Health Insurance for the Self-Employed? 462
SharkJumper writes "Looks like this question has been asked before, but might be due for an update. I'm a self-employed programmer who is about to become a father. Previously, my family's insurance has come through my wife's employer, but she is eagerly looking forward to being a stay-at-home mom. We must look for that elusive low-cost insurance in order to enable her to do this. Losing her insurance is not a huge loss as, due to failed negotiations, the hospital in our city (3rd largest city in the state), along with most of the doctors that refer to it, is dumping the network (largest in the state) that our insurance uses. On the individual coverage plan front, my research shows story after story of deception, fraud, and general run-around or obfuscation by most of the major players and nearly all the minors. With all of the bad experiences out there, I've yet to see a good review of an insurance company. What does the Slashdot crowd use and recommend? Company and plan-type? PPO? HMO? HDHP + HSA (High Deductible Health Plan + Health Savings Account)?"
Can't help with specifics (Score:2, Interesting)
For yourself you probably can get by with catastrophic coverage unless there's an existing medical condition that you haven't mentioned. And if there is, you're just about out of luck anyway since many carriers won't cover existing conditions. So unless you go to the doctor for anything except the most serious ailments, stick with catastrophic.
Instead of great health coverage for you, get LIFE INSURANCE. You can probably get some cheap 30-year term insurance which will cover your family in case something happens to you. You may want to cover your wife as well in case something happens to her and you need to hire extra help to take care of your kids. This is less common, but no less a concern.
Health insurance for your wife should probably be kept at the same level it is now, if possible. She will need extra care immediately after the birth, but once the first year rolls on she'll get into the swing of things and probably not need any special coverage. I'd argue against catastrophic-only coverage for her since if she gets sick the whole household suffers, so having the ability to go to the doctor for anything questionable will be a good investment, if only for the peace of mind of having that security.
I wonder if there isn't a self-employed plan that covers people just like you already offerred by your local carriers. I'd be surprised if there weren't. But don't kid yourself. It's expensive. You want to go with a carrier who isn't going to drop you the first time you make a claim. That's a local issue that would be well served by some research (like, I suppose, asking us idiots).
Good luck.
Re:Can't help with specifics (Score:3, Interesting)
Don't forget some sort of disability/invalidity insurance (don't know if they've got that thing on your side of the pond, it's the big thing over here in Yurrop). If you can't get that (pre-existing medical conditions and certain professional fields are a factor here), go with accident insurance.
For all the things that don't kill you but make you unable to work.
Re:Can't help with specifics (Score:2)
You once again failed to follow your own signature (plus the part about understanding that I recommended to add). Or your sense of humor is nonexistent. Or you're just pathologically vindictive.
Don't you have better things to do than scanning my posts and then pointing out a funny (and common) misspelling that I put in there deliberately ? You might want to look at some of my other posts to verify that I am indeed able to spell "Europe" correctly.
Re:Can't help with specifics (Score:2)
Oh, and I'm still waiting for a response to my other posts...
Re:Can't help with specifics (Score:2)
Many companies only exclude pre-existing conditions if you are without insurance for 30 days or more before signing up with them. If you keep continuous coverage, you're fine.
Of course, that doesn't mean they have to agree to cover you at all if you have a pre-existing condition, but that's another story.
I agree that the wife should have good coverage at least for a while yet, and a comprehensive plan for the baby is essential. Personally, I wouldn't recommend a catastrophic plan to anyone, but that's only because my random cancer diagnosis at 24 has left me super-paranoid about insurance. :) Most people aren't going to be that kind of anomaly, but it doesn't hurt to remember that it happens.
Small business associations (Score:4, Informative)
I don't know for sure if it was specifically a small business association, or that's what I just remember it as, or if it was a local or national thing, but you can try asking around. (or someone else might be able to follow up with some knowledge of these sorts of groups)
A quick look online suggests that the ASBA [asbaonline.org] has some sort of discount on health insurance
Local Chamber of Commerce (Score:2)
A nominal annual fee for membership, networking opportunities, and access to reasonably ( for some values of reasonable )... Such a deal!
