Havnt posted on DU in years... But dammit I have an insurance rant...

[bunnies]

and I need the DU community to keep me from losing my mind over this!

So, after more than a decade without health insurance, I was elated yesterday when the offer to get covered finally came. The job I started a year ago in April was finally making it happen. My love and I can finally get the care we so desperately want and need. At least thats what I thought until we sat down and read the letter. We crunched numbers over drinks and wondered, is this some sort of joke?

$162.00 a week. Thats what they want for what they call "coverage". With a $2000 per person deductible and co-pays out the wazoo. $162.00 a week. Just about half my take-home pay. Thats $702.00 a month. $8424.00 a year.
Oh, and double that to get the full cost of the plan since my employer pays nearly half.

And to think... just last year we both qualfied for assistance through our local hospital. This, we found out, when I literally crushed my hand. We waited two days to go, while my hand turned green, wondering how we'd pay the ER bill. All the while thinking about the other times we *should* have gone but didnt.
We didnt go when my man of 12 years cut his thumb to the tendon on a piece of glass.
We butterfly bandaged it up and hoped for the best.
We didnt go when I broke my elbow, which healed poorly and painfully for YEARS.
And which actually cost me full use of my right arm to this day.
But the hand was more than we thought we could deal with ourselves. So we broke down and went. And thankfully, the hospital covered my visit.

The assistance actually allowed us to get physicals for the first time since the mid 90's. And what a relief to find that we were both in good health. But this year, thanks to budget cuts, we no longer qualify. Though we have the same jobs, make the same money and live in the same apartment... we are now considered well-off enough to fend for ourselves.

Ok fine. We're more than willing to purchase coverage for ourselves. But how in hell are we supposed to afford this? What should we cut out? Food? Rent? Electricity? WHAT?!

We drive old cars. Mines a 91 honda I paid $600 bucks for. His is a 97 honda. A gift from his mom when she bought a car last year. We never eat out. We shop at goodwill. We buy the discounted produce at the supermarket. And all thats ok with us. We have each other, we get by, and we're happy. All we want is simple, basic health care we can afford. We shouldnt have to chose between having "health insurance" and living on the street.

So I guess we'll be checking the "elect not to enroll" box on the insurance form. And we'll just be a couple of the "free riders" republicans love so much to mock. But theres no freedom in watching someone you love suffer from lack of proper health care. Theres no freedom in getting shit credit due to an obscene doctor bill.
Theres no freedom in hoping a tendon will magically re-attach itself because its the only "affordable" OPTION for you.
And theres no freedom in needing to buy food over "health insurance".

And to my employer, who wants to shell out that $130.00 a week for a pile crap? I could really use a $4.00 an hour raise instead.

Its just. not. right.

[barbtries]

1. righteous rant.

i don't know what's expected. sometimes i think they're gunning for a population crash in the USA.

[bunnies]

6. Used to be "only the strong survive"

Now its only the rich. And Im still staring at this damned form. Unreal.

[aggiesal]

95. Have you looked into these Health Exchanges?

Different groups with like minded interests get together and
purchase health insurance as a group. They can get a better
deals, because they're starting from a place of strength in numbers.

I'm no expert, but I'm sure you can google Health Exchanges and
but better detail then what I'm writing.

[bunnies]

113. It appears that my state, NH, wants to ban them.

Go figure.

http://www.boston.com/news/local/new_hampshire/articles/2012/07/09/obama_says_nh_wrong_on_federal_health_reform/

WASHINGTON—President Barack Obama says New Hampshire officials are wrong to believe the state should be free from the mandates of federal health care provisions.

In an interview with WMUR-TV on Monday, Obama said the federal government picks up the tab, at least initially. And he says many New Hampshire residents will benefit from participating in health exchanges that are to be established.

The state Senate is considering barring New Hampshire officials from planning, creating or participating in a state health care exchange. Supporters argue a state health care exchange would be federally controlled.

[obxhead]

150. They can not ban the exchange.

They can refuse to run their own exchange, that is their right. However, the federal government will just run one for them. When the credit runs out, the exchange will continue to be run by the federal gov at NH expense.

There will be an exchange, the only decision to make is who runs the thing.

[HopeHoops]

2. K&R - Good rant.

[riverwalker]

3. it's time for Medicare For All

http://www.nationalnursesunited.org/affiliates/entry/medicare-for-all/


http://www.medicareforall.org/pages/Home

[krawhitham]

135. Yeah that is cool to say "Medicare For All" all the time, but it would never pass Congress

You want Medicare For All work on replacing about 75% of Congress

[Honeycombe8]

139. This must be done. It must be. A top priority. nt

[xtraxritical]

161. Vote a straight Democratic ballot, you'll be happy again!

[Indydem]

4. And thanks to ACA you HAVE TO BUY IT.

As I've said many times, ACA is not going to help more Americans get insured, it's going to make more American's poorer.

Single payer. Now. Quit fucking around.

[Melissa G]

10. "Single Payer. Now."

Quit f**king around.

Exactly. This is too serious to be left to the politicians.

[bunnies]

11. And then theres that.

Sure I'll buy this crap. Then watch us go on govt assistance for things like food and shelter. WTF kind of choice is this?! The whole damned system is rigged. "Affordable" my ass.

[JDPriestly]

19. In 2014, I believe low- to middle-income people will receive subsidies

to help cover the cost of insurance. Also, insurance costs should decline as the limits on the amount of insurance premiums that are spent on things not directly related to care take effect.

Sure, single payer would be better. Even requiring health insurance companies to be non-profit with limited salaries for the management would improve things a lot. Let's work toward getting those things.

[bunnies]

52. Separating insurance co's from profit...

seems like an impossible task. I can already hear the idiot-rights screams of "anti-capitalism".

[PotatoChip]

155. Yes. I believe that help is supposed to be

for people within 400% of poverty. That is a very generous figure extending to folks who fall soundly into the lower middle, or even mid-middle classes. Plus, as you point out JD, insurance costs are likely to decline as well... or at the very least, not continue to rise as they have been. I too would have preferred single payer, but the ACA is definitely a step in the right direction.

As long as I'm understanding these facts correctly, it sounds as if the OP's income would qualify her and her SO for help with these costs.

In the meantime, hang in there Bunnies. As frustrating as the situation is right now, help is soon to be on the way thanks to the ACA.

As a sidenote, I like your user name. Cute!

[notadmblnd]

99. If you are a low wage earner you should qualify for subsidized health insurance.

However, that program has not been implemented yet. And no, you are not required to purchase it yet either.

[ProSense]

12. Actually,

"And thanks to ACA you HAVE TO BUY IT."

...no. The poster would be exempt from the mandate based on this from the OP

$162.00 a week. Thats what they want for what they call "coverage". With a $2000 per person deductible and co-pays out the wazoo. $162.00 a week. Just about half my take-home pay. Thats $702.00 a month. $8424.00 a year.
Oh, and double that to get the full cost of the plan since my employer pays nearly half.

Chart illustrates how the mandate works
http://www.democraticunderground.com/1002881604

And thanks to ACA be eligible for Medicaid.

SCOTUS ruling on health care law a huge win for Medicaid
http://www.democraticunderground.com/1002868894

[bunnies]

16. Since the cost of the coverage is more than a third of my yearly gross...

I see I'd be exempt from the mandate. But I gross too much to be eligible for medicare. With my whopping $23k a year. sigh.

[rox63]

37. It sounds like you would be eligible for a subsidy to help with paying for insurance under the ACA

If the coverage costs more than either 8% or 10% (forget which) of your gross pay.

[bunnies]

65. I really hope so.

This whole thing makes my head hurt.

