Why Is Healthcare So Expensive

Healthcare costs are skyrocketing. Since the Affordable Care Act passed in 2010
health care costs have gone up by double digits each year. The health care bill did get more people insured
and helped with issues like preexisting conditions, but the problem with the healthcare law isn't
what it tried to do, it's what it failed to do: reduce costs. The solutions to the cost problem is with
the free market and competition.

Here are just three ideas that could make
a huge difference. Number 1: We can roll back the tax burden
on insurance companies. The ACA added a $60 billion tax on health
insurers, which made them have to charge more to consumers to cover their costs. Taxes roll downhill so a tax on insurers means
higher costs for all of us.

Number 2: We can lower the regulations on
health plans. The ACA has a lot of requirements that force
insurance plans to cover an incredibly big list of benefits. If you want a bare-bones insurance plan that
simply covers catastrophic events like a car accident or cancer you currently can't get
one. By boosting the benefits of every plan it
restricts competition and drives up prices by forcing smaller health insurers out of
the marketplace.

Low-cost catastrophic plans that are normally
purchased by younger, healthier people are no longer available because of the ACA requirements. Introducing as many health insurers to the
marketplace as possible can drive down prices by encouraging businesses to compete to cut
costs. The ACA did the exact opposite: Less competition
and higher prices. Number 3: Encourage medical innovation.

The cost to bring a new drug to market already
exceeds two and half billion dollars. And the ACA places an additional twenty-two
billion dollar tax burden on innovator drug companies, the same businesses that produce
lifesaving medications and cures for those in need. Punishing drug producers forces them to charge
even higher prices to make up for the lost money in research, development, and taxes. If we encourage, not punish drug makers it
will lead to more breakthroughs and lower costs--a win, win for all of us.

As healthcare costs skyrocket, don't forget
that the free market is our best chance to rein them in..

Why Is Health Insurance so Complicated

Americans carry many different forms of insurance. Theres car insurance, home insurance, life
insurance, even pet insurance . . .

Most of these insurance policies work well and are
fairly priced. But there is one glaring exception: health
insurance. Only health insurance becomes more complicated
and more expensive at the same time. So, the obvious question is: why? To answer this question, we have to start
at the beginning.

What is insurance? Its pretty straight-forward: You pay a
monthly fee which provides financial protection against unforeseen, sometimes catastrophic,
events. People buy homeowners insurance, for example,
to protect themselves from the financial loss incurred in the event of a fire, a flood or
theft. Because millions of people are paying into
the insurance pool, the pool has enough money to cover the unlucky person whose house does
burn down. And since insurance is meant to share risk,
it only stands to reason that higher-risk individuals have to pay more to be insured.

Someone who has had two accidents is going
to pay more for car insurance than someone who has never had an accident. Why? Because their track record indicates they
are more likely to have another accident. But while insurance provides a bulwark against
unforeseen loss, it does not protect against routine expenses. Car insurance protects you in the event that
you wind up in a car wreck or your vehicle is stolen, but it doesnt cover routine
maintenance like oil changes, replacing brake pads or tire erosion.

Why? Because everyone needs routine oil changes,
new brake pads, and new tires. So, there is no risk to protect against. Health insurance in America works very differently. Many of us have health insurance plans that
arent insurance at all.

Theyre really pre-paid health care plans. They cover routine check-ups, less serious
illnesses, and recurring expenses like prescription medications in addition to protecting you
from a health disaster. All of this has made healthcare much more
expensive and complex than any other form of insurance. That is true whether you get your insurance
through your employer, through the government, or if you pay for your own plan.

The Affordable Care Act, known as Obamacare,
was passed on the promise that it would fix these issues and bring down healthcare costs. But it has actually made the problem much
worse. First, it limited the variety of health insurance
plans private companies could offer. It did this by mandating that every plan had
to cover the same set of ten health benefits, including preventive care, maternity care,
mental health care, and contraception.

Second, Obamacare prevented insurers from
charging premiums based on the risk they were assuming. A person with a much higher risk of getting
sick couldnt be charged more than a person with a much lower chance. These two aspects of Obamacare  requiring
all policies to have certain coverages and not allowing insurance companies to charge
more for riskier clients  caused the price of insurance to rise dramatically. In Arizona, for example, the price more than
doubled between 2016 and 2017 alone.

So, how do we undo this mess? By making health insurance more like, well,
insurance. First, stop making people buy plans that include
things they wont use and dont want. Second, allow health insurers to offer more
options at different prices. Do these two things and youd make health
insurance a lot more affordable for a lot more people.

And what about people with pre-existing conditions
for whom every insurance plan is just too expensive? We do what any compassionate society does:
we make sure they get the medical care they need. But we dont need to upset the whole concept
of insurance and make healthcare more expensive for everyone else to do it. Most Americans want to do the responsible
thing and insure themselves against catastrophic health care emergencies. But with health insurance costs rising every
year, being responsible is becoming more difficult.

Im Lanhee Chen, research fellow at the
Hoover Institution, for Prager University..

Why do you need health insurance

They say health is wealth. Unfortunately, this holds true when you fall ill as well! When that happens... ...You realise the fact... ...That your coverage is really inadequate!!! Sub-limits only partially fund your treatement or prevent you from choosing the facility you want If that isn't bad enough...

You realise you've used up the complete limits in one round of hospitalisation! Leaving no room for more! To add insult to injury medical costs have risen fast like real estate prices making your current insurance policy quite inadequate! Your heart is beating faster already!!! But hold on... It's not all that bad! We know there are many confusing questions How expensive is medical treatment in my city? Is the insurance provided by my employer sufficient? Should I insure every family member individually... ... Or should I go for a common policy cover? Will my existing health problems be covered? The worst thing you can do is compromise on your medical treatment tomorrow, because you are simply not bothered today! A small premium every month could save you a fortune...

... When emergency strikes! Our well researched tools, blog posts and videos help you navigate this decisions. You'll find it's truly healthy knowledge!.

Why Are People with Health Insurance Going Bankrupt

PAUL JAY: Welcome to The Real News Network.
I'm Paul Jay in Baltimore. We're now into the beginnings of the implementation
of what everybody, including President Obama, is calling Obamacare. So now we have a little
better idea of what it is and how it might work. Now joining us to talk about it are two critics
of Obamacare.

First of all, Kevin Zeese is codirector of It's Our Economy, an organization
that advocates for democratizing the economy. And also joining us is Dr. Margaret Flowers.
She's a pediatrician from Baltimore who advocates for a national single-payer health care system,
or Medicare for all. Thanks for joining us.

MARGARET FLOWERS: Thank you for having us. JAY: So tell us now. You have been critical
about this from the beginning. You were for single-payer during the health-care debate.
But now it's passed.

It's starting to be implemented. You have a better idea what it is. So how's
it looking? FLOWERS: Right. Well, it's looking pretty
much like what we expected.

Right now the United States is the only industrialized wealthy
nation that has a market-based health care system, and the Affordable Care Act moved
us further in the direction of a market-based health care system by requiring people who
don't qualify for the public programs to purchase private health insurance. That will be going
into effect. The exchanges where people will buy that insurance roll out in October of
this year. By January 2014, people have to have insurance or face a penalty.

But what we're seeing in terms of the type
of insurance that people are going to be offered and the trends of what people are actually
purchasing right now is we're moving more in the direction of what we call underinsurance,
where people may have an insurance plan, but there are significant financial barriers to
getting actual care and significant financial risks if someone has a serious accident or
illness. JAY: [crosstalk] FLOWERS: Well, what we see, it's interesting.
Over the last three years there's been a slowing in the rate of rise of our health-care spending
in this country, and it was interesting 'cause the president said in his State of the Union
address, oh, the Affordable Care Act is already working; we're seeing our costs slowing. But
the actual data shows that our costs are slowing because people are using less health services.
The copays and the deductibles that they face mean that they don't have the cash in their
hand to go and get those health-care services. And then what we're seeing in terms of bankruptcy--and
this is actually based on a study done before the economic crash, based on 2007 data--was
that 62 percent of our personal bankruptcies were due to medical costs and illness.

Almost
80 percent of those patients had some form of health insurance. If we look at Massachusetts,
that's had the same kind of legislation on the state level, the number of medical bankruptcies
there is actually rising. JAY: So why is that? If you have health insurance,
why are you going bankrupt? FLOWERS: Because they don't cover--well, they
have co-insurances, so at some level, you know, they cover up to this level, but after
that, your co-insurance is 20 percent, so you have to pay for 20 percent of the services.
They can say that services are uncovered services, and so then you're liable for those. They
can restrict the networks.

So an interesting--out in California, Blue
Cross Blue Shield out there, that covers the largest number of public employees, dropped
Cedars-Sinai and UCLA from their network because that's where people go when they need actual
health care. So if you have a serious problem and that's the place that can treat you, you're
going to have to hold a bake sale or sell your home or do something so that you can
afford that care. KEVIN ZEESE: And Obamacare's going to make
this worse, because what Obamacare does is, you know, there's several levels of insurance
coverage--90/10, where the insurance company pays 90 percent, consumer pays 10 percent;
80/20; 70/30; 60/40. The subsidy provided by Obamacare to people who can't afford insurance
will only cover 70/30 plans.

