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Wed Jan 20, 2016, 12:50 PM

$626.43

I have excellent health insurance, it pays 100% after a $4500 deductible. That means my scripts yesterday cost $626.43 out of pocket. I figure my chemo will max me out this month. It's nice to have insurance, and it's nice I have an HSA to save money for this, but everyone in the country would be better off with single payer. I'd rather a larger paycheck deduction than to see my neighbors go without care, but then, I'm a Democrat.


And yes, I thik this is a major issue for the Primaries.

57 replies, 7327 views

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Arrow 57 replies Author Time Post
Reply $626.43 (Original post)
hedgehog Jan 2016 OP
Punkingal Jan 2016 #1
artislife Jan 2016 #2
libdem4life Jan 2016 #3
Enthusiast Jan 2016 #9
Motown_Johnny Jan 2016 #4
hedgehog Jan 2016 #5
Motown_Johnny Jan 2016 #7
dembotoz Jan 2016 #15
40RatRod Jan 2016 #31
awoke_in_2003 Jan 2016 #35
AgingAmerican Jan 2016 #6
humbled_opinion Jan 2016 #48
Bettie Jan 2016 #8
hedgehog Jan 2016 #13
TIME TO PANIC Jan 2016 #10
roguevalley Jan 2016 #11
turbinetree Jan 2016 #12
hedgehog Jan 2016 #14
turbinetree Jan 2016 #18
hedgehog Jan 2016 #20
PatrickforO Jan 2016 #16
SammyWinstonJack Jan 2016 #17
democrank Jan 2016 #19
ellennelle Jan 2016 #21
JEB Jan 2016 #54
Hell Hath No Fury Jan 2016 #22
Punkingal Jan 2016 #23
Hell Hath No Fury Jan 2016 #25
Punkingal Jan 2016 #27
Uncle Joe Jan 2016 #24
bread_and_roses Jan 2016 #26
closeupready Jan 2016 #28
DFW Jan 2016 #29
KentuckyWoman Jan 2016 #30
MuseRider Jan 2016 #32
Katashi_itto Jan 2016 #33
WillyT Jan 2016 #34
historylovr Jan 2016 #36
passiveporcupine Jan 2016 #37
mountain grammy Jan 2016 #38
neverforget Jan 2016 #39
Curmudgeoness Jan 2016 #40
Kablooie Jan 2016 #41
KittyWampus Jan 2016 #42
pnwmom Jan 2016 #43
sunnystarr Jan 2016 #44
pnwmom Jan 2016 #45
hedgehog Jan 2016 #50
drm604 Jan 2016 #46
hedgehog Jan 2016 #55
bigwillq Jan 2016 #47
tarheelsunc Jan 2016 #49
hedgehog Jan 2016 #52
Marty McGraw Jan 2016 #56
TubbersUK Jan 2016 #51
Zorra Jan 2016 #53
Tierra_y_Libertad Jan 2016 #57

Response to hedgehog (Original post)

Wed Jan 20, 2016, 12:55 PM

1. Thanks for the concrete example of cost!

I wish you well.

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Response to hedgehog (Original post)

Wed Jan 20, 2016, 12:57 PM

2. Insult to injury

 

May you have a healthy 2016. My brother got the all clear from cancer in November. Here's to renewed health for us all.

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Response to hedgehog (Original post)

Wed Jan 20, 2016, 12:57 PM

3. Those five words "...but then, I'm a Democrat." Says it all.

 

Real Democrats are not the "I've got mine...sucks to be you" Party. That's the Other Party.

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Response to libdem4life (Reply #3)

Wed Jan 20, 2016, 01:33 PM

9. Huge +1!

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Response to hedgehog (Original post)

Wed Jan 20, 2016, 01:01 PM

4. I agree.

 

Sorry to hear about your health issues. One of my best friends is a breast cancer survivor who would seem to have similar issues as you do (although it is hard to tell from just that post).

She gets her insurance through Healthcare.gov (a silver plan) and has had financial issues ever since she had to take time off due to her illness. She still has health problems due to reactions from the chemo.

She saves up money so she is ready for the first of the year and can max her deductible as quickly as possible. She still has a small copay for her prescriptions, but not much. Most are six bucks (unless I am mistaken).

The ACA has been a big help for her. I believe that a single payer would do even more. There are millions of Americans with health issues who need that help. I would gladly pay a bit more to see that happen.