[sad sally]

123. Seems the responses are "hold on, don't get sick, don't break any bones, don't need any health

care until 2014," which imo is almost impossible for most of us.

Your op is spot-on correct. Here was my take on the Affordable Care Act (not):

It's not universal coverage; estimates are that at least 26 million people will still be uninsured. A single-payer, Medicare-for-all system would provide truly universal, comprehensive coverage. Research shows the savings in administrative costs alone under a single-payer plan would amount to $400 billion annually, enough to provide quality coverage to everyone with no overall increase in health spending.

It doesn't make health care more affordable to Americans who already have insurance because it does nothing to control the increases in premiums each year, and because of high co-pays and gaps in coverage, people with insurance can still be open to financial ruin in the event of serious illness.

It won't control costs. Why? Because ACA/Obamacare perpetuates the domination the private insurance industry has. An industry more interested in profit by siphoning off billions in overhead and demanding unending paperwork from doctors and hospitals in the fight to decrease health care payments and increase their bottom line (profits), than an industry interested in health care. Doctors and hospitals used to be in the health care business, now they work for an industry with profit as the main motive for being in business.

I know that any President other than President Obama would destroy the gains made with this act, and there will be other problems to tackle after his re-election, but I'm still disappointed that the insurance industry came out the biggest winner - not health care.

[Sekhmets Daughter]

128. But you should

qualify for a subsidy to purchase insurance. Buy what is referred to as "catastrophic coverage" In fact that was the only type of health insurance until the 1970s...when HMOs became popular and began driving up health care costs. It's what we need to do for medicare and all health insurance to bring down costs. Catastrophic coverage will cover hospitalizations and emergency room visits.

[dixiegrrrrl]

21. As long as you do not ilve in a Repug state which refuses Medicaid coverage

so far 4...5? states have said they will not provide the Medicaid portion of the coverage.

[justabob]

25. yeah, until something is done about that little wrinkle

a lot of us are S. O. L.

[ProSense]

30. It's called

"As long as you do not ilve in a Repug state which refuses Medicaid coverage"

...bluster, that is unless you live in Arizona, which held out on original Medicaid until 1982: http://www.democraticunderground.com/1002923048

[Fawke Em]

64. After the hospital lobby gets done with the Republican

governors of these states, they'll either sign right up or get defeated.

[virgogal]

29. I'm on Medicare so I'm sort of out of the loop

on this topic.

Why do they have to buy it? The cost astonishes me.

[RebelOne]

70. Same here. I am also on Medicare and only pay $110 a month.

I was laid off my job in 2010 and had great insurance that gave me medical, dental and eye care for only $200 a month. Medicare does not cover that unless I am on the Advantage plan, which I cannot afford.

[Mimosa]

73. Some of us can't afford that. Or 'only $200 a month'

Had to drop my high deductible BC/BS health insurance last year. Even though I have no income my medicaid application was denied. The denial said i could apply for a hearing. Lack of care has been making me become weaker, too sick to do anything but wait to die.

I think that's part of the plan.

[sabrina 1]

148. Mimosa, I am so sorry. I had no idea!

I missed your posts though and am glad to see you again. But this is unconscionable. Is there anything we can do?

[Mimosa]

168. Thank you, Sabrina

I'm waiting for Social Security to decide on SSI . I need access to medical care soon. I waited too long to apply for SSDI , 5 years after I couldn't work. I had moved to ATL because of Katrina and I made that bad decision (among others) because I was trying not to be a drag on the system which so many needed.

Sabrina, just being able to discuss thing with people like you is a blessing.

[sinkingfeeling]

36. Except families making up to 400% of FPL will receive subsidies on their

premiums. Read the bil here: http://www.healthcare.gov/law/full/

Do you think single payer will be free?

[handmade34]

74. thanks for saying that!

"Do you think single payer will be free?" the ACA is not what I would have preferred, but it is a start and will help some...

[enlightenment]

94. I don't think anyone here believes that.

Do you think health insurance equals health care? Just because someone can get a partially subsidized form of insurance, it doesn't mean they can afford to use it.

It is very doubtful that any proponent of single-payer health CARE believes that it means it is free. "Free at the door" doesn't mean free - you know it, I know it, and every proponent of true single-payer care knows it.

What single-payer proponents also know is that it would be cheaper in the long-run for the nation, and that even people who are poor would be able to go to a doctor, clinic, or hospital and receive treatment without worrying whether or not they have covered their deductible or if they have the money to pay the remainder of the bill after the insurance pays the 70% of 'allowable charges' (subsidized insurance under the ACA is the 'silver plan' - the 70% payment plans).

It would be nice if liberals would put away this particular accusation, particularly when responding to other liberals.

[sinkingfeeling]

100. Then please explain exactly how you envision single payer to be paid for.

As in some countries where the tax rate is 45-60%? How could that be done in the USA where 50% of the country objects to paying 15-20%?

[Edweird]

109. That's easy - Canadian model. Sales tax.

Single payer was polling around 75% support during the debate.

[enlightenment]

120. Good grief.

When did this morph to a discussion about how single-payer would be paid for?

Of course it would be via taxes - and I'm not going to reinvent the wheel explaining how it could be 'sold' to the doubting public. Read through the very good, well-researched, and cited material here:

http://www.pnhp.org/facts/single-payer-resources

[BlueCheese]

103. It will be free in the same sense that public schools are free and the roads are free.

Yes, they're paid for by taxes, but taxes on income or property. Not this buy-it-yourself approach that the ACA takes.

[sinkingfeeling]

104. At what rate? How much are you willing to pay? 50% of your income?

[BlueCheese]

114. I'm not sure I understand the point of your question.

Are you suggesting that tax rates will rise to 50% to fund single-payer? If so, won't people have to pay 50% of their income for premiums under the ACA?

[sinkingfeeling]

124. No person under ACA will pay 50% of their income for premiums. Please see

healthcare.gov site.

In Canada the country has an income tax rate and then each of the provinces add on another.

"In 2010, Canada federal income tax rates vary progressively between 15% - 29%, however, adding the provincial taxes, combined Canada tax rates for individuals may go up to 50% (i.e. in Nova Scotia) for taxable income exceeding CAN 150,000. Provincial tax rates also are progressive, with the maximum rate in the range of 10% (Alberta) - 24% (Quebec)."

http://www.taxrates.cc/html/canada-tax-rates.html

Some countries with universal healthcare average 50% or more in taxes. Like Finland that averages 46.6%.

http://www.businesspundit.com/12-countries-with-the-highest-lowest-tax-rates/

[Edweird]

127. Oh yeah - those horrible Socialist hell-holes.

[Fumesucker]

129. US per capita health care costs are the highest in the world..

If those costs are going to be paid for every single American then it's going to cost a given amount of money whether it's done with subsidies and private insurance, through single payer or through a NHS..

The argument is over the funding method, not how much health care costs. Since the ACA is less efficient (20% MLR) than single payer then total costs would be lower with single payer.

[BlueCheese]

130. Thanks for the info.

However, it seems to me that if health care ends up costing enough to require very high tax rates, then under any other system, that cost will have to be borne by the consumer somehow.

[kiva]

108. Who on DU has said they think single payer would be free?

This is nothing more than a right-wing talking point employed to show how foolish and irresponsible liberals are in the 'real world'. I shouldn't be surprised that it shows up here, but I am.

[sinkingfeeling]

111. Don't know who. I asked a question.

[kiva]

118. Then maybe you should take your question

to a discussion board that actually says they think it would be free. Hint: that wouldn't be here.

