Laura Roose retweeted
When HDHPs started to become a "thing", I thought they may be the best things since sliced bread.... for about an hour (or less).
An HDHP sounds good at face value - a triple tax savings vehicle. Maybe - for a chosen few.
First, the premiums for a HDHP aren't really that much lower than other plans.
Second, if you pay for an HDHP, you also get the honor of paying the first $2000, $3000, etc. of your healthcare expenses. I just talked to a group last week. When I asked what their premium was, they said "$456 for single". I told them that it could be better but it wasn't the worse I'd seen and then ask what the individual deductible was. $9000!!!
That isn't a plan, that is theft by deception. These people are paying over $5000 per year so that they can pay $9000 per year if they need healthcare. Total - $14K per year before those billions dollar insurance companies PAY A DIME! That's $1166/month if major medical is needed. That's groceries for a month - life sustaining food not "just in case I have a heart attack" money.
So, THEN you get to delays, denials, etc. Imagine paying $14K for coverage for life saving medical needs to be denied. That is what happens.
40% of health plans in the U.S. are ERISA plans - State insurance laws don't really apply so State Insurance Commissioners are off the hook for those.
Then you get to the word "law". Sadly, "law" applies to those chosen by the government for it to apply to. Laws are written but not enforced. The Transparency Act has been in effect for over 5 years. It's just paper. An Executive Order was signed to enforce that law. It's just paper.
Then you get to our ever faithful IRS - non-profit hospitals are holding BILLIONS in "profit", buying up real estate every second of every day - real estate that they pay ZERO real estate taxes on causing the real estate taxes of average Americans to skyrocket AND, since the real estate is owned by the hospital, they get to charge you for the luxury of walking through the friggin' door to see your doctor, who they also own, so they can overcharge you again.... meanwhile, in the C-Suites, CEOs are making tens of millions in salaries, flying on chartered plains, joining social clubs (hospitals pay the dues), etc. Does the IRS care? No. When is the last time a non-profit was audited. Now ask "when is the last time the IRS audited a normal business man?" Daily. Hourly.
Lest we not forget, our government mandates that employers with over 50 employees cover their employees and the government mandates what must be covered (aka - they have to pay for coverage for their employees that may not be coverage at all when needed). Employers can give their employees money to buy coverage BUT, that money must be used to buy coverage on an individual basis. They can't just bank it and use it for medical expenses. By law, they MUST purchase what is called "insurance" from the same corrupt organizations that were sell it to employers.
Then lets get to the $1M claim. I've seen dozens of $1M claims in 30 years. Never have I seen one that was actually payable at $1M. Hospitals inflate charges, they unbundle charges and they simply make up charges. But still, a claim should be paid, no matter what the amount, when medically necessary.
To Mark's point - the entire healthcare industry (with the few exceptions of independent physicians, labs, imaging, etc) IS compromised.
And finally, if you are looking at a health insurance product, period, BE CAREFUL - it is likely rigged against you.
Do not, under any circumstance, believe that any form of government is coming to save you from healthcare costs. We are on our own.
As a side note, our government, with its last CAA, made being the fiduciary over a health plan more burdensome on company CEOs, owners, etc. so not only does the government look the other way, they put the burden of overseeing the health plans on YOU, the employer and that burden is immense.
So I went down the rabbit hole of trying to determine what are the economics for someone, who is currently healthy , to go to a HDHP with a 10k plus deductible.
The question I asked is “I dont trust insurance companies. What happens if I have a million dollar emergency and they won’t pay “. All I can say is WTF
If they don’t pay, there are Independent Review Organizations, who are supposed to be independent, and their decision to pay or not is final. I asked for examples of companies. One was ExamWorks. That rang a bell.
These motherfuckers are the same company that issued a ridiculous denial for a patient I was trying to help. So I knew the Too Big To Care, vertically integrated insurance companies hired them to do DENIALS !!! WTF.
The biggest customers of the companies that are the final decision makers for insurance carrier denials, are the biggest insurance companies.
That is beyond fucked up. It’s the definition of conflict of interest. How do state insurance commissioners allow this ?
The high deductible plans that many people say is the solution to fixing how we do insurance, may be effectively compromised
If you are looking at a HDHP, BE CAREFUL
It might just be rigged against you
Laura Roose retweeted
Steve Kerr says Roger Federer taught his Warriors team the secret to sustained success wasn’t outworking everyone, it was building a life around your craft you never want to escape from
“I’ll tell you a great story about Roger Federer. We were playing in China with the Warriors in 2017. Roger was in Shanghai for the Masters tournament, so we invited him to come speak to the team.”
“Draymond Green asked him, ‘How do you sustain success? How have you managed to win majors 20 years after you first won one?’ Everyone was expecting him to say, ‘I work harder than everybody,’ the will, all the clichés.”
“Roger Federer says, ‘I get up every morning and I make breakfast for my kids. Then I take them to school and drop them off. Then I go practice tennis for about two hours, and I’ve figured out a really good routine where I don’t destroy my body, but I can get all the work in I need.”
“‘Then I go have lunch with my wife. In the evening, we cook dinner together. The kids are all home from school. We ask them about school. There’s so much joy in the house. We put them to bed, and then I put my head on the pillow and go, “Man, that was just a great day.” And I’ve been doing that for 20 years.’”
“And it was like, yes. That’s it. That’s the formula. That’s what leads to sustained success. He loves tennis. He loves his family. He loves life. It’s not outworking everybody and banging your head against the wall, ‘I’m going to be better than everybody.’ It’s allowing your natural talent to shine through with a work ethic, with a great family life, with perspective, with peace, with mindfulness.”
“It’s perspective. It’s joy. It’s passion. It’s mindfulness. It’s an awareness that we are truly lucky. To get the most out of ourselves, it’s our daily rituals and experiences and love and joy.”
ESF’s finest 💚
Botanist Robin Wall Kimmerer, a member of the Citizen Potawatomi Nation, is author of the New York Times bestsellers "Braiding Sweetgrass" and "The Serviceberry" – books that advocate for living and working in collaboration with the Earth.
She talks with Martha Teichner about the importance of respecting both Western scientific knowledge and indigenous knowledge, planting trees, and sharing the gifts of nature.
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