Federal Judge says Health Care reform Unconstitutional

[sagesteve]

I've never had health insurance. I've always payed my own way...ALWAYS. I don't believe (and never have) that health insurance is a "right". I'm 63. I won't take Medicare either. I don't believe in pensions and never have.

[NightMonkey]

And by 2014, hopefully I should be able to purchase my own individual insurance for an actually-affordable rate, and not have to worry about pre-existing conditions and stuff like that. And, hopefully, transparency, honesty, and reasonable costs will spread throughout healthcare.

If you are that optimistic then you must think the corrupt Obamacare act will be repealed quickly and medical insurance will be deregulated quickly. I hope you are right!

[NightMonkey]

Ive already written the government off like I have written health insurance off. Health insurance is only good for major medical, acute hospitalisations, heart attacks, strokes, broken bones, car accidents, etc. Insurance is not good for handling ongoing, chronic medical conditions such as sleep apnea IMO.

I have just decided to take matters into my own hands and pay for most of my own equipment and to heck with the insurance companies...bypass them. I lucked up the first time around with my original Resmed CPAP/APAP machine, I had a pretty good insurance plan at that time. And got lucky and got hooked up with a good DME local. But unfortunately, that is not all that typical. So you just have to take matters into your own hands and get the prescription from your sleep doctor and just pay out of pocket...it makes it soooooo much easier in my opinion. No arguing with your insurance or DME over which equipment you are going to get, no arguing or hassling whether you are going to get used equipment or not, you can buy what you want and need as long as your doctor is willing to write you an rx.

Simple as you pay, you get.

Mikey

Mikey, You have it figured out quite well. Congratulations for being a responsible, capable actor in the medical care market!

Now if we could just get the market deregulated you would have a really good time.

BTW, for your medical equipment don't forget about good internet suppliers like cpap.com and several others. Do a google search.

[ResMedUser]

After having gone thru the medical system (all private btw, no medicare or medicaid or anything like that), here is what I have to say about health care in the USA.

Health care in the USA is FUBAR. It is so messed up, its beyond repair with our current political and legal system. The solution? Keep things between yourself and your doctor as much as possible and keep health insurance OUT of your life as much as possible. And pay for what you need and want. Pay out of pocket. It really simplifies your life a lot.

Here is the traditional private "chain of command" for sleep apnea patients:

1)Doctor...diagnoses you, orders equipment for you, sends you to sleep studies

2)Health insurance company...low life scum that have a built in conflict of interest, unfortunately your doctor has to comply with whatever contracts they have signed with the insurance companies and these "behind the scenes" doctor/insurance contracts often conflict with the doctor being able to administer good medicine

3)DME/RT...supplies you with your sleep apnea gear, is "supposed" to do a good job but all too often does not. Argues with you, gives you unnecessary hassles because they are trying to go cheapo on you most of the time...in other words give you the cheapest CPAP gear they can get away with and then bill your health insurance. They make the most money that way.

4)Patient...you....the OSA sufferer.

Solution? Get rid of the health insurance company by buying your OSA gear out of pocket. Because you pay out of pocket you can get the gear you need and want. This also pretty much eliminates the DME because you no longer have to deal with them and health insurance. Your DME becomes an Internet equipment supplier...someone reputable online. By getting rid of insurance with regards to equipment supplied, you eliminate a whole entire fourth layer of bureaucracy from your medical care. That makes your care a lot more simple and easy to manage.

Keep the health insurance, not all health insurance is awful. But keep the insurance for catastrophic major medical and not for ongoing, chronic medical care.

Mikey

[ResMedUser]

One of my beefs with the modern USA is there are way too many people who have this belief that someone else should do something for them. That someone else is responsible for your welfare. That is majorly screwed up thinking. In the end, when all is said and done, ONLY YOU are responsible for you. People who honestly are naive enough to believe the GOVERNMENT will look out for you properly...they have thinking issues.

The weak, the stupid, the sick die off. The strong, the smart and the healthy live and prosper and pass their genes on. People who believe they are entitled to the government paying for this and that (beyond basic things like public education and public works, police, fire department, etc.) are really really naive IMO.

You get what you pay for and if the government is in charge of things they are going to always take the cheapest but most complicated route for you and your health. Health insurance companies are bad enough...putting the government in charge...wow that is scarey.

