Family Making $56,000 Struggles With `Out of Sight' Health Cost

[PA Democrat]

Sept. 25 (Bloomberg) -- Lori and Steven Siravo earn $56,000 a year and say they can't afford health insurance.

They consider themselves lucky to live in New Jersey, where the family's income isn't too high to qualify their 16-year-old daughter, Carlie, for U.S. government-subsidized coverage under the State Children's Health Insurance Program.

``It's one of the greatest things,'' said Lori, 48, a hairdresser who pays $74.50 a month for her daughter's benefits, less than a third of what she'd have to spend for private insurance. She and her husband, who works for a small construction company, don't have insurance. ``At least I can sleep a little better at night knowing Carlie has it.''

President George W. Bush says families making that much can afford private coverage and that the 10-year-old program should return to its purpose of ``helping poor children.'' His effort to stop middle-class families from obtaining benefits in states such as New Jersey is at the heart of a conflict with Congress over renewal of the health plan set to expire Sept. 30.

http://www.bloomberg.com/apps/news?pid=washingtonstory&sid=aFNvVAEKzuck

[PA Democrat]

1. For our family of 4 cost annual cost of insurance $26,000 and that's with a $5,000 deductible

So think about it. You have to pay out $31,000 before getting a DIME of coverage. No wonder the insurance industry likes things just the way they are.

The reality is that if you are self employed, health insurance costs are overwhelming. The only affordable policies are "medically underwritten" with hundreds of conditions which exclude you from being accepted. My guess is that very few people qualify for these plans.

[FooFootheSnoo]

8. That's ridiculous

with a $5000 deductible, the insurance is basically catastrophic coverage. Why do people have to pay such high premiums for catastrophic coverage? My sister in law pays over $400/month for her family with a $7000 deductible per year. No maternity benefits (which she doesn't need anyway) and NO prescription drug coverage. It's ridiculous. She'll keep that policy for a few years and probably never pay down that $7000 deductible. So, if she keeps the policy in force for 3 years and never goes over the $7000 in one of those years the insurance company makes over $14,000 for doing NOTHING. That's just for one family. There are millions of young families paying these huge premiums and barely utilizing their coverage.

Then, they pay their CEO's millions while we struggle and do without in order to pay for shitty coverage that does NOTHING for us. If your claims go high enough that the deductible has been met, then you have to jump through hoops and beg the insurance company to pay the claims. What's wrong with this picture?

[hunter]

13. Same sort of thing here...

We pay around $35,000 before we get anything.

My wife and I consistantly reach the high deductable every year around this time, and then whoop-dee-doo, we only have a copay for our prescriptions of about $100 a month, and our other medical care drops down to about $250 a month.

Large numbers of Americans are simply out of luck when it comes to health insurance. For many Americans health insurance simply isn't availible and/or affordable.

We need a single payer health care plan now, but it's not happening because the health insurance and pharmacetical industries are deeply entrenched in our political process, and too many of us don't recognize we generally have crappy healthcare in this nation, even for people who have money or "good" insurance.

Bad medicine is still bad medicine no matter how much you pay for it. An innappropriate medication is still bad for you no matter if it's a four dollar generic or a $250 heavily advertised brand name generic work-alike paid for by expensive insurance.

[izzie]

2. Well I am retired and pay this.

The amount they take from SS,and 103.00 for the base plan on a gap insurance and all eye care and dentist. That is a lot on a person retired and old. My son has dropped his ins. as he travels just under 50 miles to his job and had to pay for gas. He makes about that amount also. It is just to high and I think it will go up. The writing is on the wall. Govt. health care is coming so the ins. will bleed us dry until we get it. They cut them self out with their own greed. We need it as we have to keep up with the world in our work place plus we pay for so much of this heath care in our tax already. The drugs and health care business is well supported by your tax dollars.

[Botany]

3. For my son and I

Divorced Dad ...... I pay $1,400 per quarter with a $100.00 office co-pay
a $5,000 major medical deductable and I pay the first $250.00 for drugs
no dental and no optical.

And it is tight to make the payment too.

We have to change the system .... single payer universal coverage

In America we pay double per person (covered and not covered) than
any other country in the world. The Insurance companies and HMOs
are making out like bandits.

[trumad]

4. I'm lucky...

I pay 2400.00 a year for a family of 5. I work for a very large corporation who can get the costs down and contributes a bunch to the plan.

[Iris]

5. I can't believe I'm saying this, but

I can't even imagine trying to get by on $56,000 with a family, much less having to try to provide insurance.

[sandnsea]

14. What??

Half the country does that, and many of them live in areas where median home prices are $200,000+ too. You do realize that, right?

[knitter4democracy]

6. The problem is bigger than we know.

We need more people like this couple speaking out and explaining what they're going through.

[Bitwit1234]

7. Our politic ans have health care and they don't know what it means

to struggle with it. I have social security and a very small pension from where I retired. Everyone know what Medicare costs. 96 dollars a month. Then I have BC/BS as a supplemental insurance which includes prescription, dental and partial payment on eyeglasses each year. I have the implants after a cataract operation and don't need eyeglasses. But the two insurances cost all together $!98 a month. That's a lot of money out of a social security check. But thank goodness I don't have to worry about my medical bills. After the two insurances I owe nothing in medical bills. The only thing I am responsible for is the 5 dollar co-pay for regular prescriptions and 15 dollars for something special. I have a hard time getting approval for the special prescriptions. Such as Nexium. It takes a while to get the prescription plan to approve it, (once a year). But I am very very fortunate when I see the price other retirees on social security prescription medicare pay.

[knitter4democracy]

10. They really don't get it, do they?

Two hundred bucks a month is a lot of money. All those co-pays add up, too. Wow. It's a wonder any of us are surviving.

[PA Democrat]

9. Half of the increase in the number of uninsured children comes from the middle class.

http://www.kff.org/uninsured/7694.cfm

A new, detailed analysis of the latest US Census Bureau data on health insurance coverage looks behind the 2.2 million increase in the number of uninsured, examining changes by age and income. Reversing years of steady declines, the number of uninsured children has grown by one million over the last two years. And, as debate continues on reauthorization of SCHIP, the analysis shows that 48 percent of the increase in uninsured children from 2005 to 2006 was among families with incomes between 200% and 399% of the federal poverty level (roughly $40,000 to $80,000 for a family of four in 2006). Among kids, the share with employer-sponsored insurance declined by 1.2 percentage points, but there was no change in the share with Medicaid or SCHIP coverage to offset the employer decline since most children in this income group are not eligible for public coverage under current rules.

[ChenZhen]

11. Thats why we need to force people to buy it!

[HughMoran]

12. Health insurance is a disaser in this country

I don't even like to go to the doc as they just push the latest meds the sales weasels have dropped off and are no longer interested/don't have time to care about the root cause of the issues. Add the insurance barely paying anything these days and you have one pissed off American.