It isn't just my friends, family and neighbors that I worry about though. I worry about the homeless. How does someone without an address or any identification receive coverage, even through Medicaid? These are the most vulnerable among us. I still feel that it is fair to judge a society by how it treats it's most vulnerable members. By that measure, the one industrialized country in the world that does not provide health care as a right fails miserably.



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Response to Motown_Johnny (Reply #4)

Wed Jan 20, 2016, 01:02 PM

5. If not for them, do it for yourself.

Imagine if tuberculosis got a real foothold among those with limited access to health care.

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Response to hedgehog (Reply #5)

Wed Jan 20, 2016, 01:06 PM

7. Bleh, I don't really worry about myself.

 


I am in good health. Never smoked, drink very little, see a doctor twice a year to monitor my blood pressure and cholesterol (my only real health issues).

Even if some form of resistant TB took hold, I would worry about children and the elderly before I would worry about myself. Odds are I would be fine.

I am in favor of a single payer system because of the people who really need it, not because of those (like myself) who don't.


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Response to Motown_Johnny (Reply #7)

Wed Jan 20, 2016, 02:14 PM

15. do not be so smug about tb....some family experience with it.....nasty nasty shit

and the antibiotics were omg expensive

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Response to dembotoz (Reply #15)

Wed Jan 20, 2016, 03:58 PM

31. My brother takes a $1,700 a month antibiotic...

...to prevent a relapse of a brain issue caused by liver failure. He hits the catastrophic cap often thanks to the ACA but it could be better. Same med purchased through Canada from Great Britain is less than $200 with and extra 30 tablets more than his current prescription. His doc told us he prescribed a med through Canada once and a short while later he received a cease and desist order threatening to take his medical licence.

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Response to 40RatRod (Reply #31)

Wed Jan 20, 2016, 04:50 PM

35. Our health care system is criminal. nt

 

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Response to hedgehog (Original post)

Wed Jan 20, 2016, 01:04 PM

6. But radical fringe and Denmark and stuff!!1!

 

Who'll think of the children?

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Response to AgingAmerican (Reply #6)

Thu Jan 21, 2016, 08:37 AM

48. Exactly radical fringe

and the I got mine screw you capitalist crowd thinks their way is mainstream? Bernie's message is powerful and may sway the mainstream to give up their blind support of the rich capitalists... anybody else is just more of the same..

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Response to hedgehog (Original post)

Wed Jan 20, 2016, 01:28 PM

8. Hoping you beat it

Cancer is terrible.

What tells me that we need single payer is going to the grocery store.

We live in a town of about 3,000 people.

Right now, at the grocery store on the bulletin board are three fund raising flyers for people who need help with medical bills. Last week there were five, I think.

All of these families are hard working, decent people (who will, ironically probably be at the Republican caucus in a few weeks), but with single payer, there would be no need for this because they could get that care without needing fund raisers.

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Response to Bettie (Reply #8)

Wed Jan 20, 2016, 02:02 PM

13. I could eat out at a fundraiser almost any week-end I choose!

I agree, a horrible way to run a railroad.

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Response to hedgehog (Original post)

Wed Jan 20, 2016, 01:53 PM

10. K & R !

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Response to hedgehog (Original post)

Wed Jan 20, 2016, 01:57 PM

11. I wish you the best, hedgehog. I agree with you.

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Response to hedgehog (Original post)

Wed Jan 20, 2016, 01:57 PM

12. I don't know you .............................but.........................

I do wish that you had Medicare right now-------------------I really do.....................no age restrictions---------------none


Honk-----------------for a political revolution Bernie 2016

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Response to turbinetree (Reply #12)

Wed Jan 20, 2016, 02:04 PM

14. We're doing fine with our bills - as I said, excellent health insurance

no fear of being dropped - Thanks Obama!

no fear of hitting a cap - Thanks Obama!

But - everyone needs this access!

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Response to hedgehog (Reply #14)

Wed Jan 20, 2016, 02:53 PM

18. I know..........................

but with Medicare you would be paying out $127.00 a month and if you got a supplemental on top of that (which I don't have) you would be paying out about $150.00 more and still be saving some money------------------------


Take care of yourself, there is only one of you....................see ya


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Response to turbinetree (Reply #18)

Wed Jan 20, 2016, 03:02 PM

20. Thanks for putting numbers to this!

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Response to hedgehog (Original post)

Wed Jan 20, 2016, 02:30 PM

16. Single payer. Single payer. Single payer.

I want single payer NOW and I'm not going to quietly acquiesce this time.

