Costco Aetna Health Insurance now available in CA

[SK in CV]

[quote=UCGal]
I think the factor was adult ages. I did some what if’ing.. and it appears my husband’s age was a bigger factor. Employer coverage doesn’t include ages of adults in the pricing. (It can’t – age discrimination, etc.) ACA and privately contracted insurance considers age and smoking status.

We’ll have a gap of one year between when COBRA runs out and he qualifies for Medicare… so we’ll have to budget extra for that year. But we can make the adjustments we need with planning.[/quote]

That bolded part isn’t exactly right. Many employer plans are age-rated. It is allowed. It’s that many HR/EB departments will insist on non-age-rated policies, for a number of reasons (none of them evil), and most large carriers will comply. So premium quotes are based on age-rated-rates, and then divided equally by the actual number of covered employees. So what happens when COBRA becomes an issue is that older employees end up with lower premiums than in the individual market and younger employees end up with sometimes much higher rates than the individual market. You’re probably a beneficiary of the former.

[no_such_reality]

That’s right SK. I just rechecked. On CoveredCA a platinum. Pl an for a 40 yo single is basically $400

At 50 it’s $500

At 55its $750

At 60 it’s $860

And 64 it’s $950

So from 40 to 60 the basis more than doubles and a cost have double digit inflation rate. Basically at a rate to double over 7 years. So by the time the 40 year old that is paying $400 today will be paying $3200/month in future dollars per month in twenty years

[quote=SK in CV][quote=UCGal]
I think the factor was adult ages. I did some what if’ing.. and it appears my husband’s age was a bigger factor. Employer coverage doesn’t include ages of adults in the pricing. (It can’t – age discrimination, etc.) ACA and privately contracted insurance considers age and smoking status.

We’ll have a gap of one year between when COBRA runs out and he qualifies for Medicare… so we’ll have to budget extra for that year. But we can make the adjustments we need with planning.[/quote]

That bolded part isn’t exactly right. Many employer plans are age-rated. It is allowed. It’s that many HR/EB departments will insist on non-age-rated policies, for a number of reasons (none of them evil), and most large carriers will comply. So premium quotes are based on age-rated-rates, and then divided equally by the actual number of covered employees. So what happens when COBRA becomes an issue is that older employees end up with lower premiums than in the individual market and younger employees end up with sometimes much higher rates than the individual market. You’re probably a beneficiary of the former.[/quote]

[UCGal]

I didn’t what-if the scenario that would never apply.

I priced for current situations, and for the next few years (from an age point of view). Granted the future ones will likely be higher due to the super inflation of health care. I was doing this to get as realistic idea of our budget as possible.

[SK in CV]

[quote=no_such_reality]That’s right SK. I just rechecked. On CoveredCA a platinum. Pl an for a 40 yo single is basically $400

At 50 it’s $500

At 55its $750

At 60 it’s $860

And 64 it’s $950

So from 40 to 60 the basis more than doubles and a cost have double digit inflation rate. Basically at a rate to double over 7 years. So by the time the 40 year old that is paying $400 today will be paying $3200/month in future dollars per month in twenty years

[/quote]

That is not inflation. Inflation is price increases over time. These are prices at a single point in time. There is nothing in that data set that would properly lead to a conclusion about what premiums might be in 20 years.

[scaredyclassic]

Please mark me DNR.

I don’t know if I’ll change My tune when the shot hits the fan but most medical care I don’t want. Keep your bypass and your angioplasty, your statins, your back surgeries, most chemo. I’ll take a hernia repair, and broken bone setting. For most things I think I’m just gonna go with the natural flow unless I get really really good odds… I don’t want to die on the table.

I just read an interview with the author of

Knocking on heavens door the path to a better way of death

Katy butler

In the sun magazine.

Pretty awesome writer.

I’m in a strange mood. Society spends a lot of money and energy for very little if any extra good life

Now good dental care.. that I covet..barackatooth?

I think ultimately I’m more concerned with a path to a good death than more health care options.

My gut sense is most medical intervention isn’t worth the risk. I don’t believe doctors or their numbers. I just dont.