Mikey

[bradb]

1)Doctor...diagnoses you, orders equipment for you, sends you to sleep studies

2)Health insurance company...low life scum that have a built in conflict of interest, unfortunately your doctor has to comply with whatever contracts they have signed with the insurance companies and these "behind the scenes" doctor/insurance contracts often conflict with the doctor being able to administer good medicine

3)DME/RT...supplies you with your sleep apnea gear, is "supposed" to do a good job but all too often does not. Argues with you, gives you unnecessary hassles because they are trying to go cheapo on you most of the time...in other words give you the cheapest CPAP gear they can get away with and then bill your health insurance. They make the most money that way.

4)Patient...you....the OSA sufferer.

Solution? Get rid of the health insurance company by buying your OSA gear out of pocket. Because you pay out of pocket you can get the gear you need and want. This also pretty much eliminates the DME because you no longer have to deal with them and health insurance. Your DME becomes an Internet equipment supplier...someone reputable online. By getting rid of insurance with regards to equipment supplied, you eliminate a whole entire fourth layer of bureaucracy from your medical care. That makes your care a lot more simple and easy to manage.

Is this serious? CPAP would have cost $1200 even by the cheapest internet price, plus $140 for the mask, $30 for the hose cover, $40 for the dishwashable humidifier tub, etc. Thanks to insurance I paid $20 for the mask (and got a rebate from ResMed for that), $69 for the humidifier and heated tube, and $80 for the machine after (a) insurance allowable took down the $1800 the DME was charging for the machine and (b) the coinsurance where insurance pays for 80% of the allowable.

HOW COULD I AFFORD TO BUY THIS STUFF OUT OF POCKET? This is what insurance is for. I know insurance and DMEs are frustrating, but why on earth would I opt to pay an additional $1400 out of pocket just for the convenience of not having to deal with them? Are you rich or something? I can't believe some of you.

[bradb]

The weak, the stupid, the sick die off. The strong, the smart and the healthy live and prosper and pass their genes on.

WOW. This is called Eugenics - and it's literally the platform that the Nazis ran on. Why are you on a website about therapy and healing? Don't you feel out of place?

[LinkC]

WOW. This is called Eugenics - and it's literally the platform that the Nazis ran on. Why are you on a website about therapy and healing? Don't you feel out of place?

Actually, it's Natural Selection...or Evolution. "Eugenics" is the artificial manipulation of those two.

[Guest]

The weak, the stupid, the sick die off. The strong, the smart and the healthy live and prosper and pass their genes on.

WOW. This is called Eugenics - and it's literally the platform that the Nazis ran on. Why are you on a website about therapy and healing? Don't you feel out of place?

No, I dont feel out of place. I am just being a total realist. It is Darwinian theory, ecology. Not eugenics or nazi stuff. The weak, the stupid and the sick die off. The smart, the strong and the healthy live and prosper. Its just the way things really are in the real world.

For example, I have OSA. I got on CPAP therapy. I got better. I am smart enough to realize that if i dont use my gear, my hypertension will not stay under control and I could very well end up with heart disease or even a stroke. Or end up with type II diabetes. I am smart, hence I am 100% compliant with my CPAP gear and I have paid attention to the details.

Others on the other hand, I have talked to and read on message boards, they find every reason under the sun NOT to use their CPAP gear. And they do not remain compliant. And they suffer from OSA forever, do not get it under control and suffer the consequences. Decreased quality of life, early heart disease or stroke, worse hypertension, probably an early death. They chose their lot in life and were IMO, stupid.

We are all responsible for our own selves in this world and there is nobody to blame but yourself...short of outright criminal activity or medical negligence.

Mikey

[LinkC]

HOW COULD I AFFORD TO BUY THIS STUFF OUT OF POCKET?

You would pay for it with the money you saved on insurance premiums. Do you really think you have spent more on healthcare than you (and/or your employer) have spent on insurance over the years? Insurance companies that don't MAKE PROFITS aren't around long. The average policy-holder is always on the losing end.

