Cycling and Health Care

[dd74]

I've been watching Senator Ted Cruz (R-Tx) "filibuster" into his 14th hr. about defunding Obamacare, and the question occurred to me about what a person would not do if they didn't have health coverage. So for you cyclists, would riding a bike be one activity you wouldn't do if you didn't have health coverage?

[2LeftCleats]

On the one hand, cycling regularly is likely to improve overall health.

On the other, one broken collarbone or fractured leg, could result in medical bills sufficient to bankrupt some people.

Tough call. Without health insurance, I'd probably continue cycling but avoid group rides and dangerous roads.

[cfox]

I've been watching Senator Ted Cruz (R-Tx) "filibuster" into his 14th hr. about defunding Obamacare, and the question occurred to me about what a person would not do if they didn't have health coverage. So for you cyclists, would riding a bike be one activity you wouldn't do if you didn't have health coverage?

Not having HI does not stop many, many cyclists. Not only riding, but racing. Many times I've seen the hat passed around to help an injured cyclist who doesn't have coverage. I think it's pretty irresponsible. Me? I don't think so, but my giant (and I'm certain soon to be giant-er) annual premium is the first bill I pay on Jan 1st every year. Most people who think they can't afford coverage (usually 20 somethings) still go to bars, out to eat, on vacation, wear nice clothes... bugs me.

[BumbleBeeDave]

. . . in my life that I would certainly keep doing exactly what I'm doing now. It has helped get me through an awful lot of down times, even in spite of that neck-breaking crash a few years ago. I think I can also make a pretty good argument that my overall health is way better because of the exercise.

But I think you have to also be a bit more specific. Would this be if I suddenly was left without health insurance right now, after having my life as it is up to this point? Or would it be if I had never had health insurance?

I think you probably mean the former, so based on that I think I'd also have to re-assess other things I do in my life . . . are there any OTHER things to change to maximize my chances for avoiding needing health care?

I'm not talking about serious accidents--sometimes you just can't avoid those. But things like infections, etc. So probably try to be more sanitary, watch what I'm doing more in public places where I might come in contact with germs that would do harm. I'm not OCD about that right now, but if I suddenly knew that picking up some germs at the gym or off that handlebar on the shopping cart could result in outrageous med expenses then maybe a bit more OCD wouldn't be such a bad idea!

BBD

[weiwentg]

When I moved to DC, I had a super bare bones plan with an $8,000 deductible for a while. It made me more cautious about cycling. The odds of an accident are low but you have to admit that the accidents can be potentially severe.

Should I also have been wary of driving, given that car accidents causing injury are rare but they can be severe? Yes. But I wasn't driving very much, actually.

[Peter P.]

When I was laid off and lost my medical coverage, I stopped racing. While I didn't stop riding, I ALWAYS thought about the risks I was taking, particularly when mountain biking. The presence in my mind definitely tempered my daring on the trails.

I figured if I got hit by a car on the road while unemployed, I'd use my auto insurance (which is legit) or that of the vehicle driver, to cover my bills.

[Ralph]

I look at H I as not only insuring against the cost of health issues, but also insuring my assets don't get used up to pay for something huge.....just like you insure your auto, home, and life. I was taught in a graduate school class once that insurance premiums (for whatever) are loses you build into your budget, so you don't have losses you cannot budget for.

I hear lots of horror stories about folks with 1/4 million dollar health tabs for various illnesses. If you are broke, no problem, society pays. But if you have saved and invested a long time for that money, you need to insure against that possible loss.

[DerekG]

Most people who think they can't afford coverage (usually 20 somethings) still go to bars, out to eat, on vacation, wear nice clothes... bugs me.

I see this all the time. It's all about priorities. That said, when I first started cycling a few years ago, I only had a major medical plan with a $2500 deductible. $2500 wasn't enough to stop me from racing, maybe $8000 would be. I would never quit cycling though, maybe just be more selective in the way or places I ride.

[Wilkinson4]

I toured 10 yrs ago after I left a job w/o insurance. My collarbone break resulted in 15k of medical charges just for that afternoon not counting my last few visits.

I don't think I could stop riding but I would limit my risk as much as possible.

mIKE


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[tiretrax]

It never stopped me when I was younger and uninsured. Now that I work full time and have a family, I am less likely to get too crazy with my activities.

I don't understand Cruz' tactics - the DHS has given one year moratoriums to four major groups, and Obama gave congressional staffs a subsidy for their entrance into health exchanges. Why not delay the whole shebang for another year until everything is in place and worked out. This is a huge undertaking with lots of new regulations that still have lots of bugs. Another year would help a lot. No one I've spoken to is prepared for it - citizens, doctors, hospitals.

[avalonracing]

Many years ago I was broke and foolished rode and raced without coverage. Not a good idea. At the time I remember thinking to myself, "Well if I get jacked up in a USCF race at least there will be some insurance".

I know a single, adult, self-employed guy who can afford insurance and refuses to get it and just uses the system when he need care. On top of that he's against the Affordable Care Act. And before you say it, yes, he IS an a-hole.