[njtosd]

[quote=TemekuT]My heart goes out to both of you – BG and CardiffBaseball. I have the same situation with my beloved baby sis, who has always been vigilant about diet, weight, exercise. She was diagnosed with stage IV cancer 2 years ago at age 47 and is fighting with all she’s got. Thankfully, when she was struggling financially in the prior 2 years, she did not cancel her PPO and now has many care choices and can be selective about her treatments. I believe my sis will benefit from Obamacare and I am fine with helping her and others similarly stricken.

On the other hand, I will now have to contribute to relatives, acquaintances, and strangers’ future medical costs due to their laziness, lack of discipline and bad choices. I have some relatives that take cholesterol meds and blood pressure meds, but indulge almost daily in bacon, egg, and donut breakfasts. I get to watch as the metabolic syndrome they obviously have transforms into diabetes. They regularly circle around parking lots to get the spot closest to the restaurant door, where they consume pizza or fried chicken, followed by sugary and fatty desserts. They have packed on the pounds around their middles, and it’s not attractive being 50 lbs overweight.

Now my sis, that’s just genetic bad luck, but I do resent paying for others’ preventable conditions.

BG – I also have an individual AETNA PPO and received the letter, and am confused about what to do. I take great care of myself, with a very healthy diet and lots of exercise. I am slim, and have no conditions at 55+. It’s not always fun to haul myself out of bed early like I did this morning, walk a few miles, and then breakfast on oatmeal, but I do it because I want to be a healthy oldster.[/quote]

TemkuT – you have a point, but you do not extend it far enough. There are very few bad things that happen to us that are completely out of our control. Genetic illnesses (including some forms of cancer) and being killed by a meteorite are a few. But let the person who never speeds, who never drinks, who manages their stress well, who stays out of dangerous situations cast the first stone.

There are some who would argue that quick cooking oatmeal (not instant – rolled) for breakfast is not the best choice in terms of it’s glycemic index. I ate it for years (and grape nuts) thinking these were very healthy (now I eat Old Fashioned Oats or eggs). Maybe these choices will end up harming me and costing you money (you seem to have an issue with eggs. . . .) But my guess is that you wouldn’t be resentful because my heart was in the right place. Does that make sense? Here’s another example – a friend of mine had a patient that almost died of liver failure due to some herbal tea she drank for a few months. That was a terrible choice – but probably her level of intelligence played into it (not smart to eat something from an unregulated source). The intelligence of our choices is largely influenced by our intelligence, which is largely genetic.

I feel like food morality is becoming the new religion. Obesity is indeed a problem – I thank my lucky stars that I have managed to avoid it. I know the food industry plays a part – but I’m not sure we know what the answer is. For years people thought ulcers were caused by stress alone. Now we know that they are caused by a bacterial infection. There is some evidence that gut bacteria play a part in obesity. Maybe all of our antimicrobial efforts are coming back to haunt us . . . .

[CA renter]

[quote=njtosd]

TemkuT – you have a point, but you do not extend it far enough. There are very few bad things that happen to us that are completely out of our control. Genetic illnesses (including some forms of cancer) and being killed by a meteorite are a few. But let the person who never speeds, who never drinks, who manages their stress well, who stays out of dangerous situations cast the first stone.

There are some who would argue that quick cooking oatmeal (not instant – rolled) for breakfast is not the best choice in terms of it’s glycemic index. I ate it for years (and grape nuts) thinking these were very healthy (now I eat Old Fashioned Oats or eggs). Maybe these choices will end up harming me and costing you money (you seem to have an issue with eggs. . . .) But my guess is that you wouldn’t be resentful because my heart was in the right place. Does that make sense? Here’s another example – a friend of mine had a patient that almost died of liver failure due to some herbal tea she drank for a few months. That was a terrible choice – but probably her level of intelligence played into it (not smart to eat something from an unregulated source). The intelligence of our choices is largely influenced by our intelligence, which is largely genetic.