What about a trade organisation? (Score:2)
Are there no similar organizations in your country doing this kind of thing?
First things first (Score:3)
Poor Americans, .. again (Score:4, Insightful)
Europe, glorious old lady that she is has long ago implemented the National healthcare to make sure that
A; Everyone has access to proper healthcare.
B; Everyone automatically pays into the healthcare fund so it can be maintained
C; Good quality in healthcare is guaranteed by state checkups.
In those days there were no "private" health insurance companies, but look what trusting in those has brought you? Deception, Fraud, and general run-around or obfuscation from most if not all of the private insurance companies.
IMHO, healthcare is not, and has never been something companies should be in charge of. A companies purpose is to make money. The state however, if it's run by others then the idiots running the American state, should be more interested in keeping it's taxpayers ALIVE and healthy so they can work and pay taxes next year.
Re:Poor Americans, .. again (Score:2)
Bob
Middle ground sollution? Look at Finland! (Score:2, Informative)
In Finland for example, there is the normal European Union type of healthcare sate, but you also have private doctors, dentists, etc... I know from one of my Ex girlfriends father, that when he needed an immediate hearth surgery, it was arranged that very same day, by the public healthcare channels. They juggle the times to try and give those who need it most service first if there are waiting lists.
When you are in a hurry and need something done now,something not very important for your life, then you go to the private healthcare. That costs you more of course, but you get service pronto.
Otherwise it's mostly better to go through the public healthcare, because pretty much all of it it reimbursed by the state.
It might be a bit harder to get a job due to the "extra" taxation from the American point of view, and yes the extra health security and money from the state for those unemployed are things that make some into mooches. But on the other side, with the EU style of government, Everyone gets superior education, great healthcare, a guaranteed minimum income to survive on and free extra education if want it while you're looking for a job.
That in my book at least outshines anything the USA has to offer. Canada on the other hand, I would actually consider moving there instead of dismissing it out of hand like the USA. No insult meant, but I find living in the USA something I hope I never have to put up with. IMO I think the place would drive me nuts wondering where the hell these supposed "freedoms" are. The USA that the family Bush is trying to create seems like NAZI wonderland to me, that I hope I never have to experience firsthand.
Re:Poor Americans, .. again (Score:5, Interesting)
Another difference is doctors here make a fortune, just like lawyers. Whereas those in the UK can work 80 hours a week for a middle income. Medical professional are also broken down into an infinite number of specialists here, there's little need to muck around with general practitioners, if you do, you'll get referred to a specialist pretty quick.
There is also free medical for low income and freeloader types. Most places will not turn you away either. If you call up front, you'll be asked about insurance. Even when you receive huge bills, you can make small monthly payments to pay it off. Children without medical cover may be covered by the state, so if you have a young kid and a big bill, yet have no insurance, and if your income is low enough (which is less than something like $50-60k I've been told) the state will pick up the tab.
It's not all doom and gloom like you think it is. Yes, there's a huge amount of profiteering, a bill will be for different values depending on payment, and insurance companies waste a huge resource avoiding payment, you really have to be on the ball even with cover. The real issues are for the long term sick, rather than fixing up a damaged body part.
Mod parent up (Score:2)
I'm on a mailing list for people who have/had the kind of cancer I had. I've noticed a definite trend between the Canadian and US list members (there are only a couple from anywhere else). The Canadian members, with only one exception I've seen so far, have to wait about two to three months between diagnosis and starting chemo.
