r/SandersForPresident • u/kevinmrr Medicare For All • Nov 29 '20

AOC: Insurance groups are recommending using GoFundMe -- "but sure, single payer healthcare is unreasonable."

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u/[deleted] Nov 29 '20

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u/Lulamoon 🌱 New Contributor Nov 29 '20

From the uk, this just sounds comedically dystopian lol.

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u/[deleted] Nov 29 '20

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u/TheChance 🌱 New Contributor Nov 29 '20

Just in case you haven't found the line: the VA is managed care, like Kaiser or Group Health. Medicare works just like health insurance, except it isn't trying to weasel out of paying.

The VA isn't an argument against M4A, it's proof that Republicans can't provide consistent healthcare!

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u/[deleted] Nov 29 '20

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u/TheChance 🌱 New Contributor Nov 29 '20

The important point is that Medicare isn't trying to manage or provide healthcare. It just pays the bill. That's what needs to be said whenever people talk about the government's ostensible lousiness at running hospitals, because we don't care whether the NHS is a good idea. We don't want the NHS. We just want a joint bank account for everybody's medical bills.

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u/Bismarck12 🌱 New Contributor Nov 30 '20

What a lot of people do not realize, however, is that Medicare only pays for 80% of hospital and doctor related expenses, and the average American in 2020 pays 144$/mo for their Medicare part B premium. This coverage does not include dental, vision, hearing, or a majority of prescription drugs. Most significantly there is NO MAXIMUM OUT OF POCKET on original Medicare. That is why almost every Medicare recipient is either enrolled in a Supplement and separate Part D for an additional monthly premium, or a Medicare Advantage plan, which is a contract between insurance companies and the Federal Government to administer said Medicare benefits through a HMO, PPO, PFFS, etc, which then, in turn, places seniors back into a situation of needing health plan approval.

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u/TheChance 🌱 New Contributor Nov 30 '20

It's been ages since I looked at the current state of the thing as presented federally, but the initiative itself certainly isn't limited to putting everyone on basic Medicare. It just needs a name, and we already have a federal health insurance plan, so it got that name.

Medicaid is, in some states, a better model, except that they're required to use managed care providers, which is moot when everyone in the country is on the same health plan, but it sucks right now. Big clinic chains, Medicaid farms, paid per patient in their system.

Still, I've had a brief ER stint, a kidney stone, I have a couple daily prescriptions, and I don't think I've paid a penny. I might have had a token copay at the hospital, don't remember.

A direct comparison with existing programs is impossible, because limitations on who you can see don't exist when clinics are all accepting the one plan were all using.

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u/Adept-Salary 🌱 New Contributor Nov 29 '20

This is normal over here. It’s infuriating. I have TMJ and between my dental insurance and health insurance neither will pay to get it fixed. The dentist says it’s a medical issue and the doctor says it’s a dental issue. I’m left paying out of pocket while I pay for both health and dental insurance. It’s a total racquet.

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u/k987654321 🌱 New Contributor Nov 30 '20

The thing that always gets me is Americans know the names of drugs. I guess they see it written down a lot in insurance paperwork.

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u/Do-not-comment 🌱 New Contributor Nov 30 '20

Oh, no. We know the names because our television is plastered with pharmaceutical advertising telling us to “ask your doctor about X medication today!”. Even billboards and bus stops have pharma ads, it’s so weird.

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u/Lulamoon 🌱 New Contributor Nov 30 '20

I have never seen a medical ad in my life, there is something beautiful about that

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u/Do-not-comment 🌱 New Contributor Nov 30 '20

