Health insurance isn't a want, it's a need. Much in the same way that no one wants to pay for auto insurance or life insurance till you really need it, which is when you can appreciate it.
OT: health insurance stuff
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Health insurance isn't a want, it's a need. Much in the same way that no one wants to pay for auto insurance or life insurance till you really need it, which is when you can appreciate it.
sorry AL .. i have to disagree with ya man.. auto yes, because there is no right to drive a car .. but when it comes to a person's life, it's their choice.. and anyone's life is their choice.. how can you mandate someone's choice?.. basically saying you have no choice over your own life?.. how does that make any sense??.. esp when libs are ok with abortions .. ain't that a choice? and why should i pay a tariff if i opt out????
Awesome post! I usually am middle of the road I vote for both parties but lately the hypocrisy and ignorance of the far right is scary.
Al, I'd be ecstatic if I had that kind of coverage -- I work for a small company and have to take an individual policy. For family coverage, I have to shell out $1500/month, then have a $5000 deductible. If it wasn't illegal to not have it, I wouldn't be bothered -- FWIW the IRS penalty is far less than I'm spending for the insurance alone.
I didn't read the thread bc I assume it's turned into a political battle. Regarding insurance, if you can get on a government/state plan you should do it. Nothing you can get in the private sector will compare. Also, you don't need to all be on the same plan. My wife is on one plan while myself and my kids are on another.
Because of the way that the law was written and enacted, if I'm to purchase insurance I have to purchase far more than I need -- the prescription coverage above was a perfect example. Among myself, my wife and my children, if we have 3 prescriptions for very basic antibiotics, it's a lot. But once the ACA kicked in, I HAD to purchase it. I saved about $200/month not buying it (since I don't get prescriptions that often, it was far more cost effective for me to pay the out of pocket on a prescription than buy the coverage for something I wasn't going to use). That option isn't available to me, and I really resent someone in Trenton or Washington thinking they know what I need better than I do.
Exactly. I needed bupkus when I was 23. And what my employer covered way back then was really good. And didn't cost me anything. :)
But you are paying for those who can't or for who it would be unaffordable.
Another way to get real reform would be to go back to what was the major medical system. I used to have that type of coverage (back in the 80s before the rise of HMOs and the like), and I was presented with the bill and saw the final cost. I paid the entire bill, and if I was entitled to anything from my insurance company I was reimbursed. The end consumer has no idea what the final cost for most procedures actually is in the current system. If people were aware, they wouldn't pay exorbitant amounts of money for these procedures where possible.
It was also a simple system, I think I had $100 or $150 deductible, after that coverage was 80/20 of "usual and customary" amounts (including prescriptions). I paid the provider, then submitted the receipt and got reimbursed.
like how an IV saline costs 2 dollars to make and they charge a couple thousand to administer in a hospital..
Please don't say that those on the left think Obamacare is great.
Obamacare was a bailout for the healthcare/drug industry, it was written by them for them.
socialism.. forced sign up for everyone.. that being said.. the pharma guys just want money for new drugs that do the same as the old drugs.. with more symptoms of course.. so they can make more money on the next new big hit!
to the OP. I would strongly question the desire to have everyone in your family on the same plan. Most Employer based plans have highly-subsidized premiums for the employee and greatly reduced subsidies for other family members. For example, to add my wife to my current plan would cost 3.75x times more. So if, for example, you're paying $20 a paycheck in premiums and your wife is paying $20 a paycheck for her premiums now, you're looking at $40 a pay period in total healthcare premiums. But if you were to move to her plan (or her to yours), all of a sudden you're paying $75 a pay period in premiums (the $20 for the employee and the additional $55 for adding a spouse). Over the course of a year, that is a $910 difference.