In the US, the average wait is under a month. I personally went from the xray where they looked for pneumonia and instead found tumors, through the scans, biopsy, and blood tests and all, to my first chemo treatment, in two weeks flat. It turned out my cancer had already metastatized and was trying to take over my lungs; if I'd had to wait 2-3 months for chemo I'd be dead. Now, I'm assuming that places like Canada and the UK aren't going to make someone wait if it is life-threatening like that, but the fact remains that cancer spreads and gets continually harder to treat. In the case of the type I had, a month is unlikely to make a difference in staging, but three months certainly could. And being a higher stage means you have to get more treatment, which (aside from costing your government/insurance more money) puts you at higher risk for secondary problems later.
Overall, even though my insurance wasn't great and I still had to pay 20%, I'm glad I was at least able to get timely care so that it didn't get any worse. And many of the hospitals were happy to write off the 20% as a charity writeoff; public hospitals are required to do so many of those a year anyhow. (Unfortunately, my main oncologist, with whom I had the biggest bills, wasn't one of those, so I do still owe quite a bit that I'm slowly paying off. But it's not wreaking financial havoc or anything.)
Change is needed now (Score:5, Insightful)
Many states have an expensive health insurance pool that has high deductible insurance that will only take care of you in catastrophic conditions. If you go for the low deductible, expect to find very high premiums and equally high copays.
With the high deductible plan you can start a health savings account (who has money to save these days?), but that may be your best option.
Most important, keep your coverage with your wife current as long as you can as you may get your prexisting conditions covered without a waiting period.
In my circumstance at least, I have found that health insurance companies have no reason to want to insure anyone that may be a liability down the road. I do not see a political solution to this, as congress is corrupt. The best they could do was pass a bill that made it hard for sick people who got burried by medical bills more difficult to declare bankruptcy. And another program that was essentially a handout to drug companies that foisted a compkicated hard to use drug plan onto seniors. That's all they have done. This last congress was the most do-nothing congress ever. It seems the only thing they had time for was to take bribes from abramoff and hit up underage pages for sex and try to cover up the trail later. The health care industry is not much better with their costs outpacing inflation 3 to 1 at least.
I know neocons are not going to like what I'm about to say, and how important that it is fighting alquaida over in Iraq blah blah blah, but the fact is with what we have spent on this war to knock over a tin horn dictator I bet we could have paid for everybody's current medical expenses in the US, let alone making it affordable.
If you're healthy and have job, you probably will not won't give what I have to say a second thought. But if your sick as I am and can't find coverage or a doctor, you know how bad it is. If your self employed doubly so. Even if you do have coverage, you have got to be noticing how your insurance premiums are getting more expensive and its covering less, your deductible is more, and prescriptions are through the roof.
But the greatest crime of the Iraq war is that it has taken attention completely away from the health care crisis. I have talked to my politicians to no avail. Gratefully though, a challenger for state office DID talk about it and it got him elected.
We had no business screwing around in Iraq (esp. with the WMD big lie) without taking care of our own at home first. It's that simple. If things aren't working for you, it's important to let your politicians and everyone around you know how you feel. Only this way will there be hope for change.
BTW, make sure that the high deductible health savings account pays for 100% above a certain point. 80%, and you still could (likely)lose your shirt if you get sick.
Re:Change is needed now (Score:3, Interesting)
Re:Change is needed now (Score:2)
Insurance covers unpredictable risks. Since the minimum healthcare costs of many individuals can be easily determined in advance to be higher than any reasonable premium, healthcare plans are not "insurance" at all. Most of them are little mini socialist-style programs run for corporations, shifting costs from the healthy to the less healthy in some arbitrary group in a predictable manner. This modern version of a feudal system keeps employees highly dependent on staying with their employers, and that's the way employers like it.
Blues (Score:3, Informative)
Re:Blues (Score:5, Insightful)
Re:Blues (Score:3, Insightful)
Quite a few of them. All it takes is cancer, or a heart attack. Two of the top killers in industrialized nations.
There are lots of reasons insurance is expensive. (Score:5, Insightful)
As long as we are unwilling to say "You know what, it's too expensive to keep you alive", a lot of people are going to die because they can't afford to subsidize the healthcare costs of the extremely sick and therefore can't get even basic healthcare.
