Posted on 11/03/2025 8:10:35 AM PST by artichokegrower
David Delfiner and Lisa Parsons received a shocking letter from their health insurance provider when they checked their mail last week. Their monthly health insurance cost will increase from $350 a month this year to $2,221 starting in 2026
(Excerpt) Read more at sfgate.com ...
I've had Medicare since 2003. My secondary is the Empire Plan which I pay for as a retired employee of NY State, and through which my Medicare-approved prescription plan is run. When I retired, I lost Dental and Vision care, and never bothered to pay for that additional coverage. For me it would have been a waste of money, since I haven't had any major dental issues or vision care needs other than having my eyes checked once a year because I'm diabetic. I had cataract surgery about 3 years ago. Medicare paid for the surgery, but wouldn't pay for my graduated lenses. Total cost was $350, which I'd rather pay out of pocket than pay for supplemental vision care insurance that I'd only use every 3-4 years.
Not exactly true…I think it was Trump 1 the senate was going to kill it but McCain killed the effort and nothing has been done since.
For health care, bring on market force:
1. Break most hospitals into two highly competitive entities
2. Convert other hospitals into real estate leasing entities with competing surgical suites and nursing wings
3. Separate out drug coverage so hospital systems can run care coverage systems and cut out insurance company overhead and meddlers. Hospital system plans might charge an age-related fee if you lack a drug plan listed by the hospital system plan.
4. Create interstate drug plans that don’t have to cover every drug. To qualify for exchange listing and federal subsidies, they would have to most (~80% or more) in all important types (large volume recombinant, small volume recombinant, breakthroughs under patent, etc.). Group and exchange plans to offer vouchers at plan set amounts for out-of-formulary drugs. Plans without minimums (or vouchers) could be vended directly to individuals and families.
5. These plans would be all the doctors (and AI) prescribe with co-pays equal to manufacturing cost
6. Have drug patents limited by government sourced product revenue and overall domestic government health care spending and not by time [so drug companies have an incentive to minimize government health care funding]
7. Require Kirchoff patent collapse to a single entity upon FDA marketing approval of a covered entity
8. reform medical education, breaking down medicine and dentistry into simpler chunks and start it in the first year of college
9. replace most primary doctoring with AI
(human doctor would confirm AI diagnosis, prescribe radiation imaging/treatment, and voucher/government co-pay drugs)
I would also make copper plans low cost by only covering Part A scope items plus what Part B would pay for any general or regional anesthesia surgery. These would be like the Blue Cross/Blue Shield plans of my youth.
I would also make bronze plans low cost by having co-insurance up to $10,000 at up to 50% with the policy upfront amount paid up front to the insurance company by the insured. Co-insurance percentages would normally be 20% and based on the Medicare amounts unless contractually specified otherwise. Policy percentages might be less for certain things and contractually capped by time periods, by say 50% of the upfront amount the first three months of the calendar year, 60% the first six months of the calendar year, 70% the first eleven months of the calendar year and the whole amount the whole calendar year. The rising percentages are so policyholders are cost sensitive most of the policy term. If and how an upfront amount would get invested would be subject to contract. Unused amounts of upfront money would be refunded after each policy is closed out. A policy would not be closed out until the time allowed for claim submission and needed for claim processing under the policy has expired.
Why are these people so desperate? By virtue of living in California one is so much more healthier. California has outlawed unhealthiness. This article cannot be true.
I sympathize greatly with you. People here who say you get what you deserve generally don’t mean it the way it comes across. They forget (or don’t know) there are a lot of conservatives in California, but the election systems are rigged the same way they are here in Massachusetts.
“Unfortunately I was already paying $2200/mo, It’s looking like I will be north of $4,000/mo in 2026. As someone that is self employed are there any cheaper alternatives?”
Mr. C works for a relative with employer/government coverage.
This relative pays for the college education of Mr. C’s children but doesn’t pay Mr. C very well.
As a result, Mr. C only pays about 10% of his PPACA premiums. The IRS pays the rest.
“Unfortunately I was already paying $2200/mo, It’s looking like I will be north of $4,000/mo in 2026. As someone that is self employed are there any cheaper alternatives?”
When I was young, my brother got insurance through the Chamber of Commerce.
“Catastrophic”
Welcome to the real actual cost of “obamacare” without being artificially reduced by govt subsidies basically across the board
It’s not health care that went up. It’s health INSURANCE.
The CR has nothing to do with Obamacare subsidies. The votes are there to continue them which will likely come after the CR is passed.
It helped me. I had major open heart surgery three years ago with nothing but Medicare A. That covered the hospital stay: $350k. But the rest (i.e. the actual surgery) was on me: Over $150k.
A friend who retired from the medical profession (he worked in surgery) told me to just ignore it. He said it’s actually factored into the hospital costs. He said that when he retired there was several million owed to him, but he just wrote it off as the cost of doing business. He still made out VERY well.
And the calls stopped after about a year. Fortunately, with modern smart phone tech, it’s absurdly easy to ignore them, and I didn’t stress out about it at all. It’s interesting. Once you’ve faced death, very little in life shakes you. In my case, very little = nothing. I don’t even stress over bad drivers any more. I’m living the best years of my life! Who knew?!
Also, it had the same impact on the cost of health care itself that student loans had on the cost of a college education.
Funding medical services for people who have never paid into any kind of system for wildly expensive procedures has an effect on things. I think, for example, of a friend whose daughter decided she was really a man, and has now undergone ‘gender affirming care’, including surgery. She, along with her former boyfriend who, curiously, went through the same identity crises and who also went the full monty with surgery, etc., drove up costs for the rest of us mostly normal people who are just getting older and need a little more medical help than we used to. My guess would be that their ‘treatment’ ran close to a million dollars. Who paid for this? You and I did. Add to this the cost of supporting illegals and their extended families. The situation for we older, middle-class worker bees is grim, to say the least. Why must this be? The system used to work for those of us who played by the rules and contributed to society. That just isn’t the case any longer.
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