So when you get a serious illness, you're paying 30 percent
of the cost of that health care. Now, what's really bad about this is that
prior to Obamacare, some of the state insurance regulators were pushing insurance coverers
to a higher level, where they would provide more coverage rather than less. Obamacare
has now put it into law that 60/40 is okay and 70/30 is what the government will pay
for. And so the 80/20 and 90/10's become less common.

So you're going to see more and more
people with underinsurance and not going to see lack of insurance completely go away. In Massachusetts, which is basically the pilot
program for Obamacare--Romneycare was the pilot for Obamacare (it's pretty much the
same plan)--what you see up there is only about half of those people who are without
insurance got covered by Romneycare. The same is going to happen here. The Congressional
Budget Office is estimating 30 million or more people will have no insurance when Obamacare
is fully implemented.

But those who have insurance are going to now be coming with underinsurance. JAY: And this is all kind of new to me. I
mean, viewers of The Real News probably know I'm a dual citizen and I was in Canada until
recently, and we don't have any of this, right? It's single, you know--. ZEESE: You have a sensible program.

JAY: You have a government health-care plan,
and when you're born you get a health card, you show it, and that's kind of the end of
it. So now that I--I have not seen this before. The insurance I have down here now, I have
a copay, but there's--I think it's, like, a $3,000 cap. After that, the insurance pays
100 percent.

FLOWERS: Of covered services. If they say
something's not covered--. JAY: Okay. But are you saying that some of
this, that copay does not have a cap? FLOWERS: It's not that the copay doesn't have
a cap.

It's what the insurance companies are able to determine. You know, they'll say that
something is not covered, that it's experimental. Or we see this all the time, where they actually
charge people for things that are in their plan that they shouldn't be paying for. And
if you're not savvy enough to understand that your plan covers that service and then fight
for it--.

[Snip] before 2005, I think, looking at our
Blue Cross program here. And what they found was that about one out of every five claims
was denied just randomly. Like, if five claims come in, they just pull one out and say, we're
not paying this one. And it wasn't based on any rationality.

It was just a way of, you
know, being able to get more money. And we have evidence of this in New York from
people that worked in these claims offices that if there was a certain level area of
the city, lower-income area, they would deny those claims because they knew people didn't
have the resources to fight back. JAY: [crosstalk] go back to my example, we
had--I think it's an 80/20. So our copay-- ZEESE: That's good coverage in the United
States.

JAY: --wasn't so terrible. But, I mean, the
final bill had to be in the realm of close to $300,000. If it had been a 60/40, we would
have been toast. FLOWERS: Yeah.

Yeah. ZEESE: Exactly right. FLOWERS: And the other thing with that is
if your babies were born in December and you met that whole, you know, what your out-of-pocket
costs were in December and January, you start all over again. And that's where some families
just can't handle that.

ZEESE: And that's what they're finding in
Massachusetts is they're finding that with Romneycare, which was, as I said, the pilot
program for Obamacare, they're seeing that people are not going to get health care when
they need it, because they know when they go it's coming out of their pocket. And that's
not a good thing. When you put off the necessary health care, what that results in is a bigger
bill later. You know, if someone's having a problem--.

FLOWERS: Or a worse outcome. ZEESE: Or a worse outcome, or, yeah, you--. FLOWERS: You can't work 'cause you're disabled
now. ZEESE: Yeah.

So it gets more costly by not
taking care of the problem at the initial stage. You let it grow and get bigger until
you have no choice but to face it. And so in Massachusetts they're finding bankruptcies
are continuing at the same level. They're finding only half the people that were uncovered
are now covered.

And they're finding those who are covered are not getting health care
that they need. That's not the kind of health-care system we should have in the United States. FLOWERS: Costs are rising. ZEESE: It's not appropriate.

JAY: So where are we at with this, then, in
terms of the politics of this? Is there any chance this debate gets reopened in the next
two, three years? FLOWERS: That's really up to the people, whether
we force it to be opened or not. I mean, it's interesting right now that you
have, you know, more kind of these articles coming out in Time magazine looking at our
health-care system. And I'm not really sure what's behind that right now, unless they're
trying to maybe win the argument by creating it early and, you know, not allowing us to
make that argument. But I think what we're going to see over the
next couple of years is we're going to see continued rise in our health-care costs, continued
poor outcomes, families continuing to face financial barriers to care and bankruptcy.
And it's up to us to start saying that, you know, these things are not okay and that there
is a real solution.

We'd like to join the rest of the civilized world and have a publicly
financed health care system. ZEESE: And just to answer your question a
little more, there are people in the country who are working on this. FLOWERS: Absolutely. ZEESE: There are.

And more and more people
are looking at it through the prism of human rights. Health care is a human right. It's
not a commodity. We don't want Wall Street health care.

We want a human right-based health
care. And there are local--there's a Maryland health care human rights campaign. There's--Vermont
has one. Oregon.

They're in Washington. They're all--coming up all over he country, 'cause
people who are looking at how Obamacare is so far being implemented are seeing premiums
rise, health-care use going down. They're seeing more problems and they're seeing what
happened in Massachusetts. And so people who are aware are organized and getting more organized.
So there's ways to get involved in this and reopen this debate.

JAY: And are there--given how paralyzed national
national politics is on this issue, are there some local examples of where there are some
other alternatives? I know in--San Francisco, I believe, has essentially a single-payer--. ZEESE: They have a restaurant tax-- FLOWERS: Right, a restaurant tax that pays
for that. Yeah. ZEESE: --that pays for health care for people
in San Francisco.

Vermont has pushed as far as you can, so far, toward a single-payer
system. They have a number of steps to get there, but they have a good grassroots campaign
that's continuing to push. JAY: So there may be some initiatives at a
municipal/state level that might make some breakthroughs here. FLOWERS: Right.

ZEESE: But this needs to be a national solution.
I mean, really you want to be able to travel throughout the United States and have health-care
coverage. JAY: Yeah. In San Francisco, you just leave
the city and you've lost your coverage. ZEESE: That's what I mean.

FLOWERS: Right. And also, you know, the thing
that I often point out is that the United States is already spending more than enough
for a universal, comprehensive, high-quality health-care system. We spend two and a half
times what the average OECD nation, you know, industrialized nation spends per person on
health care. So we have the money to do this and we have the resources to do this, and
it's really just up to us to demand that we have the kind of health-care system that we
need.

And you can't get the cost--that was my point was that you can't get the real cost
savings unless you do this at a national level. ZEESE: What I was laughing about was I was
thinking about Congress [incompr.] All this craziness about deficit. Health care's 18
percent of our GDP and going up, and you're not going to solve the deficit for the long
term without solving health care. And that's not Medicare that's the problem.
That's not Medicaid.

The problem is the big part of the system, which is the market-based
system. Paul Ryan, in his idiocy, pushing toward privatization
of Medicare, why he thinks having an insurance company making profit off of elderly people
in their health care is going to lower costs is just absurd. It makes no sense. But that's
the state of the Congress.

And, you know, Obama's even talking about
reforms of Medicare that'll make it weaker, in my view. He's done some good things [crosstalk]
Medicare Advantage. It was a good move. That's a--Medicare Advantage is a nice name for private
insurance, which was ripping off elderly people is what it was really doing.

It was not a
good part of the elderly health care in our country. So he did some good things on challenging
that. But what we're seeing in Congress is no sensible
discussion on this issue. We're seeing them push in the wrong direction toward more privatization,
more cost, higher percentage of our GDP, and more deficit, and less health care for American
people.

FLOWERS: But the answer is simple, and as
long as the people understand what it is that we require and we don't settle for anything
less,-- JAY: Which is Medicare for all. FLOWERS: --which is Medicare for all, then
we can push in that direction and do it. JAY: Alright. Okay.

Thanks for joining us,
Margaret, Kevin. FLOWERS: Thank you. ZEESE: Thank you. JAY: And thank you for joining us on The Real
News Network..

Why Are American Health Care Costs So High

Good morning Hank, it's Tuesday. I want to
talk today about why healthcare costs in the United States are so phenomenally, fascinatingly
expensive, but first I have to blow your mind: Alright, so you've probably heard that the
reason that people enjoy "free" healthcare in Australia and the UK and Canada, etc, etc
is that they pay higher taxes. That money then goes into a big pot and is used to pay
for people's healthcare, but in fact, in the US, we spend more tax money per capita on
healthcare than Germany, Australia, the UK, or Canada. That's right Hank: you pay more in taxes for
healthcare than you would if you were British, and in exchange for those taxes, you get no
healthcare.

In fact, only about 28% of Americans get their
health insurance through government funded programs, mostly poor people, old people,
and Congresspeople. But as you can see in this graph our private healthcare spending
(most Americans are privately insured through their employers) is WAY higher than anywhere
else in the world. In total, the US currently spends about 18% of its gross
domestic product on healthcare costs. Australia by comparison? 9%.