We need insurance plans that cap maximum expense - so you can sign up for death if you catch something that's going to cost 3 million to fix so you can survive the far more likely chance you get a disease/injury that costs $40,000 without going bankrupt.
Re:Blues (Score:3, Insightful)
Why not? They'll negotiate with you. In fact if you can pay them promptly, they'll cut you a better deal than they'll cut any insurance company. Insurance companies have a nasty habit of holding onto payment well after it's due. If you can get cash in hand or even set up a payment plan with the hospital, they'll take it at a great loss (compared to their asking price). They won't advertise that because then the insurance companies wouldn't think they are getting a deal.
This would be like making it illegal to negotiate on new car prices. Sure the car dealer has a high MSRP, but you're a fool to pay it. Our insurance system has it's problems, but hospitals and doctors being free to negotiate prices isn't one of them.
Re:Blues (Score:2)
Re:Blues (Score:2)
It's a vicious cycle, and I don't have any ideas for fixing it. People can't pay, so the hospitals have to charge others more to make up for it, or just stop treating people who don't have good insurance. The higher charges make more people unable to pay. Etc etc.
If you have insurance, at least they KNOW that they're going to get a good chunk of the total. They're willing to take 75% of what they charge, because it's more than they get from some people. And they probably have insurance companies that they trust more than others to actually follow through and pay their claims. I'm saddled with about 10K extra bills right now because my insurance company just kinda lost track of my hundreds of claims and doesn't seem to have any interest in paying or even acknowledging that they didn't pay a good chunk of them. That doctor doesn't know for sure that she'll see any of that from me (she will, I'll take a payment plan over bankruptcy any day thanks), thanks to my insurance company's incompetence. A more reliable company may have earned the right to lower prices because they actually pay their bills.
If your insurance pays some good-sized chunk and you're fairly poor, most public hospitals will knock 50-100% off the remainder if you apply for aid. They're required to do a certain # of charity writeoffs per year, and yes, everyone else pays for that in the inflated costs too, so if you don't like it don't ask for nationalized health care.
Re:Blues (Score:3, Insightful)
That's my take on socialized medicine: my tax rate could go up quite a bit before I'd end up paying as much more in taxes as my health insurance costs. Heck, it could probably double. I'd probably be actually financially better off with socialized medicine, and we wouldn't have these worries.
Re:Blues (Score:3, Interesting)
Wow, having worked in medical research for the last decade I have to admit I'm surprised to find out that private insurance companies are spending so much more on research than the government. It will be news to most of my colleagues, as well.
Of course, like most people, I'm sure you're completely unaware of the fact that Cuba is one of the world's foremost countries in medical research. (No doubt it is because of their cutthroat capitalist medical care market!) One of the wonderful side-effects of our embargo is that American physicians have to get a lot of new medical developments second-hand rather than being able to attend the world-class seminars right next door. But hey, who wants to be saved by a surgical technique developed by communists?
Couple of suggestions (Score:4, Insightful)
(it's even worse for a small company under 25 employees!)
If you're a member of the IEEE or any other "entrepreur" association you qualify for a group policy via them. That's usually a good deal. For example a quick search of "self-employed association" just showed as its first hit an association that offers health insurance. I have no connection and won't shill for them by including the URL.
If you live in CA I hear Kaiser is quite good though I've never used 'em myself.
Good luck. You'll find a lot of "well baby" visits will be needed in the first year or so. Well, at more than you need as an adult anyway. The insurance companies usually subsidise them because it's cheaper to catch something in the bud.
And finally, in all seriousness, consider moving to my home country, Australia. There's a preference for computer programmers under 40, and it's a great place to be or raise a kid. (though I live in California right now myself...)
Oh and have fun. One thing to be careful of / manage: I basically didn't work for the first couple of years after my kid was born and again when he was perhaps 4-6. That was really great. Try to find a way to balance the time with the family with making sure there's some regular income!
