if anyone else is here, watching this old video, because for whatever reason, you don't have any parents or adults to teach you about this stuff, my heart goes out to you. I just finished crying my eyes out over all this and I'm trying to get a hold on my life. Good luck to us both. Keep moving forward.
Why is this not taught in school? I graduated last year and had to look this up because no one told me what health insurance even does, and I'm still confused.
Thank you guys for the video, I am 21 and no one ever taught me anything about health insurance and now I can finally get my act together and try to go to a hospital.
So you have to pay monthly out of your paycheck just to have insurance, then you have to pay a deductible before your insurance will help you pay for anything, then after the detectable you have to pay a certain percentage of your bill, AND if you have a doctor visit for a cold you have to pay a copay? What kind of bullshit system is this??
From about 1985 through 1992, I had to hire a bookkeeper for my sick elderly mother that specialized in handling all the medical related paperwork, including challenging insufficient/declined claims, reimbursements, etc. The medical insurance corporations use paperwork run-around tactics against people much like huge law firms use litigation to wear down cases they're fighting. It's totally unnecessary, but works to the corporations' advantage, in terms of pay-outs. Many people are either too sick and too unskilled, legally, to deal with it. There is one great medical plan organization that does not paperwork flimflam its member-patients, and provides outstanding medical care: Kaiser Permanente. There's hardly ever any paperwork (there's no claims filing), no dealing with rejected or insufficient claim paperwork. Their medical care is great, as I had major heart surgery (at a Kaiser center that specialized in cardio related care/surgery) in 2013. Kaiser leaves other plans in the dust!
Most medical plan corporations' patient-service models are intentionally designed to be "a paperwork headache," punitive-like, and naturally favors those mega-corporations. -It's one of the strategies they use to make a profit, and legal for them to do so. Kaiser, on the other hand, uses an entirely different model of patient systems service, that's (streamlined to be easy) highly simplified for patients. And their level of medical care and expertise is fantastic.
I like capitalism. And I don't have a problem with (for-profit) medical care providing corporations, making profits. I do have a problem with some of the strategies they use.
@@The1234fanatic no you don't your 37th in the list of healthcare, 34th in the list of least likely to die from preventable health conditions, you pay astronomic amounts for it whereas we get it free and pay less tax than you. On top of that large amounts of your population get zero healthcare, you have to pay for prescriptions, hospital stays, ambulances, pregnancies etc, etc. It's a fucking shit system mate!
@@The1234fanatic No your 'healthcare system' is shyte. It's so bad the Brits working in the US fly home whenever they have a health or dentist problem because it's cheaper to pay the airfare than it is to get 'treated' in America. You have an exploitative primitive system - you pay your taxes demand free healthcare like the rest of the Western countries have by right.
I had the luxury of learning this in school. Didn’t take it seriously. Failed the class. & now here I am, looking it up 3 years later while trying to obtain my license lol
The way it typically works is that the consumer (you) pays an up front premium to a health insurance company and that payment allows you to share "risk" with lots of other people (enrolls) who are making similar payments. Since most people are healthy most of the time, the premium dollars paid to the insurance company can be used to cover the expenses of the (relatively) small number of enrolls who get sick or are injured. Insurance companies, as you can imagine, have studied risk extensively, and their goal is to collect enough premium to cover medical costs of the enrollees. There are many, many different types of health insurance plans in the U.S. and many different rules and arrangements regarding care.
Slight addendenum: Their goal is not to cover medical costs to enrollees, their goal is to maximum profits for shareholders by minimizing covered medical costs to enrollees. How they do that and to what degree will vary, whether it be by denying coverage, reducing coverage levels, increasing premiums and co-pays, reducing in-network providers, and a myriad of other ways that you will not discover until it happens to you. This isn't a charity, or a cooperative. This is a for-profit business, and their existence depends on not paying out what they take in.