Why is this? Well because everything costs
more, which seems obvious, but apparently isn't, because every article you read is like
"Oh it's because of malpractice insurance" or "it's because we're obese" or we go to
the doctor too much or people are prescribed too many medications. Well, not really. It's because everything costs more. A hip
replacement in Belgium costs $13,000.

In the US it's often over $100,000. Colonoscopies
average over $1100 a piece in the US; in Switzerland they're $655. And on average a month of the
drug Lipitor will cost you $124 if you live in the US. If you live in New Zealand? $7.

Now we are alsonot to bragricher than
all of these countries, so it makes sense that we should spend a little more on healthcare.
But we don't spend a little more. We spend a ton more. And vitally, we don't get anything
for that money, which means we are essentially paying people to dig holes and then fill those
holes back up. Like we don't live longerin fact we're 33rd in life expectancyand in
everything from asthma to cancer, according to one recent nonpartisan study, American healthcare
outcomes are "not notably superior." So why are we spending all of this money for
nothing? Well first, let's discuss some of the problems that are not actually problems.

For instance, the problem is not so-called
"overutilization:" the idea that Americans go to the doctor more and get more tests and
spend more time in hospitals. We know this because Americans actually go to the doctor
less than Europeans and spend much less time in hospitals, although to be fair, you can
stay in a Dutch hospital for seven nights for what it costs to stay in an American hospital
for one night, so no wonder we're hesitant. Also it is not because we're sicker than other
people. Everyone likes to blame obesity on our rising healthcare costs, but yeah, no.
That argument is just not supported by data.

For one thing, disease prevalence does not
affect healthcare costs that much. And for another thing, while we do have more obesity
in the United States, which sometimes leads to health problems, we have fewer smokers
and less alcohol consumption (really? Apparently yes). So that saves us a little money, and
if you compare us to like the British or the French, in the end it's probably a wash. Hank, the truth, as usual, is complex.

Like,
there are obvious inefficiencies in our healthcare system. For instance, not everyone has insurance.
If you don't have insurance, you still get healthcare, but you're responsible for paying
for that healthcare, which often you can't do, so you end up going bankrupt. That sucks
for you, obviously, because you're bankrupt, but it also sucks for the rest of us because
we have to pay not only for your care, but also for all the money the hospital spent
trying to get you to pay for your care. Also the only options available to uninsured people
are usually the most expensive options, like emergency rooms, which is just BANANAS.

But those
inefficiencies are hard to measure. Fortunately, there are things we can measure. So like I said before, because the US is one
of the richest countries in the world, you would expect us to pay a little more for healthcare
than most people. The question is, when do we pay MORE than you would expect us to pay,
and that turns out to be pretty interesting.

Let's start with malpractice and so-called
"defensive medicine." The idea here is that doctors are scared of huge malpractice suits
so they order a lot of unnecessary tests in order to, like, cover their butts. That
does contribute to our healthcare costs, like there are more MRI and CT scans in the US
than anywhere else. However, there are a bunch of states like Texas that have passed tort
reform to limit malpractice suits, and in those states healthcare costs have dropped
by an average of a whopping 0.1%. The biggest estimates for the total costs of defensive
medicine put it at around 55 billion dollars, which is a lot of money, but only 2% of our total
healthcare costs.

Another smallish factor: doctors (and to a
lesser extent, nurses) are paid more in the US than they are in other countries, and by
my possibly-faulty math we end up spending about 75 billion dollars more than you would
expect us to there. And then we have the cost of insurance and
administration costs, like paperwork and marketing and negotiating prices. That's about 90 billion
dollars more than you would expect us to spend. We spend about $100 billion more than you
would expect on drugs, not so much because we take MORE of them, but because the ones
we take cost more per pill.

Okay, and now for the big one. I'm gonna lump
inpatient and outpatient care together, because in the US we do a lot of things as outpatient
procedures, like gallbladder surgeries, that are often inpatient procedures in other hospitals.
We're just gonna make a big ball [gestures]. That big ball is $500 billion more than what
you would expect given the size of our economy. Per year.

Why? Because in the United States we do not negotiate
as aggressively as other countries do with healthcare providers and drug manufacturers
and medical device makers. So like in the UK the government goes out to all the people
who make artificial hips and says "One of you is going to get to make a crapton of fake
hips for everybody who is covered by the NHS. Here in the United Kingdom. But you better
make sure your hips are safe, and you better make sure that they are cheap, because otherwise
we're going to give our business to a different company." And then all the fake hip companies
are motivated to offer really low prices because it's a really huge contract.

Like think if
your company got to put hips inside of everyone in England and Scotland and Wales
and Northern Ireland (I guess not everyone. Just the people who need hips). But in the US we don't have any of that centralized
negotiation, so we don't have as much leverage. The only big exception is Medicare, the government-funded
healthcare for old people, which, not coincidentally, always gets the lowest prices.

So basically, Hank, in the United States,
providers charge whatever they think they can get away with, and they can get away with
a lot, because it's really difficult to put a price on, like, not dying. This is a phenomenon
called "inelastic demand," like if you tell me that this drug will save my life costs
$7 a month, I will pay you $7 a month for it. If you tell me that it costs $124 a month,
I will find a way to find $124 a month to pay for it. You can't negotiate effectively
on your own behalf for healthcare services because you NEED them.

And not like you need
a Macbook Air or the new season of Sherlock, but actual, physical need (I guess it is like
the new season of Sherlock). So basically, Hank, until and unless we can
negotiate as effectively with the people providing healthcare as Australians and British people
do, US healthcare costs will continue to rise faster than anywhere else in the world and
we WON'T get better healthcare outcomes. Hank, I know this video is long, although
it could have been much longer, but I am so tired of people offering up simple explanations
for what's wrong with our healthcare system. They say "Oh, it's malpractice," or "it's
doctors who must also be businesspeople" or "it's insurance companies" or "it's insane
rules for who can GET insurance." It's drug companies, it's government bureaucracy, it's
an inability to negotiate prices.

Yes, yes, yes, yes, and YES! It is all of those things
and more! It is not a simple problem, there will not be a simple solution, but it is probably
the biggest single drag on the American economy and it's vital that we grapple with it meaningfully
instead of just treating healthcare costs as political theatre. So I hope I've at least introduced the complexity
of the problem. I've put some thoroughly nonpartisan links in the doobly-doo for further reading.
Hank, welcome back to the United States. As you can see, everything is peachy here.

I'll
see you on Friday. Friendly reminder, educational videos are allowed to be more than four minutes long. All of the people who are commenting about how punished I am did not watch to the end of the video.
I feel dizzy..

Where Can I Get Affordable Health Insurance if I Have Diabetes

Hello, I am Ty Mason of thediabetescouncil.Com,
researcher, writer and I have type 2 diabetes. I want to emphasize that my perspective is
coming from one with Type 2 and not Type 1. Our channel is primarily for those with Type
2 Diabetes and PreDiabetes. Today I want to talk about health insurance
for those with diabetes.

After you watch the video today, I invite
you check out the description box for my new ebook. This is one of the most comprehensive diabetes
meal planning book you can find. It contains diabetes friendly meals/recipes,
recipes for different goals such as 800-1800 calories per day meal plan, diabetes meal
planning tips and tricks. There are also tons of diabetes friendly recipes
for everyone! Diabetes is primarily a self-managed disease.

In order to stay healthy, a person with diabetes
needs supplies like test strips, meters and insulin. Adequate and affordable health insurance is
important for people with diabetes to help them access the supplies, medications, education
and health care to manage their diabetes and prevent, or treat, complications. In the past, obtaining health insurance could
be difficult for people with diabetes, however recent reforms improve access to coverage. The 2010 Affordable Care Act was passed in
hopes it would give more Americans access to better health insurance at a reasonable
price.

As of the date of this video, the law is collapsing
with many insurers dropping out of the exchange leaving many with no real choice for health
insurance. The Obama Care is currently in the process
of being repealed and replaced by the new administration. I say this, not as a political statement,
but to say this is a fluid situation and the information I give to you from my research
is subject to change very quickly. Depending on the state in which you live and
the where in that state, you have the ability to purchase health insurance regardless of
the fact that you diabetes.

For many this is the most affordable option. However, some with diabetes may also qualify
for government assistance programs such as MediCare of MediCaid. My first suggestion would be for you to visit
your local social security office or visit medicare.Org
Many pharmaceutical companies also offer help on medications through discount prescription
plans that are often free of charge. If you do not qualify for government assistance,
your best option is to visit your states insurance exchange website.

This is usually found at your states insurance
dept website. You can also google your states insurance
exchange website. I know I am assuming that those of you watching
are residents of the US, other countries have different methods of insurance including government
run insurance. Health Insurance is a big topic these days.

It is sad that some people have to choose
between needed medication and making a car payment. At times, it seems the insurance premiums
cost more than the benefits. I feel your pain if you have to make those
tough decisions. I encourage you to seek out help from the
makers of your medications or testing supplies.