IMPORTANT (Score:5, Insightful)
I just got out of the Air Force and am now working as an independent contractor. Tricare does have a COBRA-type polkicy I can get but it's very expensive. I can't just get the coverage for my wife, I have to be on the policy, so I'm having to pay about $2200/3 months for it. At least it comes in 3 month chunks, so I won't have to carry it longer than I need it.
If there weren't that program available to me, I don't know what I'd do. In Georgia where I live there is a Medicade program for pregnant women, but I make too much money to qualify for that. If you make more than $1600/week with a family of 4 (they count the unborn) you make too much. My wife had to have a c-section last time and I saw the bill Tricare got. For everything throughout the pregnancy they paid out over $60k.
I have heard that if you can't get coverage and you talk to OB docs, they can usually work with you and sometimes you can end up paying less than if you had insurance. I have not looked in to that yet. Good luck!
Re:IMPORTANT (Score:2)
I knew that the US medical insurance system sucks, but I didn't know that it sucks so much. Good luck for your wife, that she delivers without any problems for her or the baby.
Re:IMPORTANT (Score:2)
A colleague of mine started work for us, got pregnant very early on and left after ten months to go on maternity leave. Difficult labour and eventually gave birth via C-section.
This is in the UK so it's all on the NHS and paid for by the taxpayer, the company don't provide private health insurance.
What would happen in the US - presumably the company would have some form of health insurance, but she wouldn't be covered so they'd just let her die? I'd really like to know how it would work. She's young in and wouldn't be able to afford to pay for the operation herself.
Re:IMPORTANT (Score:2)
Oh no, that's not going to happen. Ending up neck-deep in debt is the likely outcome, with all its nasty side effects (sleeping under bridges and such).
Re:IMPORTANT (Score:2)
Go for the high deductible (Score:4, Interesting)
For the record, the place I got in trouble was picking the cheaper plan and then getting a physical. Burried back in the fine print was a clause that they don't cover anything preventative, but that wasn't obvious when I was ordering the plan or looking through the main section of the booklet. Had I clicked a link to the provider's comparison of all their plans, it would have jumped out like a sore thumb. Personally I think it borders on criminal when a company doesn't make it obvious where you risk owing a lot of money and what coverage is missing that many others would frequently include.
And a final note, always get the price an uninsured person will be responsible for up front for everything! This is what you'll be stuck paying when the insurance company says they aren't responsible, and you should be able to afford it. My family's neighbor (a doctor), myself, and many others agree, the medical system in the US is broken. Insurance is complicated, costs are going up, and lawsuits are giving insane sums of money for just about anything. My biggest peeve is that you aren't told how much you owe until a month after the procedure is done. Admittedly this is a service and things may fluctuate when you find a problem, but every doctor uses charge codes and their office knows their fee for that code, and the insurance companies know what they have agreed for those codes. But no one will tell you those numbers until after you've had the service. Congress would do a lot for people by requiring every insurance provider to publish how much they cover and what the patent is responsible for on a standard list of charge codes, and make it available before signing up for that coverage.
IEEE (Score:4, Informative)
They have some good group deals for insurance setup just for cases like yours. They also have group life and a few other things that might be of interest.
Oh, and its a good organization to boot
How about.. (Score:4, Insightful)
You know, one of those where it's recognized that decent healthcare for everyone is a good thing.
It's quite silly, the way you do it in USA. It prevents people from acting rationally, to the detriment of all. (it's the same in *parts* of Europe, you guys aren't alone about it.)
For example, a friend of mine (living in the USA) is currently at home (watching his baby) while the mother works. He works a little evenings and earns a little extra for the family, but little enough that he was still health-insured trough his wife.
Then he got offered a larger position. He had to turn it down. It'd have put him above the limit where he'd need his own health-insurance, so in the end he'd have ended up working *more* and getting *less*, which is nonsense.