[sinkingfeeling]

121. Funny that the person to whom the question was addressed never responded.

[kiva]

125. Maybe they think that right wing accusations

that have been addressed many times on this board don't need a response.

Or maybe they are a troll.

Or maybe they had to do something other than read DU.

Or maybe your quick wit has stunned them into silent acquiescence...hard to tell, isn't it?

[Sekhmets Daughter]

126. In the U.K.

A 20% sales tax pays for health care for everyone.

[sinkingfeeling]

165. UK's health care is paid by collection of the NIC based on income.

http://en.wikipedia.org/wiki/National_Insurance

The contributions component of the system currently consists of mandatory contributions, National Insurance Contributions (NICs), paid by employees and employers on earnings, and by employers on certain benefits-in-kind provided to employees. The self-employed contribute partly by a fixed, weekly or monthly payment, and partly on a percentage of net profits above a certain threshold. Individuals may also make voluntary contributions, in order to fill a gap in their contributions record and thus protect their entitlement to benefits. Contributions are collected by HM Revenue and Customs (HMRC) through the PAYE system, along with Income Tax and repayments of Student Loans.

[sabrina 1]

149. Single payer will be the same as it is in every other civilized country where no one

NO ONE would have to write an OP like this. And NO one dies for lack of healthcare. What is your point by saying 'do you think single payer will be free'??? This is what we heard from Republicans, this accusatory insult as if we here do not know that to have Nationalized HC there will be a HC tax, like the SS tax, which works just fine.

Just get the damn profiteers out of our HC because they serve no function other than to grab 20% of the money which should be going to actual care with no more of an overhead than 3% as it has been for Medicaid.

This patchwork quilt of who is or who is not eligible for what, who gets subsidies, who doesn't , what are the co-pays, now that people are forced to buy a shoddy product they will not be able to use anyhow, so it is essentially just a donation to the useless and UNNEEDED Health Insurance Corps. Let them find another way to make a living, they are in the way and using up money that we badly need for sick people.

So sick of people trying to defend this monstrous for profit Health Insurance system we have in this country. As if the lives of human beings come second to defending politicians and their funders in the HC business.

[sinkingfeeling]

159. Apparently you did not follow the conversation. I asked that question to the

person who wrote this in reply #4.

"And thanks to ACA you HAVE TO BUY IT."

Now that, to me, looks like what the Tea Party has been yelling about. The poster also said he wanted single payer. So I asked if he thought it would be free. Then about 3 or 4 others all chimed in.

Since your rant is about the 'UNNEEDED' health insurance corps., would you please explain why Candad relies on insurance companies to provide 30% of the health care there?

About 27.6% of Canadians' health care is paid for through the private sector. This mostly goes towards services not covered or only partially covered by Medicare, such as prescription drugs, dentistry and optometry. Some 75% of Canadians have some form of supplementary private health insurance; many of them receive it through their employers.[37] There are also large private entities that can buy priority access to medical services in Canada, such as WCB in BC.

http://en.wikipedia.org/wiki/Health_care_in_Canada

[sabrina 1]

162. No, the tea-party and right wing talking points include accusing Democrats of being so stupid

and lazy and greedy for handouts, that they think a National HC system would be free. A very stupid and insulting, which it is meant to be, accusation against those who advocate for a humane, rational HC system for all Americans.

You implied that you agreed with them when you too asked the same question.

Most countries that have a National HC system, meaning humane societies where no one is ever refused medical care because of money, also have the choice of private insurance. We know that too, believe it or not, Democrats are pretty informed about all of this.

[sinkingfeeling]

164. Did not imply any such thing. I was rebutting the cry and hue that's been

on DU from the start of the healthcare debate about the mandate. I guess it's OK with you to pick up the RW talking point that it's still 'un-American to be forced to buy insurance no matter what the SCOTUS says'.

So in deferrence to your wisdom, I will never again try to explain ACA to anyone.

[mercymechap]

66. I agree wholeheartedly with you

but since single payer was not going to get a chance, at least we have something to work on. I think we need to support ACA, so that we can have something to reform and make better. If the Republicans are able to repeal it, we'll be back to where we were and we'll all be damned.

[handmade34]

72. not true

http://www.familiesusa.org/resources/publications/reports/health-reform/helping-families.html

please learn all about ACA before disparaging it... it is not what I preferred or perfect but it is a start...

[firehorse]

78. yes, but with a cap of 8% of your income, which is better than the offered 50%.

[turtlerescue1]

106. None of you know how grateful I am to no longer feel very alone!

For the sake of humor I call it "Natural Living". Because of what I live on- there's no money for a Dr.'s appt, the Rxs I'm supposed to be taking, yeah that I can find a way to do, but not the $85 for a Dr "visit". So life and death is "natural".

Yes, supposedly my yearly income qualifies for the free stuff. Except I was once a Navy wife, and some of the strangest things happened at Oak Knolls in Oakland. But it would still beat a poke in the eye with a sharp stick, and if poked in the eye with a sharp stick at least I could have it looked at. Be a change.

The reason so many repiglican govs are refusing, is- its the MASSES, Ayn Rand's "human ballast". Its a lot like being invisible. At least they could be compassionate enough to give all of us who aren't valuable First Aid and Anat & Phys and Med Surg procedures, even with used textbooks. I mean the majority claim to be that Conservative Christian Right, maybe practice what they so adamantly preach as they condemn everyone around who maybe has a mind of their own.

The only way to survive is to keep laughing.

[harun]

137. Not exactly. Thanks to ACA this individual should be able to someday have

a choice of options.

But I totally agree, Single Payer Now.

[Honeycombe8]

140. The ACA is targeting to help people just like the OP. The working poor. Subsidized health ins.

They can't afford it. The govt will kick in to help them afford it.

There is no single payer right now, so that's no help. It will take years to get it, starting with electing a majority of both houses as Democrats. But that's years away. The ACA is a step in the right direction.

The ACA will help this OP.

[renate]

5. sometimes America is just plain embarrassing

People in other developed countries couldn't imagine undergoing the things you describe without getting medical care... it's BARBARIC.

[bunnies]

8. Barbaric is exactly right.

Sometimes when I think about the things we've had to do it makes me feel, literally, ill.
Meanwhile assholes like rush limpballs sit there blathering on about all this FREE healthcare losers like me supposedly get. Its infuriating.

[Melissa G]

7. Excellent Rant!

When will America join the legions of other civilized countries that do not hold their population hostage to an insane health care system?

Oh, wait... we prefer to be like Somalia.

[progressoid]

9. Its just. not. right.

Agreed.

[littlewolf]

13. When I worked for the state

my health care was free ... if I wanted to include my wife ..
"family coverage" it was 700. a month .... no kids ... just wife
it was unreal ....

[tridim]

14. I just turned down my company's policy..

Got individual coverage that is quite a bit better for 1/3rd the price. YMMV.

[Liberal Veteran]

15. Thank you. It does drive home the point about the uninsured by choice.

I'd be willing to bet the overwhelming majority of people classified as "voluntarily uninsured" are people who have been given a choice between high insurance premiums and basic necessities that make life bearable.

But of course, it is not politically expedient to look at why people "choose" to go without health insurance. The people who keep bringing it up as either freeloaders, stupid, or miserly tend to be people that have absolutely no understanding how high premiums can decimate a family budget.

And this isn't money that they will get back. If you pay 150 dollars a week for health insurance, you will NEVER see that money again. You have to find a way to make do without 600 dollars a month or you have to pray you stay healthy without insurance.

