# So Much for "Affordable"



## Don M. (Oct 24, 2016)

The ACA premiums for 2017 were announced today, and it looks like the average costs will be about 25% more than the 2016 rates.  In addition, with insurers dropping out of the exchanges, about 1 in 5 people will have only 1 insurer to provide coverage.  So Much for "affordable" and "competition".  However, since most of the people receiving coverage under this plan are receiving subsidies from the government, all this really means is that the taxpayers will be on the hook for even more money flowing to our Health Care Industry....and these funds will just be added to our already out of control National Debt.    

We already pay twice as much for health care as most other nations...and the general health of our population is far worse than those in most other developed nations.  I wonder how long it will be before the people of this nation wake up and realize what a Rip-Off our present system is.


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## mathjak107 (Oct 25, 2016)

the aca  plans were far from affordable unless you got a subsidy . the copays  and out of pockets were ridiculous


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## jnos (Oct 25, 2016)

Once again, or still, the all powerful insurance companies are pulling the strings. They seem to be in control of our country's health care. It has to change If the Affordable Care Act were expanded and more people joined the cost would be lower.


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## mathjak107 (Oct 25, 2016)

our aca insurer went bankrupt last year . what a hassle that was


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## SeaBreeze (Oct 25, 2016)

jnos said:


> Once again, or still, the all powerful insurance companies are pulling the strings. They seem to be in control of our country's health care. It has to change If the Affordable Care Act were expanded and more people joined the cost would be lower.



I'm happy with the ACA, the costs before Obamacare were through the roof, ridiculous.  They were raising each year too, big time!  My monthly cost is $363 and will rise to $393 ish with some changes in same plan.  I rarely go to doctors and am on no prescription meds, so it's just fine for me, much better than before when I retired and had to pay Cobra out of pocket and all out of pocket from then on.  The best thing, and I can't believe it's taking so long to do, but we're on the way, is Universal (Single Payer) health care.


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## Aunt Bea (Oct 25, 2016)

I'm another fan of the ACA, as a step towards universal health care.  I figure the single payer system will kick in a couple of years from now when I transition to medicare, that's how my life seems to work.  Still a single payer system will be good for millions of people.

I need to look seriously at a higher deductible to lower premiums this year if the projected increase is as high as they are reporting in the news.  Can't wait until the exchange opens on November 1 so I can see exactly what things will look like in 2017.


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## bluebreezes (Oct 25, 2016)

Aunt Bea, you can get a preview now of the plans and pricing at healthcare.gov.


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## Grumpy Ol' Man (Oct 25, 2016)

For 8 years, we heard "Repeal and replace" for this obstructionist GOP Congress.  Not once have we heard them say, "Let's put our heads together and fix what is wrong with the ACA."  Yet, when asked to bring forth the plan they would offer to replace the ACA... it is total and complete silence.  I firmly believe changes could have been made that would have seen multiple insurers compete for the business, thereby seeing prices drop.  Instead, they will either continue to rape the system or bow out.


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## Knight (Oct 25, 2016)

Not that I expect either political party to come up with something that would reduce costs while providing better care than anywhere else on the planet . The financial impact on 1/6th. of the economy if reduced could be devastating. 

I have never seen a report or study that defines the various reasons for high cost. You would think by now the list would be nailed down and some bright minds would be submitting ideas to solve what those issues might be. Then present what they found and what they plan to do to the American people.


Probably my previous job and what made me successful at it was defining the problem then figuring out a long term low cost solution. That job was as a mechanic that led to supervision & finally a position that made it possible to retire at age 54. 

For those that think a single payer system is the answer, look at some of the things that are not going well in countries that have that as a system in place now. Or look at a comparison like the VA or even the expected inability to pay benefits for Medicare & Medicaid in the not to distant future. Our government is great at throwing money at a problem but that doesn't solve the problem or hasn't anyone noticed the national debt climbing. Not easy to find domestic debt but it can be found and it ain't pretty.


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## Butterfly (Oct 25, 2016)

There really isn't any competition in the ACA that I see.  Here most insurers have pulled out and only a very few (2 or 3) are left and those have limited plans.  

Some people say that part of the problem is that healthy people, particularly younger healthy people, would rather just roll the dice and pay the penalty than pay the premiums.  So carriers are left with the older, higher risk people, and already sick people who the carriers wouldn't have insured before.  I sure don't think that's anywhere near the whole answer, though.  The ridiculous inflation of prescription drugs is certainly part of the problem and the huge top heavy bureaucracy doesn't help either.

IMHO, most of the Medicare problems could be solved by getting rid of the earnings cap for SS and Medicare payroll deductions.