Everyone is a loser in this scenario:
Stupid. Very stupid.
It should pay to work. Putting someone in a situation where they get *less* for working *more* just serves as an insurance that these people won't, infact, work more.
There's similar mechanisms in welfare-programs too, where you earn $100 more and get $150 less from welfare. The effects are similar. (it'd have been different if you'd earned $100 more and as a consequence gotten $50 less from welfare, that'd have been fine)
Re:How about.. (Score:2)
You know, one of those where it's recognized that decent healthcare for everyone is a good thing.
I know why you think that, but it's not a "good thing", for a simple reason: What if you don't like you're health care? I can go to another insurer. I can go to another doctor. I can do pretty much any damn thing I want. I never have to wait for anything. You're at the mercy of what your government provides, including the infamous "waiting list".
No thanks. I'd like my complex-and-expensive knee surgery scheduled in a few hours, thank you. I'll take freedom over the nanny state any day.
Re:How about.. (Score:3, Informative)
besides, in europe you can also go to another insurer if you don't like your healthcare. but all insurers provide basic services by law.
Re:How about.. (Score:4, Informative)
If you see everything as black and white ...
I can go to another insurer too. A different public one, or a private one. I can go without insurance if I really wanted to.
I can go to another doctor.
Me too ! I can go to any doctor in the whole country. And some of the neighboring countries, too.
State-run medical care doesn't exclude any of the things you mentioned. It all depends on the details of the implementation. You're at the mercy of what your government provides, including the infamous "waiting list".
You're just replacing one waiting list with another one (ordered by who'll pay the most).
Look into using an 'umbrella' company (Score:3, Informative)
If you're planning on having more children after.. (Score:2)
Good luck with the little one
What about COBRA? (Score:5, Informative)
After the 18 months of COBRA runs out, the insurance company is required to offer you a non-group policy that is not medically underwritten. I think they usually call this a HIPAA policy. This will probably be more expensive than the policy you get through COBRA, but you can't be denied for pre-existing conditions.
It's been a while since I've read the DOL publication on COBRA, so follow the link above to verify that none of the details have changed.
HDHP + HSA (and don't spend the HSA money) (Score:4, Informative)
Also, the HSA regs give you tax advantaged savings based on the money you put into the HSA (not the money you take out of it). Check with your accountant, but I believe that nothing in the IRS regs says you must pay for all healthcare expenses with HSA money. Yes, you can't use HSA money for anything but healthcare (unless you are over 65 or disabled), but that doesn't imply that you can't use non-HSA money for healthcare costs. An HSA is a great way to build more tax-deferred savings if you've hit the limits on other tax-deferred savings programs.
US Health Care Costs (Score:3, Interesting)
Government (Score:2)
Speaking From (Too Much) Personal Experience... (Score:5, Informative)
1. Extend your wife's plan with COBRA even after she quits at least until your baby is born. Do this, even if that means traveling further because your closest hospital is no longer in network. My first child required an emergency C-section and a few days in the neonatal ICU. He was almost 11 pounds at birth and there was no way he was coming out through the in door, so to speak. The bill was pretty amazing, but I didn't have to pay much out-of-pocket. So, if there are additional expenses related to your child's birth, at least you won't be completely screwed. On a side note, my son ended up with cerebral palsy, possibly due to decisions made by our doctor and his team. Learn up front about what can go wrong, and don't assume the experts are paying close attention to your wife/child.
2. Never go without health insurance and life insurance. I was 33 years old and my wife was pregnant with our third child when I found out I had testicular cancer. I caught it before the cancer had spread, but I still required one minor and one major operation, all kinds of diagnostics, and years of follow-up. My bills, way back in 1994, were well over $100K. My insurance at the time covered almost all expenses. Because I had life insurance, I had one less thing to worry about. Without life insurance, I probably would have died simply from stress.
