BOHICA! Just looked at the 2013 Health Benefits Comparisons

Well, I'm happy to say that I don't have much experience with hospitalization. That's why I was concerned. I've already found out on another issue about next year's insurance that something that would be illegal for an insurance company to do is legal because AMR is self-insured; so, it doesn't hurt to ask. (Before this trip, I had not been an inpatient in a hospital for 56 years--since I had my tonsils out at age 11.)

jimntx. PM coming at you my ol' Amigo !
 
So tell me plz. WHAT will Change with these truly SAD circumstances(with these F Insurance companys)if this country continues with the GOP in control of ANY of the 3 branches of Government ?
(EXCEPT that the rates will CONTINUE to go up )
Answer:...NOTHING. ABSOLUTELY NOTHING !

The ONLY Way to bring those dirty bas-tard Ins. Comp's to 'heal like a DOG' is to have Democrats in control of ALL 3 houses !

Dems = More Middle class jobs !
More Middle class jobs = More Unions !
More Unions = much lower Ins. Rates !

The Democrats were already in a position where they controlled all 3 houses. What did they accomplish? Would it have been any different if Republicans controlled all 3 houses? I doubt it.

The only real thing the government accomplished during President Obama's presidency was passing Obamacare.

The main problem with Obamacare is the cost. How are we going to pay for it? We are already going more and more into debt every day. Obamacare does nothing to reign in out of control medical cost. Obamacare does nothing to increase the number of doctors. In fact the only thing it accomplishes is employing more IRS agents which are paid through..........taxes.

This story shows what the REAL problem is with our health care system.

Arizona Hospital's $80,000 Bill Stings Worse Than Scorpion Venom
  • An Arizona woman was shocked when her brush with a scorpion led to a stinging $83,046 hospital bill.
    Marcie Edmonds, 52, called the poison control center an hour after a bark scorpion stung her in the stomach while she was opening a box of air conditioner filters. She experienced mild tingling, throat tightness, darting eyes, muscle spams, and difficulty breathing, ABCNews.com confirmed.
    As a typical illness from the venom progresses from numbness and tingling to uncontrolled muscle movements, it can resemble a seizure, aid Dr. Steven Curry, the Director of Medical Toxicology at the Banner Good Samaratin Medical Center. The muscle spasms spread to the chest and cause respiratory problems, which can be life-threatening – especially in children, Curry said.
    The poison control center advised Edmonds to go to a hospital, so she went to Chandler Regional Medical Center, where doctors administered two vials of a relatively new anti-venom called Anascorp which was approved by the Federal Drug Administration last August and is distributed to hospitals for about $3,800 per vial, toxicologists say.
    Edmonds left the hospital after a three hour stay, but the bill that arrived several weeks later came out to $83,046, or $39,652 per Anascorp vial, ABCNews.com confirmed. 10 times what the hospital paid for each vial.
    "Everyone I talk to says, 'You've got to be kidding,' " Edmonds said to the Arizona Republic.
    Chandler Regional Medical Center released a statement apologizing for Edmond's treatment costs, explaining that they are working to adjust the high "out-of-network" bill she received for the anti-venom.
    "In addition, we are also currently reviewing our pricing of this expensive specialty medication," the statement said.
    Anascorp had been administered for free to about 2,000 scorpion sting patients during a 10-year clinical trial in the United States before to last year, said Dr. Keith Boesen, the director of the Arizona Poison and Drug Information Center.
    The drug is made from horse antibodies and comes from Mexico, where it costs about $100 per dose, according to Kaiser Health News. Boesen explained that this is because about 10,000 people are treated with the drug there each year, bringing down costs.
    In the United States, however, there is only one scorpion that has the potential to be lethal in humans: the bark scorpion. And it's mostly found in Arizona and its neighboring states. The number of people treated with Anascorp each year is much smaller in the U.S.
    "It's only given to 200 people," he said, explaining that the small number of drug recipients have to share the costs of the lengthy clinical trial.
    So far this year, the Banner Good Samaritan Poison and Drug Information Center, which handles poison control for Phoenix, has had 5,414 calls for scorpion stings. No deaths have been reported in more than three years, according to Good Samaritan spokeswoman Rebecca Armendariz.
    Although Edmonds' experience was scary, toxicologists are most worried about children under 6 years old. The smaller or younger a child is, the more likely it is that the venom will have a life-threatening effect on that child because the scorpion releases the same amount of venom regardless of its target's body mass.
    "A scorpion sting that would just affect my leg would affect an entire child's body," Boesen said.
    It's those children that are most often prescribed the expensive anti-venom because it's often cheaper than spending two days in the intensive care unit on a ventilator, which is often the alternative, said Dr. Richard Clark, who directs the toxicology department at the University of California San Diego.
    "The only way to justify spending that on an anti-venom is that 99 percent of the time it costs less than a day in the ICU," he said.
So, in Mexico Anascorp cost $100.00 dollars. Here in the United States it cost $39,652.00. Does anybody else see a problem here? This is where we need Health Care Reform.

