  That doesn't even include the bill for the anesthegiologist which was close to $1000.  When I called I was told I called the wrong place.  I had called the clinic and need to call the surgery center.  The "clinic" and the "surgery" center are under the same roof, same building, same doctors.  The clinic is in the front, surgery center in the back.  But, they each have separate billing departments and the clinic couldn't help me with surgery center billing questions and vice versa.  When I contacted the surgery center's billing department, I was told I was given an "estimate" and the total cost isn't always the same as the estimate.

To me, that's like asking, "How much to buy this truck?"

"Oh, $30,000."

Then getting a bill in the mail for $90,000.

And of course I was paying my monthly premiums and co-pays.

This is a huge part of the problem.

We need to move towards a free market, in regards to health care.
This is one thing that Trump picked up from Johnson, to take back some voters.
He's spoke about insurers across state lines and pharmaceuticals from Canada (like his word means much though).
I am cautiously optimistic, only because he brought a few Libertarians onboard.

[oncemoreuntothejimbreech]

(12-20-2016, 12:37 PM)michaelsean Wrote: Not for me.  Regular Dr visits and prescriptions aren't affected by my deductible.  My son's MRI and surgery were.  

I'd love to read your plan.  But, this goes back to my complaint insurance companies make it as complicated as possible.  I've seen two patients both with BCBS from the same state.  But, their prescription plans were different.  So the prescription I thought would be covered under BCBS wasn't. So then I had to call the pharmacist and have him enter different medications individually into his his computer program with the patients prescription plan until we found a suitable substitute which was covered at an affordable price.  And what is affordable varies from patient to patient.  Some can't afford a $20 co-pay.  

This type of crap decreases my productivity because no I'm dealing with stupid insurance quirks instead of seeing patients which affects my employer's revenue (which can result in price increases.)  Patient's wait times increase.  Patients get more irritated the longer they have to wait.  The patients miss more work and lose more income the longer they wait.

I live near a state line so the preferred medication (or tier level) may be determined by the patient's geographic location.  For example, two similar patients both with pneumonia.  I want to prescribe a fluoroquinolone.  Both patients carry BCBS, but on different sides of the state border.  The fluoroquinolone preferred (tier 1) in State X for pneumonia is Levaquin.  The fluoroquinolone preferred (tier 1) in State Y is Avelox.  The reason one fluroquinolone is preferred (tiered higher) over the other is favorable prices negotiated between the drug company and the insurance company.

Some insurance companies have reserves in the bank which far exceed their insurance liability.  No one is ever going to make me believe we don't pay enough for health insurance.

[oncemoreuntothejimbreech]

(12-20-2016, 12:48 PM)Rotobeast Wrote: This is a huge part of the problem.

We need to move towards a free market, in regards to health care.
This is one thing that Trump picked up from Johnson, to take back some voters.
He's spoke about insurers across state lines and pharmaceuticals from Canada  (like his word means much though).
I am cautiously optimistic, only because he brought a few Libertarians onboard.

In theory, that sounds good.  But, can you give me an example of one market which is truly a free market?

Look at the trends in healthcare right now.  Smaller networks are being bought out by larger networks, creating 'super-networks.'  This is happening on both the care side and the insurance side.  The larger your organization the more leverage you bring to the negotiating table to bargain for more favorable terms.  Larger hospital networks can negotiate better reimbursement rates.  Larger insurance companies can negotiate lower reimbursement rates.  Anytime there is a free market someone is trying to "corner the market" IOT charge whatever they want. 

Those state lines which act as barriers didn't occur in a vacuum.  Businesses look out for their own welfare in the political arena as well.  It's just another tool they use to "corner the market."

[*michaelsean*]

(12-20-2016, 01:00 PM)oncemoreuntothejimbreech Wrote: I'd love to read your plan.  But, this goes back to my complaint insurance companies make it as complicated as possible.  I've seen two patients both with BCBS from the same state.  But, their prescription plans were different.  So the prescription I thought would be covered under BCBS wasn't. So then I had to call the pharmacist and have him enter different medications individually into his his computer program with the patients prescription plan until we found a suitable substitute which was covered at an affordable price.  And what is affordable varies from patient to patient.  Some can't afford a $20 co-pay.  

This type of crap decreases my productivity because no I'm dealing with stupid insurance quirks instead of seeing patients which affects my employer's revenue (which can result in price increases.)  Patient's wait times increase.  Patients get more irritated the longer they have to wait.  The patients miss more work and lose more income the longer they wait.

I live near a state line so the preferred medication (or tier level) may be determined by the patient's geographic location.  For example, two similar patients both with pneumonia.  I want to prescribe a fluoroquinolone.  Both patients carry BCBS, but on different sides of the state border.  The fluoroquinolone preferred (tier 1) in State X for pneumonia is Levaquin.  The fluoroquinolone preferred (tier 1) in State Y is Avelox.  The reason one fluroquinolone is preferred (tiered higher) over the other is favorable prices negotiated between the drug company and the insurance company.