Of course, premiums aren't the only component of the health care plan. The other big ticket things to look at are the deductible and the out of pocket max. The deductible is coming out of your pocket before the insurance companies pay anything. Most plans (though not all) double the deductible for families. Since with a child you will already be on a family plan with one insurance company, moving to the same plan could actually lower your overall deductible. Say you have a $500 deductible and your wife has a $250. When the child is added to your wife's plan, her deductible will go up to $500. If you were then added to her plan as well, the deductible would not change (of course, check your plan details to make sure it operates this way). If you use a decent amount of healthcare during the year, you might find some savings here (especially if there is a big disparity between the deductibles on the two plans).
The last big ticket item is the yearly max. That is generally per-member and it is max amount out of pocket you will have to pay during the calender year. Since it stacks per-member, the math here is easy. This is only relevant in years when you're going to have a lot of medical expenses. Things like childbirth or major surgical events generally blow through most yearly maxes on employer plans. So if you have a case where the two plans have a big discrepancy in yearly maxes and you know you have a major medical event coming, you can try to optimize for that. For example, if your plan had a $2000 max per person and your wife's had a $5000 and you knew last November that she was pregnant, moving her onto your plan would have been a guaranteed savings of $3000 (minus the difference in the premiums). Of course, you don't always know when major medical events are coming, so this sort of thing isn't always easy to optimize around.
After that, you get into the details of the plan. One thing to look at is the percentage coverage. Most plans have something like 90/10 or 70/30, where the first number is the % of expenses the insurance company covers and the second is the percent you pay, after you've hit your deductible. In a plan with a high deductible, in a year where you don't spend a lot on health care, the percent coverage doesn't even matter. In years where you have major medical events and hit your yearly max, the percent coverage doesn't matter. It is those in-between years where it can have a financial impact. It is something where you need to look at the history of healthcare usage in your family (and understand the small children can often generate a fair bit of healthcare costs) and figure out where you think you're going to fall.
After that you've got coverage (as in which hospitals and doctors are in the plans). If there are doctors or facilities you really like having access to, that might push you one way or another, if the financial differences aren't great or if the facilities differences are huge (probably more important if you're seeing a lot of high-end specialists). Types of coverage is another thing. Some plans have very low limits on things like mental health visits or physical therapy visits. If someone is a high consumer of those services, a lack of coverage might dictate choice (if your insurance company covers 10 visits a year, anything after that is our of your pocket and doesn't NOT count towards your yearly max out of pocket).
In the end, depending on how the two plans stack up, the math may be very simple (one plan is way better than the other) or it may be very hard (the two plans have comparable costs and make trade-offs in different areas). For me and my wife, it has made sense to stay on separate health care plans. Part of that is due to the incredibly low premiums we pay as employees vs spousal coverage. Part of that is due to the fact that we've never both hit our deductibles in the same year (so having two separate deductibles is a net saving over having one, higher deductible). Part of it is also due to us both having access to high deductible HSA plans where we get generous contributions from our employers towards the HSA (something else to consider in the math if you have such a thing available to you). There isn't a one-size fits all policy, so you've basically got to get all the plan documentation and do the homework.
hope this helps
Of course, premiums aren't the only component of the health care plan. The other big ticket things to look at are the deductible and the out of pocket max. The deductible is coming out of your pocket before the insurance companies pay anything. Most plans (though not all) double the deductible for families. Since with a child you will already be on a family plan with one insurance company, moving to the same plan could actually lower your overall deductible. Say you have a $500 deductible and your wife has a $250. When the child is added to your wife's plan, her deductible will go up to $500. If you were then added to her plan as well, the deductible would not change (of course, check your plan details to make sure it operates this way). If you use a decent amount of healthcare during the year, you might find some savings here (especially if there is a big disparity between the deductibles on the two plans).
