I read your link tom418 (which is to a blog, BTW), and I stand by what I said. There are many HDHPs available in Mass, but they do have to meet minimum standards. That by no means makes them "deluxe" policies, to use your term. For example, in order not to trigger the tax (or fine, if you prefer), a MASS HDHP: must not limit benefit payments because an individual develops Alzheimer's, mental illness, alcoholism or other chemical dependency after the policy is issued; it can't have a pre-existing condition limitation that lasts for more than six months after the policy's effective date; it must be guaranteed renewable or non-cancelable, etc, etc. Standards like these are a long, long way from demanding that people can only buy "delux" plans, which is what your post claims. What will happen and who will pay their health care costs if one or both of the Williams eventually develops Alzheimer's and their policy doesn't cover it and they, themselves, run out of money? Why should the rest of the taxpayers of Mass pay for them just because they opted for the cheapest type of insurance they thought they could get away with? Apparently, the plan the Williams couple has doesn't meet the minimum standards, but there's just no way to tell why from your link because no further info is provided. So given that you don't have the foggiest idea what their plan covers and doesn't cover, your question "In what way would a high -deductable plan (like the MA couple I mentioned had) be useless?" can be answered, "Don't know exactly, but maybe in a lot of ways."

O.J. -- A few years ago our MD 'fired' us as patients! Bizarre guy. We'd only started with him because he would take our medical coverage. Then it was a challenge to find another internal medicine MD. Finally found a multiple-doctor practice nearby and were assigned their newby, who has worked out OK. (Not the best MD I ever had...but then THAT one never even billed an insurance company going back to the 1980s; it was pay upfront and submit your own claims.) One of the best things about our current situation is the manager of the practice. The whole office is run beautifully. I agree about the problem about too few RN's. I've had two hip replacements and the removal of a staghorn calculus.. All surgeries were done in hospitals that were 'Top Rated' and with 'Top Rated' MDs. HOWEVER, the nursing staff was so thin that I was advised by my doctor to hire my own practical nurse for the first 48 hours post-op on the kidney stone surgery! (Was I ever glad I did! Still, I signed myself out prematurely -- before they could kill me with incorrect meds.) Meanwhile that group of hospitals is really raking it in. I've followed their fortunes, having been born at the original one.