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Response to PatrickforO (Reply #16)

Wed Jan 20, 2016, 02:34 PM

17. +1000000

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Response to hedgehog (Original post)

Wed Jan 20, 2016, 03:02 PM

19. I wish you all the best, hedgehog.

I`m for single payer.

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Response to hedgehog (Original post)

Wed Jan 20, 2016, 03:03 PM

21. i so feel for you

i have so many patients who struggle with this, when obamacare was supposed to help.

well, it did; would have been worse. but it could be so much better.

and bernie's plan to make healthcare available to everyone is so much better.

i'm sick to death the HRC is pushing the GOP talking points about the costs, without even considering the benefits, the actual financial benefits!

think of it this way:

family of 4 pays at least $12K a year for premiums.
also pays say the same in taxes each year.
but also pays thousands in deductibles and at least hundreds in co-pays.

now, let's increase those taxes by the less than 2% bernie proposes: that comes to about $240. a year.

but here is what you get: NO CO-PAYS. NO DEDUCTIBLES. AND NO PREMIUMS.

so, by my math, it saves each family at least the cost of premiums every year, which is pretty huge.

plus, it's just all covered. it is all covered. your healthcare is covered.

and i sure hope that means dental and vision too.

good grief, this is not rocket science folks!

good luck, good buddy.

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Response to ellennelle (Reply #21)

Thu Jan 21, 2016, 11:37 AM

54. Single payer health care would be the biggest and best economic stimulus. IMHO.

 

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Response to hedgehog (Original post)

Wed Jan 20, 2016, 03:07 PM

22. My cousin -- stage 4 lung cancer.

 

She is an older woman who works two part-time jobs because that is all she could get where she lives. She just found out the chemo gave her blood clots in her legs that need dissolving. The cost for that drug? $2900 for a one month supply. The deduction on her insurance? 6k+.

My cousin doesn't HAVE 6k to her name.

She had to start a GoFundMe campaign to raise the money to pay for her treatment and medications her insurance won't be covering.

THIS IS NOT THE COUNTRY I WANT TO LIVE IN, where people with cancer have to scramble to come up with money at a time they should only be worried about healing.

SINGLE. PAYER. NOW.

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Response to Hell Hath No Fury (Reply #22)

Wed Jan 20, 2016, 03:11 PM

23. My sister-in-law of lung cancer in December....your cousin has my deepest sympathy.

So sorry! These real stories are what people here who ridicule Bernie's plan need to hear.

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Response to Punkingal (Reply #23)

Wed Jan 20, 2016, 03:22 PM

25. So sorry to hear about your SIS. :(

 

Yes, real people with real stories of struggle even in this age of the ACA.

This is my cousin's third dance with cancer. She knows it is technically terminal this time but she's a fighter determined to soldier on. Don't know how she does it!

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Response to Hell Hath No Fury (Reply #25)

Wed Jan 20, 2016, 03:28 PM

27. i don't know how she does it either...working two jobs. What a nightmare!

Insurance and medical costs should be the least of her worries. Such a shame for things to be this way in this country.

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Response to hedgehog (Original post)

Wed Jan 20, 2016, 03:15 PM

24. Kicked and recommended.

Thanks for sharing, hedgehog.

Peace, strength and healing to you.

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Response to hedgehog (Original post)

Wed Jan 20, 2016, 03:28 PM

26. K & R to the max! I was waiting for a prescription today

and the woman in front of me was having a problem because they couldn't find her filled script. Then she told them that she had dropped it off and had it filled, but when she saw the price she couldn't afford it and the pharmacy said they would hold it for her till her payday. Maybe she was at the start of a two-week pay period, who knows, but someone put it back. So she's been without whatever prescription she needs for however long it's been. Meanwhile, those of us behind her probably three deep could not help but hear it all, just due to the acoustics. When she turned away from the counter I could see her face flaming.

What a country.

Single payer! No more of this.

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Response to hedgehog (Original post)

Wed Jan 20, 2016, 03:30 PM

28. We can NOT open this discussion again. Moderators, please close this thread.

 

It's divisive to the country. Thank you.

