silver plan: 12k deductible, 1400$ per month

my concern isn't that pfizer is going to walk away from the US market. My concern is more that right now the US is exclusively making research for a company like pfizer viable. Thus if the US basically says we are only going to pay 25% of your asking price, is there enough incentive for Pfizer to continue to do R&D for new drugs? Currently the time period of exclusivety on a drug is their chance to get that R&D money back.

Thus I see 2 possible scenario's 1) the R&D dries up and or 2) the cost of these drugs globally will have to rise in order for the cost in the US to go down, thus the price will have to come close to a equalization globally.
 
https://www.healthcare.gov/find-premium-estimates/#results/&aud=indv&type=med&state=TX&county=Travis&age0=50&age1=45&age2=42&age3=5&employerCoverage=no&householdSize=4&income=180000

catastrophic plans for your criteria resulted un premiums of $67 to $113/month. deductibles are all $6300 per person. Not sure what ctiteria you were using.

The gold plans for your criteria go from $954 to $1656/ month. there are a couple of plans for $1300/ month with zero deductibles.

How do you have a healthy family of 4 with 3 adults in their 40's?
 
What I was saying is for you to choose the adult ages: 2 adults age 42, 2 adults age 45, and 2 adults age 49 and post the results. The ages of the 2 kids is irrelevant. Forget it though. Just choose 2 adults age 49. 2 male kids ages 10, 11. Look for PPO plans and if the plan doesn't work like the catastrophic plans which are for people under 29, do not include them.
 
7of 49 plans

Monthly Cost
• Under $700(0)
• $700 to $800(0)
• $800 to $900(4)
• $900 to $1,000(5)
• $1,000 to $1,100(3)
• $1,100 to $1,200(7)
• $1,200 to $1,300(1)
• $1,300 to $1,400(0)
• $1,400 & Above(3)

Deductible
• Under $500(0)
• $1,000 to $2,500(0)
• $2,500 to $5,000(2)
• $5,000 to $10,000(1)
• $10,000 & Above(4)


The cheapest plan is:
• Blue Choice Bronze PPO 006
Bronze
$842.12
• $6,000 (individual) $12,700 (family)


Below are the other plans offered:
Individual and Family health plans
• Showing 1-7 of 49
Plan Office Visit Deductible Monthly Cost
• Blue Choice Bronze PPO 006 Bronze
Compare
• You pay nothing after deductible
Find Doctors
• $6,000 (individual) $12,700 (family)
• $842.12
•
• Last day to apply for 2/1/2014 start date (Subject to carrier's guidelines)
• Blue Choice Bronze PPO 005 Bronze
Compare
• You pay 20% after deductible
Find Doctors
• $5,000 (individual) $12,700 (family)
• $851.54
•
• Last day to apply for 2/1/2014 start date (Subject to carrier's guidelines)
• myCigna Health Savings 6100 Bronze
Compare
• 0% after deductible
Find Doctors
• $6,100 (individual) $12,200 (family)
• $911.67
•
• myCigna Health Flex 5500 Bronze
Compare
• $30 PCP/$60 Specialist, no deductible visits 1-2, then 40% after deductible
Find Doctors
• $5,500 (individual) $11,000 (family)
• $944.63
•
• Blue Choice Gold PPO 001 Gold
Compare
• 30 Copay
Find Doctors
• $3,250 (individual) $9,750 (family)
• $1,403.88
•
• Last day to apply for 2/1/2014 start date (Subject to carrier's guidelines)
• Blue Choice Gold PPO 002 Gold
Compare
• 10 Copay
Find Doctors
• $1,500 (individual) $4,500 (family)
• $1,435.78
•
• Last day to apply for 2/1/2014 start date (Subject to carrier's guidelines)
• Blue Choice Gold PPO 011 Gold
Compare
• $30
Find Doctors
• $1,000 (individual) $3,000 (family)
• $1,471.94
 
When I read the terms of these plans, it makes me grateful that my wife is a federal employee (far cheaper even for a family plan and no deductible). (And before the wisecracks start, yes, I understand this means I'm grateful to the taxpayer for subsidizing my health insurance.) Unless the options dramatically improve (hahahaha!!!!!), we'll never leave that system.