[oldpotatoe]

I've been watching Senator Ted Cruz (R-Tx) "filibuster" into his 14th hr. about defunding Obamacare, and the question occurred to me about what a person would not do if they didn't have health coverage. So for you cyclists, would riding a bike be one activity you wouldn't do if you didn't have health coverage?

somebody needs to buy ted a bike.

[PQJ]

Another year would help a lot. No one I've spoken to is prepared for it - citizens, doctors, hospitals.

Another year wont help me at all. I left a group plan when I decided to go out on my own, and on the individual market my wife's pregnancy is a pre-existing condition that won't be covered. Thus I'm getting screwed with COBRA 'cos I don't have a choice (and no, sticking around at my old employer just to hang on to my group coverage wasn't a 'choice'). Speaking only for myself here, I'm looking very forward to the ACA kicking in.

Separately, a friend didn't delay the opening of his franchise 'cos he wasn't 100% ready. He's working through the kinks in real time.

Separately x2, the waivers that have been granted thus far (esp. those to congresspeople) are a bloody disgrace. Much like our political system.

I know it wasn't the OPs intent but this thread is a hot potato and to the extent I've done so, I apologize in advance for the opinions express herein, which are entirely my own.

[thwart]

somebody needs to buy ted a bike.

I'd volunteer to install and adjust the brakes... ;)

[Lewis Moon]

I'd volunteer to install and adjust the brakes... ;)

I'll make sure his saddle is on "right".

[cfox]

Another year wont help me at all. I left a group plan when I decided to go out on my own, and on the individual market my wife's pregnancy is a pre-existing condition that won't be covered. Thus I'm getting screwed with COBRA 'cos I don't have a choice (and no, sticking around at my old employer just to hang on to my group coverage wasn't a 'choice'). Speaking only for myself here, I'm looking very forward to the ACA kicking in.

Separately, a friend didn't delay the opening of his franchise 'cos he wasn't 100% ready. He's working through the kinks in real time.

Separately x2, the waivers that have been granted thus far (esp. those to congresspeople) are a bloody disgrace. Much like our political system.

I know it wasn't the OPs intent but this thread is a hot potato and to the extent I've done so, I apologize in advance for the opinions express herein, which are entirely my own.
do you know what your premiums will be under ACA? Neither do I. COBRA is freakin expensive (and I know you can't use it forever), but it might look cheap vs. what we're gonna get. I hope I'm wrong, but in the years I've been insuring myself, it's never gotten cheaper.

edit: I agree on the waivers...like so many other things, a lack of lobbying power for the self employed leaves us holding the bag yet again

[buddybikes]

Do whatever necessary to get insurance. Thus far my family this year has added up over 65,000 in expenses, primarily from our healthy daughter that was diagnosed with Ulcerative Colitis and c diff infections.

[zap]

I'm a firm believer in insurance.

I always had employer coverage (here in the USA) when I was in a conventional career and when I left said convention (started my own biz), I went on my wife's plan. Certainly not inexpensive (federal gov. health plan)........surprises the hell out of folks when I tell them how much we pay......might have saved a few bucks (at the time) if I got health coverage on my own.

If I were in a position to consult, I would highly recommend that someone who participates in cycling have health insurance. The risks are higher (than those who view exercise as a walk in the park) and it sucks make rent payments to hospitals/doctors for years.

[avalonracing]

somebody needs to buy ted a bike.

Ted needs more than a bike.

[oldpotatoe]

Ted needs more than a bike.

geeeezz, I want to say more but I know political discussions are frowned upon..so I won't.

I've been lucky to have health care or insurance my entire life so....I can't imagine not being w/o it BUT when I was hit by a P/U truck from behind whilst riding..at 10:30 on a Saturday morning...my 5 days in the hospital, where they really did nothing more than monitor me..no surgery..broken back but just a brace..totaled almost $15,000 per day....

[bobswire]

geeeezz, I want to say more but I know political discussions are frowned upon..so I won't.

I've been lucky to have health care or insurance my entire life so....I can't imagine not being w/o it BUT when I was hit by a P/U truck from behind whilst riding..at 10:30 on a Saturday morning...my 5 days in the hospital, where they really did nothing more than monitor me..no surgery..broken back but just a brace..totaled almost $15,000 per day....

I'm assuming you have Veterans health care as do I,which IMO is some of the best in the World. I've had Blue Cross, Kaiser along with their high premiums so I'm hoping the public wakes out of their stupor to realize Obamacare or however one wants to label it is a godsend compared to what they are paying for now.

[tmf]

do you know what your premiums will be under ACA? Neither do I. COBRA is freakin expensive (and I know you can't use it forever), but it might look cheap vs. what we're gonna get. I hope I'm wrong, but in the years I've been insuring myself, it's never gotten cheaper.

edit: I agree on the waivers...like so many other things, a lack of lobbying power for the self employed leaves us holding the bag yet again

Here is a calculator I found that can be used to get an estimate of an annual premium and any subsidy you may be eligible for. Enter just a few numbers, and you'll have an estimate. The estimate given is for the "Silver" plan, and also includes the estimate for the "Bronze" plan.

http://kff.org/interactive/subsidy-calculator/

[54ny77]

I can recall a few years or so back when a young promising kid on Rock Racing crashed and had bad dental damage. There was a fundraiser online that was organized by Mr. Bahati to help pay for it, since the team wouldn't do so and, amazingly, didn't even provide dental insurance for its riders. I contributed to the cause, and could only think what a scumbag Mike Ball was for even allowing that to happen.