K&R

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Response to hedgehog (Original post)

Wed Jan 20, 2016, 03:43 PM

29. Cancer spares no one, but hits the poor hardest

My wife's brother had it (stage 4 glioblastoma--100% death sentence), and despite fabulous treatment, and living 2 years longer than the doctors thought he would, he died at age 51. My wife had breast cancer, and though it spread due to her second class ("Kassenpatient" status in the German health insurance system, and her treatment was far more invasive that it would have been if she had been treated earlier, at least when it DID finally get treated, it cost her nothing. She had the whole gamut--two operations, the second of which was so invasive, they had to keep her in the hospital for a month. Then a round of chemo lasting almost 2 months. Then radiation lasting six weeks. Then a rehab spa, specifically designed for patients with breast and thyroid cancer, where all but two of the patients were women, predictably enough. Her employer was furious that he had to keep her on, being absent for about a year, but there was nothing he could do about it, and she ended up working 11 more years before retiring. So far, she is still with me. Imagine health spas for rehab, each one finely tuned to various kinds of cancer being treated, and available at no cost to all recovering cancer patients that want them. This is standard in Germany.

While my father was wasting away with terminal pancreatic cancer in 2000, there was a suggestion that Medicare reduce the amount of outpatient cancer care it covered from 95% to 85%. As one who knew only too well what that meant, my dad gathered up what energy he had left, arranged a conference call between him, Sen. Moynihan (D-NY for those who don't remember) and the Clinton White House. He told them (paraphrasing here), "you idiots, don't you realize that if you make it more expensive for outpatients, that patients will just get themselves checked in overnight to realize the better coverage? This would cost the Medicare system a fortune!" Even the thick-headed bureaucrats realized their mistake when they had it laid out for them in simple terms, and they withdrew the proposal. Not everyone has the White House or US Senators on speed dial, of course, but the more we flood our reps in Congress with stories and suggestions, the more they will be forced to realize that their action affect real people, not just numbers on a spreadsheet.

I don't see that anyone contends that Obamacare is the Omega of progress in our health care system. All have said it's a good start. As long as we have a solid Republican majority in one of our houses of Congress, I'd be amazed if we get anything better, and for too many of us, it's not adequate. If November leaves us with the same situation as now, all I can say is that anyone who refuses to vote for the Democratic candidate had better remain in excellent health, or else be financially well off. Why? If the Republicans keep both houses of Congress AND win the White House, the repeal will go through, probably with nothing to replace it for those who will lose coverage, and pre-existing conditions will immediately once again be legitimate grounds for cutting off or refusing coverage. A president can advocate single payer, but he (or she) cannot make it the law of the land with one wave of a magic wand. Executive orders can go only so far, but for broad initiatives, even the POTUS needs a little help from his friends.

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Response to hedgehog (Original post)

Wed Jan 20, 2016, 03:47 PM

30. big k and r

another "good insurance" patient who shows us the math means many people with "good insurance" could easily be broken by medical care costs.

thanks for posting.

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Response to hedgehog (Original post)

Wed Jan 20, 2016, 04:01 PM

32. Wishing you well.

I hope this year is a good one and by the end of it you find yourself fully recovered from whatever ails you and the treatment that can make things pretty tough for a while.

"But then I am a Democrat", those words. One would think you would not have to say that. Sadly you do.

Be well.

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Response to hedgehog (Original post)

Wed Jan 20, 2016, 04:01 PM

33. I had foot surgery. Arthritis was in the right toe joint and making it impossible to walk. Let

 

alone practice Kendo. 2k surgery cost me 38.00. I am pretty happy and can walk much better hoping to be at kendo practice next month.

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Response to hedgehog (Original post)

Wed Jan 20, 2016, 04:03 PM

34. Thank You For That !!!

 



& Rec !!!

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Response to hedgehog (Original post)

Wed Jan 20, 2016, 06:23 PM

36. K & R

I'd rather a larger paycheck deduction than to see my neighbors go without care, but then, I'm a Democrat.

What more needs to be said?

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Response to hedgehog (Original post)

Wed Jan 20, 2016, 06:32 PM

37. Damn, it hurts to read this OP

No one should have to face this.

If I had to pay that for chemo, I'd be dead now. I can't scratch up that kind of dough.

I hope you can hang in there till we fix this mess.

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Response to hedgehog (Original post)

Wed Jan 20, 2016, 06:48 PM

38. All the best to you, hedgehog.

Yes, single payer would be better for everyone. I agree because I too am a Democrat.

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Response to hedgehog (Original post)

Wed Jan 20, 2016, 06:50 PM

39. K & R! I wish you a speedy recovery!

I'd rather pay more taxes to help everybody than my money go to a private insurance company.

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Response to hedgehog (Original post)

Wed Jan 20, 2016, 07:09 PM

40. Think of how many people would not be able to pay the deductible.

I am sorry that you are going through treatment for cancer. A horrible thing to deal with. And you are lucky that you can afford the deductible of $4500. That is not small change. But wow, hitting that deductible in the first month of the year!