Holy Mother of God...my mother was in a ICU bed, cost per day $4100, for 30 days...so that is $123000, then 3 weeks in a hospice bed, $1000 per day= $21000, total $144000, since we live in a country where the government elects to take care of it's citizens, in the end she had to pay $0. There was no worry that the family was going to be bankrupt by her illness, there was no worry about any bills coming in the mail. Now, my father has cancer. All treatments are pre-booked. Medication provided, home care provided, no cost. And the United States says they have the better system...yah ok
Good thing your country has the money to do that. Where do you live though? Because based on that, I can bet being in the U.S can improve the percentage of opportunities and allow you to get a higher income due to that increased percentage. Im saying you could get more money in the U.S due to the kind of place it is. You could come here, get rich over youtube videos and make 6 mil a year, in that case, I doubt you'd be worrying about the 6000 dollars you pay a year.
@@gorgiablessins3522sdf are you living in reality? USA is the richest country on the planet and cant provide basic and expected support, like free medical care, to its citizens. USA is an absolute joke of a country
@@hasan3545 it’s a joke? Is that why illegals are pouring in here every day risking their life in doing so? Do people like you know how stupid you sound?
Was on the affordable health care site and was totally confused. Read a couple of websites explaining how it works, and it helped some, but was still confused about a few things. But after watching this, it helped me finally understand it 100% (I guess it has to do with the simple video which explains visually )
But why do we have to pay deductibles if we pay monthly? Is there any health insurance plan where you don't have to pay deductibles? especially if you rarely go or don't go at all that year. This is why I pay for any doctor, dentist or vision visits in cash.
That exists, but basically smaller deductible equals bigger premium. This is valid for any insurance (e.g. vehicles) where there is a deductible involved.
they don't say anything about this in school but they sure teach us how to use unnecessary maths that i will never use in life, how to make batteries out of lemons and how to write shitty poetry. Thanks school! I will absolutely need all of that after i graduate
In the UK, everyone pays a tax called national insurance, which is around 11-12% for most people. This pays for all public services, e.g. police, education, welfare and healthcare. And that's it, there are no more charges for healthcare (so it isn't 'free' as people say) except for prescription charges which vary across the four nations of the UK. Prescriptions are free in Scotland and are set at £9.15 ($11.90) per prescription in England, no matter what the actual value of the medicine is or how many doses are given. For people who have regular prescriptions, there is an annual charge of around £120 ($156) per year for all medicine no matter the amount or actual cost. For people who don't work, there are no charges at all (including free prescriptions) and this cost is funded by the national insurance contributions of all taxpayers. Makes me glad to be British!
No, if you pay insurance you must pay for the trivial details, that's how companies can survive, if they pay for everything, they would go bankrupt because then people will not be paying enough to take core of the trivial cost.
I am an American... but I don't know if I want to be. This system of health insurance is unfair. Even though the amount you may pay is smaller, this still causes major issues with the poor in our country. The fact that you have to pay at all for healthcare is just wrong, in my opinion. I think that it should be a human's right to be in good health. I watched this on part of a lesson for a financial literacy class about Health Insurance. This lesson is really making me think that moving to Canada might not be such a bad idea, when I get old enough to do it.
I have a 1500.00 deductible. I cant get my sleep study cause I would have to front 560.00 dollars. I pretty sure Im hardly ever sick enough every year to meet the deductible. Time to cancel my med insurance and live like a normal American. Sorry boss, Im trying to be productive but my body is shutting down do to sleep deprivation. I work in the medical field where I help care for people who are very sick, but when it comes time to keep the caregiver going no one cares.
Imagine you have a $100,000 heart surgery, and because you live in a country with universal healthcare, you get the treatment you need at no direct cost to yourself. And imagine that amount of your taxes which pay for that universal healthcare is LESS than the average American pays in tax just to support Medicaid and Medicare - many of whom will not benefit from it for many years if at all. You don't have to imagine it, you just have to live in a country with sensible healthcare for all.
With one major key you forgot to mention, under this system, the insurance company is losing a lot of money. In order for them to remain in business people collectively need to pay more money than what they gain from medical bills. But in the country where we are in the top ten for highest obesity rates, cancer rates, heart failures, and other diseases, typically this system simply can't work if healthcare industries pay each customer their medical bills they would go bankrupt almost instantly. Just check how many people sought treatments for each of these diseases and you'll see the amount of money required to pay it off is way too high for health insurance companies to afford. So they do what the system was designed to do (and this is the key) is deny health care to those in need essentially saving the companies millions if not billions annually at the expense of people's homes and lives.