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## Carla (Oct 25, 2016)

Grumpy Ol' Man said:


> For 8 years, we heard "Repeal and replace" for this obstructionist GOP Congress.  Not once have we heard them say, "Let's put our heads together and fix what is wrong with the ACA."  Yet, when asked to bring forth the plan they would offer to replace the ACA... it is total and complete silence.  I firmly believe changes could have been made that would have seen multiple insurers compete for the business, thereby seeing prices drop.  Instead, they will either continue to rape the system or bow out.



I feel the same way. Remember when they began working on healthcare, when Obama took office? He did all but beg both parties to work to together to work on a solution. I can only assume they had no ideas then either. Many of these insurers are for profit and have shareholders. What I have heard recently is that the biggest issue is insurance companies are being forced to take in people with existing conditions. So, if you lose your job and health benefits and are unfortunate to have an existing condition which so many people do as they age, they want to either refuse you or charge you an exorbitant rate!  Something needs to be done to reel the insurance companies back in and they really need to do something very soon!

Speaking of insurances--it's the same with homeowners and car insurances. My homeowners has almost doubled in eight years even though the value of my home hasn't really changed. I've never had to file a claim.  What a racket. 30 yrs of collecting premiums.


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## Knight (Oct 26, 2016)

Butterfly said:


> There really isn't any competition in the ACA that I see.  Here most insurers have pulled out and only a very few (2 or 3) are left and those have limited plans.
> 
> Some people say that part of the problem is that healthy people, particularly younger healthy people, would rather just roll the dice and pay the penalty than pay the premiums.  So carriers are left with the older, higher risk people, and already sick people who the carriers wouldn't have insured before.  I sure don't think that's anywhere near the whole answer, though.  The ridiculous inflation of prescription drugs is certainly part of the problem and the huge top heavy bureaucracy doesn't help either.
> 
> IMHO, most of the Medicare problems could be solved by getting rid of the earnings cap for SS and Medicare payroll deductions.


Young and healthy have this to fall back on as do others,

*Emergency Medical Treatment and Active Labor Act* (*EMTALA*)[SUP][/SUP]


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## Butterfly (Oct 26, 2016)

Knight said:


> Young and healthy have this to fall back on as do others,
> 
> *Emergency Medical Treatment and Active Labor Act* (*EMTALA*)



EMTALA only requires a hospital to treat an EMERGENCY condition and *stabilize* you, or to treat you if you are a woman inactive labor.  Otherwise you're SOL.  And in an emergency, they don't have to treat you all the way through, they just have to stabilize you.  That's all.


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## QuickSilver (Oct 26, 2016)

Butterfly said:


> EMTALA only requires a hospital to treat an EMERGENCY condition and *stabilize* you, or to treat you if you are a woman inactive labor.  Otherwise you're SOL.  And in an emergency, they don't have to treat you all the way through, they just have to stabilize you.  That's all.



Not to mention.. this care is NOT free.. You will be billed.. if you cannot pay... you will be placed for collection or sued.. You can lose whatever savings or assets you have.. You will also lose your credit rating.. and likely will have to file for medical bankruptcy.  .  and in the end,  the REST of us will have to pay in higher healthcare costs and higher premiums..


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## mathjak107 (Oct 27, 2016)

obamacare has 2500-3k deductibles and almost 7k out of pockets plus almost 5k in premiums for an individual if no subsidy . a healthy person is far better rolling the dice than insuring today . that fine is a great savings .

while we all who have coverage may not like that fact the reality is the healthy people are doing just that . the risk pool ended up being those who are most likely to need care


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## Capt Lightning (Oct 27, 2016)

As a Brit, I admit to being confused by the American health system.  I seems much simpler here.  You pay a percentage of your salary for National Insurance which includes state pension and National Health Service (NHS).  From then on, treatment is free at the point of delivery.  In England you may have to pay for prescriptions, eye tests etc.,  but they are free in the rest of the UK.

Sounds great, and it is if you have a serious illness, accident etc...  However if you have a minor complaint  (even if it is making your life a misery), then you will have to wait months for treatment.  If you can afford it, best to go privately, but if you can't, then you have to suffer.


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## Knight (Oct 27, 2016)

QuickSilver said:


> Not to mention.. this care is NOT free.. You will be billed.. if you cannot pay... you will be placed for collection or sued.. You can lose whatever savings or assets you have.. You will also lose your credit rating.. and likely will have to file for medical bankruptcy.  .  and in the end,  the REST of us will have to pay in higher healthcare costs and higher premiums..