Even paying your own way for routine care is difficult since you get charged a non-negotiated rate that was jacked up by health provider as a result of those same negotiations in order for them to get the insurance company to pay a reasonable fee while giving the insurance company beancounters an imaginary figure of how much they decreased the cost with their payment schedule.

I could write a thesis on the problems that infest our health care delivery like ravenous oversized bedbugs.

The bottom line is that is that you can't explain to people making really good money that 150 dollars a week or more for many people isn't a choice between health care and HBO, or health care and having a mani-pedi....it is literally a choice between health care and paying the rent, or the utilities, or having a dependable automobile.

They don't get it. The people who claim this is a choice are people who don't realize it is a false choice. We see it as medicine vs. food. They see it as medicine vs. a $900 t-shirt or club membership.

[JDPriestly]

22. The point of the ACA is that in 2014 low-income people will get subsidies,

financial assistance to pay for their insurance.

I think we should require all insurance companies to be non-profits. Used to be many of them were non-profits. And when they were, even poor families like mine were insured to at least some extent. (Not for dental care or for preventive care.)

Do you think doctors and nurses should work for free?

[pnwmom]

33. I agree with you about non-profits. I suspect the for-profits will get out of the market

rather than limit themselves to the 15% in administrative costs and profits.

[Edweird]

41. "Do you think doctors and nurses should work for free?" - That is a red herring.

This isn't about doctors and nurses, but instead about the worthless parasite insurance companies and the excessively greedy pharma industry. It's about the private for-profit delivery system that Obama fought to maintain.

[JDPriestly]

112. The ACA requires insurance companies to spend 80% of premiums

on delivering healthcare and refund to customers money received for premiums from the customers that exceeds the 20% that they are allowed to take for costs and profit.

In that the ACA requires companies to insure people even if they have pre-existing conditions, a lot of the administrative costs of reviewing patients' and specific expenses' eligibility for coverage will be saved.

[Edweird]

119. That's nothing more than an incentive to elevate healthcare costs more.

20% of $200 > 20% of $100
The more care 'costs' the higher their profit. That anyone is promoting this as a 'feature' is absolutely mind-boggling.

[Liberal Veteran]

59. Absolutely not. I think that if a dr must charge $50 dollars for a papsmear.

He should charge $50 dollars and get paid $50 dollars for a papsmear.

It should not be:

If your health insurance is:

UnitedHealthPlan 1 - $5.50
UnitedHealthPlan 2 - $20.00
Unitedhealthplan Plus - $32.00
Cigna - $24.40
Jim and Bobs cheap insurance - $45.00
Blue Sickle - $13.00
Uninusured - $50.00

The cost and labor with a small markup might cost 22 dollars, really, but because of the negotiated agreement to accept reimbursement from 5 different groups the doctor doesn't charge $22 dollars because the insurance company would come back and say, "We will only reimburse $5 dollars per papsmear".

That's the way it is.

This isn't the fault of the doctor or provider. It is the fault of a system that is incredibly complicated and broken and ends up charging the neediest the highest average cost per service. Those costs are not in any way related to what the actual cost+labor+profit really is, but on a fee schedule created by insurance companies.

[JDPriestly]

116. Yes. I would like the simple system we had in Europe -- single payer.

In some countries, you go to the doctor, and the doctor knows how much he gets from the insurer for a particular procedure or consultation. It's all known in advance. You have just a direct contact with your doctor and don't think about enrolling in insurance. It seems to be just done.

The system in France seemed different. The doctors just seemed to be paid a salary, but I could be wrong about that.

I paid a small co-pay for medications in Europe, but never paid a cent to a doctor. That was maybe 25 years ago. It was a great system.

[Mimosa]

75. How we those subsidies be issued?

Will there be a lot of paperwork?

I have MS. I am often too weak, too brain-fogged, to tackle filling out detailed forms.

In Canada and most other developed countries sick people don't have that difficulty imposed upon them. BTW, medical professionals don't 'work for free' in Canada, France, New Zealand or any developed country.

[lumberjack_jeff]

97. They're administered by the insurance exchange.

It sounds as if they credit you for the appropriate amount when you sign up for coverage.

[Mimosa]

115. Thanks for the info.

That would work. Annual tax credits wouldn't help most of us.

[JDPriestly]

117. Tax credits only help the rich. Right, Mimosa.

[LanternWaste]

163. And yet people still tell me there are no stupid questions..

"Do you think doctors and nurses should work for free? ..."

And yet people still tell me there are no stupid questions...

[JDPriestly]

166. If you don't buy insurance, there are four alternatives:

1) the doctors and other medical personnel take care of you for free

2) the government pays for your care -- the taxpayers pay

3) the responsible citizens who can afford it and buy insurance pay extra for their insurance to cover your costs

4) you pay cash for the treatment that is within your means and forgo the rest (like treatment for cancer, advanced diabetes, heart, brain surgery, etc.)

Can't think of any other choices. So either you get insurance (including tax-payer paid insurance) or your freeload or you do without. With the ACA, you will be able to afford insurance.

And if the insurance companies raise the rates a lot, everybody will scream for single payer and/or non-profit insurance.

[bunnies]

23. exactly.

This is exactly it. And we have nothing left to cut. Hell, we dont even have tv anymore! I guess if we stopped paying our electricity, stopped eating and used no heat or hot water - we could come up with that $160.00 bucks a week. Problem solved.

[Auggie]

17. It's not right. Have you looked into raising the deductable?

The only way my wife and could afford health insurance was to keep the deductable high. We're paying just over $400 a month. No, I'm not happy about it. But it was the most workable solution for us.

[bunnies]

26. We dont get that option.

Take the company plan as-is or nothing at all. I feel like they've made in unaffordable on purpose so they dont have to spend money on it. My company KNOWS how much I make FFS. Who are they trying to kid?

[Auggie]

28. That's terrible

Not sure what to say ... keep looking for another job?

Best of luck to you.

[JDPriestly]

18. Health care costs a lot of money. Hopefully, beginning in 2014,

you may be entitled to financial assistance to pay part of your insurance premiums.

This is still the transition period. Once the government subsidy for healthcare insurance for lower to middle income people comes into effect, your situation should improve.

Seems you are complaining not about the ACA which at least provides you with coverage that you previously lacked, but about the cost to you compared to your income.

ACA is not perfect, but at least you are not denied any coverage. Can you imagine how much healthcare for the situations you describe would cost you if you had no insurance? And what if you have some truly serious condition like cancer -- that can't be treated in an emergency room?

You are benefiting from the ACA. See what you can do to pay the premiums until 2014 when you get the government subsidy.

[bunnies]

31. But I dont have insurance.

Havent had insurance for over a decade. Sure, the companies may not deny me, but when cost is prohibitive what good does that do? I cant afford for a third of my income to go to BCBS. Is ACA responsible for me being offered this plan? I dont know. But insurance is currently, still, out of reach for us.

[harun]

138. Remember, Insurance is not equal to Health Care. Just because you have insurance

doesn't mean they still won't send you the bill or simply not pay.

There are hospitals around here that provide services and work out a payment plan with you, don't charge interest and promise to never report you to collections if you are late. Look in to if there are any near you.

Faced with high cost insurance it is what I would do.

[Liberty Belle]

151. Bingo. My deductible is so high, I've declined tests I need but can't afford.

$2,000 deductible. I need an MRI, but have no savings. Already had a couple other expensive tests, and still have to pay those off. I have to pay $700 a month in premiums too, just for me, because I've had cancer before and this is the cheapest I can buy. It's shameful! And I will probably die anyway one of these days if I can't get diagnosed properly because I can't afford thee tests.

