# I despise Trump but would vote for him over someone who wants to take my family's insurance away **URL:** \ **Category:** Politics & Elections\ **Created:** [September 17, 2019, 2:00am UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357 "2019-09-17T02:00:10Z")\ **Posts on this page:** 20\ **Page:** 9
**Author:** ![campp](https://avatars.discourse-cdn.com/v4/letter/c/c5a1d2/32.png) [@campp](https://boards.straightdope.com/u/campp)\ **Post date:** [September 23, 2019, 6:29pm UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/162 "2019-09-23T18:29:55Z")
> [@bump](#): > > There’s almost certainly a review process for that kind of thing; it’s hard to believe that the insurance company is claiming lack of medical necessity/emergency and having it just stick like that. He should be able to request a third party utilization review if one hasn’t already been done, and if it was there should be a pretty clear indication of WHY it wasn’t medically necessary, complete with the diagnosis and treatment listed, and the guidelines for the typical treatment of that sort of condition. They also should have probably reached out to the original treating provider for their rationale- maybe there was some confounding factor that wasn’t entirely clear from the case documentation. > > At that point, he needs to go back to the ER doctors and sue them for negligence or malpractice if they diverged from the accepted treatment guidelines. One way or another, either the ER docs or the insurance company reviewer fucked up, and he needs to get that straightened out. I believe there is a formal appeal process. Whoever decided it was not “necessary” will have to prove their medical credentials that proves they know what they are talking about. That’s part of the Regulatory dept at the Ins Co. They cannot get out of that one, since the denier is usually some hourly schlub. Anyway, this is how I’ve seen these stories get worked out. It will likely involve legal action however. He should win. ---
**Author:** ![This\_Just\_In\_2](https://avatars.discourse-cdn.com/v4/letter/t/bbe5ce/32.png) [@This\_Just\_In\_2](https://boards.straightdope.com/u/This_Just_In_2)\ **Post date:** [September 23, 2019, 6:47pm UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/163 "2019-09-23T18:47:58Z")
> [@Grim\_Render](#): > > You never see a European, or Japanese or Canadian worry about not being covered, or losing healthcare. Its medieval, like fear of goblins. I think this is why its easy for those of us not from the USA to assign dishonest motives to Americans who are simply afraid of losing the care they and their families have. Its a very alien mindset, where that is actually a real worry. I like your analogy. As someone who lived in the US for several years and had good insurance I felt adequately covered from the goblins but was definitely annoyed that life events (like having children) cost me several thousands. It is quite foreign to have to budget a couple thousand a year for insurance deductibles and co-pays. What really seemed bizarre was the multitudes working in the insurance industry. I knew someone who worked at a general practitioner / doctors office. They had 3 doctors and about 15 support staff. Why so many staff? Many of the staff, including my friend’s only job was to call insurance company’s and harass them for the money owed to the doctors. So it is also worth mentioning that there is a huge industry built up around these goblins and their treasure. Goblin trackers, goblin hunters, goblin trappers etc. The Health Insurance is the medieval Goblin middleman - who is controlling their access to Health Care. ---
**Author:** ![Horatius](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/horatius/32/3572_2.png) [@Horatius](https://boards.straightdope.com/u/Horatius)\ **Post date:** [September 23, 2019, 7:21pm UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/164 "2019-09-23T19:21:10Z")
> [@bump](#): > > At that point, he needs to go back to the ER doctors and sue them for negligence or malpractice if they diverged from the accepted treatment guidelines. One way or another, either the ER docs or the insurance company reviewer fucked up, and he needs to get that straightened out. …because the one thing you really need after major surgery is an extremely complicated, probably years-long lawsuit involving multiple possible defendants, and all their lawyers, who are all pointing the blame at the other people. ---
**Author:** ![Bryan\_Ekers](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bryan_ekers/32/183_2.png) [@Bryan\_Ekers](https://boards.straightdope.com/u/Bryan_Ekers)\ **Post date:** [September 23, 2019, 8:54pm UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/165 "2019-09-23T20:54:19Z")
You can’t trust the opinions of \*sick \*people. If they knew what was good for them, they wouldn’t be sick in the first place. ---