Please note where I highlighted the green text with the purple numbers. The excuse for the ridiculous price is that the United States has far fewer incidents of scorpion stings per year than Mexico treated with Anascorp. They throw that 200 doses number up there to make you think they only have 200 incidents per year. When in fact they had 5414 (for one city mind you Phoenix). They are purposely giving that specific medication to very few people to justify keeping the price artifically high. So apparantly having HALF the incidents of Mexico (again these are only the cases that Phoenix handled) justifies a $39,552.00 price increase. Get freaking real.
 
So tell me plz. WHAT will Change with these truly SAD circumstances(with these F Insurance companys)if this country continues with the GOP in control of ANY of the 3 branches of Government ?
(EXCEPT that the rates will CONTINUE to go up )
Answer:...NOTHING. ABSOLUTELY NOTHING !

The ONLY Way to bring those dirty bas-tard Ins. Comp's to 'heal like a DOG' is to have Democrats in control of ALL 3 houses !

Dems = More Middle class jobs !
More Middle class jobs = More Unions !
More Unions = much lower Ins. Rates !


(Please use this post and not the one above as this one was edited)
The Democrats were already in a position where they controlled all 3 houses. What did they accomplish? Would it have been any different if Republicans controlled all 3 houses? I doubt it.

The only real thing the government accomplished during President Obama's presidency was passing Obamacare.

The main problem with Obamacare is the cost. How are we going to pay for it? We are already going more and more into debt every day. Obamacare does nothing to reign in out of control medical cost. Obamacare does nothing to increase the number of doctors. In fact the only thing it accomplishes is employing more IRS agents which are paid through..........taxes.

This story shows what the REAL problem is with our health care system.