[Honeycombe8]

141. The ACA will subsidize ins. coverage for the working poor, which is what sounds like you are.

If you can't afford, the govt will kick in. How much, I don't know. Depends. It's on a sliding scale.

There will also be exchanges, where coverage will be offered at a lower rate, not counting the subsidy.

But that is a couple of years away.

[HiPointDem]

20. kr

[Ron Obvious]

24. We're in a similar position...

Except we're having to buy in the individual market. Premium increases of 35% at the time, extremely high deductibles and claims only partially paid or ignored altogether. We spent over $13,000 on healthcare expenses (insurance, meds, dental) last year and we're basically in good health.

We can afford it for now and don't qualify for any assistance, but I'm sorry I don't share in the enthusiasm for ACA either. Maybe I'll be pleasantly surprised in a couple of years, but I'm rather sceptical.

[bunnies]

35. I remember 20 years ago...

I had BCBS, the same company theyre trying to sell me now. They "prequalified" me for a surgery then rejected the claim after the fact, sticking me with a $20,000 bill that ruined my credit for years. Makes me wonder if its even worth it at all. $13000 out of pocket is just insane. It simply shouldnt be legal.

[Ron Obvious]

47. Yep, BCBS for us as well.

We're self-employed and BSBC was our only option 12 years agp when my COBRA ran out.

Just for comparison, in the Netherlands, a country that recently switched to a mandatory insurance scheme like ours, a cousin of mine working there pays something like 100 to 150 Euros a month for full coverage +prescription, vision, dental with no copays and no deductibles. He's a few years younger than me but also middle-aged.

We have the worst of all worlds when it comes to our medical costs.

All the best of luck to you and yours!

[BlancheSplanchnik]

27. .....

you're right.

It's just NOT RIGHT!

[Abra]

32. The Obamacare Solution: You just need the government to FORCE you to buy that insurance.

And if the government decides you really cannot afford it, no worries! They will borrow the money, give it to the insurance company for you, and leave your kids stuck with the bill.

[ProSense]

34. Do you

And if the government decides you really cannot afford it, no worries! They will borrow the money, give it to the insurance company for you, and leave your kids stuck with the bill.

...really believe that most people on the left are concerned about that last point? I mean, not only does it sound like deficit hysterics, but it's also 100 percent wrong. The ACA actually reduces the deficit.

[Abra]

69. I do not think they care, but they damn well should

I know... as a Democrat I am supposed to pretend that the money just magically appears. We love the let's pretend game every bit as much as Republicans do.

I am supposed to pretend that FORCING the American people to buy something from a private corporation, and in this case one of the most despicable industries in existence, is a great deal. Just like I was supposed to pretend (under Clinton) that exporting our jobs and vaporizing our middle class was a super progressive idea. But personally I am tired of playing that game, and I wont pretend that passing a bill written BY the insurance industry and the Heritage Foundation is a win for the people, my kids, or liberalism.

If someone had asked ANY of us in 2008 if they would support a mandate we would have laughed in their face. And I include Obama in this. Here he is, in 2007 and 2008:

#!

[ProSense]

98. Actually,

"I am supposed to pretend...If someone had asked ANY of us in 2008 if they would support a mandate we would have laughed in their face. And I include Obama in this. Here he is, in 2007 and 2008:"

...no one cares what you "pretend." The law and mandate were upheld. You, like the Republicans, will simply have to deal with it.

As for 2008, quite a few people supported the candidates who ran on a mandate (don't ask how I'd expect you to know that).

President Obama never stated that the mandate was unconstitutional or that he was completely opposed to any mandate. His argument was always affordability before a mandate. In fact, the statement about homelessness was specifically to reiterate the affordability point.

<...>

OBAMA: Let's break down what she really means by a mandate. What's meant by a mandate is that the government is forcing people to buy health insurance and so she's suggesting a parent is not going to buy health insurance for themselves if they can afford it. Now, my belief is that most parents will choose to get health care for themselves and we make it affordable.

Here's the concern. If you haven't made it affordable, how are you going to enforce a mandate. I mean, if a mandate was the solution, we can try that to solve homelessness by mandating everybody to buy a house. The reason they don't buy a house is they don't have the money. And so, our focus has been on reducing costs, making it available. I am confident if people have a chance to buy high-quality health care that is affordable, they will do so. That's what our plan does and nobody disputes that.

http://transcripts.cnn.com/TRANSCRIPTS/0802/05/ltm.02.html

<...>

SEN. OBAMA...According to Senator Clinton...there are more people covered under her plan than mine is because of a mandate. That is not a mandate for the government to provide coverage to everybody; it is a mandate that every individual purchase health care...If it was not affordable, she would still presumably force them to have it, unless there is a hardship exemption as they've done in Massachusetts, which leaves 20 percent of the uninsured out. And if that's the case, then, in fact, her claim that she covers everybody is not accurate....

MR. WILLIAMS: And Senator Clinton, on this subject --

SEN. CLINTON...Senator Obama has a mandate in his plan. It's a mandate on parents to provide health insurance for their children. That's about 150 million people who would be required to do that. The difference between Senator Obama and myself is that I know, from the work I've done on health care for many years, that if everyone's not in the system we will continue to let the insurance companies do what's called cherry picking -- pick those who get insurance and leave others out.

<...>

SEN. OBAMA...I do provide a mandate for children, because, number one, we have created a number of programs in which we can have greater assurance that those children will be covered at an affordable price. On the -- on the point of many adults, we don't want to put in a situation in which, on the front end, we are mandating them, we are forcing them to purchase insurance, and if the subsidies are inadequate, the burden is on them, and they will be penalized. And that is what Senator Clinton's plan does.

- more -

http://www.nytimes.com/2008/02/26/us/politics/26text-debate.html?pagewanted=print

Edwards Statement On Health Care Mandate
November 28, 2007

Chapel Hill, North Carolina – Senator John Edwards released the following statement today on the need for clear, direct answers on how we will reach universal health care:
"We need true universal health care reform that covers every single man, woman, and child in America. It is wrong to leave anyone without the care they need. A universal system will work better for all of us – delivering better care at lower cost.

"Barack Obama's plan leaves out 15 million people. The truth is that some people will choose not to buy insurance even though it's affordable, knowing that the rest of us will pay for their emergency room visits.

"But it is just as bad to say that everyone will have insurance without a plan to get there. Hillary Clinton says her plan will cover everyone through a 'mandate' but does not provide even the most rudimentary idea much less a detailed plan of how this 'mandate' would work. To get fundamental change in our health care system, we need a fundamental change in our politics. That starts with being clear and direct about what we are going to do and how we are going to do it."

Edwards' truly universal health care plan will ensure that every American has health insurance. He will require proof of insurance when income taxes are paid and when health care is provided. Families without insurance will be enrolled in Medicare, Medicaid, SCHIP or another targeted plan or be assigned a plan within new Health Care Markets.

Families who lose coverage will be expected to enroll in another plan or be assigned one. For the few people who refuse to pay, the government will help collect back premiums with interest and collection costs by using tools like the ones it uses for student loans and taxes, including collection agencies and wage garnishment.

http://www.presidency.ucsb.edu/ws/index.php?pid=91170#axzz1qqZ9tZYk

[sinkingfeeling]

40. Please enlighten us with your solution to the high cost of medical care?

[Abra]

56. Single Payer

[sinkingfeeling]

61. And do you expect that to be 'no cost' to you? How would you pay for it?

Base it on the Medicare structure? Well, Medicare is a form of insurance and there is a monthly premium for Part B. And most Medicare participants also have 'supplemental' insurance.

[Abra]

80. Nope

I do not expect anything to be "no cost."