Quite often they can be very helpful. Dont forget to get my new ebook and please,
subscribe to our channel for many more videos like this one in the future. Thanks for watching. I am Ty Mason..

What does the EPO, PPO, HMO, POS stand for in HEALTH INSURANCE What is network provider

Welcome back to my channel Lets Talk Money. Today I would like to explain the network
types most commonly known as EPOs, PPOs, HMOs and POS plans. Some plan types allow you to use almost any
doctor or health care facility. Others limit your choices or charge you more
if you use providers outside their network.

You can easily identify the type of plan by
looking at the description next to the plan name. Lets look at each network type.  Preferred Provider Organization (PPO):
PPOs give you the choice of getting care from innetwork or out-of-network providers. You pay less if you use providers that belong
to the plans network.

Youll pay more if you use doctors, providers,
and hospitals outside of the network, and you may have higher out-of-pocket costs for
services. If you have a PPO plan, you can visit any
doctor without getting  a referral.  Exclusive Provider Organization (EPO):
A managed care plan where services are covered only if you use doctors, specialists, or hospitals
in the plans network (except in an emergency). No referral is required to see a specialist  
Point of Service (POS): A type of plan where you pay less if you use doctors, hospitals,
and other health care providers that belong to the plans network.

POS plans require you to get a referral from
your primary care doctor in order to see  a specialist.  Health Maintenance Organization (HMO):
A type of health insurance plan that usually limits coverage to care from doctors who work
for or contract with the HMO. An HMO generally wont cover or has limited
coverage for out-of-network care except in an emergency. If you use a doctor or facility that isnt
in the HMOs network, you may have to pay the full cost of the services you get.

HMO members usually have a primary care doctor
and must get referrals to see specialists. Weve been talking so much about provider
networks, SO what is that? Well, a provider network is a list of the
doctors, other health care providers, and hospitals that a plan has contracted with
to provide medical care to its members. These providers are called network providers
or in-network providers. A provider that hasnt contracted with the
plan is called an out-of-network provider.

Please subscribe to our channel! Dont forget to share your happiness!.

Young Adults Need Affordable Health Insurance

Young Adults Need Affordable Health Insurance

As graduates around the country are getting organized for new adventures and every day jobs, the importance of cut priced wellbeing coverage is beginning as much as be a fact. In a model new ballot  published by UnitedHealth Group, Inc, over 2/three of young adults throughout the US comprehend they desire cut priced clinical coverage, on the other hand over 1/2 of them say they might still now not have the recommendation they desire to settle on the suitable classification of preservation to satisfy their calls for.

1,000 young adults have been polled and sixty seven% of them haven't made any plans for clinical coverage. While these 18 - 21 year olds comprehend they desire coverage preservation, they is now not infrequently always fresh involving the preservation they have got thru their parents and do now not even comprehend when that preservation will end.

Young adults are throughout the fantastic and quickest increasing close by of the 46 million uninsured individuals throughout the US. This alarmingly big close by of Americans, alongside with the 25 million underinsured, goes thru brilliant opportunity by now not having related preservation throughout the case of a clinical desire.

When you would like cut priced wellbeing coverage and that you just'll now not get preservation thru your employer, it is able to also be now not clean how that you just'll even start the manner of locating preservation on your personal.

Determine your coverage calls for: Before that you just'll became conscious of the least costly clinical coverage, you would like to appreciate how coverage guidelines work. When it involves price, there are two concerns to perceive -the deductible and the co-pay. Nearly all coverage policy have each and every a deductible and co-pay you are guilty to pay.

The deductible is the quantity of clinical expenditures you'll have to pay out of pocket earlier your coverage preservation kicks in. The co-pay is the portion of every and every certain user price you will have got to pay, with the exception of the coverage market's portion. For event, whilst you've a $500 deductible, you are guilty to pay the first $500 of clinical expenditures in step with year, earlier your coverage market pays irrespective of what element. With the co-pay, you will have got to pay a proportion of every and every price, aas a rule at the time of your carrier.

To lend a hand shield your wellbeing coverage cut priced, you will have possibilities how you pay these expenditures. If you are in kind of splendid wellbeing, settle on a cut deductible and stronger co-value. If even when, you go to the in style practitioner incredibly aas a rule, you pay be stronger off with cut co-funds, on the other hand an elevated deductible. Once your annual deductible is reached, you'll have a lot less expense thru out the year. For the least costly wellbeing coverage top rate, settle on each and every larger deductibles and stronger co-funds. This will now not a lot slash than spread your rates out over a duration of time.

You can take monitor quotes and plans for clinical coverage on-line. This manner that you just'll glance at a vary of categories of guidelines from multiple corporations and take your time locating out the gold intensive-spread multiple to your clinical coverage calls for.

It is especially imperative for young adults to have a favorable realizing of the classification of coverage they desire. With the vast diversity of wellbeing coverage corporations, at the part of the style in guidelines and preservation, the principle straightforward manner to became conscious of the least costly wellbeing care preservation is to operate a little study and take monitor your possibilities. Most importantly, even when, is to circumvent going with non wellbeing coverage at all so that you just do now not became conscious of yourself with big expenditures that you just'll now not manage to pay for to pay.

Why I Don't Have Health Insurance

Why I Don't Have Health Insurance

When married it gave the affect a professional thought to have neatly-being coverage plan, mainly as my 3 little toddlers were born and rates were lined. But things went awry when one required a minor operation on the age of 3 years to faultless an umbilical hernia. The last discontinue result is that during its role of going throughout the stomach button things out so it was once no immense deal. When offered to the insurer for price, even although, they used one excuse after the several now not to pay the rates.

This grew to changed into me off and from that day to this I haven't had coverage plan. It seems, even although, that I don't want it. In Australia we have got Medicare, which covers everyone for it doesn't matter what want they've got got to peer a doctor or go into sanatorium. When it was once first added everyone was once utterly lined nevertheless due to the years this has been eroded to partial duvet.

But my case is determination again. Following my reincarnation and with a prevailing link to the Spirit of the Universe, the precise God, it commissioned me to do surprising things. As proof of this I asked for restoration of my sinus, a  I had from the age of 3 years. It was once mechanically long gone. When it advised me to exhibit up my job on the age of 45 years and paintings only for it the Spirit also advised me that every phase may only neatly also be offered.

Over the following many determination years correct here is precisely what has occurred to the amazement of those that recognize me optimum. One of these is my eldest son who's making an try and get me to take neatly-being coverage plan owing to my age. He are now not succesful of recognize how the Spirit works in my life and my refusal to have coverage plan on whatever is beyond his comprehension.

My coverage plan is the Spirit and every phase is committed to it. My mindset is that if it needs to take seen of me then I can not be neatly keen to maintain it. If, alternatively, it's conserving me fit and healthful then why may also I now not believe it? Many my age are struggling stipulations which are now not a space of my predicament.

While many have coverage plan and feel dependable they're greater almost always than now not those that suffer the much. The coverage plan businesses paintings on fear and believe. The only 1 in my life that can be believe-beneficial is God, whom I serve with get satisfaction from. It has acquired rid of all threats and the things of evil from around me so why may also I desire to have it back?

What a Single Payer Health Insurance Plan Looks Like

PAUL JAY: Welcome to The Real News Network.
I'm Paul Jay in Baltimore. The debate about health care is continuing.
Supreme Court has found what people call Obamacare constitutional. It will come into full force
in 2014. But proponents of what's called single-payer health care or government-run health insurance
plans are continuing to fight, and the evidence seems to be on their side.

Those countries
that have government health insurance plans, people live longer and the cost of the health
care is less. Now the fight in the United States seems to be moving to the state level,
because there doesn't seem to be much that's going to happen at the national level, at
least in the foreseeable future. And one of those states is Maryland. And a recent study
looks at what would single-payer health care look like in the state of Maryland.

And now joining us is the author of that study,
Gerald Friedman. He's a professor of economics at the University of Massachusetts in Amherst,
and he did this study for Health Care for All Maryland. Thanks for joining us, Gerald. GERALD FRIEDMAN: Thank you for having me.

JAY: So before we dig into some of your research,
just sort of give us the bigger picture of why this would make sense for Maryland. FRIEDMAN: Well, the big picture is that health
insurance provided by competing private companies is inherently inefficient and destructive
of people's health. I mean, that's a strong statement, but I think it is well founded. The problem with private health insurance
is that it's not like selling shoes.

If you're a shoe company, you want to sell more shoes,
you want to make a better quality shoe at a better price to attract more business. Health
insurers don't want more business. They want to get rid of sick people. Eighty percent
of your costs as a health insurer are incurred for about 20 percent of your people.

You know,
in some places it's 90-10--90 percent of your costs go to 10 percent of the people. If you
can find those people, identify those people, and figure out a way to get them to go away,
go to a different company, then you will be in a position to lower your prices and increase
your profits. That is what health insurers try to do. JAY: Let me interject for a second.