I feel like food morality is becoming the new religion. Obesity is indeed a problem – I thank my lucky stars that I have managed to avoid it. I know the food industry plays a part – but I’m not sure we know what the answer is. For years people thought ulcers were caused by stress alone. Now we know that they are caused by a bacterial infection. There is some evidence that gut bacteria play a part in obesity. Maybe all of our antimicrobial efforts are coming back to haunt us . . . .[/quote]

Totally concur with you on this, njtosd. I’ve seen too many situations where people who’ve always taken care of their health were stricken with cancer, heart attacks, strokes, etc. while others who’ve smoked, drank, and eaten junk all their lives managed to make it into their 80s relatively unscathed. I think we like to attribute health problems to a person’s lack of discipline because we all want to believe that we have far more control over our lives than we really do.

I, for one, acknowledge our lack of control where health and death are concerned; and I have no problem paying for someone else’s healthcare because I know that I could just as easily be in their shoes. Anyone who thinks that we are in control needs to spend some time in a chemo room to see how many “fat” people who “deserve it” get cancer (very few chemo patients are obese, at least based on what I’ve seen).

We all need to be a bit more compassionate because what we are all guilty of doing things that might compromise our heath and well-being in some way; and that includes those who participate in various diet and exercise regimes.

[scaredyclassic]

colonscopies severe risk is .5%, colonc ancer .22 % ina given year. and there are less invasive alternatives for finding colon coancer.

so…why did i think i needed a colonoscopy/ why didn’t my primary car person try to talk me out of it, or at least advise on risks, prior to the referral?

once i made my way to the colonoscopy guy, she’s not going to try to talk me out of it, probably…

wonder how many decisions just get shuttled along like this.

wife says, doctors in general dont have time to really sit down with patients and go through it in detail. not reimbursable, that discussion. so, we just refer.

weird. making me think this system is not set up for maximinizing health…

[CA renter]

Capitalism is all about maximizing profits, and nothing else. That’s why we need to regulate it. Personally, I believe in capitalism for the wants, as long as it doesn’t pollute the environment or use up scarce natural resources; we need socialism for the needs, and for the allocation of scarce natural resources, IMHO.

There is an inherent conflict of interest in a for-profit healthcare system. What’s best for patients (prevention, a healthy life with the least intervention) is not at all what’s best for the medical industry.

[joec]

This is all why the US is the only country in the industrialized world without a more national comprehensive healthcare system…

It’s impossible to do what’s best for a business (maximize profits) compared to what’s best for the people (stay healthy and out of the hospital). It’s just not possible (sorta like an agent representing a buyer who also represents the seller).

[njtosd]

[quote=CA renter]Capitalism is all about maximizing profits, and nothing else. That’s why we need to regulate it. Personally, I believe in capitalism for the wants, as long as it doesn’t pollute the environment or use up scarce natural resources; we need socialism for the needs, and for the allocation of scarce natural resources, IMHO.

There is an inherent conflict of interest in a for-profit healthcare system. What’s best for patients (prevention, a healthy life with the least intervention) is not at all what’s best for the medical industry.[/quote]

One of the biggest roadblocks is medical malpractice/product liability. In most places other than the US doctors, pharma companies, etc don’t have to worry much about lawsuits (contingency fee arrangements are not allowed in most countries and lawyers are VERY expensive). This changes the ultimate cost of healthcare. Would the average American be willing to give up the option of suing for malpractice or product liability if they were negligently harmed?

[CA renter]

[quote=njtosd][quote=CA renter]Capitalism is all about maximizing profits, and nothing else. That’s why we need to regulate it. Personally, I believe in capitalism for the wants, as long as it doesn’t pollute the environment or use up scarce natural resources; we need socialism for the needs, and for the allocation of scarce natural resources, IMHO.

There is an inherent conflict of interest in a for-profit healthcare system. What’s best for patients (prevention, a healthy life with the least intervention) is not at all what’s best for the medical industry.[/quote]

One of the biggest roadblocks is medical malpractice/product liability. In most places other than the US doctors, pharma companies, etc don’t have to worry much about lawsuits (contingency fee arrangements are not allowed in most countries and lawyers are VERY expensive). This changes the ultimate cost of healthcare. Would the average American be willing to give up the option of suing for malpractice or product liability if they were negligently harmed?[/quote]

Under no circumstances should the ability to sue for malpractice be waived. While many doctors make understandable mistakes, there are too many stories where arrogant doctors didn’t listen to the patient or other healthcare providers (like their nurses) and ended up causing permanent damage and injuries to their patients.

