I am slightly off topic here, but In my opinion the vast majority of the fraud in insurance including medicare is big players upcoding procedures so they can get more money out of the system. As a stupid idea, just to explain, the doctor uses a tongue depressor to look at your throat for 5 seconds and codes it as a complex examination for possible throat cancer. For us "we the people" I am sure there is some fraud but it is tiny in comparison
It should be noted that another number that’s being explained away or discounted is the number of us who have been forced to lower our coverage from “gold” to “bronze” plans. We’re small business owners, we’ve always been income ineligible for premium tax credits, we buy our health insurance through the ACA marketplace because we have no other options to buy health insurance because we’re required to buy through the ACA marketplace. We are now paying $1800/mo for our bronze plan with a $28,000 family deductible, and then, after meeting that deductible, it covers 80% coverage of “allowable charges for pre-approved treatment with in-network providers.” We do not have coverage for prescriptions, vision, dental, or any other “non-medical”services. Our “gold” coverage went up to $2400/mo for the same coverage at open enrollment, again as small business owners who have always been income ineligible for premium tax credits. This is for the two of us as we can no longer afford to cover our college age kids. At these rates and coverage we will most likely not continue to purchase health insurance coverage next year. For-profit health insurance is simply non-sustainable for much of the American population who are self-employed, income ineligible for premium tax credits, and have no other options than to purchase health insurance through the ACA Marketplace. The same ACA Marketplace that first gave us those options as small business owners years ago when we had no other options.
Yep, that's exactly the point of my state by state cost analysis, which I talk about towards the end of this post; I look at the average increase in both premiums AND out of pocket expenses (which I estimate based on people "buying down" to worse plans--from gold to silver, from silver to bronze, from PPOs to HMOs, etc.
Everything in the trump regime world is circuitous, complicated word salads of nefarious conspiracies when the simplest explanations fit best in a realist world. Ironically who exactly is stealing from US on an industrial scale out in the open right now with nary a peep from the GOP?
The sickest thing and most corrupt thing in this country is the Trump regime and those in his bubble. It is a mystery that having a health care program (insurance) for all is such a fight and always has been. The current behavior reflects this sickness---I call it a pandemic of non-caring.
I am slightly off topic here, but In my opinion the vast majority of the fraud in insurance including medicare is big players upcoding procedures so they can get more money out of the system. As a stupid idea, just to explain, the doctor uses a tongue depressor to look at your throat for 5 seconds and codes it as a complex examination for possible throat cancer. For us "we the people" I am sure there is some fraud but it is tiny in comparison
It should be noted that another number that’s being explained away or discounted is the number of us who have been forced to lower our coverage from “gold” to “bronze” plans. We’re small business owners, we’ve always been income ineligible for premium tax credits, we buy our health insurance through the ACA marketplace because we have no other options to buy health insurance because we’re required to buy through the ACA marketplace. We are now paying $1800/mo for our bronze plan with a $28,000 family deductible, and then, after meeting that deductible, it covers 80% coverage of “allowable charges for pre-approved treatment with in-network providers.” We do not have coverage for prescriptions, vision, dental, or any other “non-medical”services. Our “gold” coverage went up to $2400/mo for the same coverage at open enrollment, again as small business owners who have always been income ineligible for premium tax credits. This is for the two of us as we can no longer afford to cover our college age kids. At these rates and coverage we will most likely not continue to purchase health insurance coverage next year. For-profit health insurance is simply non-sustainable for much of the American population who are self-employed, income ineligible for premium tax credits, and have no other options than to purchase health insurance through the ACA Marketplace. The same ACA Marketplace that first gave us those options as small business owners years ago when we had no other options.
Yep, that's exactly the point of my state by state cost analysis, which I talk about towards the end of this post; I look at the average increase in both premiums AND out of pocket expenses (which I estimate based on people "buying down" to worse plans--from gold to silver, from silver to bronze, from PPOs to HMOs, etc.
See here for methodology & use the drop-down menu at the top to pick a state, any state (I still have 3-4 left to go): https://acasignups.net/enrollee_cost/2026/main
Everything in the trump regime world is circuitous, complicated word salads of nefarious conspiracies when the simplest explanations fit best in a realist world. Ironically who exactly is stealing from US on an industrial scale out in the open right now with nary a peep from the GOP?
The sickest thing and most corrupt thing in this country is the Trump regime and those in his bubble. It is a mystery that having a health care program (insurance) for all is such a fight and always has been. The current behavior reflects this sickness---I call it a pandemic of non-caring.