Those rates are just ridiculous. I'm all for high-deductible medical insurance, but the whole point of accepting a high deductible is to have a low premium but self-insure up to a significant amount. if you're paying in the $850 - $1,500 per month range, you shouldn't have a high deductible.

Hell, even the most expensive plan you mentioned has a $3,000 family deductible. For that price, you shouldn't have to wipe your own ***, much less pay a $3,000.00 deductible. Highway robbery.
 
^^^^^

Yes, Deez you are 100% correct. That is why I kept asking PharmD to look it up. It has a lot more impact compared to the cursory looks earlier in the thread. Basically what is now happening is that people with good jobs and high income and a healthy family are now subsidizing others to such an extent that they are being forced out of the healthcare system. So lower income people are now able to afford healthcare but the middle class, upper middle class, and lower upper class cannot afford it.

There would be a huge revolt but many people in those income brackets work at companies and get subsidies from their companies and "rich" people don't revolt anyway. However, if you are self employed and your spouse does not work at a large corporation, you are now screwed.

And going back to your highway robbery comment, each year a crappy plan costs $900 per month and has a $12,000 deductible. So basically for $10,800 per year your family is covered for a catastrophic event. Any event that costs less than $22,800, the cost of the deductible plus the amount paid in insurance, will be paid for out of pocket. And even after you pay $22,800 for the insurance, you will have to pay a co-pay for the exceeding amount.

So the question for healthy people or mildly unhealthy people in the upper tax brackets is whether it is worth the risk to go uninsured. The market has flipped from the poor having to make these tough choices to the economic drivers of the country. That can't be healthy for the future of the country. The hope is that large employers drop coverage before the mid-terms so that its full impact can be seen. If this is allowed to go on a few more years, people with money will go bankrupt and die because they went uninsured and lost the gamble. However, more importantly from a political perspective, we will have gone so far down the path of Obamacare, that it will be impossible to reverse. At that point, more government control will be necessary.
 
^^^^^^^^ Interesting points. It wouldn't surprise me if we see wealthy people go uninsured, pay out of pocket for routine stuff, and then travel somewhere else if they need care that's exorbitant in the United States.

In reply to:
Click to expand...
 
There is a growing trend towards concierge medicine. Basically, you pay your premium directly to your doctor each month and you get unlimited office appointments/calls for prescriptions etc.

I think this model will become very popular, but will have to navigate plans for hospitalizations.
 
Have any hospitals tried a concierge medicine approach? An interesting business model would be if you pay a hospital a set fee per month and if you get sick or injured, the hospital would treat you for as many days as required. Coupled with concierge medicine such a plan would almost eliminate the need for insurance. It would be similar to an HMO but with some advantages and disadvantages. Specialty docs and pills, chemo, and medical devices would be all that would be needed for complete coverage. And those prices would come down if people were having to pay out of pocket.
 
I mentioned the hospital issue in my post about concierge.

There are hospitals who cater to this crowd, but the models have experienced mixed success. The hospitals I work with have not tried any models like this, but they all talk about exploring new ways to survive.
 
Again, I have no direct experience or knowledge in this area. As it stands now, concierge medicine will be in addition to insurance for hospitalization. The theory is that ACA will exacerbate the shortage of physicians. As a result, concierge programs will provide privileges like guaranteed appointments, calls etc.

Hospitals realize this will be a growing trend so they are interested in capitalizing on any program that will legally help them survive ACA. I have heard some are considering partnerships for designated services, room and board and testing services linked to the concierge medicine practice. The theory is these patients will either have insurance or financial resources to pay for services.
 
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