I hope Karma pays Ball a visit one day.

Not having HI does not stop many, many cyclists. Not only riding, but racing. Many times I've seen the hat passed around to help an injured cyclist who doesn't have coverage. I think it's pretty irresponsible. Me? I don't think so, but my giant (and I'm certain soon to be giant-er) annual premium is the first bill I pay on Jan 1st every year. Most people who think they can't afford coverage (usually 20 somethings) still go to bars, out to eat, on vacation, wear nice clothes... bugs me.

[christian]

My biggest disappointment is that I can't opt out of my employer health plan to join an Exchange. I'd happily pay $9,456 per year for my family premiums and to add my family to the overall risk pool; we're well-to-do, young, healthy, and active -- an actuarial dream family.

Even if we'd have to get to single-payer by opt-in, I'm raising my hand to opt.

[cfox]

Here is a calculator I found that can be used to get an estimate of an annual premium and any subsidy you may be eligible for. Enter just a few numbers, and you'll have an estimate. The estimate given is for the "Silver" plan, and also includes the estimate for the "Bronze" plan.

http://kff.org/interactive/subsidy-calculator/

Thank you very much for that link, it's the only thing I've seen that sheds any light on ACA.

The "premium" is close to what I'm paying now, but my out of pocket max go from $3,000 to $12,700. Super.

[thwart]

The "premium" is close to what I'm paying now, but my out of pocket max go from $3,000 to $12,700. Super.

From the calculator:

However, in many cases coverage will be more comprehensive and accessible than what is typically available today in the non-group market. As a result, 2014 premiums in the calculator cannot necessarily be compared to what people buying insurance on their own were paying before the law.

[thwart]

Found this, from US News&World Report, helpful as well (note that catastrophic plan is available to those under 30 OR if bronze plan is more than 8% of income):

ACA Bronze Tier Health Insurance vs. Catastrophic Plans
By ANDREA ADLEMAN
August 28, 2013

In the state-run health insurance marketplaces, the government-approved health insurance plans are divided into five tiers: platinum, gold, silver, bronze, and catastrophic. Analysts expect young adults to gravitate towards the bronze and catastrophic plans, which are the lowest-cost options.

Both the bronze and the catastrophic plans cover basic preventative health services including cholesterol tests, immunizations and screenings for depression and alcoholism (a full list is here). Both also cover, to varying degrees, all 10 categories of “essential health services”: hospitalizations, emergency services, ambulatory (outpatient care) services, some maternity and newborn care, pediatric care, vision and dental care for children, mental health and behavioral health treatment, rehabilitative and habilitative services and devices, laboratory services, and chronic care services.

There are some key differences between these two tiers, however. This chart can help you decide which plan may be right for you.

[dd74]

But I think you have to also be a bit more specific. Would this be if I suddenly was left without health insurance right now, after having my life as it is up to this point? Or would it be if I had never had health insurance?
I was talking about in both cases, actually.

[professerr]

Thank you very much for that link, it's the only thing I've seen that sheds any light on ACA.

The "premium" is close to what I'm paying now, but my out of pocket max go from $3,000 to $12,700. Super.

Where does it specify max out of pocket at $12,700? I can't find anything going higher than $6,400 (excluding monthly premiums of course).

I just ran the calculator for a relative in her mid 40s, perfect health, and the silver plan came out $600 per year in smaller premiums, $3000 lower deductible, and $2500 lower max out of pocket. This is compared to a high deductible individual Blue Shield ppo plan she currently is enrolled in. Obviously, ymmv.

No way I'd race without health insurance. Probably wouldn't ride at all.

It always saddens me to see listings from people selling expensive bikes to pay for medical bills. And, of course, because they had no insurance, the amounts the hospitals charge such uninsured people is vastly higher than they could charge an insurance company.

[professerr]

Never mind on the $12,700 cap -- I see this is the family cap not the individual cap.

[cfox]

From the calculator:

However, in many cases coverage will be more comprehensive and accessible than what is typically available today in the non-group market. As a result, 2014 premiums in the calculator cannot necessarily be compared to what people buying insurance on their own were paying before the law.

My current HI would be considered a "double platinum" plan...it's very expensive but has very comprehensive coverage and let's my family use any doctor we want. I cannot imagine any "Silver" ACA plan (the one the calculator uses) will be able to offer what I have now, so yeah, I'll be paying more for less.

[christian]

Thank you very much for that link, it's the only thing I've seen that sheds any light on ACA.

The "premium" is close to what I'm paying now, but my out of pocket max go from $3,000 to $12,700. Super.

My current HI would be considered a "double platinum" plan...it's very expensive but has very comprehensive coverage and let's my family use any doctor we want. I cannot imagine any "Silver" ACA plan (the one the calculator uses) will be able to offer what I have now, so yeah, I'll be paying more for less.

What's preventing you from staying on your current plan in 2014?