Some insurance companies have reserves in the bank which far exceed their insurance liability.  No one is ever going to make me believe we don't pay enough for health insurance.

I literally didn't know I had a deductible for two years until I had a stress test, and had to foot the whole bill.  That was the first thing we had done that was eligible for the deductible.  

[oncemoreuntothejimbreech]

(12-20-2016, 02:00 PM)michaelsean Wrote: I literally didn't know I had a deductible for two years until I had a stress test, and had to foot the whole bill.  That was the first thing we had done that was eligible for the deductible.  

You may not know, but the provider's clerical staff check it every time with every patient when they verify insurance coverage. 

[*michaelsean*]

(12-20-2016, 02:11 PM)oncemoreuntothejimbreech Wrote: You may not know, but the provider's clerical staff check it every time with every patient when they verify insurance coverage. 

I know, I'm just saying that I wasn't aware of it because we did nothing that involved the deductible.  My wife knew because she's the one that reads over our policy every year.

[oncemoreuntothejimbreech]

(12-20-2016, 02:15 PM)michaelsean Wrote: I know, I'm just saying that I wasn't aware of it because we did nothing that involved the deductible.  My wife knew because she's the one that reads over our policy every year.

The deductible could affect medical treatment without you even knowing.  That will probably vary from one provider to another.  Some believe medical treatment shouldn't be dictated by the ability to pay, but rather the patient's medical condition.  Basically, everyone is entitled to the same quality of medical care regardless of ability to pay.  A billionaire with pneumonia gets the same quality of care as a Medicaid recepient with pneumonia.  Other's believe if the patient can't afford the treatment, you're not doing them any good.  

As an example, the billionaire has excellent health insurance and has alredy met his deductible or the deductible doesn't matter because he is a billionaire.  The provider may be more likely to order a chest xray or other ancillary tests depending upon the patient.  Whereas with a patient who may not be able to afford the cost of a chest x-ray or ancillary testing or even the treatment itself, the provider may write a prescription for an antibiotic to treat a suspected pneumonia when it is actually a bronchitis and the antibiotic is useless and a complete waste of money.  Or the provider may write a Rx for a cheaper, but potentially less effective antibiotic due to cost.  Or vice versa, the provider may write a prescription for a very expensive antibiotic because it treats a wide range of bacterial causes of pneumonia fearing the patient will be lost to follow up. A provider may send that patient to get an chest x-ray which the patient doesn't get because they can't afford it and the pneumonia gets worse and they eventually go to the ER and are admitted which significantly increases their medical costs which they couldn't already afford.  Or the provider may offer the patient an option of immediate antibiotic treatment for a suspected pneumonia warning the patient if it is bronchitis the money spent on the antibiotic is wasted, or close follow up with treatment as indicated which means more office visits and co-pays and lost work and lost wages.  When offered options some patients have told me, "Well, you're the doc.  You tell me."  Some of them got pissed off at me when I offered them a choice.  Then there is my favorite, picking the least shitty option out of a list of shitty options. ("You need to go to the ER now because your oxygen level is 86%."  "I'm not going.  Give me a Z pack.")

[Mike M (the other one)]

(12-20-2016, 01:14 PM)oncemoreuntothejimbreech Wrote: In theory, that sounds good.  But, can you give me an example of one market which is truly a free market?

Not anymore, early 1900's we could, but since the SEC, FDA, Dept of Labor, FTC,  were created we had some examples (NYSE being one of the last and the SEC took care of that). 

[oncemoreuntothejimbreech]

(12-20-2016, 05:52 PM)Mike M (the other one) Wrote: Not anymore, early 1900's we could, but since the SEC, FDA, Dept of Labor, FTC,  were created we had some examples (NYSE being one of the last and the SEC took care of that). 

Ah, the good ol' days. Been downhill ever since. 

[Rotobeast]

(12-20-2016, 01:14 PM)oncemoreuntothejimbreech Wrote: In theory, that sounds good.  But, can you give me an example of one market which is truly a free market?

Look at the trends in healthcare right now.  Smaller networks are being bought out by larger networks, creating 'super-networks.'  This is happening on both the care side and the insurance side.  The larger your organization the more leverage you bring to the negotiating table to bargain for more favorable terms.  Larger hospital networks can negotiate better reimbursement rates.  Larger insurance companies can negotiate lower reimbursement rates.  Anytime there is a free market someone is trying to "corner the market" IOT charge whatever they want. 

Those state lines which act as barriers didn't occur in a vacuum.  Businesses look out for their own welfare in the political arena as well.  It's just another tool they use to "corner the market."

Yeah, everything would be pretty ruthless wouldn't it ?

I guess that in my mind, I was thinking of the industry having a "reset".