In a single payer system, there would be no need for the vast number of for profit insurance companies currently operating in the US. They would be largely removed from the equation. The money would be paid to and held by the government at no profit. That is one of the primary benefits. Were single payer ever to be enacted in the states there would undoubtedly be large scale redundancies in the health insurance industry. That is unfortunate but necessary. A small health insurance industry would remain as it does in countries with single payer like the UK. Unfortunately it is the power of this sector both financially and politically which is a major obstacle to single payer being implemented.
Indeed, unlike America which created a private healthcare system which by design is corrupt to the core. It lives off of denying people healthcare which is really just beyond insane. It's basically killing people for money. It's sick.
What a brilliant video. Great advice, simple and practical. I like your video presentation. It is informative too, at the same time. Thanks a lot for your guidance!
I really love the content you posted on your RU-vid channel, it is always super helpful and informative. Keep posting such an amazing videos, I love watching all your videos.
In the US, medical care is not considered a right afforded to all people. You either have to pay for it out of pocket if you can afford it, or have one of those prized jobs that provide you medical insurance. Americans believe in what they call the Free Economy. This means that they believe power and wealth should have its way. They believe that those with the money should make the rules. They don't believe that people should organize themselves into institutions (aka government) that prevent the misuse of power by those at the top of the socio economic ladder. Canadians believe in a combination of Free Market and social initiatives to curb the tendency of big corporations to misuse their power and wealth. Canadians also believe that medical care is a right rather than a privilege.
Good explanation but i am still not clear on how the system works. For example, if i have an insurance plan that pays approx.$600-$800 monthly then how does the costing work?
If you lived in any other developed country you wouldn’t have to worry about these silly complexities. You will be cared without any bills being thrown at you.
Finally. I think I kind of get it now. I dont now why they dont teach this in school. I wasted my life, money and energy in classrooms to learn useless nonsense like Plato and Aristotle.Now I am here trying to cram this.
I think that you could have a deductible and co-pay and an out of pocket max with a single payer system. If this is indeed the way to keep unneeded doctor visits.
If you like your doctor, you can keep him (hmmm, I didn't). The average American will save $2500 per year when ACA comes out (hmmm, no!) I guess the system was better before 2008.
I never had an education about this insurance system, I am still confused, I do not have health insurance nor any of my family members, my grandparents never had any disease nor their parents luckily. My parents are still healthy at the age of 65, I have never been hospitalised. I still don't have health insurance and have no plan to buy it.
Seems like Health Insurance really only benefits those who get majorly ill and sustain prolonged hospital stays which is fine. I have no problem with it because that could be any of our relatives or friends🤷🏾♂️. We’re basically paying premiums to cover each other’s health lol. The “free” preventative check ups are nice too. So seems like we’d be putting ourselves at risk and selfish of us to not be enrolled in a health insurance plan.
I dont fully understand the people complaining on here? Would you all fucking rather pay 100,000 thousand dollars out of your own fucking pocket, or pay 5,000? What? You thought you shouldnt have to pay that 100,000 dollars? Lol, Doctors gotta get paid somehow. Next time dont get fucking hurt. This system seems extremely useful and fair.
I just applied for medical insurance my deductible is 5000 say if i go to my doctor for a cold. Would i be responsible for paying the entire amount charged by my doctor since i haven't met deductible yet?