Arizona Hospital's $80,000 Bill Stings Worse Than Scorpion Venom

  • An Arizona woman was shocked when her brush with a scorpion led to a stinging $83,046 hospital bill.
    Marcie Edmonds, 52, called the poison control center an hour after a bark scorpion stung her in the stomach while she was opening a box of air conditioner filters. She experienced mild tingling, throat tightness, darting eyes, muscle spams, and difficulty breathing, ABCNews.com confirmed.
    As a typical illness from the venom progresses from numbness and tingling to uncontrolled muscle movements, it can resemble a seizure, aid Dr. Steven Curry, the Director of Medical Toxicology at the Banner Good Samaratin Medical Center. The muscle spasms spread to the chest and cause respiratory problems, which can be life-threatening – especially in children, Curry said.
    The poison control center advised Edmonds to go to a hospital, so she went to Chandler Regional Medical Center, where doctors administered two vials of a relatively new anti-venom called Anascorp which was approved by the Federal Drug Administration last August and is distributed to hospitals for about $3,800 per vial, toxicologists say.
    Edmonds left the hospital after a three hour stay, but the bill that arrived several weeks later came out to $83,046, or $39,652 per Anascorp vial, ABCNews.com confirmed. 10 times what the hospital paid for each vial.
    "Everyone I talk to says, 'You've got to be kidding,' " Edmonds said to the Arizona Republic.
    Chandler Regional Medical Center released a statement apologizing for Edmond's treatment costs, explaining that they are working to adjust the high "out-of-network" bill she received for the anti-venom.
    "In addition, we are also currently reviewing our pricing of this expensive specialty medication," the statement said.
    Anascorp had been administered for free to about 2,000 scorpion sting patients during a 10-year clinical trial in the United States before to last year, said Dr. Keith Boesen, the director of the Arizona Poison and Drug Information Center.
    The drug is made from horse antibodies and comes from Mexico, where it costs about $100 per dose, according to Kaiser Health News. Boesen explained that this is because about 10,000 people are treated with the drug there each year, bringing down costs.
    In the United States, however, there is only one scorpion that has the potential to be lethal in humans: the bark scorpion. And it's mostly found in Arizona and its neighboring states. The number of people treated with Anascorp each year is much smaller in the U.S.
    "It's only given to 200 people," he said, explaining that the small number of drug recipients have to share the costs of the lengthy clinical trial.
    So far this year, the Banner Good Samaritan Poison and Drug Information Center, which handles poison control for Phoenix, has had 5,414 calls for scorpion stings. No deaths have been reported in more than three years, according to Good Samaritan spokeswoman Rebecca Armendariz.
    Although Edmonds' experience was scary, toxicologists are most worried about children under 6 years old. The smaller or younger a child is, the more likely it is that the venom will have a life-threatening effect on that child because the scorpion releases the same amount of venom regardless of its target's body mass.
    "A scorpion sting that would just affect my leg would affect an entire child's body," Boesen said.
    It's those children that are most often prescribed the expensive anti-venom because it's often cheaper than spending two days in the intensive care unit on a ventilator, which is often the alternative, said Dr. Richard Clark, who directs the toxicology department at the University of California San Diego.
    "The only way to justify spending that on an anti-venom is that 99 percent of the time it costs less than a day in the ICU," he said.
So, in Mexico Anascorp cost $100.00 dollars. Here in the United States it cost $39,652.00. Does anybody else see a problem here? This is where we need Health Care Reform.

Please note where I highlighted the green text with the purple numbers. The excuse for the ridiculous price is that the United States has far fewer incidents of scorpion stings per year than Mexico treated with Anascorp. They throw that 200 doses number up there to make you think they only have 200 incidents per year where using the medication would be appropriate (yet apparently we only have 1 poisonous scorpion therefore this medication should cover all poisonous scorpion bites). When in fact they had 5414 (for one city mind you, Phoenix). They are purposely giving that specific medication to very few people to justify keeping the price artificially high. So apparently having HALF the incidents of Mexico (again these are only the cases that Phoenix handled) justifies a $39,552.00 price increase. Get freaking real.

We don't need Obamacare. What we need is Health Care Reform to reign in cost.
 
  • Thread Starter
  • Thread starter
  • #19
(Please use this post and not the one above as this one was edited)
The Democrats were already in a position where they controlled all 3 houses. What did they accomplish? Would it have been any different if Republicans controlled all 3 houses? I doubt it.

The only real thing the government accomplished during President Obama's presidency was passing Obamacare.

The main problem with Obamacare is the cost. How are we going to pay for it? We are already going more and more into debt every day. Obamacare does nothing to reign in out of control medical cost. Obamacare does nothing to increase the number of doctors. In fact the only thing it accomplishes is employing more IRS agents which are paid through..........taxes.

This story shows what the REAL problem is with our health care system.