[professerr]

My current HI would be considered a "double platinum" plan...it's very expensive but has very comprehensive coverage and let's my family use any doctor we want. I cannot imagine any "Silver" ACA plan (the one the calculator uses) will be able to offer what I have now, so yeah, I'll be paying more for less.

My relative told me she got notice from Blue Shield (CA) saying she can keep her existing individual plan. Can't you?

[thwart]

My current HI would be considered a "double platinum" plan...it's very expensive but has very comprehensive coverage and let's my family use any doctor we want. I cannot imagine any "Silver" ACA plan (the one the calculator uses) will be able to offer what I have now, so yeah, I'll be paying more for less.You are in the minority.

I'd have to assume your employer is paying some of your premium.

Or... I want the name of your insurance company... and I'd love to find out how they can make a profit in today's market.

[cfox]

What's preventing you from staying on your current plan in 2014?

There won't be a "my plan" in 2014. My plan will be scrapped and new ACA compliant plans will be offered. I think this is the case for most if not all self-insured people. It's easier to just rip up the old ones rather than tweak this-and-that to make sure the plan is compliant. Like I wrote before, I will be shocked if the new plan (that is closest to my current plan) isn't substantially more expensive.

[cfox]

You are in the minority.

I'd have to assume your employer is paying some of your premium.

Or... I want the name of your insurance company... and I'd love to find out how they can make a profit in today's market.

My employer is me, the name is Blue Cross Blue Shield, and my premium is $20k/year for a family of four (44,43,11,9 yrs old)

[thwart]

My employer is me, the name is Blue Cross Blue Shield, and my premium is $20k/year for a family of four (44,43,11,9 yrs old)

Gotcha. I was assuming you were paying ~ $14K a yr.

Family of 3 here (59, 57, 24). Oldest daughter has her own plan.

Silver plan for us is ~ $14K, with additional max of ~ $13K OOP costs. In semi-retirement, we may actually do best with the catastrophic plan.

[cfox]

My relative told me she got notice from Blue Shield (CA) saying she can keep her existing individual plan. Can't you?

Nope, I got a letter about 2 weeks ago telling me my plan would be ripped up and I'd be offered three new ACA compliant plans. I'd love to keep my current plan.

[biker72]

Ted needs more than a bike.

+100
John McCain called him a "wacko bird".

[biker72]

I have a Medicare substitute plan that includes drug coverage.
I get calls monthly from a company RN asking how my cycling/exercise is doing...etc.

My insurance company encourages me to ride. I guess the benefits of cycling outweigh the risk of broken bones as far as they are concerned.

[BumbleBeeDave]

+100
John McCain called him a "wacko bird".

. . . This is an intersting discussion wih lotsof useful information, but let's be careful with the partisan political references. I'd hate to have to shut it down.

Thanks . . .

BBD

[verticaldoug]

+100
John McCain called him a "wacko bird".

John McCain is not the brightest bulb. It may be a case of Cruz playing chess and McCain playing checkers.

I have great respect for Alan Dershowitz. Whether Dershowitz really said Cruz is brilliant or it is some PR company planting the story into the net, I don't know. But I am pretty confident, Cruz just staged a academy award level performance for his real objective. (2016)

[biker72]

My son is self employed with no employer to pay any part of his health care.
Hopefully he will qualify for some premium reduction.

[professerr]

Nope, I got a letter about 2 weeks ago telling me my plan would be ripped up and I'd be offered three new ACA compliant plans. I'd love to keep my current plan.


You got me worried, so I just called Blue Shield to check on this for my aunt. I was told Obamacare specifically exempts grandfathered plans from most of the obamacare requirements other than those they already had to comply with last year anyway. So she can keep her existing plan if she wants.

Anyway, you can always move to CA -- we’ll still take you. Here, your premium for silver would be around 12K. That’s 8K per year less than what you are paying now, which would take the sting out of the possibility you’d burn through the higher deductible, no?

Joking aside, I’m curious what state you are in where the obamacare premium for silver is close to the $20K you're paying now. Quite a jump.

My bigger worry would be about which doctors will be included under the networks for the new plans -- seems that is not settled, no?

[christian]

Nope, I got a letter about 2 weeks ago telling me my plan would be ripped up and I'd be offered three new ACA compliant plans. I'd love to keep my current plan.Respectfully, that's a business decision that BC/BS is making. Any plan which was in existence on March 23, 2010 could have been grandfathered by BC/BS and you could've kept it. I can't speculate why BC/BS is cancelling your present plan, but non-compliance with ACA certainly isn't the whole truth.

[#campyuserftw]

I'm assuming you have Veterans health care as do I,which IMO is some of the best in the World. I've had Blue Cross, Kaiser along with their high premiums so I'm hoping the public wakes out of their stupor to realize Obamacare or however one wants to label it is a godsend compared to what they are paying for now.

Some interesting data:

'Obamacare Will Increase Avg. Individual-Market Insurance Premiums By 99% For Men, 62% For Women'

http://www.forbes.com/sites/theapothecary/2013/09/25/double-down-obamacare-will-increase-avg-individual-market-insurance-premiums-by-99-for-men-62-for-women/

Veterans. My dad is 100% disabled. My mom received TriCare Coverage as the spouse. She loved it and enjoyed heading to the VA with my dad. As a retired, registered nurse, she spent 3 days a week volunteering at the Woman's Veterans Administration Health Clinic, where she would also receive great healthcare when needed.