There
kind of is that in Maryland, is there not, where the state actually takes people that
a lot of the private insurance companies don't want and puts them through this Maryland plan. FRIEDMAN: Yes, exactly, exactly. One aspect
of--the president's law, Obamacare, the Affordable Care Act, has provisions to try to restrict
this behavior by companies. Until those provisions, the ban on preexisting conditions, until that
kicks in, states have been subsidized from the federal government to set up these care
pools for special insurance for people who can't get insurance otherwise.

Overall throughout the United States about
100 million people have some condition that an insurance company would look twice at or
three times at before giving you insurance. Certainly if you've ever had cancer, insurance
companies don't want you. If you have HIV, insurance companies don't want you. If you
have an obsessive-compulsive disorder, a history of chronic depression, if you're overweight,
if you have heart disease, if you have high blood pressure--.

JAY: Or if you're pregnant. FRIEDMAN: Or if you're pregnant, that's right,
or if you're pregnant, insurance companies don't want you. JAY: Unless they already have you. Like, if
you haven't been insured--and I happen to know this through personal experience recently--if
you haven't been insured, you can't go out and get new insurance if you're pregnant,
except through this pool that the state creates.

So isn't this some form of indirect subsidy
to the insurance companies? Like, we'll take the most serious conditions, publicly finance
them one way or the other, and you can keep your pool nice and profitable. FRIEDMAN: Exactly. Exactly. The high-risk
pool is a subsidy to the insurance companies during this interregnum until 2014 when the
whole law kicks in, and then they are supposed to take everybody.

But in fact they'll still
find ways. They'll--the fastest-growing cost center in American health care is administration
of the health insurance industry. That has risen in cost eightfold since the 1970s. And
that--if you compare the United States and Canada, two-thirds of the extra increase in
cost for health care in the United States is accounted for by rising administrative
burden in the United States compared to Canada.

JAY: Now, I know in one of the papers you
wrote, there's a cartoon, and it's kind of ironic, that one of the arguments against
a government insurance plan is it would be too bureaucratic. But the facts don't lead
you there, do they? FRIEDMAN: No, they don't. They don't. Just
to give you the raw number, the cost of administering the existing Medicare system, the traditional
fee-for-service Medicare, is 2 percent--that is, $0.98 Out of every dollar that goes into
Medicare goes out to pay for services, health care services.

By contrast, the mandate in
the Affordable Care Act is that insurance companies get up to 80 percent. So the health insurance industry admits that
it is ten times less efficient than Medicare. They have ten times as high an administrative
burden in the private insurance system. And the reason they do that is not because they
like to waste money; it's that they use their bureaucratic apparatus to screen out sick
people.

They make it hard for you, they try to identify you, they try to scare you away
from procedures that you need, in the hope that you will leave after a while. JAY: I'll give it a--I can give a--now let
me just explain the parameters of all of this interview we're doing for our viewers. We're
going to do a series one after the other where we're going to dig into this proposal for
Maryland and talk about this health care issue. So this is part one.

And I won't know how
many parts it is until we get to the end. I'll give you one example recently. We've
just had two little twins, and they're in the neonatal unit, and the decision to move
them from the neonatal unit to a lesser-care facility is essentially going to be made by
the insurance companies. The insurance companies have people that are micromanaging these files,
and they're looking at exact--studying individual care of people and then deciding what the
next step should be.

I mean, they won't fight it based on a hospital saying the hospital
must keep the kid here, but they've created the criteria when the kid should move, not
the hospitals. FRIEDMAN: Yeah, yeah, as if they have a license
to practice medicine. I mean, this is standard practice in America these days, that health
insurers are practicing medicine, they're dictating which drugs are approved on their
list, so that if your doctor wants to prescribe a different--give you a different prescription,
well, sure they can prescribe, but the insurance company won't necessarily cover it. They say,
no, you should take this other drug.

They want to prescribe how long you're going to
stay in the hospital, which second opinion, which specialist opinions are needed, which
procedures are appropriate. I mean, this is all done by insurance companies. JAY: And let me add, 'cause people that watch
The Real News know I'm a dual citizen, and I still get health care in Canada as well,
and you don't get the micromanaging that--like this in the Ontario health care system, for
example. There's very broad parameters that are established by the insurance system, but
then all the decisions are really made by doctors after that, not, you know, getting
phone calls from the insurance company.

FRIEDMAN: And we see the difference. The United
States and Canada had about the same life expectancy in 1971 when Medicare, Canada's
health insurance, was enacted. You know, about the same life expectancy, and we were both
paying about 7.5 Percent of our gross domestic product to pay for health care. So we have
very similar situations.

Now, since then, Canada has added 6.5 Years
of life expectancy, compared to five years of life expectancy added in the United States.
So Canadians now live longer than people in United States, a year longer, and Canada's
expenses have gone up to 10 percent of gross domestic product while we've gone up to 17
percent. So we're spending a lot lot more to get less
than Canada's doing. The difference is the cost of administering these health insurance
companies, all those people supervising the doctors, and all the time that the doctors
have to spend dealing with the health insurers. JAY: So I'm going to jump in.

So we're going
to pick this up in part two of this series of interviews and we're going to dig into
this proposal for Maryland and just see where these cost savings would be and compare what
a single-payer plan in Maryland would look like compared to the existing for-profit insurance
plans. So join us for the next in this series of interviews with Gerald Friedman on The
Real News Network..

Why Does My Health Insurance Want Me To Fill Out A Form After I've Been Injured In An Accident

Why Does My Health Insurance Want Me To Fill Out A Form After I've Been Injured In An Accident

You have been despatched the style for the motive that your wellbeing and fitness upkeep has paid for clinical bills which it believes is often times the consequence of everybody else's fault. If so, they wishes to explore out that ideas for the motive that they might per likelihood neatly likely in reality have a true to be repaid or reimbursed in case you agree for a contract or recuperation in the direction of the at-fault grownup, industrial or insurer for that at-fault grownup or industrial. This is popular as "subrogation". Your wellbeing and fitness upkeep policy will probable have a "subrogation" part or clause pointing out this.

It also is on your easiest victorious interest to overall and move back the style to your insurer for the motive that in case you don't and you get a contract or recuperation on your confidential injury case, your industrial too can additionally come after you for the amounts they've paid.

Under Pennsylvania Law, when you are injured in an coincidence, you will also additionally wishes to post your clinical bills to your wellbeing and fitness upkeep. You is often times wondering why you wishes to take a look at this if the injury became inspired by everybody else and that they have obligation upkeep. For occasion, If you are injured attributable to the falling or being injured for that motive of a hazardous circumstance to estate, or for that motive of an risky product, unless the obligation upkeep industrial has "med pay", you wishes to post your clinical bills to your upkeep. Your upkeep might per likelihood neatly likely in reality have a true of subrogation, meaning in case you agree for a contract or recuperation in the direction of a 3rd-get collectively, your wellbeing and fitness upkeep has the true to be repaid.

So, inside of the finish, the at-fault upkeep industrial is paying the clinical bills by being to blame to reimburse your wellbeing and fitness upkeep industrial from a contract. Your wellbeing and fitness upkeep is smoothly fronting it and the style they choice you to fill out allows that method.

Using My BenefitsHealth Insurance Made Clear

So, you enrolled in
a UnitedHealthcare plan. You got your card. We're happy to see you. Now you probably want to know
how your benefits work.

Well, you've come
to the right place. Simply log in to
your member website, myuhc.Com, or download the mobile app to get the most
out of your benefits.  The first thing
you need to know is what's covered
under your plan.  You can search
for network doctors, clinics and hospitals, tests, services and treatments, or conditions.

Maybe you're not sure if you need to go
to the doctor at all. With NurseLine, you can talk
with a nurse on the phone 24/7 or chat with one online. You could save time,
money, and worry.  You can check myuhc.Com to see if your local pharmacy
is in our network.

You can also check to see
if your medications are covered and find lower-cost options
like generics.  When it's time for managing
your benefits and paying your bills, we've got a handy tool for that. We can help you track
the whole process from start to finish. You can view the status
of your claims and track payments.

If you have a balance, you can even pay
your bills online. Okay, so now you know about
managing your benefits. But staying healthy
to begin with is even better. Exercising and eating right
are a great start.

But getting regular checkups
and screenings is also important. There's plenty about that
at myuhc.Com too. You'll find information
on preventive care that may keep small problems
from becoming big ones. The best part is that most
preventive care services are available
at no cost to you when you use
network providers.

(Cheering) If you have questions
about your benefits, check the website,
or give us a call at the member number
on your ID card. We're here to help. Be sure to check out
our other videos on the UnitedHealthcare
YouTube channel to learn even more
about using your new plan. Thanks for watching.

.

What You Need To Know About The Health Insurance Deductible

What You Need To Know About The Health Insurance Deductible

If you havent been paying consideration, your wellness coverage plans deductible is additionally a deficient shock and a shock to your monetary establishment stability. People pay an oversized huge variation of money for wellness coverage plans, and then nonetheless get a crucial invoice after touring a wellness care issuer. Whats taking place?