Arizona Hospital's $80,000 Bill Stings Worse Than Scorpion Venom

  • An Arizona woman was shocked when her brush with a scorpion led to a stinging $83,046 hospital bill.
    Marcie Edmonds, 52, called the poison control center an hour after a bark scorpion stung her in the stomach while she was opening a box of air conditioner filters. She experienced mild tingling, throat tightness, darting eyes, muscle spams, and difficulty breathing, ABCNews.com confirmed.
    As a typical illness from the venom progresses from numbness and tingling to uncontrolled muscle movements, it can resemble a seizure, aid Dr. Steven Curry, the Director of Medical Toxicology at the Banner Good Samaratin Medical Center. The muscle spasms spread to the chest and cause respiratory problems, which can be life-threatening – especially in children, Curry said.
    The poison control center advised Edmonds to go to a hospital, so she went to Chandler Regional Medical Center, where doctors administered two vials of a relatively new anti-venom called Anascorp which was approved by the Federal Drug Administration last August and is distributed to hospitals for about $3,800 per vial, toxicologists say.
    Edmonds left the hospital after a three hour stay, but the bill that arrived several weeks later came out to $83,046, or $39,652 per Anascorp vial, ABCNews.com confirmed. 10 times what the hospital paid for each vial.
    "Everyone I talk to says, 'You've got to be kidding,' " Edmonds said to the Arizona Republic.
    Chandler Regional Medical Center released a statement apologizing for Edmond's treatment costs, explaining that they are working to adjust the high "out-of-network" bill she received for the anti-venom.
    "In addition, we are also currently reviewing our pricing of this expensive specialty medication," the statement said.
    Anascorp had been administered for free to about 2,000 scorpion sting patients during a 10-year clinical trial in the United States before to last year, said Dr. Keith Boesen, the director of the Arizona Poison and Drug Information Center.
    The drug is made from horse antibodies and comes from Mexico, where it costs about $100 per dose, according to Kaiser Health News. Boesen explained that this is because about 10,000 people are treated with the drug there each year, bringing down costs.
    In the United States, however, there is only one scorpion that has the potential to be lethal in humans: the bark scorpion. And it's mostly found in Arizona and its neighboring states. The number of people treated with Anascorp each year is much smaller in the U.S.
    "It's only given to 200 people," he said, explaining that the small number of drug recipients have to share the costs of the lengthy clinical trial.
    So far this year, the Banner Good Samaritan Poison and Drug Information Center, which handles poison control for Phoenix, has had 5,414 calls for scorpion stings. No deaths have been reported in more than three years, according to Good Samaritan spokeswoman Rebecca Armendariz.
    Although Edmonds' experience was scary, toxicologists are most worried about children under 6 years old. The smaller or younger a child is, the more likely it is that the venom will have a life-threatening effect on that child because the scorpion releases the same amount of venom regardless of its target's body mass.
    "A scorpion sting that would just affect my leg would affect an entire child's body," Boesen said.
    It's those children that are most often prescribed the expensive anti-venom because it's often cheaper than spending two days in the intensive care unit on a ventilator, which is often the alternative, said Dr. Richard Clark, who directs the toxicology department at the University of California San Diego.
    "The only way to justify spending that on an anti-venom is that 99 percent of the time it costs less than a day in the ICU," he said.
So, in Mexico Anascorp cost $100.00 dollars. Here in the United States it cost $39,652.00. Does anybody else see a problem here? This is where we need Health Care Reform.

Please note where I highlighted the green text with the purple numbers. The excuse for the ridiculous price is that the United States has far fewer incidents of scorpion stings per year than Mexico treated with Anascorp. They throw that 200 doses number up there to make you think they only have 200 incidents per year where using the medication would be appropriate (yet apparently we only have 1 poisonous scorpion therefore this medication should cover all poisonous scorpion bites). When in fact they had 5414 (for one city mind you, Phoenix). They are purposely giving that specific medication to very few people to justify keeping the price artificially high. So apparently having HALF the incidents of Mexico (again these are only the cases that Phoenix handled) justifies a $39,552.00 price increase. Get freaking real.

We don't need Obamacare. What we need is Health Care Reform to reign in cost.

The reason medication is so much more expensive in the U.S. than in other countries, is that the Republicans have made sure that the government is not allowed to negotiate with the pharmaceutical companies on price. Here, whether you are buying the drugs yourself, your insurance company is buying them, or you are purchasing them through Medicare, you have to pay whatever the pharmaceutical company wants to charge for it. In other countries, such as Canada and Mexico, the government does not allow pharmaceutical companies to charge $100/pill for medications. And, as a U.S. citizen, you are subsidizing the cost of medications in other countries where Big Pharma is not allowed to gouge the customer on price.
 
jimntx I do not know if a law exist baring the government from negotiating with pharmaceutical companies. I would like to see proof of that claim. To my knowledge government has always gone with the lowest bidder. Second most of pharmaceutical purchases are made either through private individuals or private entities (insurance companies). I think (my opinion) it is more likely that insurance itself is responsible for this mess we are in. Health Care corporations (pharmaceuticals, hospitals, medical device manufactures) see insurance as a nice big pool of money to exploit. Health Care was not always so outrageously priced.
 