Sherrmann: I don't know how to do italics either, so I'm just going to use the age old quotes, should I quote you. =0) The different systems were all listed on a website at one time, but it was several months ago, I believe it's "hillaries" plan that has the communist bent I mentioned (though I could be wrong on that....). Obama had one that makes a immediate "check-up" mandatory, though I don't remember what happens if you tell them to pound sand. "WHY ARE YOU NOT BOTHERED BY THAT?" Who says I'm not?!? Ok, I'm not as bothered by companies restricting the folks who choose to use their company, because each and every one of those folks have the choice not to give that company their money. (I also understand that those companies have made agreements with the doctors on their list, that they can only charge their people certain amounts, thus saving the insurance company and the consumer both money. Thus the reasons for the lists.... of course you can go outside your system, but the company will only pay the amount they have worked out with the doctor on their list... you will have to pay the rest.) Consumers seem to have forgotten that what they buy, they get. If there is not an option out there that they find ok, then they have the choice not to buy at all. We had a post either here or in the money saving forum that proves that point to the letter. Someone wanted to be able to pay their bill by phone without charge. At least 5 folks came on saying that they should just accept what the company offered, even if it wasn't what they wanted. Excuse me WHAT?!?!?!? Why the heck should we do that? There are too many companies offering similar services to settle for what one company offers. My dad just had a woman for a satellite company tell him that he had to either pay $70 for a service call, or pay a monthly fee to have them come out and fix their equipment, that there was no other choice. She was actually shocked to find out that HIS choice would involve a rival company and NOT paying this company's bogus fees. (they came out and fixed their stuff without charge) Yes, I know, just like that lady on the phone, many believe that they do not have a choice in the insurance company they choose. It's simply not true. You always have a choice. It may be between something bad and something worse, but it is still a choice. "I DON'T THINK IT IS OK FOR "SOME OF US TO FALL THROUGH THE CRACKS." NO ONE IS MORE ENTITLED TO GOOD HEALTH CARE THAN ANYONE ELSE." No, it's not "OK", but it IS going to happen. No matter how good the system it's still run by people, and people aren't perfect. There are folks in every system in the world falling through those cracks. Are wealthy people "entitled" to more/better care simply because they can pay for it themselves? As much as it seems to go against the grain, and that I hate the word "entitled"....... Yes. In the same way as they are "entitled" to better houses, better cars, and even better tvs. They can pay to fly to where ever the expert in their particular problem is, they can afford to stay as long as they need to in that area, they can afford the fees that the best can charge. They can also chase all over the world for the latest "cure" not available here, to the scientists and the wackos who they think can help. They can pay to have a private nurse come to their home and stay with them for 24 hours a day for months and/or years. And as much as many may hate it, those wealthy folks chasing the fountain of youth, allow the experts to volunteer their time helping those that may not have as much. Allows them to charge less if anything to those who can not afford to pay. And in the case of a home health nurse... pays a living salary for someone else. This does not mean that everyone should not be able to get some basic care. It does not mean that everyone should be able to get good care. And if you need me to pay for your basic health care, then you should be willing to go through the systems currently in place. They may be broken, but they are in place. Somehow it seems to speak to the "throw away" society we have become that no one is interested in fixing what we have, they just want to go out and buy "healthcare 2.0". Kidney cancer (hopefully you are doing better now) is not a minor ailment. I believe that the comment was directed at those who could not be bothered to take a few hours off work to take a kid with a cold to the regular doctor. Anyone who has ever been in an ER has seen the number of folks with routine care concerns that are filling up the seats and bogging down the staff. Each and every one of those folks are going to be charged ER rates, which is probably 2-3 times more than a regular office visit, even including the time off work. Which may have something to do with Americans "paying twice as much" for care than other parts of the world, if in fact we do. If we do it is probably the ONLY thing we pay more for. I believe that I am intelligent enough to make my own decisions, and am old enough to take responsibility for my own actions or inactions. Whatever they may be. I wonder how many folks will be thrown into financial trouble by these plans (even those without a communist bent). With many living paycheck to paycheck and that's without insurance... how much worse off will those that we are supposedly trying to "help" be? How many will tank out and go under with the additional tax burden? Yes, it sounds good as long as you do not scratch the surface. So did ARM's and IO loans not too long ago......

I see my General Practitioner when I feel like it - sometimes make an appointment, sometimes not. Need see him only for medicals - thank God. I hear that if I get more than one a year, I may have to pay for at least part of the additional visit. As it is - no charge. My family has history of prostate trouble, so I might be able to avoid that extra cost. He has sent me for a couple of prostate tests - first cost $20., second (for more extensive checking) cost $40. I had an MRI test for that about three years ago - think it cost me something, though was not major. In the ordinary course of things, I'd probably have had to wait for a period, so I guess he called it emergency. When I see him for illnesses, no charge - to me. If I need to visit a specialist, I understand that quite often it entails a substantial waiting period. No charge if I make such visits for necessary service (e.g. if I want cosmetic plastic surgery, to pull my face up an inch or two, I must pay for that myself). No charge when I visit hospitals. If I want semi-private or private room, there's a surcharge that I must pay, but ward service for most illnesses is at no cost. Drugs while in hospital are free - but not after I leave. But, being over 65, I get a break on drug costs. I live in Canada. There is a major effort going on at the moment to open our doors to U.S. style private medical system - which many of us are trying to forestall. We hear that major medical costs are the primary reason for personal bankruptcies in the "good old U.S.A.". Good wishes for health of mind, body, spirit - and pocketbook - to all of you seniors. joyful guy/Ed P.S. U.S.ers in nearby states are reputed to come to Canada by the busload to fill their prescriptions - and a major drug company is threatening to cut off supplies to some of the Canadian pharmacies who make them available on a major basis (largely via internet) to U.S.ers. EB