Well, written into your coverage plans coverage are deductibles, or the sum of money you've to always pay beforehand the coverage plans business will pay the relax. So on the identical time as you could smartly smartly suppose that the deal is which you pay $25 for a wellness care issuer speak to or $15 for a prescription, youre now now not totally exclusive. You first have to always meet your deductible.

So while you occur to have a wellness coverage plans deductible of $500, then the coverage plans will now now not pay you one thin dime until eventually youve paid out $500. Sometimes it may smartly smartly get a chew intricate, as throughout the case of a circle of kinfolk. Some plans have separate deductibles for each human being human being throughout the circle of kinfolk. Others have most efficient one deductible for someone collectively.

The time to suppose almost your wellness coverage plans deductible is whereas you're obtaining the coverage. If you've a low deductible, your charges will probably be a lot better. Its tempting to head collectively with the upper deductible and cut charges, on the other hand be careful. Look scale back at what huge variation of doctors visits and other scientific visits you had throughout the old yr. If you most efficient went as temporarily as to a wellness care issuer closing yr, if could be more settlement potent so which you'd get the upper deductible coverage and in actuality pay for the few facilities which you do use. Just make guaranteed you've the cash feasible whereas you'd prefer it.

A decent question to invite is what the target of the wellness coverage plans deductible is. Its in point of statement now now not in actuality to enlarge the coverage plans providers revenue, despite the tested truth that it doesnt hurt their bottom lines.

The foremost purpose is to  consumer obtaining conduct. Think of it this approach. Most concerns you purchase you pay for with your very own money, without reference to whether you pay with money, a mastercard, or take out a mortgage. Its in point of statement in actuality between you and the human being making the sale. If you're getting a mortgage, the monetary establishment or whoever is lending the cash doesnt in point of statement get entangled throughout the need of what you're obtaining. They may smartly smartly additionally refuse to lend the cash or positioned on some prerequisites, on the other hand thats almost it. In the quit, however it, you're guilty to pay.

But when obtaining wellness care, there is a third birthday occasion interested: the coverage plans business. They may smartly smartly additionally in point of statement pay extra for your wellness care than you've paid in charges and deductibles. So they've an incentive so which you'd use fewer wellness care facilities in order that they may have less to pay for. By making of us pay a wellness coverage plans deductible, they may be creating an incentive for of us now now not to beneath suppose twice beforehand operating off the wellness care issuer.

The Structure & Cost of US Health Care Crash Course Sociology #44

The health care system in America is...Complicated. Doctors, hospitals, insurance
and drug companies  it can be hard to navigate all the moving
parts of healthcare, and its even harder if youre
trying to do it when youre sick. Theory and statistics can give us a broad
understanding of the social and cultural forces
that affect health. But for the average American making choices
about healthcare, the questions that matter
most are the practical ones.

After all, when youre running a fever,
the most important question is where can you
find a doctor to make you better. And then after the fever has gone down and
you get the bill, your question might become,
How do I pay for this? And why does giving me an aspirin count as
a separate thing that I get charged for? Its easier to answer these questions once you
understand how the US structures and finances
its health care system. So, lets do it. [Theme Music] Lets start with the basic structure of
the healthcare system in the United States.

Health care is split into different sectors
the private, the public, and the voluntary sectors. Private and public sectors supply insurance
and care to most Americans. In the private sector, 56% of patients pay
for their health care with insurance that they
get primarily through their employer. There are also public health insurance
plans for vulnerable groups  like Medicare, which covers elderly Americans,
and Medicaid, which covers Americans below a
certain poverty threshold.

The government also provides healthcare through
things like VA hospitals and the Bureau of Indian Affairs, and it has a legal mandate to provide
healthcare for people in federal prison. But the voluntary sector is different, in that it includes
charitable organizations that do health research and
provide free or low-cost health services, like the American Cancer Association or
the March of Dimes. So, with all of these options available, what
determines how easy or hard it might be to
get access to health care? In this context, access refers to entry into,
or use of, the health care system. In 1981, two professors of Public Health at
the University of Michigan  Roy Penchansky
and J.

William Thomas  came up with what they called the Five As of
health care access: availability, accessibility,
accommodation, acceptability, and affordability. So, the first a asks: Does the person
live where the health services they need are
readily available? If you live in a major city, you might take it for
granted that finding a doctor or a 24-hour clinic
on short notice is just a google search away. Urban areas have more doctors, specialists,
and hospitals  all of which means that a wider
variety of services are available. By contrast, rural areas are more likely to
experience shortages of healthcare workers.

Urban areas have twice as many doctors per
person as rural areas! Rural areas also tend to have issues with
the second a, accessibility. Accessibility here refers to a persons
literal ability to get to facilities and keep
appointments. Transportation to appointments can be much
more difficult in rural places, where providers
tend to be farther away. This is especially hard for people with chronic
illnesses or disabilities that make it impossible
for them to drive by themselves.

Time can also be a limiting factor. Doctors appointments are usually during
business hours, so patients may have to miss
work to get the care they need. Low-income and blue collar workers are more
likely to have jobs that dont offer paid sick leave  and they may even be fired
if they miss work due to illness. Sociocultural factors can also impact the
accessibility.

And so can the accommodations provided by
health services. Accommodations are the ways that services are
organized to accept clients, like the hours that theyre
open or the ways that they communicate with patients. Language barriers can make it especially hard
for non-English speaking patients in the US. So accommodations like translators or multilingual
information packets, can help mitigate the disparities.

And finding the right accommodations
for different populations can be difficult, too. For example, Hmong Americans, who primarily immigrated as refugees from Southeast Asia in the wake of the Vietnam war, have higher mortality rates than native-born Americans. Providing medical information can be hard,
because no written form of the Hmong language
existed until the 1960s, meaning that many Hmong people cant read
or write in their own language, and dialects vary,
making it hard to find the right translator. Once you get past all those other obstacles, theres still the matter of whether the doctor and patient have similar ideas about how the whole doctor-patient relationship should work.

Some people want a doctor who gives them the
information they need to make decisions themselves. But others just want to leave all the decision-making
to the doctor and just be told what pills to take. How satisfied a patient is with their healthcare tends to depend on the match between their preferences and their doctors style of care, or the doctor-patient congruence. A patients satisfaction with a provider
will determine if they return.

So the next a, acceptability, is based on
whether a doctor meets the patients preferences  both in terms of their professional
abilities and in their personal traits, like
gender, race, or age. For example, many people feel more comfortable
with a doctor of the same gender as themselves, so if none are available, they may not find
that health care experience acceptable. The last A of the five As is a pretty important
one, particularly in the United States: affordability. How people pay for health care in the US, and more importantly if people can pay for health care, is closely linked to how we financially structure the healthcare system.

The US has whats known as a fee-for-service
healthcare system, where services are unbundled
and paid for separately. So if you go in for a check up and the doctor
orders a blood test and an x-ray, the charges
on the bill will be separated into three parts: the x-ray, the lab test for the blood, and
the cost of the doctors time. There are pros and cons to a system like this. It incentivizes doctors to do a lot of tests,
because theyll get a separate fee for every test.

Which can be good  you want your doctor
to be thorough when youre not feeling well. But a fee-for-service system also incentivizes
overtreatment, and this drives up the cost of care. The US also relies on a third-party payer
system, which means that medical costs are
paid through a third party, like a commercial insurance company
thats responsible for paying the doctor on
behalf of the patient. Third-party payer systems often rely on cost-sharing,
where the insured patient pays a little each month,
whether they need care or not.

This helps limit the overall costs to the
insurance provider. An insurance premium is the amount you pay
to the insurance company each month so that
you can keep your coverage. A deductible is the portion of the health
care costs that youre responsible for yourself
before your insurance kicks in. Most insurers offer lower monthly premiums if you
accept a higher deductible  so its kind of a trade off: do you want to pay more per month and not
have to worry about meeting the deductible, or would you rather pay less per month and worry
later when faced with more expensive medical bills? Health insurance exists to protect us
from health uncertainty.

We dont know if well get sick or how
expensive being sick will be, making it pretty much impossible to save
enough money against the possibility of a very
costly illness. So lets go to the Thought Bubble one last time,
to discuss how health insurance helps us manage
financial risk in the face of a health crisis. Suppose theres a 1 in 50 chance that youll
break your leg and have to pay $7,500 to get
an x-ray, a cast, and some therapy. You might not be able to dig up that much
money.

But what if you have 49 other people who also
are worried about breaking their leg? If you all agree to chip in $150 dollars to
a pool that will go to whichever one of you
breaks their leg, you all can rest easy knowing that you wont have
to empty your bank account if you fall out of a tree. This is a simple example of a risk pool  a
group of individuals who are covered under
one insurance plan. An insurance company decides how to set their
premiums and deductibles based on how likely the risk
is that theyll have to pay out an insurance benefit. Take our broken leg example.