I do, however, expect that money spent for healthcare provide actual healthcare rather than padding the bonus checks of middlemen.

[sinkingfeeling]

81. Then I suggest you put aside about $500K-$1million for your healthcare.

Then you can pay your expenses directly.

[freshwest]

88. As in Europe? When they say, paid nothing, that's not true, their income taxes are higher.

They already paid in to have their health care delivered the way it is, and distributed equally, so it's no wonder that they don't pay twice whem getting the return on their investment, their government. We don't have a spirit of brotherhood in this country, a belief in common needs as the generation that sufffered total devastation in Europe post WW2. That is what began their health care system, they felt obligated to pay. Americans regard government as evil and taxes as punishment, not the cost of maintaining a civilized nation. In that way, we are thinking that rebelling against the good is wrong, and act selfish and childish, not as mature as Europeans do.

Those with less, don't want to pay anything because their wages are so low to begin with. Those with a little more, demand to get refunds, exemptions, waivers, vouchers, deductions, to try to not pay. Those with the most money either pay when they feel like it, the tax code being what it is so that they can hold onto their money unlike the first and second groups, who pay payroll deductions up front and don't have the money in their hands all year. The majority of the rich work the system to not only pay nothing, but get their sources of revenue enriched with tax dollars from the other groups.

The solution? We need to vote like our lives depended on it and be willing to see our money go to people and things that don't give usany return personally. Accept the possibillty like many in Europe that we will not become rich, but will live well in a certain space in society, with dignity and respect, but smaller than Americans demand. That's what the people in social democracies do.

They fight and squabble as much as we do, but believe some things are necessary for the good of their society. I don't see any unity in this country in regards to that. So I don't think my 'solution' is going to happen any time soon. The GOP and the monied groups are organized and forgive each other for everything. We shred each other and kick and scream.

BTW, that is not a direct response to you personally. It's a general rant. Welcome to DU.

[Abra]

96. Great post! I could not agree more.

I am just frustrated reading Democrats, my team, trying to piss down my back and tell me it's raining.

[BumRushDaShow]

43. Link?

Or are manufactured right-wing talking points being passed off as some sort of fact?

[Abra]

71. To?

What I posted is the heart of the bill.

Everyone will have an individual mandate. They will be forced to buy insurance or pay a fine. Those under a certain income level will be eligible for government assistance, meaning borrowed money handed straight to insurance companies.

There is nothing in the bill actually stopping insurance companies from jacking rates or so-pays into the stratosphere, thus turning these government mandated minimum policies into wastepaper. They are doing that now, and once everyone in America is required by law to buy from them, why would they stop?

They make their money by collecting more from you than your healthcare costs them. The hundred-million paycheck the CEO of Unitedhealth took home last year was a sliver of that difference. And now we have just made their job (and margins) that much nicer. They no longer have to compete for your money, they no longer have to earn it, now you have no choice.

What business wouldn't love that?

As it happens I am self-employed, and I would LOVE IT if everyone were required by law to buy something from me. I'd raise my prices immediately. The only difference is that I would actually give you something for your money.

[BumRushDaShow]

79. What you posted wasn't a link to the section in the law

or anywhere else other than the same tired talking points, that justifies the spin.

How about starting here: http://cciio.cms.gov/

And then try again?

[Abra]

82. Great! You have the link. Post any example of an inaccuracy in anything I said.

I'll wait.

[BumRushDaShow]

102. You obviously didn't bother to go to the link

When you wrote:

There is nothing in the bill actually stopping insurance companies from jacking rates

you left out this http://cciio.cms.gov/programs/marketreforms/rates/index.html

Now I expect you to argue against the fact that actual federal government agencies would be overseeing rates because by golly, those anti-federal government talking points must be inserted in there somewhere!

As an FYI, I think the vast majority on DU, including me, want single-payer, but how to get to that point has caused so much ridiculous discord here that you can't tell the difference between some posts here and those at RimJob's site. Too many would have all or nothing at all.

And no I won't "wait" for your response because your arguments are not for discussion but for knee-jerk attacks.

[SoCalDem]

107. -cadabra

[nanabugg]

38. Well, the lies an disinformation about ACA are flying. Wonder what we will hear next? nt

[bunnies]

42. My post isnt about the ACA.

Am I missing something?

[Edweird]

51. Either you posted in the wrong thread or your reading comprehension is extremely low.

[just1voice]

55. We'll likely hear some bullying from someone calling the posters liars

without any discussion of the myriad of possibilities that exist in the real world. Here's a little insight wherein the person tries to look at the actual meaning of the AHA:

https://www.freespeech.org/text/memphis-doctor-obamacare-put-politics-aside-focus-facts

[ErikJ]

39. Get a 2nd job!

Its the AMERICAN thing to do. Part of that "American exceptionalism" ya know.

[bunnies]

45. good point.

I only work between 50 and 75 hours a week as it is. If only I didnt need sleep, I could be exceptional.

[GoneOffShore]

44. Totally righteous rant - I could rant as well

As our insurance renewal went up to $1900/month for the two of us. I'm 64 and Mrs GoS is 52. She had breast cancer two years ago.
We renewed and are paying $1400/month until Medicare kicks in for me in Dec. That with a $3000 deductible and $45 dollar co-pays. I'll still have to do some sort of supplemental but the costs are going to go down.

[bunnies]

48. It infuriates me that we have been conditioned to think

that $1400 a month is a deal. It is, of course, when compared to $1900 a month. But in my mind it should be criminal to charge either of those premiums. Hopefully Mrs GoS has beat it and is doing well? I cant imagine going through something like that.

[GoneOffShore]

49. thank you and yes she's fine.

We try to enJoy every day.

[sinkingfeeling]

54. Bunnies, we all know that insurance premium costs are extremely high.

However, so is the cost of medical services. My cancer ran well over $300,000. As I posted somewhere yesterday, I got a tetanus shot and it was $56 at a student clinic on campus. My Primary Care doctor would have charged more for the shot and for an office visit which is like $85. Somebody posted about going into one of those walk-in clinics and being charged $402 for the single visit. These costs don't exist in other countries. Some because the government sets the prices doctors and hospitals can charge. That will never happen here because of half the country believing we must have 'free market' pricing on everything.

[bunnies]

60. Youre correct. And its ridiculous!

I got an itemized statement for that physical I got as a result of the hospital program. The bill was well over $1000. For a physical! My ER visit for that crushed hand? Almost as much money. For a few x-rays, one demerol pill, one rude doctor and a cast. I dont care if it is "socialist" the government should DO SOMETHING about it. How can anyone living in the country be against controlling the costs?!

[Skittles]

46. I've said it all along

nothing as been done to address the cost of medical care - they simply want all of us to buy "insurance" many will be unable to afford OR use

[just1voice]

50. But don't worry, if a slew of unknowns workout it'll cost a little less years from now, LOL

That is if your state even participates in another bunch of unknowns.

[NoMittens]

53. I'm Starting to Get Nervous About Obamacare Implemention ---should I be?

Will I be able to afford health insurance or will I make to much to get a subsidy? Will the plan have a HUGE deductible? Will I be able to keep my same doctors? After reading bunnies' post, this is starting to get very scary. Please, someone help explain that everything will be OK!!!

[Roselma]

58. Fear not if you are a person of average (or lower) means.

Check out this calculator that will give you an idea of what you'd be expected to pay from your own pocket for coverage in the exchanges.

http://healthreform.kff.org/SubsidyCalculator.aspx


Read the small print at the bottom. Everybody will have a max out-of-pocket (above and beyond the premiums) in a given year. Preventative care will be no-copay and will not be reduced by the annual deductible.