It's over. She got the letter in the mail last month. No more. TriCare is gone. She must now rely on Medicare. Her upcoming cataract surgery, "Is going to cost me a lot of money out of pocket now, and I had no idea, and I have to find a Doctor who'll take me" she offered. My mom was literally in tears at the letter which came in the mail. She loved volunteering at the clinic and, "It was a great program. I had fantastic care I wanted to keep and was told I could".

The impact on Veterans and their families is something which would be nice to see clearly defined. Google "Obamacare TriCare" and you may be surprised. I won't post the links as they are quite controversial.

[enr1co]

FYI - The Blue Cross and Blue Shield System consists of 37 independently operated Blue Cross and Blue Shield member companies, a Federal Employee Program® and an Association.

For example, Blue Shield of California is a separate company and organization from Anthem Blue Cross which also services California.

Plans and rates will vary between all Blue Cross and Blue Shield companies across the US so its worth confirming any changes with your respective BC/BS.

[Ralph]

I'm on medicare. Having catarac surgery next week. Do have a seconday plan. Have made my deductibles for the year. Catarac surgery will cost me about nothing out of pocket. Lots of fear mongering out there.

[#campyuserftw]

I'm on medicare. Having catarac surgery next week. Do have a seconday plan. Have made my deductibles for the year. Catarac surgery will cost me about nothing. Lots of fear mongering out there.

Either my mom, who spent 22 years in healthcare as an RN, is lying, dumb, or fear-mongering. Who knew this from a retired registered nurse (she who voted for Obama)? She was booted from TriCare, and she didn't see that coming, either. Dad the USMC retired, is livid. Neither of them is fearful or spreading fear, but one is very sad, and the other, furious.

[christian]

Your mom better read that letter again - what you're saying doesn't jive with the law -- the only changes to TriCare (which is authorized under totally separate statutes and administered by the DoD) was that TriCare enhanced the under-26 dependent coverage and that the 11(ish) TriCare plans had to comply with some of the other regulations for minimum coverage, which they do. What TriCare plan does she have?

[christian]

BTW, I'm no great fan of the ACA, which I feel obligated to say since my last two posts have been implicit defenses of the program.

[professerr]

Some interesting data:

'Obamacare Will Increase Avg. Individual-Market Insurance Premiums By 99% For Men, 62% For Women'

http://www.forbes.com/sites/theapothecary/2013/09/25/double-down-obamacare-will-increase-avg-individual-market-insurance-premiums-by-99-for-men-62-for-women/

Veterans. My dad is 100% disabled. My mom received TriCare Coverage as the spouse. She loved it and enjoyed heading to the VA with my dad. As a retired, registered nurse, she spent 3 days a week volunteering at the Woman's Veterans Administration Health Clinic, where she would also receive great healthcare when needed.

It's over. She got the letter in the mail last month. No more. TriCare is gone. She must now rely on Medicare. Her upcoming cataract surgery, "Is going to cost me a lot of money out of pocket now, and I had no idea, and I have to find a Doctor who'll take me" she offered. My mom was literally in tears at the letter which came in the mail. She loved volunteering at the clinic and, "It was a great program. I had fantastic care I wanted to keep and was told I could".

The impact on Veterans and their families is something which would be nice to see clearly defined. Google "Obamacare TriCare" and you may be surprised. I won't post the links as they are quite controversial.

I can't speak to your mom's situation, and I don't understand the link between that and Obamacare.

But, it is worth noting that the source of the data you quote on premiums going up is a headline to a column in Forbes written by a Senior Fellow at the Manhattan Institute, a libertarian think tank, and "a paid advisor to health care investors and industry stakeholders."

People can weigh for themselves the relevance of that.

[cfox]

You got me worried, so I just called Blue Shield to check on this for my aunt. I was told Obamacare specifically exempts grandfathered plans from most of the obamacare requirements other than those they already had to comply with last year anyway. So she can keep her existing plan if she wants.

Anyway, you can always move to CA -- we’ll still take you. Here, your premium for silver would be around 12K. That’s 8K per year less than what you are paying now, which would take the sting out of the possibility you’d burn through the higher deductible, no?

Joking aside, I’m curious what state you are in where the obamacare premium for silver is close to the $20K you're paying now. Quite a jump.

My bigger worry would be about which doctors will be included under the networks for the new plans -- seems that is not settled, no?
I'm in Connecticut, and my current plan would be whatever the highest level (gold? palladium?) would be, not silver.
Respectfully, that's a business decision that BC/BS is making. Any plan which was in existence on March 23, 2010 could have been grandfathered by BC/BS and you could've kept it. I can't speculate why BC/BS is cancelling your present plan, but non-compliance with ACA certainly isn't the whole truth.
Oh, I agree for sure it was a business decision. I am surprised, even with my high premium it must still not be a money maker.

[#campyuserftw]

I can't speak to your mom's situation, and I don't understand the link between that and Obamacare.