I worked for Genentech. The biggest culprits are the insurance companies. Consider the major players in AMERICAN healthcare: Hospitals, Doctors/nurses/staff, drug makers, drug distributors and insurance companies. Hospitals: hosting/keeping the lights on of a real facility.... NECESSARY role in the system. Doctors/nurses/staff: running around interfacing w/patients...NECESSARY role in the system. Drug makers: A grayer area here but they actually do make R&D intensive medicines... Could their profits be regulated/capped in a balance to not stifle innovation but reign in profits? SURE. But they also play a NECESSARY role. Making monoclonal antibodies takes serious knowledge. Now here are the two key ways costs get inflated & where Americans get gouged. Drug makers make bulk purchase agreements with McKesson (ticker MCK $50B+ market capitalization), Cardinal (ticker CAH $20B market cap) and Amerisource Bergen (ticker ABC $33B market cap).... These distributors make nothing, they create contracts with end users hiding the prices they pay to purchase... Google the market cap or CEO pay of each of these companies and remember they each pay a C-suite of executives crazy $ and WHAT DO THEY DO? ...(drum roll)..."distribution". Something requiring no special expertise and certainly not something a not for profit entity armed with cutting edge technology could do WITHOUT the profit motive involved. They simply buy in bulk directly from the manufacturer (like Polivy or Avastin or Rituxan from Genentech) and then jack up prices to the end user hospitals, pharmacies and hence patients or rather the patient's insurance....which brings me to the REAL ASSHOLES in this train wreck of a system. Insurance companies: What do they do? Provide a facility for people to get surgery at? Nope. Go to medical school for years and then interact with patients? Nope. Use technology to make medicines? Nope. INSURANCE SIMPLY CHARGES PEOPLE THE HIGHEST PREMIUMS POSSIBLE AND THEN DENY/DELAY CLAIMS until people die or give up. ABSOLUTELY NOT ESSENTIAL. A NOT FOR PROFIT ENTITY COULD ABSOLUTELY ADMINISTER A NATIONAL PLAN WHERE THE REAL STATISTICS OF DISTRIBUTED RISK COULD BE RELIED ON WITHOUT HAVING TO PAY INSURANCE CEOs 7 figures. Please Google "top 10 health insurance CEO pay" and marvel at the excess pay for merely collecting premiums and then trying as hard as they could to not pay claims. Those excesses are funded by the premiums we all pay. Absolutely not necessary. Getting rid of them would cut the costs everyone is always complaining about. We should have a not for profit national healthcare system without for profit insurance. Sure I can hear some express fear about the cost but we'd trade our $400/month premium for a new lower $300/month tax that would mostly only be for those making over a solid threshold. I support Bernie and all who support a national healthcare system without unnecessary middle men & the costs profit pursuits add.
Listen carefully the words **MOST*** and ***Covered*** are very important and insurers won't give you a list of what they won't cover or what things don't make the MOST list. MOST can mean as low as 50.0000001% of any or everything. So in her example they could and will claim you didn't see the right doctor or you didn't get pre-autorization or they didn't use a in-network facility or a used a anesthetist that wasn't in-network. Wala you owe $100,000.00!
+Anh Quan Chu Premium is a repeating, flat-rate cost that you pay regardless of whether or not you get healthcare services. If you go to the doctor (urologist, oncologist, etc) 100 times or 0 times in a year, you will still pay the same premium. Deductible is basically a threshold, and actually protects people from high healthcare costs. The deductible you only have to pay if you get healthcare services. The reason the deductible helps people is because once they pay their own money for services up to that amount, then they pay only a percentage of the rest. Why is this all so complicated with deductibles, copays, and coinsurance? It is to prevent what we call 'moral hazard'. If people didn't have to bear some of the costs of healthcare, then they would be more likely to incur healthcare costs (because they don't have to pay). It's all very complicated, but that is simply because people's behavior is very complicated. The system is a direct reflection of our behavior.
This video only explains what the basic mechanics are for existing health insurance practice. It does not explain about the many faults and problems with the health care industry.
Oh.... come on. It's super easy!!! Not like those European style social healthcare systems where you are simply covered for everything just because you are alive.
Honestly, I'm not trying to understand this nonsense. I can not believe that the congress pass a bill which required every American to have health insurance or pay the penalty. I haven't been to the hospital for three years now but had to keep the health insurance to avoid the penalty with my taxes. These insurance companies are getting powerful every days and the government allow it. Theses health insurance companies looks more like bankers to me, they are making a lot money over people and keep getting rich when we have to work so hard to obtain that money.
All because they fund most politicians election and re-election campaigns. Been a crooked system ever since 1880, and I'm sure most would argue long before that.
Do you know why exactly the government made that law? I think it's a really stupid and ridiculous law. I'm 26 and haven't had health insurance for a very long time. But someone in my family keeps pressuring me to get it. I think it's pointless because I would have to work just to keep myself to have health insurance. I don't want to do that... Personally I wouldn't be concerned about myself until I'm 40.