What if some of those fifty people were really
into extreme sports and actually had a 50%
chance breaking their leg? If the insurance company knows that,
they might increase the price that you have to
pay into the pool, because theres a greater likelihood that more people
will need them to shell out $7500 for a broken leg. Some insurance plans set prices using community
rating in which everyone in the risk pool is charged the
same price to buy into the insurance plan. But in the US, insurance plans typically use
experience rating, where different groups that
have higher or lower risks pay different prices. For example, smokers are at a higher risk for
heart disease and lung cancer, so an insurer might
charge you higher premiums if you smoke.

Thanks Thought Bubble. Hopefully, that helps you better understand
how insurance plans work. Access to affordable insurance can make
a huge difference in the quality of health care
that a person receives. People without insurance use preventative services
less often, are more likely to postpone medical care, and are more likely to move between different
doctors, resulting in worse continuity of care.

As a result, being uninsured is associated
with a greater need for more expensive and
more urgent medical procedures. The high costs of medical care in the US and the
high number of uninsured people are big parts of what
spurred the passage of the Affordable Care Act and kicked off the national debate about
the best way to deal with these twin problems
in the US health system. Of course, what weve covered here today,
is only one understanding of how healthcare
works in the US. Theres so much more to consider and explore
in this topic and, quite frankly, with everything else
that weve discussed throughout this course.

But even though Crash Course Sociology
has to come to an end, the number of questions that remain unanswered
about how societies work is never ending. Hopefully this course has given you some helpful
tools and perspectives to use as you analyze and
participate in the social world. Thanks for joining me and dont forget to
be awesome. Today, we talked about what the health care
system in the US looks like, the five As of health care accessibility,
and a couple of contributing factors to the
affordability of health care: Fee for service care and the structure of our health
insurance system which encourage higher spending.

Crash Course Sociology is filmed in the Dr.
Cheryl C. Kinney Studio in Missoula, MT, and its
made with the help of all of these nice people. Our animation team is Thought Cafe and Crash
Course is made with Adobe Creative Cloud. If you'd like to keep Crash Course free for
everyone, forever, you can support the series
at Patreon, a crowdfunding platform that allows
you to support the content you love.

Thank you to all of our patrons for making
Crash Course possible with their continued
support..

What to Do If You Can't Afford Health Insurance

What to Do If You Can't Afford Health Insurance

Do You Lack Health Insurance?

If you're an American, and you lack medical coverage, you're not on my own. In preceding due 2009, it changed into envisioned that moderately plenty 46 million individuals inside the US would now not have a fitness plan. Recent prime unemployment figures haven't made this discern any diminish.

Some of the ones individuals lost their neighborhood fitness plans when they lost their job. Others are self hired or paintings for a industrial that might now not be imparting neighborhood fitness. There are alternative exclusive fitness plans for sale, yet countless us indubitably won't deal with to pay for them, or they might not get certified via one. While politicians haggle over the matters, sick everyone is having bother getting therapy.

Are You Sick or Healthy?

If you're very healthful, or if you already have a fitness element, make guaranteed to are taking a look for coverage. It will likely be, of path, heaps less complicated to uncover low in significance exclusive medical coverage while you're healthful. This manner you  be geared up in case you do get sick or get break in an accident. Even a fully principal ride to an emergency room for a damaged bone can significance countless numbers of dollars.

If you have got already are break or sick, it's going to be difficult to get it covered via exclusive plans now. But even the ones which are already sick could have to specialise in to locating some supply. I hope to give some percentages for you.

COBRA

Under federal legislation, some corporations could have to escalate their neighborhood scientific plan to terminated staff of employees. This  be a favorable variety for the ones folks who're amongst jobs. The so much efficient element with it's the importance. Instead of indubitably paying your worker contribution, now you're going to just about to naturally even could have to pay the complete premium kind. Many ex-staff of employees are very surprised when they find out how plenty right here's.

Individual Health Insurance

If you lack main scientific, and you're considerably healthful, you'll even so much likely purely perchance uncover that a exclusive scientific plan is moderately low in significance. It is hugely a false impression that neighborhood compliment are for all time greater cost-robust than human being plans. Because insurers can underwrite each applicant, they'll so much likely purely perchance hugely be supplied to be imparting diminish fees for greater healthful individuals.

If you have got an variety to escalate your neighborhood compliment (i.e. COBRA) or buy exclusive coverage, indubitably make bound the new plan will accept you, and that it'll canopy amenities you need. It is hard, as an representation, to get human being plans that canopy accepted maternity. But while you're certified, which optimum individuals in comparatively neatly appropriate fitness has to be, and the plan satisfies your wishes, you is additionally differ glad with donning your own fitness plan.

State Risk Pools

Every US state has some style of fitness plan for oldsters who have a pre-sleek day fitness activity that receives them declined for other coverage. In some states, those plans  be very costly yet it. This is a favorable variety if you do have money or fee reductions, yet indubitably would now not have medical coverage.

Paying For Prescriptions

If you won't have the funds on your prescription medicinal tablets, search advice from the Partnership for Prescription Assistance (PPARX). Their web content is PPARX.org. This staff offers some amount of get right of entry to to a lot of of exclusive and public criticism applications. Their web content says they've have been given helped countless numbers and countless numbers of Americans get supply, they customarily is additionally supplied to enable you to.

Low Cost Health Clinics

You can uncover some diminish significance fitness clinics. Many be imparting fitness amenities on a sliding scale. The PPARX web content we discussed approximately also has a honest search characteristic. You can enter your zip code and realize if you'll even uncover a shut-via elements. I entered my very own zip code for a scan, and I changed into surprised to locate out that there have been indubitably the several of the ones clinics inside a brief strain of my condominium. I had now not been acutely mindful that there have been any speedier than.

Financial Aid For Health Problems

If you have got a main affliction, you is additionally supplied to get toughen from a economic criticism program. These are gradually non-earnings, and barely they're is normally called co-pay applications. Again, PPARX has info on countless those organizations.

County Health Systems

Try taking a look for a county or public fitness gadget on your own position. They could have to deliver decreased worth amenities for victims. You will just about to naturally be locked into riding their hospitals, docs, and so forth., yet make guaranteed to have get right of entry to to care.

Public Health Insurance Programs

If you have got an fully low money, and few belongings, you'll even so much likely purely perchance qualify for Medicaid. This is the federal and state program to insure the bad. Moderate money households could have to visible allure on the Childrens Health Insurance (CHIPS) plan for his or her state. Income checklist to canopy toddlers are higher than the ones for adults, and those plans may so much likely purely perchance also canopy pregnant females.

What To Do If You Have No Health Insurance

I would inform any human being to get to the base of the manner they might achieve medical coverage as with out element as feasible. For instance, make guaranteed to effort to workout for a exclusive policy while you're healthful! You are just about to naturally now not going to uncover coverage from a exclusive industrial once you're already sick or break. If you do uncover a plan that accepts you, it's going to just about to naturally be even greater costly That is how coverage works.

It is for all time greater amazing to devise past. Of path, right here's now not for all time feasible.. If you have got a so much current fitness element, and no fitness plan, make guaranteed to visible allure at thought about one of many a very powerful potentialities we indexed.

What Is The Cost Of Health Insurance

What Is The Cost Of Health Insurance

A query that plagues many humans is what's the significance of medical guarantee? With the finished plans and possibilities and courses and changes, its no surprise americans have a troublesome time sorting out what their medical guarantee in bodily reality bills.

The first an component of the significance of medical guarantee you're likely to have to unavoidably pay is the pinnacle class. If you get your medical guarantee by means of your activity, it actually is often deducted out of your paycheck. So have to unavoidably even though you multiply the diversity deducted similarly time you're paid by the diversity of instances you're paid in a yr, youll know the full range you're paying on your medical guarantee premiums.

Most optimum likely, that just is on no account very the complete range. Employers over and over again pay a portion in their employees medical guarantee premiums. If your organisation is the the remainder like the ones Ive worked for, they made assured all of us knew just how loads they paid for our medical guarantee. Add what they pay to what you pay and  be the full pinnacle class. If youve on no account imperative to pay on your medical guarantee by yourself, youll now assume about why americans who dont get it by means of their jobs every now and then have a troublesome time paying for it.

Whether you're deciding to buy your medical guarantee yourself or get it by means of work, there are some solutions which you most likely can cut down your bills. The option to attempt out it actually is to appearance at each the distinctive portions that move into answering the query of what's the significance of medical guarantee.

These involve deductibles and copayments. The deductible is the diversity of funds which you're going to pay on your clinical charges turbo than the reassurance commerce pays one red cent. If your deductible is $500 and your clinical funds for the yr are $495, the reassurance commerce can pay now not no matter. If your funds are $one thousand, then you honestly can pay the primary $500, then they pay the the remainder.

A gentle rule is the bigger your deductible, the lower your pinnacle class.

Co funds are a assortment commission for a express provider. A few frequent examples are a significance of $20 for a smartly-being care educated dialogue over with or $10 for a prescription. You pay the copay first. The guarantee pays the the remainder. Again, the bigger the copayments, the lower the deductible. These the distinctive charges are an component of your medical guarantee bills.