But, it is worth noting that the source of the data you quote on premiums going up is a headline to a column in Forbes written by a Senior Fellow at the Manhattan Institute, a libertarian think tank, and "a paid advisor to health care investors and industry stakeholders."

People can weigh for themselves the relevance of that.

I called my mom just now. Last I saw her, she was literally in tears and talking about it made her upset. She is 71, my dad is 73. He was medically retired, 100% disabled USMC Veteran. Here are the facts and I'll quote her:

"I used to be able to go to the VA Hospital. I love it there as I spend a lot of time taking your dad for his three-times a week physical therapy. So, I decided five years ago to volunteer at the woman's clinic.

For my health care, I used to be able to walk into the VA and let's say an antibiotic bill was given to me on the way out for $100.00. I would hand them my Medicare Card and my TriCare Card. Eighty percent of the bill was written off to Medicare, who was never charged in reality, as its a government program and so the VA didn't ever send them a bill. The remaining twenty percent of the bill was sent to TriCare. I paid nothing on the spot, and would receive a bill from Tricare for a few dollars, maybe five dollars for that $100.00 initial bill.

I used to have a wonderful doctor I knew for five years. Two months ago he let me know I need cataract surgery. I didn't have it done as I had a family wedding and could not fit it in.

Last month I received a letter from TriCare. Now? I can go to the VA Hospital. Let's pretend I have that same $100.00 bill for an antibiotic. Now I must pay 80% of that $100.00 on the spot. The VA sends the 20% left over to TriCare, who will pay a small portion of that remaining 20%."

cliffs = what cost my mom nothing, now will cost her 80% out of pocket. The VA System is, "Essentially forcing me away from them and now I need to drive 30 minutes away, instead of five minutes to the VA, and find someone who'll accept my Medicare. The cataract surgery is for both eyes, and it's going to cost me a lot of money out of pocket, that I'll never be reimbursed for. Your dad and I are both shocked and devastated."

I dropped the subject. I offered to help with the rides to/from cataract surgery, and any other help they need. She said to me, "I am all for everyone having care. I am a nurse. I love healthcare, but this? I get screwed over as Obama told those who have TriCare and Medicare that we were 'double-dipping'. As the the wife of a Marine, who spent nearly fifty years taking care of your dad, I enjoyed the past five years of the VA taking care of my health issues. Most of all, I will miss my doctor."

I asked her if she will still volunteer up there? "No. I will stop at the end of October. I am so angry about this, that going there makes me furious."

Note: there is NO fear mongering, or drama here. This is a factual story and two good people, my parents, one who all but gave his life for this country, got hosed over. My mom said, "Don't bring this up with dad. He turns red, then pale white from anger."

His VA healthcare has not changed. These are good, noble people who did nothing wrong, and did not want any changes to her health care coverage. Now either her story is a farce, she's misinformed, or she wants to fear-monger. Or like she said, "I feel like I was lied to all along the past few years and we didn't see this coming." She was valedictorian of her nursing class, spent a very long time working at the best, local hospital, retired, decided to volunteer at the VA, was in the loop all along of the pending Healthcare Act, but nobody saw this coming.

[choke]

the question occurred to me about what a person would not do if they didn't have health coverage. So for you cyclists, would riding a bike be one activity you wouldn't do if you didn't have health coverage?Health insurance or the lack thereof has never been a factor in my decision to ride or to do anything that some might consider 'dangerous'.

[93legendti]

Enjoy The (Un)affordable Health Care Act, which doesn't cut premiums by $2,500; does nothing to cut costs (tax increases on medical devices and the hiring of 16,000 IRS agents alone to implement?); costs twice as much as promised, and still leaves 30 million uninsured. Don't forget the $7,000 marriage penalty, the $64 million missing slush fund (as reported today), doctor shortage, and, despite sign-ups supposed to start October 1, BCBS in Michigan STILL doesn't know what plans will cost:


"Healthcare costs in the United States are like a tapeworm eating at our economic body."

Those words come from famed investor Warren Buffett, who said he would scrap Obamacare and start all over.

"We have a health system that, in terms of costs, is really out of control," he added. "And if you take this line and you project what has been happening into the future, we will get less and less competitive. So we need something else."

Buffett insists that without changes to Obamacare average citizens will suffer.

"What we have now is untenable over time," said Buffett, an early supporter of President Obama. "That kind of a cost compared to the rest of the world is really like a tapeworm eating, you know, at our economic body."

Buffett does not believe that providing insurance for everyone is the first step to take in correcting our nation's healthcare system.