[Mimosa]

93. Tax credit?

I put in the annual income back a couple of years when I had an income. ( I still have no income, btw, and am not on disability or SSI). The calculator said a person in my income group would be issued a 'tax credit'.

I'm wondering if the provisions of the ACA expect a person in Bunnies situation (or mine for years) to accept insurance at whatever price offered then receive compensation in the form of a tax refund? If the premiums gouge into a person's monthly income then they can't afford to pay other expenses including mortgge, credit card bills, etc.. That happened to me when I hit over 50, then over 55 and health insurance became an ever increasing percentage of budget.

Subsidies in the form of annual tax refunds will not help many people and they will be forced to pay a tax penalty and still do without.

Medicare for all would have been a sane solution.

[lumberjack_jeff]

101. Officially, it's a tax credit. In practice, it's a discount on the cost of coverage.

Based on your income, the insurance exchange applies your applicable credits on the spot.

[Roselma]

57. Oh....if only you can hang in there until 2014.

Based upon what you've written, I'm guessing that your subsidies will be almost the total cost of any policy you may select. Here's a quick calculator to see what you'd be paying: http://healthreform.kff.org/SubsidyCalculator.aspx

MIND YOU....you may not be eligible for the insurance exchange in your state. You may be forced to take your employer's insurance. BUT, you will get subsidies to help you pay for your employer's insurance premiums.

[Mimosa]

84. The only sure thing the 'Affordable Care Act' does is guarantee profits for insurance corporations

I paid increasing premiums for BC/BS individual policies for 30 years. They finally priced me out, leaving me broker and sicker. They denied tests and treatments. IMO, those greedy profiteers who come BETWEEN us and our doctors have been 'institutionalized' as the gatekeepers of our health.

[frazzled]

62. Is that the only plan offered by your employer?

We were buying the PPO (you know, the kind where you can just go to a specialist if you want, without prior approval) but the deductible started going up to $2000 a year. Several years ago, we hadn't used the insurance at all, but at the end of the year, my husband had to have a test and I had to have a foot x-ray. That ate up our $2000 deductible, and we felt like we weren't getting a good deal at all.

So when the next sign-up time occurred for benefits, we looked at the HMO coverage. Same company, but NO deductible, 100% hospital coverage in network, and the premiums were lower. Plus we saw that we could keep all our same doctors. So we signed up and have been happy with it. It's paid for everything (some fairly big stuff) and has worked well. Only difference is that it's a pain in the butt to have to call or see our primary care physician if we need to see a specialist, like a dermatologist or ophthalmologist (for anything but a standard yearly vision check). But that's a small inconvenience in comparison to the money saved and better coverage.

If that is not available to you: in 2014, when the ACA is implemented, if this insurance constitutes more than a certain percentage of your income (depending on what that is), you can opt out of your employer's insurance and get a subsidy to buy insurance on the exchange.

Insurance that costs 50% of your paycheck is not allowed in the ACA, so that will change for you.

On the other hand, let me just say: $8,000 a year for insurance sounds crazy: but just 36 hours in the hospital can cost that in a heartbeat. (Take it from experience: my husband had to go to the ER with what turned out to be a staph infection in his leg, was admitted overnight to be on IV antibiotics and released the next evening, and the bill came to nearly $10,000. Our insurance paid every penny of it.)

[bunnies]

67. unfortunately, yes.

The letter is clear on that point. Take this plan or nothing. Its an Anthem BCBS hmo. According to this sheet, on top of paying them $162.00 a week, nothing about that trip to the hospital for my hand would have been covered. ER copayment- $250. X-rays, physician etc, - subject to $2000 deductible. I know its worth having if something catastrophic happens. But not being able to buy food is pretty catastrophic too. No one should have to make this choice.

[Spitfire of ATJ]

132. Sounds like your employer is getting a kickback.

Or you work in a place that put in a lot of past claims or is a hazardous environment.

[mercymechap]

63. I'm just wondering.......

aren't there any Republicans that fit into this category? Are all the people that are having a hard time Democrats/liberals or nothing at all? I can't believe that only Democrats/liberals are the ones in this awful situation and wonder how Republicans that find themselves in similar situations rationalize their party's policies?

[bunnies]

68. Ive been wondering the same thing all day. nt

[Scuba]

76. Well yeah, but...

and of course....

http://www.democraticunderground.com/1002498796

[bunnies]

87. Maybe I should buy this shit insurance anyway...

Im going to need it for when my head explodes thinking about this graphic.

[Steerpike]

77. If your employer offers insurance you do not qualify for anything

In general, full-time employees with employer coverage available that meets specified requirements are not eligible for premium subsidies, unless the employee would have to pay more than 9.5% of income for the employer-provided coverage.

[bunnies]

85. These vultures are trying to sap me for nearly 50% of my net income.

It sure as hell should qualify me for *something*.

[mysuzuki2]

83. You may be helped by Rmoneycare when it kicks in.

It is supposed to srt up insurance exchanges with the premiums set by income. Hang in there!

[billky]

86. Insurance

But are you not forgetting that the insurance you buy will be based on your income? Maybe they'll make it so we can afford it; I'm in the same boat as you; I have nothing.

[bunnies]

91. This wasnt meant to be about the future or the ACA...

Just the obscenity of my current situation. Welcome to DU.

[Abra]

89. When I think healthcare I think Heritage/GOP/Insurance Industry

I mean, if you can't trust these guys to look out for the little guy, who can you trust?

[dkf]

90. You pay all that BEFORE you get any care.

And then it's ridiculously expensive to get through the deductible and the copay.

We are building on something that is broken and have now frozen into place this crazy unaffordable system.

[bunnies]

92. exactly.

Even WITH this insurance, We'd have paid out-of-pocket for every single situation we've been in. In fact, we would have avoided going to the Dr. even more than we did because the insurance cost would have eaten up half of my income!! Its absurd.

[dkf]

146. What we need is a reasonable catastrophic policy and access to cash for service.

OR premiums that may be semi expensive but covers everything. Your situation is the worst of both worlds, high premiums and high deductibles and out of pocket costs. That is no solution. It pisses me off that anyone calls it "freeloading" when the alternative is plain old unreasonable. You don't even sound all that sick where your expenses should be so exhorbitant.

You deserve better and we deserve better.

If Obama wanted to force us to buy in he really needed to address costs and give us options that we trust.

[NNN0LHI]

105. I can explain this

Your wages and benefits are now being patterned after the wages and benefits of the scabs who built your Honda's.

At one time everyone's wages and benefits were patterned after union workers pay and benefits and it was a lot better that way.

Good luck.

Don

[Festivito]

110. Your boss may profit from your premium.

You might look for a private plan.

Your boss may have picked that plan because he gets a free vacation. He will have to report that on the true HC cost on your W-2. HC minus perks.

Add that BCBS will return $ to the boss if 80% is not spent on HC. He'll show you his monthly payments, but not his one month credit, and not his perk.

[bunnies]

122. huh. Ya know? I wouldnt be surprised.

He already owns a house in Portugal so maybe he's getting some airfare. Surely someones probably getting a benefit and it sure as hell isnt me. I shoulda figured insurance companies give perks to employers. Could the whole thing be any more absurd?!

[Festivito]

134. Insurer might charge more than needed on purpose.

Then hold the money and collect the interest. Returning the money by credit makes employer think he won't get it if he changes insurers. Not true, but some will fall for it.

Oh, it can become more absurd, can't it though.

BTW, we all should know the real cost by Jan 31, 2012, on our 2011 W-2s. But, if insurers purposefuly overcharge, I'm not sure how that will work for the W-2s.