With the amount of people not paying federal taxes and drawing on the entitlements that are available to be used. Do you or others really think they care if their credit is ruined if they even have a credit rating that could be ruined, or that they have assets to be lost to a collection agency? 

It isn't rocket science to do a web search to discover that poverty in America exists. 

Then there is Obama Care.

[h=3]Illinois *emergency room* visits *increased* after *...*[/h] www.chicagotribune.com/business/ct-emergency-visits-obamacar... 


Cached
Aug 30, 2016 *...* Illinois *emergency room* visits *increased* after *Obamacare*, study says ... effect — the opposite of what many hoped would happen *under* the landmark ... reduce the *use* of pricey services, such as *emergency department* visits, ... 
 Whether it's EMTLA or paid for by taxes supporting Medicaid IMO the end result is the same. 


Unless and until the differences in America are recognized and a base of facts relating to needs is established a lot of the money being thrown at the system now is wasted. 

For example N Y city population vs. rural Georgia or Louisiana  have different levels of need. What distinction does Obama care make?


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## Knight (Oct 28, 2016)

Capt Lightning said:


> As a Brit, I admit to being confused by the American health system.  I seems much simpler here.  You pay a percentage of your salary for National Insurance which includes state pension and National Health Service (NHS).  From then on, treatment is free at the point of delivery.  In England you may have to pay for prescriptions, eye tests etc.,  but they are free in the rest of the UK.
> 
> Sounds great, and it is if you have a serious illness, accident etc...  However if you have a minor complaint  (even if it is making your life a misery), then you will have to wait months for treatment.  If you can afford it, best to go privately, but if you can't, then you have to suffer.


Capt the concept sounds good until you realize that dealing with 360 million people scattered over 50 states with a Soc. Sec. system that is already taking a portion of pay to do what you describe. 

Then there is congress here that took & is still taking as far as I know those funds and has used them like they do in the general fund. 

The ACA or Obama Care which ever is better understood had a good concept but wasn't thought thru. Expecting and getting the desired results to cover the cost of insuring isn't happening. 

One feature Medicaid to insure those that were not insured was intended to provide preventive care. Having the ability to see a doctor as a preventive measure in theory makes sense. Reality is finding a doctor that has time or low patient load that accepts Medicaid to see the newly insured. Isn't happening so those minor complains are being addressed in the E R's here. 

The overall result, lots of articles explaining that the ACA isn't performing as intended.


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## Don M. (Oct 28, 2016)

The overall result, lots of articles explaining that the ACA isn't performing as intended.[/QUOTE]

Not Too Surprising....given that most of the ACA was probably written by the Health Care Industry Lobbyists.  I doubt that any of the politicians had any real idea of what they were doing when they "sponsored" this legislation.  After all, I seem to remember Nancy Pelosi saying that "Congress needs to pass this Legislation, so they can find out what's in it".  Now, if that didn't raise any red flags in Washington, it's no surprise that this ACA isn't living up to expectations.


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## mrstime (Nov 5, 2016)

Here in Canada each province approaches medical care differently. In BC we have single payer insurance. We pay $135.00 peer month and it covers all Dr's visits, any hospital care for the two of us. In the past 4 or 5 years the premiums have increased several times .  One of the differences between our medical care and the US is that in the US every doctor's office seems to have all sorts of machines to diagnose, here if the Dr wants an xray we go to the hospital for that , the same for most  tests including blood tests.  Our insurance covers all that.


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## Carla (Nov 5, 2016)

mrstime said:


> Here in Canada each province approaches medical care differently. In BC we have single payer insurance. We pay $135.00 peer month and it covers all Dr's visits, any hospital care for the two of us. In the past 4 or 5 years the premiums have increased several times .  One of the differences between our medical care and the US is that in the US every doctor's office seems to have all sorts of machines to diagnose, here if the Dr wants an xray we go to the hospital for that , the same for most  tests including blood tests.  Our insurance covers all that.




We have independent labs in my state that do blood, urine and other related testing. Hospitals do it but it is more expensive.  For other type of testing, we have hospital and independent sites that do CT scans, MRI 's and testing of that nature. We have many hospital annexes that will provide those services too, including X-rays and mammograms. Primary care doctors write a prescription for us to have these type of tests performed. If we are seeing a specialist, then yes, they may have some equipment on hand but they don't usually have that much as the equipment is expensive and radiologists read a lot of the results.

It seems in our country, healthcare is more of a business than a service. They send you for so many tests--just to eliminate possibilities, which often runs into a lot of money and anguish. I'm sure it is used to protect Drs from lawsuits too, but IMO it is quicker for a doctor to order tests than to take the time to talk to a patient and get a complete history. Over recent years, I have had so many types of tests to figure out what is causing a chronic form of anemia. Very invasive testing that in itself can be risky. I have had it, enough is enough! I believe there is a point in which all it does is continue to drain our wallets and cause insurance rates to go up.