But the issue of medical liability seems overblown, at least based on what I’ve read. Of course, ~$56 billion isn’t insignificant, but it’s the price we pay to ensure that doctors give more consideration to their patients’ well-being.

—-

In an effort to separate fact from fiction—and to provide the first academic study of medical liability system costs— a comprehensive analysis from Harvard School of Public Health (HSPH) researchers found that medical liability costs totaled about 2.4% of annual health care spending in the United States, or $55.6 billion per year in 2008.

Medical liability costs in U.S. pegged at 2.4 percent of annual health care spending

[FlyerInHi]

[quote=njtosd]
Obesity is indeed a problem – I thank my lucky stars that I have managed to avoid it. I know the food industry plays a part – but I’m not sure we know what the answer is. [/quote]

Consuming too many calories is the problem.

I think the answer is obvious. Just look at old family picture of parents and grand parents.

We have more knowledge that ever, we but don’t use. Everybody has a smart phone or computer. They should log their food intake using a nifty app and the answer will be staring at them on the screen.

People are so full of it. they won’t even collect they own data so they make educated decisions.

[CA renter]

[quote=FlyerInHi][quote=njtosd]
Obesity is indeed a problem – I thank my lucky stars that I have managed to avoid it. I know the food industry plays a part – but I’m not sure we know what the answer is. [/quote]

Consuming too many calories is the problem.

I think the answer is obvious. Just look at old family picture of parents and grand parents.

We have more knowledge that ever, we but don’t use. Everybody has a smart phone or computer. They should log their food intake using a nifty app and the answer will be staring at them on the screen.

People are so full of it. they won’t even collect they own data so they make educated decisions.[/quote]

No, it’s not just about “diet (calories) and exercise.” We know that hormones, chemicals, medicines, etc. all play a role in weight gain or loss. We also know that each body is different and responds differently to certain foods, chemicals, and types of exercise.

If it were all about “diet and exercise,” then why can two people eat the same foods, get the same amount of exercise, and end up with entirely different bodies and fat compositions?

Why are some women naturally large-breasted while some are naturally flat-chested? Why do some people carry weight around their waist or upper body, while some carry their weight around their hips and thighs? We are all different; our bodies are responding to diet and exercise, and ALSO to chemicals and hormones in our food and environment. A hundred years ago, we had “clean” food with few, if any, pesticides or herbicides, no GMOs, no “chemical” foods created in laboratories. I think these changes in our food, water, air, medicines, etc. are every bit as culpable as diet and exercise.

[FlyerInHi]

[quote=CA renter]
If it were all about “diet and exercise,” then why can two people eat the same foods, get the same amount of exercise, and end up with entirely different bodies and fat compositions?[/quote]

You know that people who are addicted to food or other substances lie, right? They sneak food and even lie to themselves.

I share part-time a house with a friend who is by my standards obese (but “husky” or “beefy” in the vernacular). We come and go in Vegas and sometimes don’t see each other for months.

The guy is a manly man full of braggadocio. It’s always WTF this and WTF that and everything is so f’ing obvious, duh.

The guy has never lost a pound in whole f’ing life, but keeps on gaining. Says he eats healthy.

Guess what? I always see receipts from fast food outlets.. delivery pizza.

Until people who are fat start logging all their food intake and be honest about it, we can’t believe a thing they are saying. The data is there to be collected. People should use their own personal data to get their own answers.

He’s a good friend and in a social setting, I never bring up the subject. But here, it’s an academic discussion about health.

Yes, there are hormonal and chemical issues… etc which cause addiction and over consumption. But calorie is the only way to gain weight.

If you use less, eat less. Why should someone who has a low metabolism feel entitled to eat the same as someone with has high metabolism? It’s not a total food intake contest and the one who has more wins. That should be f’ing obvious!

[Author]

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