**Author:** ![Kent\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kent_clark/32/105_2.png) [@Kent\_Clark](https://boards.straightdope.com/u/Kent_Clark)\ **Post date:** [September 23, 2019, 9:03pm UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/166 "2019-09-23T21:03:11Z")
> [@bump](#): > > There’s almost certainly a review process for that kind of thing; it’s hard to believe that the insurance company is claiming lack of medical necessity/emergency and having it just stick like that. He should be able to request a third party utilization review if one hasn’t already been done, and if it was there should be a pretty clear indication of WHY it wasn’t medically necessary, complete with the diagnosis and treatment listed, and the guidelines for the typical treatment of that sort of condition. They also should have probably reached out to the original treating provider for their rationale- maybe there was some confounding factor that wasn’t entirely clear from the case documentation. > [@campp](#): > > I believe there is a formal appeal process. Whoever decided it was not “necessary” will have to prove their medical credentials that proves they know what they are talking about. In other words, it’s a feature, not a bug? And what happens while the patient slogs through the appeal process, the doctors and hospital turn the bills over to collection agencies, and the insured patient’s credit is ruined. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [September 23, 2019, 9:23pm UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/167 "2019-09-23T21:23:15Z")
Yes, basically, that’s it - there’s always a formal appeals process, but it’s lengthy, full of paperwork and red tape, if you don’t get ALL the forms and fill them ALL out completely and carefully you can be summarially denied (again), and yes, it’s very much a feature and not a bug - the insurance company wants to delay paying as long as possible. Even better if the patient gives up, or is too tired/sick to continue On top of that, if a patient is unable to do the appeals themself, HIPAA is used to deny access to concerned relatives/friends, sometimes necessitating that one of them go to court to be declared legal guardian and in possession of medical/legal/financial proxy (best to ask for all three at once). Which process may or may not be completed before time runs out for appeals (because of course there are time limits). ---
**Author:** ![Euphonious\_Polemic](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/euphonious_polemic/32/3002_2.png) [@Euphonious\_Polemic](https://boards.straightdope.com/u/Euphonious_Polemic)\ **Post date:** [September 23, 2019, 9:47pm UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/168 "2019-09-23T21:47:13Z")
> [@campp](#): > > I believe there is a formal appeal process. Whoever decided it was not “necessary” will have to prove their medical credentials that proves they know what they are talking about. That’s part of the Regulatory dept at the Ins Co. They cannot get out of that one, since the denier is usually some hourly schlub. Anyway, this is how I’ve seen these stories get worked out. It will likely involve legal action however. He should win. This sounds like a fantastically efficient system. The free market in action. And great for the patient as well! I only wish that in my country, we had the opportunity to have a major legal battle between my doctors and insurer after I have undergone a major medical treatment. Sadly, I am denied this freedom. \ ---
**Author:** ![Translucent\_Daydream](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/translucent_daydream/32/16170_2.png) [@Translucent\_Daydream](https://boards.straightdope.com/u/Translucent_Daydream)\ **Post date:** [September 23, 2019, 9:49pm UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/169 "2019-09-23T21:49:01Z")
I guess I just know and am a shitty poor person - Almost everyone I know does NOT have insurance. On one hand, I can count the people in my family, immediate and extended that have employer insurance. I don’t think any of my friends or acquaintances have it either. Is really only 8% uninsured in the US? I would say that from my position (mid 30s in age) only about 8% actually have insurance. Its bizarre to hear people talking about their insurance to us “poor unwashed folks”. Part of me wants to slap them up side the head and say, “Bitching about your co-pay to go to the doctor? At least you get to fucking go to the doctor at all, buncha jackasses.” I was reading this thread earlier, and asked everyone around work, “Hey who has insurance?” The CFO of our company and the CEO do. That’s it around here of the 40 or so people around this bubble. They are on Medicare. I went through my cell phone contacts, and of the 180 or so that are real people, about 10 have insurance through their employer. A lot of their kids are on CHIP though. ---
**Author:** ![EdelweissPirate](https://avatars.discourse-cdn.com/v4/letter/e/8491ac/32.png) [@EdelweissPirate](https://boards.straightdope.com/u/EdelweissPirate)\ **Post date:** [September 23, 2019, 10:44pm UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/170 "2019-09-23T22:44:36Z")
> [@Broomstick](#): > > On top of that, if a patient is unable to do the appeals themself, HIPAA is used to deny access to concerned relatives/friends […] This is absolutely a real thing: HIPAA is used by healthcare bureaucrats as an all-purpose cudgel. I recently had an Kafka-esque appointment at a prominent teaching hospital in Oregon—an Oregon health & science university, if you will. The hospital administration would not tell me where my appointment was, with which provider or even confirm that I had an appointment at all, citing HIPAA. They caved when I pointed out that I couldn’t possibly show up at the right place at the right time if they wouldn’t tell me where it was. That experience can be blamed on an