It would make more sense to send someone around to countries that have successful healthcare plans in place. Find out what works in countries outside the US. Figure out what complaints, if any, people have and see if we could improve upon them but strive to make it affordable to everyone. Visit countries that may have plans that do not work well--we can learn from that too. We're kind of brainwashed to a degree, into believing socialized medicine is very bad!  Treating it like a business hasn't worked. Insurance companies want to make profits and shareholders do as well. Before shooting down Obamacare, let's see what can be done to improve it or have a plan in place so that no lives are lost in the interim. We're not talking only about poor people--we are talking about many middle class people as well. Politicians really need to be in touch with the "outside world" where a lot of people are struggling with this issue.


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## BlondieBoomer (Nov 5, 2016)

mrstime said:


> Here in Canada each province approaches medical care differently. In BC we have single payer insurance. We pay $135.00 peer month and it covers all Dr's visits, any hospital care for the two of us. In the past 4 or 5 years the premiums have increased several times .  One of the differences between our medical care and the US is that in the US every doctor's office seems to have all sorts of machines to diagnose, here if the Dr wants an xray we go to the hospital for that , the same for most  tests including blood tests.  Our insurance covers all that.



When Obamacare was in the works and being negotiated we heard all kinds of stories about how dreadful single payer or socialized medince in Canada and England is and how Canadians were coming over the boarder in many cases for care that they couldn't get in Canada. We were told they had to wait months for care and sometimes died in the meantime. We heard about overcrowded ER facilities were people sometime had to wait for S days in terrible conditions to get care and that drugs that are available in the U.S. aren't available there.


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## SeaBreeze (Nov 5, 2016)

mrstime said:


> Here in Canada each province approaches medical care differently. In BC we have single payer insurance. We pay $135.00 peer month and it covers all Dr's visits, any hospital care for the two of us. In the past 4 or 5 years the premiums have increased several times .  One of the differences between our medical care and the US is that in the US every doctor's office seems to have all sorts of machines to diagnose, here if the Dr wants an xray we go to the hospital for that , the same for most  tests including blood tests.  Our insurance covers all that.



Mrstime, I've heard nothing but good things from Canadians about their healthcare system.  By the way, you live in a beautiful country, we've been to BC, Alberta, Northwest Territories, Yukon, etc. on camping trips in the past, our younger days.  Awesome scenery, and beautiful wildlife!


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## SeaBreeze (Nov 5, 2016)




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## Butterfly (Nov 5, 2016)

Maybe it's true in other places, but here there are not nearly that many who have insurance through their employer.  Many of our large employers have left and small employers do not offer it.  I only had insurance through my employer here once in my work history.  And the sad thing is that some of the large employers who do remain have found ways to get around offering insurance to many of their employees by getting around the "full time" requirement.


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## SeaBreeze (Nov 5, 2016)

I had insurance through my employer for decades, union job, Kaiser for me and my husband at very low cost.  When I retired I was shocked to see the Cobra payments I had to pay out of pocket, and the costs went up each year from there.  Was throwing my retirement savings right out the window, I was happy when the ACA kicked in.  Now I just have one year until I can sign up for Medicare.  Kaiser will keep me on the same plan and I don't have to do anything this enrollment period.  The cost will go up around $30+ per month, not sure of the exact figure for the Silver Plan.


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## Aunt Bea (Nov 6, 2016)

I too had health insurance through a previous employer.  The rates were reasonable until my COBRA expired and they moved me into a retiree pool.  The retiree pool had never been explained to me or others when we were going through our separation documents.  The rates in the retiree pool were very high because it only contained the old and sick former employees.  When ACA kicked in that gave me some relief and now I'm looking forward to Medicare eligibility.

I took a look at the 2017 rates for my individual ACA Platinum plan, $905.00/month with an estimated income based subsidy that will lower the monthly premium to $774.00/month that is up $109.00/month over 2016.  Only a couple more years until I'm eligible for Medicare.


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## BlondieBoomer (Nov 6, 2016)

Aunt Bea said:


> I too had health insurance through a previous employer.  The rates were reasonable until my COBRA expired and they moved me into a retiree pool.  The retiree pool had never been explained to me or others when we were going through our separation documents.  The rates in the retiree pool were very high because it only contained the old and sick former employees.  When ACA kicked in that gave me some relief and now I'm looking forward to Medicare eligibility.
> 
> I took a look at the 2017 rates for my individual ACA Platinum plan, $905.00/month with an estimated income based subsidy that will lower the monthly premium to $774.00/month that is up $109.00/month over 2016.  Only a couple more years until I'm eligible for Medicare.