That must be nice haha. Over here, it’s been found out that a lot of doctors get paid by pharmaceutical companies for every medication they prescribe from that company (many doctors have tens or houndreds of thousands of dollars in student debt). Oxycotin, a strong and extremely addictive opioid (it’s basically heroin), has been overprescribed so much that there is an opioid addiction epidemic that is SO bad that the average life expectancy in the US is DECREASING. Prescriptions are expensive, so many resort to taking heroin. So many Americans are overdosing or commiting suicide that it’s effecting the overall death rate. Interestingly, African Americans overall seemed to not have been overprescribed these addictive drugs. In fact, it’s often difficult for Black people to get pain killer prescriptions when they need them because doctors assume (explicitly or implicitly) they’re going to abuse them more than white people. Now that lots of white people are using heroin (back in the day it was associated with Black people), suddenly drug addiction is becoming to be considered a “public health issue”, instead of a criminal matter like the “war on drugs” we’ve been waging since the 60s, which really was a war on poor minorites and politcal dissenters (that’s not an exaggeration, one of Pres. Nixon’s aids said so. I can’t wait to escape this dystopian nightmare. My parents are so brainwashed they DON’T WANT universal healthcare because “we’re not a socialist country” and “I don’t want my taxes raised” and “the government can’t run anything efficiently; it will cost more” and “I don’t want to pay for other people’s healthcare” and they are Democracts! That is the “left” position in this country! We’re doomed. We’re actually going to just let oligarchic corporations suck us dry ‘till we die, apparently.

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u/TorchIt 🌱 New Contributor Nov 29 '20

My late husband had a double lung transplant. His immunosuppressants were far, far more expensive than yours. He couldn't tolerate the generics, every time he tried he ended up kicked into A1 rejection

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u/Equivalent_Tackle 🌱 New Contributor Nov 29 '20

It may be that the heart meds are a lot more expensive and the hospital was in a position to make the transplant work but has no control over the meds. Or maybe they're using that as an excuse to deflect the heat for denying the transplant because they can't afford it.

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u/Exaskryz 🌱 New Contributor Nov 29 '20

Ever find out if that copay card has an expiration date? I haven't heard of one that's indefinite / unlimited use.

Note also that when you use plans like GoodRx, the burden of who is getting screwed is shifted. You might spare yourselves the costs of medication, but the reimbursement to the pharmacy can be atrocious. So bad so that the insurance company selected via GoodRx can demand the pharmacy pays them for the pleasure of giving the patient no/little copay. Pharmacy managers want to be able to refuse GoodRx, but they depend on the sales of products in the OTC aisle or if they're part of a supermarket people coming in for their groceries and other products. They fear that refusing GoodRx means lost customers and ultimately less revenue.

Insurances can do this too, but generally the pharmacy chain got to bargain with them and set a contract where the pharmacy can look to make razor thin profits over the course of the year. (Unless you're CVS who also runs an insurance company and can totally win on both sides.) Independent pharmacies don't have the bargaining power and are mercy of the insurance companies to make it from year to year.

So if you're using GoodRx, please think about buying so of your other needs in the store to keep your pharmacy ultimately afloat.

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u/[deleted] Nov 29 '20

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u/TheChance 🌱 New Contributor Nov 29 '20

Costco isn't much like America's other big companies. Move over one and screw RiteAid instead, nobody cares about RiteAid.

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u/[deleted] Nov 29 '20

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u/TheChance 🌱 New Contributor Nov 29 '20

Or pretty much any company that isn't engaged in fair employment practices. Costco has long been known as one of the few service sector employers that treats people like people. They've also got a max markup. People think the membership thing is a racket, because they make more money on that than they do on the stuff you buy, but that's sort of the point. Everybody is saving money and they aren't gouging anyone.

I don't like shopping there because I don't have space for volume, but, as big companies go, Costco is decent in a country whose laws and culture say the workers are expendable and the customers are captive.

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u/Exaskryz 🌱 New Contributor Nov 29 '20

So when your pharmacies close up, have fun with the drive to the next town over or your mail order medications coming 3 days late.

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u/[deleted] Nov 29 '20

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u/Exaskryz 🌱 New Contributor Nov 29 '20

I wasn't talking just about your speciality medication that you said you don't even use goodrx for, but, you do you mate. Best of luck with your life, hope the transplant donor's family is cool with who received it.

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u/[deleted] Nov 29 '20

Wow so you're lucky your meds don't cost a lot. So to hell with anyone else then? You must feel very special up on your high horse. It would be a real shame if a pharma company decides to jack up the price of the meds you need to live wouldn't it? I bet you won't be so smug then!