overzealous bureaucrat, but there’s a more serious side: my mom is slipping into dementia and has begun confabulating when asked about meds and appointments. I am her medical executor, but that doesn’t kick in until she’s ruled incapacitated. Of course, my mom’s doctors won’t talk to me—let alone help me help her—until my full power of attorney has kicked in. My mom thinks that she just has to call her doctor and say it’s ok if they talk to me. It doesn’t work that way. And this is a case where the providers likely want my help—if my mom’s doctors’ billing departments were fighting me for fighting a charge, I don’t doubt they’d try to fend me off with HIPAA. Maybe I’m naive, but I doubt most people who say “I can’t tell you because HIPAA” are doing so cynically. But because so many medical bureaucrats see it as a trump card to make the questions stop, it gets abused—a lot. ---
**Author:** ![EdelweissPirate](https://avatars.discourse-cdn.com/v4/letter/e/8491ac/32.png) [@EdelweissPirate](https://boards.straightdope.com/u/EdelweissPirate)\ **Post date:** [September 23, 2019, 10:52pm UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/171 "2019-09-23T22:52:04Z")
Just to be clear, HIPAA unambiguously prevents my mom’s doctors from talking to me under these circumstances. I’m not arguing that they should disregard HIPAA and talk to me anyway. I’m saying that, once I have medical power of attorney, I expect to get stonewalled unless I can wave the relevant documents in the face of the person saying “no.” If they won’t tell me when/where my own appointments are “because HIPAA,” I expect to get an avalanche of false-positive “no” responses even after I’ve got my mom’s medico-legal ducks in a row. Many providers’ offices are outright patient-hostile under the best circumstances. It’s unlikely that will change when you’re fighting an erroneous bill. ---
**Author:** ![Aspenglow](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/aspenglow/32/76_2.png) [@Aspenglow](https://boards.straightdope.com/u/Aspenglow)\ **Post date:** [September 23, 2019, 10:56pm UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/172 "2019-09-23T22:56:20Z")
**Translucent Daydream** , I appreciate your empirical contribution to this thread. Can I ask for a clarification, however? Are you sure your young work force co-workers are on Medicare? I ask because I keep seeing people in this thread, not just you, mixing up the terms, Medicare and Medicaid. It’s confusing, but it’s important to understand the difference between these 2 programs. _Medicare_ is a federally funded program for folks who have attained the age of 65 or who have become permanently disabled and unable to work. They and their employers have paid into the program during their working lifetimes. They are entitled to it. There are lots of components to Medicare, meaning Parts A, B, C and D, and each covers different things. But the main point to keep in mind about Medicare is that it is for people over age 65 or people who suffer from a permanent disability. _Medicaid_ is for low income folks and is a safety net program funded with combined state and federal funds. You can apply for Medicaid at any age, but you must have a very low income to qualify. One thing to keep in mind about Medicaid is that there are claw-back provisions – meaning that if you have tangible assets such as a home, or you receive an inheritance, or if your income at some point exceeds the low income threshold, you can and probably will be made to pay the money back and/or be kicked out of the Medicaid program. Medicare has no such provision. Once you qualify for Medicare, you qualify. No claw-backs. When Democratic candidates advocate for a Medicare for all system, they’re talking about offering the existing Medicare program, now available mostly to only those over the age of 65, to everyone in some form or another. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [September 23, 2019, 11:18pm UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/173 "2019-09-23T23:18:38Z")
> [@Broomstick](#): > > Most people are quite healthy most of the time, which is why they can be happy even with shitty insurance coverage. For the most part, they aren’t using it, or only a very tiny bit of it. > > That’s the problem - people don’t realize how vulnerable they are until it’s too late. And then, well, it’s too late. Exactly. Medical expenses follow a power law distribution. 1% of Americans make up about 25% of medical spending in a given year. 5% make up 60% of spending. 20% make up over 80% of spending. 50% make up 97% of spending So you flip that around and it means that 50% of Americans make up 3% of spending 80% of Americans make up 20% of spending 95% of Americans make up 40% of spending 99% of Americans make up 75% of spending Most people are mostly healthy for most of their lives. So they think they have good insurance because the only health care they get is the occasional doctors visit and a few generic medications. Plus the way our system is set up, people with truly expensive health problems tend to get pushed onto public plans. Medicare covers the elderly. Medicaid covers the destitute elderly and the disabled. Even with the public sector socializing the risk and taking the highest risk, highest cost patients off of the marketplace, the private insurance marketplace is still garbage. ---