The last big ticket item is the yearly max. That is generally per-member and it is max amount out of pocket you will have to pay during the calender year. Since it stacks per-member, the math here is easy. This is only relevant in years when you're going to have a lot of medical expenses. Things like childbirth or major surgical events generally blow through most yearly maxes on employer plans. So if you have a case where the two plans have a big discrepancy in yearly maxes and you know you have a major medical event coming, you can try to optimize for that. For example, if your plan had a $2000 max per person and your wife's had a $5000 and you knew last November that she was pregnant, moving her onto your plan would have been a guaranteed savings of $3000 (minus the difference in the premiums). Of course, you don't always know when major medical events are coming, so this sort of thing isn't always easy to optimize around.
After that, you get into the details of the plan. One thing to look at is the percentage coverage. Most plans have something like 90/10 or 70/30, where the first number is the % of expenses the insurance company covers and the second is the percent you pay, after you've hit your deductible. In a plan with a high deductible, in a year where you don't spend a lot on health care, the percent coverage doesn't even matter. In years where you have major medical events and hit your yearly max, the percent coverage doesn't matter. It is those in-between years where it can have a financial impact. It is something where you need to look at the history of healthcare usage in your family (and understand the small children can often generate a fair bit of healthcare costs) and figure out where you think you're going to fall.
After that you've got coverage (as in which hospitals and doctors are in the plans). If there are doctors or facilities you really like having access to, that might push you one way or another, if the financial differences aren't great or if the facilities differences are huge (probably more important if you're seeing a lot of high-end specialists). Types of coverage is another thing. Some plans have very low limits on things like mental health visits or physical therapy visits. If someone is a high consumer of those services, a lack of coverage might dictate choice (if your insurance company covers 10 visits a year, anything after that is our of your pocket and doesn't NOT count towards your yearly max out of pocket).
In the end, depending on how the two plans stack up, the math may be very simple (one plan is way better than the other) or it may be very hard (the two plans have comparable costs and make trade-offs in different areas). For me and my wife, it has made sense to stay on separate health care plans. Part of that is due to the incredibly low premiums we pay as employees vs spousal coverage. Part of that is due to the fact that we've never both hit our deductibles in the same year (so having two separate deductibles is a net saving over having one, higher deductible). Part of it is also due to us both having access to high deductible HSA plans where we get generous contributions from our employers towards the HSA (something else to consider in the math if you have such a thing available to you). There isn't a one-size fits all policy, so you've basically got to get all the plan documentation and do the homework.
hope this helps
Name me one socialist that likes Obama or Obamacare.
Just because you say something it does not make it true.
@megadrone .. <-- like he said, maybe you should have read it.. you sign up and have health care OR you are TAXED.. meanwhile you libs are all about freedom of choice(abortion for women).. where is my choice? about MY body and MY health care?? and why am i TAXED for a choice I made? why should i be forced into something i don't want?.. ever think that as a pagan i wish to live my life naturally?.. if i die so what?.. isn't that my choice?.. you libs say it's a women's choice for abortion after all.. what about my choice? does it not matter to you?
#socialism is what it is
Watch what you're assuming about someone's political slant. You don't know me or my positions.
I indicated that I had a pretty decent health insurance 30 years ago, provided by my employer, as part of my overall compensation for employment. It covered what I needed at no additional cost to me. After meeting my deductible, fees were reimbursed at 80% of usual and customary charges. From that you inferred that I am a socialist, pro-choice liberal. That's some leap.
"what about my choice? does it not matter to you?"
No, not really.
How about the military draft in times of crisis/security?
How about property, income, capital gains, food taxes?
Again, think "common good." You don't get to be selective in this this regard.
What the hell are you talking about? My post was in response to yours that sarcastically said to "get Obamacare" as if it was a plan you can sign up for. I was just pointing out that this isn't the case. I guess you didn't bother to read my earlier post because if you did you would see that I am vehemently against the ACA.
The last time I had an ER visit was during a time when I did not have health insurance. I was in the ER for about an hour or maybe even less, no broken bones, no stitches or anything, they just did a few tests and told me I was fine. Nothing was free, I paid a few hundred bucks on my way out of the hospital, and then almost every other day for the next couple weeks I was hit with another bill, totaling almost $10,000. I am tired of hearing people say that the uninsured get everything for free because it is a flat out lie.