So what's the significance of medical guarantee? Hard to assert. Insurance bills are diverse for each state so its troublesome to supply belief. Some plans cowl solely the basics; others cowl each smartly-being want achievable. Its been pronounced that on common a unmarried contributors annually pinnacle class is approximately $3000 and a domestic can pay nearly $6500 a yr. A adult in New York can pay approximately 2.5 instances extra for a comparable plan sold by any particular in a rural Midwestern state.

Keep in brain the query just is on no account just what's the significance of medical guarantee, but what's the significance of now not having it. While medical guarantee can take a a lot better piece of your paycheck than youd like, believe what could in all danger exhibit up have to unavoidably even though you imperative visible surgical therapy.

A very best possible exercise session is to retain tune of your clinical charges. If you know what styles of facilities you're optimum likely to need and how gradually, which you most likely can extra exciting ascertain how big of a deductible you'd like. Youll even be succesful to extra hopefully know which of the now not obligatory safety youll receive or understand to skip. Asking the query what's the significance of medical guarantee is a hugely very best possible first step in managing this expense.

The real reason American health care is so expensive

I cannot tell you how obsessed I am with this chart. It shows exactly what is wrong with America's conversation about health care. On one level, you've seen this chart before. It shows health care spending as a share of the economy of a bunch of countries.

There's Germany and France and Japan and Canada and oh! There's America. But now I want to add something you haven't seen to this chart. This is how much of that spending in each country is private and how much is public. Here's what's amazing: America's government spending on health care on programs like Medicaid and Medicare and the VA - our versions of socialized medicine.

It's about the same size as these other countries. These countries where the government runs the whole health care system! And then there's our private spending. It's the private insurance system that makes health care in America so expensive. Conventional wisdom says that the government is more expensive than the private sector.

"It can't say no. It's corrupt, it's inefficient, it's slow." "If you want something done right you give it to the private sector." That is what we hear in America all the time. And yet here we are with the biggest
private sector spending the most. If you look at the data on physician visits and hospital discharges, you can get rid of one theory.

Americans don't consume more health care than people in these other countries. We don't go to the doctor more than the Germans or the Japanese. In fact we go to the doctor less. The difference between us and them is that we pay more.

Every time we go to the doctor for everything from an angioplasty to a hip replacement from a c-section to a pain reliever. In America, the price for the same procedure at the same hospital, it varies enormously depending on who is footing the bill. The price for someone with public insurance like Medicare or Medicaid is often the lowest price. These groups he covers so many people that the government can demand lower
prices from hospitals and doctors and they get those lower prices.

If the doctors and hospitals say 'No' they lose a ton of business. They lose all those people on Medicare all those people on Medicaid. But there are hundreds of private insurance companies And they each cover far fewer people than a Medicare or a Medicaid. And each one has to negotiate prices and hospitals and doctors are on their own.

And if you're uninsured, you have even less leverage. Nobody is negotiating on your behalf. So you end up paying the highest price. One study found that most hospitals charge uninsured patients four times as much as Medicare patients for an ER visit.

Other countries, they don't have this problem. Instead of every private insurance company negotiating with every healthcare provider. There's just this big list. The country, the central government, they go and they say, "If you want to sell to us, to all of our people, then here's what you can charge for a checkup.

Here is what you can charge for an MRI. Or a prescription for Lipitor. And so then whether that bill goes to the heavily regulated private insurance companies in Germany or directly to the government like in the UK. Each country is telling the doctor or hospital or drug company how much that bill will be.

And because the government controls access to all of the customers. It's an offer that hospitals and doctors and pharmaceutical companies typically can't refuse. "I'm going to make him an offer he can't refuse." In America the idea is that you'll be a consumer. That you'll do what you do when you go to
Best Buy and buy a television.

But that just doesn't work in healthcare. It doesn't work in healthcare because you often come and get health care when you're unconscious, in an ambulance, when you're scared, when it's for your spouse or your child It is a time when you have the least bargaining power. You are not usually capable of saying, 'No.' You're not knowledgeable enough to do it, you're not comfortable doing it, or you're not conscious enough to do it. That's why in other countries the government is a person who can say 'No' for you.

You can say, 'No, that's too expensive you're going to have to lower your price' because they do have that power. Anchor: A new push for single-payer health care right here in the US. Demonstrator: What do we want? Crowd: Single-payer! Demonstrator: When do we want it? Crowd: Now! Anchor: California and others are saying maybe we should adopt the European model. Klein: If we decided to create a single-payer system with one of these huge price lists in the US.

There would be nothing to stop lobbying from hospitals from doctors from drug companies. And those prices would get influenced. So we could end up with a single-payer system that is expensive. Even as expensive as our current system.

It all depends on how much you negotiate down the prices and now in America these groups have so much power
because they are so rich. That it's really hard to get them to bring down the prices. This is the irony of American healthcare: It's so expensive that it's become
hard to make it cheaper. All that money they make, that becomes political power.

And years and years and years of overpaying - those are huge industries now. And they have a lot of influence in Congress. Under a single-payer system if we did drive prices down, doctors and hospitals they would be paid less than they are right now. That might mean some of them close or some go out of business or some move.

It would be really painful. One person's waste is another person's essential service or local hospital or their income. But then single-payer it's not an all-or-nothing choice. For instance, there's a really interesting section of Bernie Sanders Medicare-for-all bill.

Where he lays out this interim plan. It's a plan he wants while he's setting up his new single-payer system. And in that plan, he expands Medicare to cover vision and dental. And he opens it to nearly everyone.

Not just people 65 and older. All kids go on Medicare automatically and most adults can buy in. That plan, on its own, it wouldn't get American health care spending far down overnight. But it would at least begin to recognize what we already know and what most other countries already do: That health care is one of those things the government can do cheaper and better than the private sector..

Understanding HMO, PPO and FFS Health Insurance Plans

Understanding HMO, PPO and FFS Health Insurance Plans

Health insurance is supplied in a number paperwork in up up to now instances. Traditionally, wellness insurance coverage have been indemnity plans; the insured paid a leading class, the wellness care provider bought wellness care facilities, the wellness insurance plan turn into billed, and the wellness insurance plan paid for lined facilities. As wellness care costs grew to be astronomical, wellness insurance organizations developed countless plans that have been geared in direction of providing high-prime high quality wellness care at inside your means costs. Managed wellness care grew to be the buzzword for the wellness insurance market, and wellness insurance coverage grew to be more progressed.

Health renovation corporations, or HMOs, and much recognized provider networks, or PPOs, have mostly changed the whole indemnity wellness plan. HMOs and PPOs make the most of necessities to embody wellness care costs. These wellness plans are identical principally procedures. Both HMO and PPO plans agreement with wellness care competencies to deliver wellness care facilities at decreased rates for the wellness insurance plan participants. Typically either plans require the the member have a first care provider, or PCP, who serves as a "gateway" to coordinate glance after the member, and all area of expertise facilities are accessed by referral from the PCP. Both HMOs and PPOs require that certain facilities and merchandise, at all instances the more pricey ones, be reviewed by the wellness insurance reviewers for prior approval or prior authorization previously the carrier is rendered. The wellness care provider ought to submit justification for these facilities as "medically mandatory", and the reviewer determines whether the carrier is a lined carrier. The plans do make provision for emergency cases that could now not anticipate prior approval/authorization, although although require an approval manner.

HMOs and PPOs range in imperative procedures, no topic the actuality. A PPO plan incessantly covers facilities rendered by competencies that do not appear like in the plan network, at the same time at all instances at a diminish charge than given for network competencies. HMOs at all instances be providing no insurance for out-of-network wellness care competencies.

Advantages of HMO/PPO plans customarily surround diminish wellness insurance premiums than the ones of total wellness insurance coverage. HMOs and PPOs incessantly be providing insurance for preventive and wellness renovation care now not lined by indemnity plans. The wellness plan member is at all instances now not required to file claims for wellness care facilities; agreement competencies invoice the wellness insurance plan with out safeguard up.

Disadvantages of the ones managed wellness care plans surround limiting insurance to competencies in the wellness care plan. Plan participants ought to amendment leading care competencies if their provider is considerably now not in the wellness plan network. Many participants don't hope to amendment wellness care competencies. Another disadvantage is that prior approval/authorization processes maybe time- and decelerate the birth of imperative wellness care facilities. Specialty wellness care can handiest be accessed through referral from the PCP.

In abstract, HMOs and PPOs be providing diminish premiums and elevated insurance, although limit participants to their network of competencies. Indemnity plans permit the member to exercise the wellness care provider in their choice, and to entry area of expertise care after they hope, although at all instances pay greater premiums for wellness insurance insurance. Ultimately the wellness plan member ought to make a decision out whether series of wellness care provider and entry to area of expertise care are well valued at the greater premiums. Whatever plan is selected, it actually is integral for participants to know their wellness insurance plan, adding what facilities are lined and what competencies are in network.