[Guest]

Is this serious? CPAP would have cost $1200 even by the cheapest internet price, plus $140 for the mask, $30 for the hose cover, $40 for the dishwashable humidifier tub, etc. Thanks to insurance I paid $20 for the mask (and got a rebate from ResMed for that), $69 for the humidifier and heated tube, and $80 for the machine after (a) insurance allowable took down the $1800 the DME was charging for the machine and (b) the coinsurance where insurance pays for 80% of the allowable.

HOW COULD I AFFORD TO BUY THIS STUFF OUT OF POCKET? This is what insurance is for. I know insurance and DMEs are frustrating, but why on earth would I opt to pay an additional $1400 out of pocket just for the convenience of not having to deal with them? Are you rich or something? I can't believe some of you.

I am very serious. I just paid $1300 for a new machine myself. I gave up dealing with my local DME and my insurance company when I needed a new machine that works as well as my original machine. Insurance is a scam for chronic conditions, DMEs try to rip you off by giving you the cheapest, lowest end gear they can squeeze by on. And you get screwed over as the patient. I had some money stashed away and spent it on new gear, because I value my health and want to maintain what my original machine has given me for three and a half years. That is worth $1300 to me.

Mikey

[PST]

HOW COULD I AFFORD TO BUY THIS STUFF OUT OF POCKET?

You would pay for it with the money you saved on insurance premiums. Do you really think you have spent more on healthcare than you (and/or your employer) have spent on insurance over the years? Insurance companies that don't MAKE PROFITS aren't around long. The average policy-holder is always on the losing end.

I'm not sure that's true with health insurance. The insurance carrier is really bundling two products. One is insurance, and of course I expect to pay something to have my risk smoothed out, so I have no complaint that the premium will be more than the expected payout. But with health insurance I'm also joining a purchasing cooperative that can get me a better price for medical care than I can get on my own by holding out to sellers the prospect of high volume purchase. Health insurance is a medical Sam's Club. Anything my insurer and I pay for -- no matter how we split the price using deductibles and co-pays -- costs about half of what local doctors and hospitals claim to charge the self-paying customer. It is possible that both the insurer and I are coming out ahead.

[ResMedUser]

HOW COULD I AFFORD TO BUY THIS STUFF OUT OF POCKET?

It is possible that both the insurer and I are coming out ahead.

LOL

It is possible...

Yeah, anything is possible. I have been dealing with health insurance long enough to know how they do things. Insurance does not like to pay if they can get out of it, period. When you factor in the "hassle" and "stress" factor of arguing with your insurance and DME over the gear you are going to get, when you will get it, etc. its just easier to just pay out of pocket. My blood pressure stays down that way.

For major medical, catastrophic...where someone slams into me when I am in my car. Or if I have a heart attack (possibly from the stress of screaming into the phone at my DME who will not do what I want), sure health insurance is needed.

Otherwise, you can keep it...

Mikey

[roster]

The weak, the stupid, the sick die off. The strong, the smart and the healthy live and prosper and pass their genes on.

There is no indication that this is happening in the U.S. in the last fifty years. In fact the opposite tends to happen. Fertility rates are higher among the poorer less educated segment of the population. And conversely as people become more educated and more prosperous they tend to have fewer children. The very good thing about the U.S. is that people are able to take advantage of the freedoms, educate themselves, work hard, and pull themselves out of poverty.

BTW, I like many of your ideas such as self-reliance, careful analysis of the marketplace, and making good economic decisions for yourself (being a wise consumer). Also the idea that basic medical care is to be paid out of your own pocket and insurance is to be used for unexpected expensive medical care is a sound individual practice.

As far as Darwin goes, I studied his theory over many years and was highly impressed by it. Eventually I came to the conclusion that it could be boiled down to, "Those survive that survive." While Darwin's work can be used to describe what has already happened, it is a poor predictive tool.

[roster]

I am very serious. I just paid $1300 for a new machine myself. I gave up dealing with my local DME and my insurance company when I needed a new machine that works as well as my original machine. Insurance is a scam for chronic conditions, DMEs try to rip you off by giving you the cheapest, lowest end gear they can squeeze by on. And you get screwed over as the patient. I had some money stashed away and spent it on new gear, because I value my health and want to maintain what my original machine has given me for three and a half years. That is worth $1300 to me.

Mikey

What type of machine did you buy? Top-of-the line CPAP and APAP machines cost much less than that. You can even get a decent Bipap for much less than that.