"Attack the costs first, and then worry about expanding coverage," he said. "I would much rather see another plan that really attacks costs. And I think that's what the American public wants to see. I mean, the American public is not behind this bill."

http://moneymorning.com/ob-article/obamacare-buffett.php?code=dis-oc-buffett


"President Obama's national health care law will cost $1.76 trillion over a decade, according to a new projection released today by the Congressional Budget Office, rather than the $940 billion forecast when it was signed into law."

http://washingtonexaminer.com/cbo-obamacare-to-cost-1.76-trillion-over-10-yrs/article/1175831

"Unions To White House On Obamacare, Taft-Hartley Plans: 'You Made The Problem, You Fix It':

'Our responsibility is not to the political left or right, it's to our (union) members," Schlittner said. "As far as this law is concerned, we think if it's not fixed, it could cause harm to our members who've bargained for health care. These are not rich people, they're workers in grocery stores."'

http://www.huffingtonpost.com/2013/08/21/unions-obamacare-taft-hartley_n_3790548.html


"In fact, the CBO projects that under Obamacare over the next decade, the number of uninsured will never fall below 30 million. Here are the year-by-year projections from the report:

2013 - 55,000,000
2014 - 44,000,000
2015 - 37,000,000
2016 - 31,000,000
2017 - 30,000,000
2018 - 30,000,000
2019 - 30,000,000
2020 - 30,000,000
2021 - 31,000,000
2022 - 31,000,000
2023 - 31,000,000"

http://www.weeklystandard.com/blogs/cbo-uninsured-under-obamacare-never-falls-below-30-million_733740.html
http://www.cbo.gov/sites/default/files/cbofiles/attachments/44190_EffectsAffordableCareActHealthInsuranceCover age_2.pdf

"I just see a huge train wreck coming down," (Sen. Baucus) told Health and Human Services Secretary Kathleen Sebelius at a Wednesday hearing. "You and I have discussed this many times, and I don't see any results yet."

http://thehill.com/blogs/healthwatch/health-reform-implementation/294501-baucus-warns-of-huge-train-wreck-in-obamacare-implementation

"Behind the numbers in 3 key states. In Florida, for instance, officials constructed a hypothetical silver-level plan based on the offerings available today. Then they looked at how the cost of that plan compares to the average silver plan that will be available on the exchange. Florida found premiums will rise between 7.6% and 58.8%, depending on the insurer. The average increase would be 35%...
Ohio, meanwhile, said there would be an average increase of 41% by comparing a trade association's report of premiums for all plans available today with the average premium expected on the exchange.
Indiana officials said prices would rise an average of 72%. But they were looking at the cost of providing care, not actual premiums."

http://money.cnn.com/2013/08/06/news/economy/obamacare-premiums/index.html


"If you like your plan, you can keep our plan":

"Residents of the Garden State have recently been informed that state-approved, private health insurance coverage that suited 106,000 of them just fine does not suit the federal government at all, and thus will come to a sudden and non-negotiable end next year.

At that point, those New Jersey residents who have taken advantage of low-cost insurance because they're rich in health but poor in financial resources will be at the mercy of a government-fabricated "market" in which the individual buyer has no leverage at all."

http://www.cleveland.com/obrien/index.ssf/2013/08/you_can_keep_your_health_care.html

[christian]

I called my mom just now. Did your mom recently turn 65? Does she not pay for Medicare Part B? All of these events would impact her Tricare eligibility and costs. I'd try to get to the bottom of this. I'd recommend you call an advisor and figure out what's going on.

[avalonracing]

Interesting how the forum members who often post links to, and cite, um, "facts" from neo-con websites are already having serious problems as a result of the Affordable Care Act while those who do not read the same, uh, "studies" do not seem to be affected by impending legislation.

Kinda like a neo-con buddy of mine who says that he knows of a number of doctors that are considering getting out of the business because they are going to go broke because of the so-called Obamacare. When I mentioned comment this to a number of physicians at a party (the hosts were both doctors hence the high number of physicians present) they all chuckled and called complete BS. The general thought was, "Yes, we are all going it give up on lucrative careers that we spent many years training for because according to talk radio not going to be able to make a living".

[bobswire]

Some interesting data:

'Obamacare Will Increase Avg. Individual-Market Insurance Premiums By 99% For Men, 62% For Women'

http://www.forbes.com/sites/theapothecary/2013/09/25/double-down-obamacare-will-increase-avg-individual-market-insurance-premiums-by-99-for-men-62-for-women/

Veterans. My dad is 100% disabled. My mom received TriCare Coverage as the spouse. She loved it and enjoyed heading to the VA with my dad. As a retired, registered nurse, she spent 3 days a week volunteering at the Woman's Veterans Administration Health Clinic, where she would also receive great healthcare when needed.

It's over. She got the letter in the mail last month. No more. TriCare is gone. She must now rely on Medicare. Her upcoming cataract surgery, "Is going to cost me a lot of money out of pocket now, and I had no idea, and I have to find a Doctor who'll take me" she offered. My mom was literally in tears at the letter which came in the mail. She loved volunteering at the clinic and, "It was a great program. I had fantastic care I wanted to keep and was told I could".

The impact on Veterans and their families is something which would be nice to see clearly defined. Google "Obamacare TriCare" and you may be surprised. I won't post the links as they are quite controversial.

I'm sorry about you Mom's Tri Care and I'm not up on it to fully give a reasoned response but I did find this that counters what you stated.
http://www.tricare.mil/CoveredServices/BenefitUpdates/Archives/8_20_12_NewContractor.aspx

As a Vet my coverage won't be affected at all under the new health plan.
I just received this from the Veteran Administration. Don't believe all those horror stories, I'll leave it at that to keep the politics out of it.

http://i42.tinypic.com/vmurl3.jpg

[professerr]

I'm in Connecticut, and my current plan would be whatever the highest level (gold? palladium?) would be, not silver.