Particularly if you have children/dependents on your insurance, brace yourself. A Valium or two taken in advance (make sure it is from ExpressScripts so you can afford it) may help the blood pressure.

Example: I currently pay about $70/month for top of the line, employee only, coverage with a $150 annual deductible and $1000 maximum out of pocket expense. I expected the premium and the annual limits to increase, but...


The closest thing to what I currently have is called the Standard Option.

The minimum premium among the 2013 options that I can find so far for employee only is $70.69/month, and that includes a $750 annual deductible with a $2000 maximum out of pocket expense. Note this is Preferred Administrator (BCBS) for my state (Texas) in-network only. For out-of-network expenses, the annual deductible is$3000! Out of pocket maximum is $6000. That is for employee only. If you choose the "Tier One or Tier Two" administrator, the premium goes to $88.36/mo or $106.04.

If your family is included, the preferred administrator premium jumps to $247/month with a $2250 annual deductible and a $5000 out of pocket max. Oh, and the money you pay (employee or family) for your annual deductible does NOT count in the calculation of your annual out of pocket.

The Value Option has $300 annual deductible and $1750 out of pocket maximum; however, the monthly premium is $112.50. Double annual deductible and almost double out of pocket over this year, but triple the monthly premium. Ouch!

One of the things that concerns me is the hospital in-patient coverage. The chart specifies pre-authorization required (no other option mentioned). I was admitted to the hospital earlier this month through the emergency room. I was in the hospital for 3 days. I was admitted at 11pm. I doubt seriously the insurance administrator is going to have staff on duty at that hour of the night to pre-approve my admission. Does that mean I would just have to eat the entire hospital cost? All I can get out of HR chat is, "You should attend the road show at DFW on 11/02." Now, since I don't have my November schedule yet, there is a real possibility I might be flying that day. Do my questions just go unanswered if I can't attend their road show? Anybody know the answer to this one?

Cry me a river..our monthly insurance is $700/month and $7500 in deductable.
 
  • Thread Starter
  • Thread starter
  • #24
And, if you are making so much money that you can afford such ridiculously expensive insurance, why are you even mentioning it? And, how many people in your family are covered by that insurance? Unless, you work for a really small company. AMR has approx. 50,000 employees in our insurance group, but since AMR is self-insured, we evidently are not getting (or being given) the discounts usually available to large groups.

For 2013, an employee and family here at AMR will have a $2250 deductible and a $5000 out of pocket max. And, by the way starting next year, our deductibles are not counted in our out-of-pocket. They don't start accruing out-of-pocket until after the deductible is met. So, an employee and family will have a $7250 cash outlay minimum and that's in network. If for any reason they have to go out of network, the deductible jumps to $9000 and the out-of-pocket to $15000 which means $24000 cash outlay for one year.
 
The reason medication is so much more expensive in the U.S. than in other countries, is that the Republicans have made sure that the government is not allowed to negotiate with the pharmaceutical companies on price. Here, whether you are buying the drugs yourself, your insurance company is buying them, or you are purchasing them through Medicare, you have to pay whatever the pharmaceutical company wants to charge for it. In other countries, such as Canada and Mexico, the government does not allow pharmaceutical companies to charge $100/pill for medications. And, as a U.S. citizen, you are subsidizing the cost of medications in other countries where Big Pharma is not allowed to gouge the customer on price.
US consumers subsidize the development of drugs that are sold worldwide because many COUNTRIES – including those who have nationalized health care – will not pay the price for medications that many drug companies charge. The option for the drug companies is either to sell at a price those countries will pay or lose the business. Many countries simply do not offer the variety of medications that are available to Americans and American medicine is far more heavily focused on prescribing medications than in just about any other country in the world. US consumers pay so much for medications because American consumers want to be able to take a pill to solve every problem, a mindset that doesn’t exist in many other parts of the world.
And, if you are making so much money that you can afford such ridiculously expensive insurance, why are you even mentioning it? And, how many people in your family are covered by that insurance? Unless, you work for a really small company. AMR has approx. 50,000 employees in our insurance group, but since AMR is self-insured, we evidently are not getting (or being given) the discounts usually available to large groups.