I read a news story today that said that over half of the people in this country could not come up with $500 for an emergency because they haven't got that much in savings. So think of how many people would not be able to afford the prescription you got, much less the $4500 deductible. And to be honest, most insurance has much higher out of pocket expenses than this.

We need universal health care. Now.

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Response to hedgehog (Original post)

Wed Jan 20, 2016, 07:41 PM

41. I'm lucky enough to get health insurance from my union.

We have several plans to choose from.
I chose Kaiser and I'm glad I did.

Last November my wife had to go through a very major surgery.
The bill, including the hospital stay, came to $150,000.00!

We were charged a copay of $15.00 (Plus a parking fee of $8 a day.)

It shows you what insurance is capable of.
I know we are tremendously lucky but we shouldn't be.
This is what everyone should be offered!

(By the way, the operation was successful. My wife is recovering on schedule.)

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Response to hedgehog (Original post)

Wed Jan 20, 2016, 07:42 PM

42. Correction, we'd be better off with Universal Health Care.

 

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Response to hedgehog (Original post)

Wed Jan 20, 2016, 08:56 PM

43. Medicare doesn't pay for prescriptions so Medicare-for-all won't solve the problem.

People on Medicare pay private insurers for extra policies for medications, and even those don't cover everything.

My mother has drug bills to pay for every month, even though she has both Medicare and a private plan.

Regardless of the above --

I'm so sorry you are having to go through all of this, and wish you a swift and full recovery.

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Response to pnwmom (Reply #43)

Wed Jan 20, 2016, 11:58 PM

44. Plus since Medicare covers 80%

you have to buy a Supplemental policy. For those like me who have no other income than SS (which comes to $1300/month after the monthly cost for Medicare and Part D are subtracted) I buy Plan F which covers the full 20% and pays for the yearly Medicare deductible. This costs me $250/month. It goes up every year. I could never survive if I had to get my own place. Thank God for my kids who fight over me to stay with them.

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Response to sunnystarr (Reply #44)

Thu Jan 21, 2016, 12:12 AM

45. My mother pays for a part B, and for an extra drug plan,

and yet she still has an extra drug bill every month.

Your children sound wonderful. I'm so glad you have them.

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Response to sunnystarr (Reply #44)

Thu Jan 21, 2016, 10:26 AM

50. When we get Single Payer, the fight will shift to ensuring it is funded

well enough to meet our needs. Britain's National Health Service is often held up to prove single payer doesn't work, with those who can afford to hiring private doctors. It's my contention that theNHS has been underfunded from the start.

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Response to hedgehog (Original post)

Thu Jan 21, 2016, 07:15 AM

46. You consider a $4500 deductible to be excellent insurance?

High deductible plans shift costs to the sickest patients.

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Response to drm604 (Reply #46)

Thu Jan 21, 2016, 11:38 AM

55. It's high deductible, but after that I pay nothing. So it's really

about getting the lowest out -of-pocket in case of serious illness. The next rung done had a lower deductible, but only payed 80% after that, and had a higher out-of-pocket.

I hate gambling and guessing how sick you and your family may be next year!

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Response to hedgehog (Original post)

Thu Jan 21, 2016, 08:04 AM

47. K and R (nt)

 

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Response to hedgehog (Original post)

Thu Jan 21, 2016, 09:40 AM

49. Single payer sounds great. Now tell us, how is Bernie going to pass it through Congress? eom

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Response to tarheelsunc (Reply #49)

Thu Jan 21, 2016, 11:04 AM

52. You've got to get into the game to win -

you don't get anywhere if you forfeit before the game begins.

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Response to tarheelsunc (Reply #49)

Thu Jan 21, 2016, 11:47 AM

56. With a Large Movement


of People behind him working hard.

If your interested https://berniesanders.com/organize/ is just the place to start!

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Response to hedgehog (Original post)

Thu Jan 21, 2016, 10:29 AM

51. K & R n/t

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Response to hedgehog (Original post)

Thu Jan 21, 2016, 11:24 AM

53. Recommend

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Response to hedgehog (Original post)

Thu Jan 21, 2016, 11:56 AM

57. Over the last 3 years my wife has had 2 cancer surgeries and a stroke.

 

We have very good insurance and medicare. Our out-of-pocket expenses have been about $25,000. Which we managed to afford.

As I sat in the waiting rooms and looked around I thought of how many people there were unable to afford the treatment necessary to save the lives of their loved ones.

I'm for single payer even if it should cost us more.

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