**Author:** ![kenobi\_65](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kenobi_65/32/13178_2.png) [@kenobi\_65](https://boards.straightdope.com/u/kenobi_65)\ **Post date:** [September 23, 2019, 11:22pm UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/174 "2019-09-23T23:22:52Z")
> [@Translucent\_Daydream](#): > > Is really only 8% uninsured in the US? I would say that from my position (mid 30s in age) only about 8% actually have insurance. Its bizarre to hear people talking about their insurance to us “poor unwashed folks”. Part of me wants to slap them up side the head and say, “Bitching about your co-pay to go to the doctor? At least you get to fucking go to the doctor at all, buncha jackasses.” > > I was reading this thread earlier, and asked everyone around work, “Hey who has insurance?” The CFO of our company and the CEO do. That’s it around here of the 40 or so people around this bubble. They are on Medicare. As I noted upthread, I work in the industry, and, yeah, nationally, 8% is accurate. But, it does vary (quite a lot) by state: [the Kaiser Family Foundation has a site](https://www.kff.org/state-category/health-coverage-uninsured/) where you can look at the rates by state – Texas is at 17% uninsured, Oklahoma and Alaska at 14%, etc. But, if you limit the data on that KFF site to people age 19-64 (since low-income children may be on CHIP, and the vast majority of those age 65+ are on Medicare), the national uninsured rate is 12%, and in Texas, it’s 24%. One factor in whether or not people have employer-based health insurance or not is the size of the company: if a company has 50 or more full-time employees, they _must_ offer health insurance to the full-time employees. If they have under 50, it’s optional (and many don’t). It sounds like the place you work, with 40 or so employees, doesn’t have to offer coverage. And, the above also alludes to another factor: people who aren’t employed full-time at a single job likely won’t be offered health insurance coverage by their employer, even if the company is big enough. And, finally, ACA (Obamacare) policies tend to be expensive. Although the ACA features subsidies for moderate-income people to help them afford coverage, part of the law around the subsidies depended on a plan in which the individual states would raise the income ceiling for qualifying for Medicaid. But, a number of states (particularly “red states”) chose not to, leading to a situation in which someone can be making too much money to qualify for Medicaid, but not be making enough money to qualify for a subsidy to buy an ACA policy. ---
**Author:** ![kenobi\_65](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kenobi_65/32/13178_2.png) [@kenobi\_65](https://boards.straightdope.com/u/kenobi_65)\ **Post date:** [September 23, 2019, 11:31pm UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/175 "2019-09-23T23:31:47Z")
> [@Aspenglow](#): > > **Translucent Daydream** , I appreciate your empirical contribution to this thread. Can I ask for a clarification, however? Are you sure your young work force co-workers are on Medicare? I took what **Translucent Daydream** was saying was that only two people at their employer – the CEO and the CFO – have health insurance, and that the two of them have it because they’re on Medicare (and, thus, they’re both age 65+). But, I may be mistaken in my interpretation. ---
**Author:** ![Aspenglow](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/aspenglow/32/76_2.png) [@Aspenglow](https://boards.straightdope.com/u/Aspenglow)\ **Post date:** [September 23, 2019, 11:44pm UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/176 "2019-09-23T23:44:49Z")
> [@kenobi\_65](#): > > I took what **Translucent Daydream** was saying was that only two people at their employer – the CEO and the CFO – have health insurance, and that the two of them have it because they’re on Medicare (and, thus, they’re both age 65+). But, I may be mistaken in my interpretation. Oh, I think you are right, and my apologies to **Translucent Daydream** if I misunderstood. Which it appears I did. All the same, there does seem to be confusion around the 2 programs and I’ve been wanting to clarify the differences for awhile now. There’s even a thread floating around here touting ‘Medicaid for all’ – and no one is pushing for that. Thanks for the catch! 🙂 ---
**Author:** ![you\_with\_the\_face](https://avatars.discourse-cdn.com/v4/letter/y/ecccb3/32.png) [@you\_with\_the\_face](https://boards.straightdope.com/u/you_with_the_face)\ **Post date:** [September 23, 2019, 11:58pm UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/177 "2019-09-23T23:58:48Z")
How many American slaves in 1860 were scared and maybe even angry at the prospect of Emancipation? I don’t know how many there were, but undoubtedly there were some who preferred the devil they knew to the uncertainty that was freedom. Sure, with slavery you had to constantly live with the threat of violence hanging over your head like a dangling 500-lb anvil. Sure, you couldn’t become educated, acquire wealth, or have kids without worrying they’d be snatched away from you at any time. And sure, you had to put up with all kinds of indignities like rape, being literally treated like a brute animal, and being worked beyond exhaustion so white folks could have nice big fancy houses and wear the finest clothes. But it was a system you knew. As long as you played by its