Oh, I agree for sure it was a business decision. I am surprised, even with my high premium it must still not be a money maker.

OK, got it. I think things might not be as bleak for you as you think: Currently you’re paying about $20K a year for a two adult, two children family, with a $3000 max out of pocket, right? Gold plans in CT provide a max out of pocket of $12,000 for the family ($6,000 if you stay in network). A silver plan for a family like yours living in, say, Greenwich will cost about $13K. Gold plans are about 15% higher, so I believe you should expect to pay $15K for a Gold plan. That’s $5000 less per year than you’re paying now.

Given your current $3000 max, as long as you are not exceeding $8000 per year in medical expenses, you’ll come out ahead with Obama care (because you’re guaranteed to save $5000 in premiums). Right? You’ll do even better if you stay in network -- you’ll always come out ahead no matter what your medical expenses because the amount you save in premiums ($5000) is always greater than the amount by which the max out of pocket increased ($3000). A key thing, then, in selecting an insurer is who is in their network.

Note, btw, I used the max out of pocket number for the Gold plan, not the deductible which is much lower: $6000 per family vs. $12000.

I'm working this out for my aunt too, and the numbers work even better for her.

[jtakeda]

I've been watching Senator Ted Cruz (R-Tx) "filibuster" into his 14th hr. about defunding Obamacare, and the question occurred to me about what a person would not do if they didn't have health coverage. So for you cyclists, would riding a bike be one activity you wouldn't do if you didn't have health coverage?



I have no health coverage. Doesn't stop me from riding.

[beeatnik]

Bike shop owner in LA broke his hip MTBing in the Arizona desert less than a year ago. After the accident, he had to wait a week for surgery because he was/is uninsured. His friends have held a fundraiser or two. Saw him on the bike last night. His shop is still open.

It's a wacky system.

[Dale Alan]

No coverage here . Not riding has never crossed my mind.

[cfox]

OK, got it. I think things might not be as bleak for you as you think: Currently you’re paying about $20K a year for a two adult, two children family, with a $3000 max out of pocket, right? Gold plans in CT provide a max out of pocket of $12,000 for the family ($6,000 if you stay in network). A silver plan for a family like yours living in, say, Greenwich will cost about $13K. Gold plans are about 15% higher, so I believe you should expect to pay $15K for a Gold plan. That’s $5000 less per year than you’re paying now.

Given your current $3000 max, as long as you are not exceeding $8000 per year in medical expenses, you’ll come out ahead with Obama care (because you’re guaranteed to save $5000 in premiums). Right? You’ll do even better if you stay in network -- you’ll always come out ahead no matter what your medical expenses because the amount you save in premiums ($5000) is always greater than the amount by which the max out of pocket increased ($3000). A key thing, then, in selecting an insurer is who is in their network.

Note, btw, I used the max out of pocket number for the Gold plan, not the deductible which is much lower: $6000 per family vs. $12000.

I'm working this out for my aunt too, and the numbers work even better for her.
If you are correct and that's how it works out for me, I am going to find you and hug the hell out of you

[cfox]

Interesting how the forum members who often post links to, and cite, um, "facts" from neo-con websites are already having serious problems as a result of the Affordable Care Act while those who do not read the same, uh, "studies" do not seem to be affected by impending legislation.

Kinda like a neo-con buddy of mine who says that he knows of a number of doctors that are considering getting out of the business because they are going to go broke because of the so-called Obamacare. When I mentioned comment this to a number of physicians at a party (the hosts were both doctors hence the high number of physicians present) they all chuckled and called complete BS. The general thought was, "Yes, we are all going it give up on lucrative careers that we spent many years training for because according to talk radio not going to be able to make a living".

There are a lot of doctors in NYC that haven't accepted any type of insurance for years. You pay me, then you deal with your insurance to get reimbursed. That's one way to go if you practice in an affluent area..

[dd74]

Kinda like a neo-con buddy of mine who says that he knows of a number of doctors that are considering getting out of the business because they are going to go broke because of the so-called Obamacare. When I mentioned comment this to a number of physicians at a party (the hosts were both doctors hence the high number of physicians present) they all chuckled and called complete BS. The general thought was, "Yes, we are all going it give up on lucrative careers that we spent many years training for because according to talk radio not going to be able to make a living".
You nailed it. I have two friends who are doctors, one of whom I ride with, who is livid about Obamacare. He happens to be a nuclear cardiologist, voted (R) in the last election, and is now considering leaving the practice entirely for reasons I'm certain many of you can realize with your own $$ intelligence.

Buddy #1 is from Queens, NY, brought up with a bit of monetary opportunity.

Buddy #2 is a E.R. surgeon, sees ···· that would make many of us puke. He says O-B care is a much-needed asset to Americans, and at any rate, will not leave his trade. He is from Ethiopia, and brought up with war and displacement.

Draw whatever conclusions you want from these varying socio-national demographics. I believe both have a certain amount of right and wrong to their positions.

[BumbleBeeDave]

. . . we're done with this one.

Some very good discussion here, but it has unfortunately veered over the edge into partisan politics and away from the OP's original question.

BBD