I know insurance costs have gone way up but that sounds really high for a single person. Who is the insurance carrier? Is it some type of 0 deductible plan?


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## Butterfly (Nov 6, 2016)

BlondieBoomer said:


> I know insurance costs have gone way up but that sounds really high for a single person. Who is the insurance carrier? Is it some type of 0 deductible plan?



I just couldn't afford that -- not and be able to keep eating.


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## bluebreezes (Nov 6, 2016)

My 2017 ACA premium rate after subsidy actually went down because my earnings estimate will be lower. I'm very pleased with this program, the insurance plans, and the providers in my network. ACA allows me to retire early and get quality healthcare before I'm eligible for Medicare.


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## Aunt Bea (Nov 6, 2016)

BlondieBoomer said:


> I know insurance costs have gone way up but that sounds really high for a single person. Who is the insurance carrier? Is it some type of 0 deductible plan?



The plan is from Excellus Blue Cross Blue Shield and has an annual deductible of $2,000.00 with various copays.  My premiums were higher than this, for a similar plan, prior to ACA.  The only reason I'm mentioning my situation is to illustrate that the ACA is not just a program for expanded medicaid coverage or people with severe pre existing conditions who might be considered a drain on the system.  I think many people that receive health insurance through an employer have an incorrect idea of the ACA and who actually uses it.


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## BlondieBoomer (Nov 6, 2016)

Aunt Bea said:


> The plan is from Excellus Blue Cross Blue Shield and has an annual deductible of $2,000.00 with various copays.  My premiums were higher than this, for a similar plan, prior to ACA.  The only reason I'm mentioning my situation is to illustrate that the ACA is not just a program for expanded medicaid coverage or people with severe pre existing conditions who might be considered a drain on the system.  I think many people that receive health insurance through an employer have an incorrect idea of the ACA and who actually uses it.



Wow, that amount of money per month is terrible. If you wanted to switch insurance companies would there be cheaper options? Even a family member who is a long term cancer survivor could get lower rates in California. I wonder if it's because California has a health care exchange? Are you in a state that doesn't have an exchange?


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## mrstime (Nov 6, 2016)

BlondieBoomer said:


> When Obamacare was in the works and being negotiated we heard all kinds of stories about how dreadful single payer or socialized medince in Canada and England is and how Canadians were coming over the boarder in many cases for care that they couldn't get in Canada. We were told they had to wait months for care and sometimes died in the meantime. We heard about overcrowded ER facilities were people sometime had to wait for S days in terrible conditions to get care and that drugs that are available in the U.S. aren't available there.


It apparently true that some people have to wait a while for treatment but I can attest to the fact that when the problem is life threatening there is no wait. I am alive because there was no waiting. I presented at the ER that took about 1/2 an hour it was decided to hospitalize me to see if the bleeding ulcer would stop it didn't I was given 4 units of blood, the next very early morning I had surgery and was given another 3 units of blood and spent the next 7 days in ICU, 3 more days in a regular room and finally went home.

Then I actually had the same surgery here and in the US. Half of my thyroid was taken out there I had 80% insurance I was in hospital less than 24 hours went home to recover. Then the bills came pouring in the total to us was twelve thousand dollars. remember that was after the 80% paid by the insurance company. Then half was taken out here, I was in hospital 2 days, then sent home they wanted to send me a housekeeper, I said no to that. They did send a nurse everyday to check on how I was doing. After a week I begged off she agreed I was doing well and really didn't need her. Cost to us ? Nothing.


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## Aunt Bea (Nov 6, 2016)

BlondieBoomer said:


> Wow, that amount of money per month is terrible. If you wanted to switch insurance companies would there be cheaper options? Even a family member who is a long term cancer survivor could get lower rates in California. I wonder if it's because California has a health care exchange? Are you in a state that doesn't have an exchange?


We have an exchange and we have a handful of companies to choose from.  Some of the companies that are available for the same coverage that I have are a little bit cheaper but, I chose this plan because Excellus tends to make it easy to use the insurance, don't dispute claims with lots of red tape, have excellent customer service, etc...  

I think in the next few years a more workable less expensive way to provide health insurance will evolve with a single payer/medicare for all type program.  IMO once the major employers in this country have a way to off load the burden of providing health insurance, as part of a benefit package, to the government  it will snowball and we will have a large enough pool of people to make it work.  We'll see!


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