rules—as oppressive, inhumane, inefficient, and ridiculous as those rules were—you could get by. Maybe even be happy sometimes. I have to think that people like the OP have fallen prey to the same change phobia these slaves had. Employer-based health insurance is the only system we know. Most of us barely can conceive of anything different. So I’m going to ask the same question that I would ask all those change phobic slaves: what about it is worth defending? Corporate executives see to it that people pay more into the system than they get out of it…tell me, why should the common man fight to see this continue? What exactly as we afraid of? Being able to get the lump in our breasts checked out _without_ worrying about co-pays, deductibles, whether or not our preferred doctor is in the network, and other crap like that? Being able to quit a bad job \*without \*instantly jeopardizing everyone in our family’s access to healthcare? ---
**Author:** ![wolfpup](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wolfpup/32/10618_2.png) [@wolfpup](https://boards.straightdope.com/u/wolfpup)\ **Post date:** [September 24, 2019, 12:29am UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/178 "2019-09-24T00:29:32Z")
> [@Northern\_Piper](#): > > I understand where you’re coming from, but I have to quibble with you a bit, in your description of how car insurance works in Sask. Yes, we have government-mandated car insurance from SGI ("Saskatchewan Government Insurance "). Everyone has to get their basic coverage from SGI. > > But that’s just the basic “plate package”, to ensure everyone has the statutory minimum coverage, no funny exclusions or conditions. If you want more coverage than the stat minimum, there’s nothing stopping you as consumer from shopping around getting more coverage from a different insurance company. SGI offers extended coverage as well. > > And that’s just what I did: sat down with my independent broker and reviewed the options available to me for added coverage. I might be persuaded that government-run car insurance is a good idea, but the point I was making is that since it is, in fact, truly insurance in the correct meaning of the word, there is at least a risk that a public plan might be structured in a way that limits your coverage options. But the OP’s concerns are without merit since the kind of single-payer system being proposed isn’t insurance at all, but essentially a payment system for all medically necessary health care. > [@Northern\_Piper](#): > > And that type of model might work for UHC in the US. If I’ve understood correctly from posters from Australia and New Zealand, i think that sounds sort of like their UHC system. In a sense it works that way in Canada, too, since one can take out private insurance for drug coverage and for dental. In my view the critically important thing about UHC is that all medically necessary services must be covered, from doctor’s visits to the most expensive surgeries. > [@Northern\_Piper](#): > > There aren’t still major diffs between car insurance and health insurance, though. Car insurance is simpler than health insurance. As a consumer, I understand the coverage issues for car insurance better than health insurance. ANd there’s rarely that crisis situation that arises with health care. But still, a basic state package with individual private add-ons could offer a way to UHC. Doesn’t have to be single payer monopoly, so long as the basic package is truly comprehensive. I disagree that there aren’t major differences, or that car insurance is simpler. My car insurance policy runs to many pages of fine print, with lots of terms that I don’t even understand. My health care coverage is basically defined by the fundamental principle that it pays in full for all medically necessary services. That sure seems simple to me. > [@Northern\_Piper](#): > > General agreement here. I think it’s best to consider health care as public service, not an insurance commodity. Which supports the notion that comprehensive health care coverage such as the single-payer system being proposed or the one we have in Canada isn’t “insurance” at all and shouldn’t be thought of that way. ---
**Author:** ![survinga](https://avatars.discourse-cdn.com/v4/letter/s/cab0a1/32.png) [@survinga](https://boards.straightdope.com/u/survinga)\ **Post date:** [September 24, 2019, 12:37am UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/179 "2019-09-24T00:37:16Z")
> [@Novelty\_Bobble](#): > > what does “almost all” mean? how much did you have to pay out of pocket in that year? > > What were those costs? How much is “not much” how much did they have to pay out of pocket in that year? In the “almost all” reference, I think I had a $35 co-pay. In your “not much” question (I love how people demand that I have perfect knowledge, but no one else gets these kinds of questions), I don’t know exactly what they paid, but it was such that I never heard them utter anything at all about cost. And I know they have the same insurance I have, since we work together, so again “almost all” of their costs were covered, as we don’t have high deductible plans and coverage on major illnesses is very good. Maybe over a year or two, they paid out a few hundred bucks…These are anecdotes to answer your questions of course, but many people on this board use anecdotes. ---