This is the same situation I am in. I paid the full amount of my premium, no help from my job, for a plan that had no copays or deductible because it didn't cover prescriptions, which I don't need. Now I don't have that option anymore.
How are you going to pay if you suffer a catastrophic injury? Ie: You end up in the hospital for a month?
draft .. no.. if i want to join in a cause then i do it on my own accord because it's something i believe in
property.. no .. i bought it i own it
capital gains and income.. no.. why take money that you worked hard for?
out of pocket.. you pay into the scam that is "insurance" .. you always pay anyway
What about school taxes?
If I don't have kids, why should I have to pay to educate other people's kids. If you have kids, you should be responsible for feeding them, clothing them, and educating them.
The worst are the people who send their kids to private schools, and then want me to pay more so they can get a credit to offset the cost of the private school they decided to send their kids to. So they want me to to pay twice: once for the public school they don't use and again for the private school.
what if your pocket isn't big enough to cover a hospital bill that large?
Calculated risk. Like buying life insurance when you're 25 -- statistically speaking, you're not cashing in for a while. But at least life insurance at 25 is relatively cheap if you're not likely to die.
You were responsible and paid your ER bill. Good for you (but sorry for your health event). However, those without means or without responsibility may not pay, in fact, most often do not pay. And that's the problem wherein that cost/expense is passed on to those who can and do pay. This is not fiction but is reality.
Always a good idea to engage the provider and plead your case, as you can likely negotiate a reduced bill and a payment schedule.
We are all in this together, sport. For the common good, we all contribute and step up to keep a great nation together and moving forward, against all challenges, foreign and (ahem) domestic. We need an educated, healthy citizenry. We need an infrastructure to support our needs, economic and otherwise. We need a strong, capable defense to protect us, our interests, our allies. Toward that end, we are all obligated to contribute. That is all.
"The Sanders Medicare For All proposal would save the average family more than $5,000 per year. It also would increase, not lower, incomes for 95 percent of Americans, according to Professor Gerald Friedman, Professor of Economics at the University of Massachusetts at Amherst.
Professor Friedman writes that if Medicare for All was enacted "we would, as a country, save nearly $5 trillion over ten years in reduced administrative waste, lower pharmaceutical and device prices, and by lowering the rate of medical inflation.""
http://www.huffingtonpost.com/roger-hickey/sanders-economic-plan-bes_b_8906166.html?utm_hp_ref=tw
Professor Friedman writes that if Medicare for All was enacted "we would, as a country, save nearly $5 trillion over ten years in reduced administrative waste, lower pharmaceutical and device prices, and by lowering the rate of medical inflation.""
http://www.huffingtonpost.com/roger-hickey/sanders-economic-plan-bes_b_8906166.html?utm_hp_ref=tw
Do you have any statistics to back up the claim that most people in that situation wouldn't pay? I'm sure there are people who can't afford to, and it is very unfortunate that our healthcare system left them out in the cold, but I have a hard time imagining that people who have the means to pay would just choose not to and instead would rather have collections agencies come after them and let their credit score plummet. People who can afford to buy health insurance do so because they know that without it, even a minor medical need can be a life-changing financial nightmare. If people really believe the rhetoric that uninsured people get everything for free, then why don't they just drop their health insurance and save money?
To clarify, I was referring to indigent and lower socioeconomic ER patients, individuals who use the system and do not pay at point of service. They are covered by Medicaid. They do not have private or ACA insurance. The Emergency Medical and Treatment Labor Act of 1986 stipulates that hospitals receiving federal funds cannot refuse care based on a patient's ability to pay. We all pay for the care rendered to these individuals via our tax dollars and via increased insurance premiums and increased charges at point of service.
Everything is a calculated risk until he ends up in the hospital. Then the rest of us have to pay because he selfishly decided to take a calculated risk. Everybody should be required to have health insurance, because you just don't know.