Good luck.

[Honeycombe8]

142. I think the healthcare cost is tax deductible for employers. I think. nt

[Festivito]

156. I think they get to use pre-tax dollars to buy it.

Although, some of that might depend on the type of corporation. I'm thinking this because a co-worker in business offers his workers health care and he tells me that he gets no break. That made no sense and I think he's going to check into it further.

There are provisions in ACA for tax relief and even penalties for not offering health care.

I'm just a working stiff trying to keep up.

[Omaha Steve]

131. K & R

[jody]

133. Don't agree "my employer pays nearly half." That half is really yours in any economic or cost

accounting sense.

If that money was not used for health insurance it could have increased your wages by the same amount.

[Motown_Johnny]

136. it could also be increasing profits by the same amount

Your argument only works if the employee is able to go work elsewhere for more money.

If not then the employer will continue to pay as little as necessary to keep the employee.

[Honeycombe8]

143. So you're saying the cost of the coverage is over $16,000/yr for employee and spouse?

Since it's over $8k for you two, and your employer pays half?

QUESTION: How much just for you?

QUESTION: What state are you in?

QUESTION: What is the size of your employer's company? How many people are being covered under the group policy?

[bunnies]

153. the 8k is my half of the premium. correct.

for just me the cost is $83.00 a week.
live in NH.
I have no idea. The company is spread out over new england and Ive only ever met a few of the other employees. I would guess maybe 50 (ish) but could be way off.

[Honeycombe8]

167. Here's a policy for the two of you for $384/mo. www.healthcare.gov Lumenos H S A.

I made certain assumptions (you female, spouse male, both 35 born 1/1/77, you no medical condition, you are the primary, neither have smoked in last year, picked a 03_____ zip code out of the hat).

I put in that data for the state of New Hampshire.

I got a bunch of policy options.

I selected to show me only those $400/mo or less. This was one:


Lumenos H S A Plus 3500/20 Family

Anthem Health Plans of NH(Anthem BCBS)

Compare (up to 3) Click to Compare
In-Network Out-of-
Pocket Limit:
Individual: Not Applicable
Family: $5,000.00 Doctor Choice:
PPO Estimated Monthly Base Rate:
Estimated monthly base rate is $384.15 per month.
Annual Deductible: Individual: Not Applicable
Family: $3,500.00 Prescription
Coverage:
Yes You may be charged more.
71% received surcharged quotes.
Annual Maximum Benefit:
Individual: Not Applicable
Family: No Maximum How many applications are denied?
18% who applied were turned down.


That is a FAMILY policy. Deductible $3,500...I think that's for the whole family, not each person.

It might be lousy insurance. Don't know what it does and doesn't cover. But hopefully it would protect against a serious illness, and pick up an ER visit.

Use www.healthcare.gov to see what's out there. The cost of the policy thru your employer sounds so high. But I don't know what kind of policy it is, either. Low deductible, maybe?

[Meiko]

144. Good rant and I am sorry to hear

about your difficulties. Not many things today just make me stop in my tracks and wonder WTH, but health care is one of them. The United States has resources and wealth almost beyond imagination, it's unbelievable really. What I can't follow is why with these resources at our disposal should anyone have to go without health care. Does the government care that little? and how about the citizens? do we despise each other so much that we would allow a sick person to die because we don't want to chip in a few extra bucks for taxes to support a decent system for everyone. When a new sports stadium needs to get built we have people standing in line to give away money, our priorities are screwed up.

We shouldn't have to buy insurance. You register with the system and if you need to see a doctor you go, that's it. The government picks up the tab. The rethugs can call it socialized medicine if they want, I call it common sense. Now I don't necessarily agree that health care is a right but it is a necessity and this country can afford to take care of it's citizens as far as health care is concerned. The amount of money the government wastes is staggering and could easily be applied to a decent health care system.

[treestar]

145. The whole point of the ACA is the government would subsidize you

to get insurance. Now you're covered if you pay the huge premium, but then you would be covered with help.

You have to pay for medical care. That's the whole point of having insurance. To let you pay for it.

You could not afford it out of pocket and would get ER only, leaving conditions to fester until they became an emergency. And you'd still owe the ER bill, it would just be hard for the hospital to collect, and you could declare bankruptcy.

But with the ACA you would not have to do that.

[colorado_ufo]

147. Bunnies, do you have a checking account or other type of bank account?

It is not widely known, but in many banks, their insurance coverage includes all their depositors as part of their class. You may be part of that bank's group, and that is certainly not information that they will volunteer!

When I worked for a cancer doctor many years ago, we successfully got several patients onto their bank's group insurance plan, since they were depositors for a substantial amount of time, and before they became ill (dodging the pre-existing condition exclusion). Credit unions offered even more options.

Many years have passed, and my advice may be out of date, but it is worth a try - check into it!

[bunnies]

154. come to think of it, they DO give me life insurance free with my account...

Not much, but it indicates you might be right. Thanks for the advice! Ill definitely look into that.

[proud patriot]

152. Free Ride for now my sister .. the system sucks

Let's fix it . lol I know , not easy but let's carry on .

went many years w/o insurance...all the money I owe is for my or my sons' medical bills.

I shared and recc'd this .. hang in there

[raouldukelives]

157. Great rant! Hope things start turning brighter.

You story is one of the many why we must have health care reform. We have the insurance part pretty well covered I think. Now, as before, we have to work to provide people with health care. With the current plan put in place to provide the framework we have to push for single payer in every state. We have to appeal to people to divest themselves of health insurance investments. I don't know how somebody could sleep at night knowing they are profiting off others suffering but it happens all day, every day. Military stocks, oil stocks, prison stocks, health stocks, hell the whole market is only rigged to only cause profits from pain. If not for us, for future generations.
If we can get enough people to stop being the source of the problem and start really caring about others well-being instead of money we'll be a long way there.
Hang in there!
Oh, and welcome back.

[Zorra]

158. The system is irrevocably broken, and not just the HC system.

I suggest hooking up with Occupy.

When enough of us get together we'll be be able to change things.

Until then, well...ya know...ranting might make us feel a little better, sometimes, I suppose.

Sorry about your HC problems.

I've done a few good DU rants about HC myself in the past year.

Things have to change, and they won't change until we take it upon ourselves to take serious action to change them.

[tomtharp]

160. A twisted path to end the disparity?

I've had health ins 3 of the last 14 years. dropped it 3 years ago to pay my mortgage; since I returned my home to the bank last year, I'm trying to get it again.
Here is what really chaps me: I have paid taxes since 1986. I am a carpenter/contractor that has literally generated millions of dollars of real goods with my hands. Why do I pay for all government employees to have benefits I can barely afford? Government workers are working for me, If I don't have insurance, why should I pay for my employees to have it???
Being poor now has made me mean enough to think: lets take away all health benefits for every cop, firefighter, judge, congressperson, DMV worker, and every other public worker, even teachers. I'll bet if not one government employee had health benefits we could have single payer in one year instead of ten or never. Obviously this is a mad rant, but it is how I feel. I'm a progressive, pro choice, pro pot, obama voter, yet I am jealous of the coddled cop/fireman/teacher benefits. I've taken 3-4 sick days in 10 years, never had a paid sick day in my life. I would go work for WI governor Walker for 1/2 the benefits the unions have. I guess the local 18% unemployment, combined with no industry other than the dead housing market, and my 3rd year of a 30% pay cut has made me resent public sector workers.
?: Is it not completely unfair that the tax payers pay for bean counting pencil pushers like dmv or building inspectors to have benefits, while the real wealth generating workers of society do not have those benefits ??