**Author:** ![Translucent\_Daydream](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/translucent_daydream/32/16170_2.png) [@Translucent\_Daydream](https://boards.straightdope.com/u/Translucent_Daydream)\ **Post date:** [September 24, 2019, 1:31am UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/180 "2019-09-24T01:31:22Z")
> [@Aspenglow](#): > > **Translucent Daydream** , I appreciate your empirical contribution to this thread. Can I ask for a clarification, however? Are you sure your young work force co-workers are on Medicare? > > I ask because I keep seeing people in this thread, not just you, mixing up the terms, Medicare and Medicaid. It’s confusing, but it’s important to understand the difference between these 2 programs. > > _Medicare_ is a federally funded program for folks who have attained the age of 65 or who have become permanently disabled and unable to work. They and their employers have paid into the program during their working lifetimes. They are entitled to it. > > There are lots of components to Medicare, meaning Parts A, B, C and D, and each covers different things. But the main point to keep in mind about Medicare is that it is for people over age 65 or people who suffer from a permanent disability. > > _Medicaid_ is for low income folks and is a safety net program funded with combined state and federal funds. You can apply for Medicaid at any age, but you must have a very low income to qualify. One thing to keep in mind about Medicaid is that there are claw-back provisions – meaning that if you have tangible assets such as a home, or you receive an inheritance, or if your income at some point exceeds the low income threshold, you can and probably will be made to pay the money back and/or be kicked out of the Medicaid program. > > Medicare has no such provision. Once you qualify for Medicare, you qualify. No claw-backs. > > When Democratic candidates advocate for a Medicare for all system, they’re talking about offering the existing Medicare program, now available mostly to only those over the age of 65, to everyone in some form or another. My cursor must have jumped. The two people with insurance at my work are on Medicare because they are over 65 years old. Sorry that was jumbled. When I lived in Oregon I was on the state program and that was the only time I’ve been insured in the past 10 years I think. That was the only time my wife has had insurance either. ---
**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\ **Post date:** [September 24, 2019, 1:53am UTC](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357/181 "2019-09-24T01:53:21Z")
> [@wolfpup](#): > > I might be persuaded that government-run car insurance is a good idea, but the point I was making is that since it is, in fact, truly insurance in the correct meaning of the word, there is at least a risk that a public plan might be structured in a way that limits your coverage options. Why on Earth would the government want to limit your coverage options? Because government is inherently eee-vil and wants people to suffer? With all due respect, you’re thinking like some Americans who think government can’t be trusted to provide basic services, like health-care. 😃 The principle of our mandatory insurance is that everyone has the same basic coverage, thought necessary to address most liability issues. But nothing stops you as a consumer from buying more (e.g. More third party liability coverage) if you want to, and you’ve got the extra cash to pay for it. And if by chance you’re hit by someone who doesn’t have insurance (e.g. Driving even though they don’t have a permit), the eee-vil government will pay you out from the Uninsured Motorist Fund, so you get compensated and don’t have to make an insurance claim and take a hit on premiums. It’s almost as if the eee-vil government wants to help its citizens. 😛 > [@](#): > > I disagree that there aren’t major differences, That was an auto correct typo - meant to say “there are major diffs between car insurance and health care.” Darn technology! :eek: > [@](#): > > or that car insurance is simpler. My car insurance policy runs to many pages of fine print, with lots of terms that I don’t even understand. My health care coverage is basically defined by the fundamental principle that it pays in full for all medically necessary services. That sure seems simple to me. I was referring to US health care policies, which sure seem a lot more complex than auto insurance. What’s the premium? What’s the co-pays? Who’s in network? What medical conditions are covered? (Using the example in this thread, is back surgery to prevent paralysis covered?) I’m not a car guy, but I’ve got a pretty good idea of what’s covered by my car insurance. Does the average US person know what’s covered by their health “insurance”? Personally, I would have thought back-surgery-to-prevent-paralysis would be covered by most insurance policies, but if you don’t read the fine print carefully … > [@](#): > > Which supports the notion that comprehensive health care coverage such as the single-payer system being proposed or the one we have in Canada isn’t “insurance” at all and shouldn’t be thought of that way. No dispute here. [Previous page](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357.md?page=8) [Next page](https://boards.straightdope.com/t/i-despise-trump-but-would-vote-for-him-over-someone-who-wants-to-take-my-familys-insurance-away/840357.md?page=10)