For 2013, an employee and family here at AMR will have a $2250 deductible and a $5000 out of pocket max. And, by the way starting next year, our deductibles are not counted in our out-of-pocket. They don't start accruing out-of-pocket until after the deductible is met. So, an employee and family will have a $7250 cash outlay minimum and that's in network. If for any reason they have to go out of network, the deductible jumps to $9000 and the out-of-pocket to $15000 which means $24000 cash outlay for one year.
The rates he is quoting are not terribly out of line with what self-employed persons pay for insurance. Very few employees understand how much large companies contribute toward health care, exactly why deductibles are becoming larger and larger. Employers cannot continue to provide a benefit which their employees believe costs little to nothing. The average American large company spends about $12,000 per year on health care benefits for full-time employees.
I'm not sure why so many Americans are okay with paying more & more each year for less & less coverage...
Because not very many will agree to ditch their insurance coverage or choose to get/stay sick because of the cost.
Health care is labor intensive and requires a lot of customization and allows little “assembly line treatment” (you can’t put all of the throat infections in the corner of the room and quickly go from one to the next dishing out the treatment.)
Health care is also high-tech, esp. as it is practiced in the US. Again, many countries do not pay for the continued escalation of technology that medical device producers create and which doctors want because the incremental benefits from all that new technology is harder to justify against existing technologies.
Health care is also not a product that consumers largely choose…. Doctors usually spend consumers’ money. Increased copays are designed to make consumers talk w/ their doctors about cost and alternative treatment plans – but few consumers do.
Finally, the whole lawsuit issue inflates costs here compared to what is allowed in other countries.
There are a number of factors about US health care that will make it far harder to fix than many people of either political persuasion admit.
The aging of America will only add to health care costs as fewer and fewer young, healthy people are forced to pay for services that are used by older people.
 
Jaconin777 may I ask who your employer is that you have to pay such an outragous price?

I'm self-employed and unfortunately, my premium certainly isn't outrages. My premiums have almost doubled the past few years.

As WT stated, the amount I pay isn't too far off the norm.

"MOUNTAIN VIEW, CA – November 2, 2011 – According to the ‘Cost & Benefits of Individual and Family Health Insurance Plans’ report, released today by eHealth, Inc. (NASDAQ: EHTH), the average premium paid for individual health insurance coverage in the United States in 2011 was $2,196 per year ($183 per month); families paid an average annual premium of $4,968 ($414 per month). The report also found that the average deductible for individually-purchased health insurance plans in 2011 was $2,935 for individuals and $3,879 for families."

http://news.ehealthi...nce-218305.aspx

Again, that's average. Some pay more, some pay less.

And, if you are making so much money that you can afford such ridiculously expensive insurance, why are you even mentioning it? And, how many people in your family are covered by that insurance? Unless, you work for a really small company. AMR has approx. 50,000 employees in our insurance group, but since AMR is self-insured, we evidently are not getting (or being given) the discounts usually available to large groups.

For 2013, an employee and family here at AMR will have a $2250 deductible and a $5000 out of pocket max. And, by the way starting next year, our deductibles are not counted in our out-of-pocket. They don't start accruing out-of-pocket until after the deductible is met. So, an employee and family will have a $7250 cash outlay minimum and that's in network. If for any reason they have to go out of network, the deductible jumps to $9000 and the out-of-pocket to $15000 which means $24000 cash outlay for one year.

While I make a decent amount of money, the amount of insurance I pay for my family of 3 certianly adds up quite significantly (relative to others here). Being self-employed, we don't have the luxury of having a large corporation and being able to negotiate good rates, terms etc. Also, there is only so much one can do when rates go up. Mind you, I have a PPO. An HMO would certainly be cheaper but..1)"you get what you pay for" and HMO's certainly doesn't provide the best care and 2)rates will go up regardless.

p.s.-I never have stated anywhere "I make so much money". ;)

Where is that at?

West Coast... B)
 
  • Thread Starter
  • Thread starter
  • #30
Ok, so your snarky comment was totally unnecessary because it is a given that individual policies are more expensive than group insurance. What you pay vs. what we pay is apples and oranges. However, our group insurance is more expensive than it ought to be. Our employer has chosen to pay substantially less for each employee than they have paid in the past. I know. I know. AMR is in bankruptcy. A bankruptcy where they went into bankruptcy with $5 billion in the bank.
 

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