3. If you have pre-existing conditions, you really need some type of group plan. Individual insurance plans are out of the question if you have any kind of serious pre-existing condition (cerebral palsy, testicular cancer, etc.). I know, because I tried this route. I pay around $10K per year for medical/dental at my current company. I thought that was a ripoff until I tried to get insurance on my own. Your only reasonable way to get health insurance is to be in some kind of group plan where your risks can be spread across a large pool of individuals. Even then you may have problems if you have any coverage gaps or you aren't going into a large enough group plan. If you have no pre-existing conditions and are healthy, the medical savings plan along with a high deductable plan is a cost-effective approach.
4. Without health insurance, you pay much higher rates for the same procedures/care. I recently had a 4-day stay in the hospital (as a result of the cancer surgery 10 years earlier). The unadjusted bill was 3 times the amount of the adjusted bill. Without insurance, you get the unadjusted bill and no expert on your side to help negotiate the bill down.
Hopefully your luck will be better than mine when it comes to health. However, I can say that insurance has saved me from financial ruin on more than one occasion. More important, insurance allowed me to make career and life decisions (like having more than one child) that I may not have made if I was paying out the ass for the rest of my life due to one bad medical experience.
I wish I had an answer for our country's current medical insurance problem. I don't think a government-based single-provider solution is best, but I think government may need to help fund large group plans that are affordable for the tens of millions of americans that want insurance but can't afford it. The uninsured are driving up costs for the rest of us by waiting too long to get care, and then entering the system directly through hospital emergency rooms. I'm encouraged by the pay-as-you-go clinics that are popping up at Wal-Marts and elsewhere for non-emergency care. It costs a lot less to pay $25 at a clinic to have your kid checked out than to wait until your kid is seriously ill and then take him/her to the emergency room.
Best of luck with your new family.
Re:Speaking From (Too Much) Personal Experience... (Score:2)
Actually, isn't this the point of _any_ type of insurance ? The cherry-picking in individual plans leads the whole principle ad absurdum, but I guess it's the best for the people that an insurance company really cares for (its shareholders).
Same boat, here's my solution (Score:3, Interesting)
Ideal: put $10,000 - $15,000 in the bank for emergency use and go with a super-high deductible ppo. Your rates will be low, maybe about $150
Next best thing: I went with Farm Bureau (www.fb.com) - I'm not a farmer, but they help self-employed people get insurance. The rates were the most reasonable I could find, and there was a person I could go talk to. They also do retirement planning and other types of insurance - most importantly, they have good rates on long-term-disability, which you should definitely have if you're self employed and you care about the long-term needs of your family. They also have life insurance at fair rates, but I got a better rate through my home/car insurance company (allstate).
"What he said" mostly, but.... (Score:4, Insightful)
1. I pay $135 month for $5K deductible at age 57. Every five year increment goes up a few bucks. Every year the whole grid goes up a few bucks. "Full" insurance with a small deductible and small co-pays would be about $550/month. Rationale: At $550/month that's, umm $6600/year. $135 is $1620. If I get 'really' sick, I break even. In any case it would appear this is a lot less expensive than some of you are paying for a similar $5K deductible.
2. Several people seem to think voting Democratic or moving to Canada/Britain/etc. will solve the problem. Does anyone really think nationalized health care will give us a BETTER system? Do you REALLY want Hiliary calling the shots here? Just look at our military or the VA system. The VA, if you can get on it, is totally free. I won't say it's a bad system, but let me say this. My father was on it. I thought it was a good deal at the time. But had he been on medicare plus a supplemental he could have used local doctors instead of the long ride to a VA facility--and he just might still be alive today. I dunno, it's hard to figure it out in hindsight, but I wish we had the option of doing his health care over again the other way. He DID get a free slot in the wall at the Veteran's Cemetery, though.
3. The worst problem, imho, is that we've messed up by insisting health care be part of employment. Now people think employer-paid insurance is a "right" and will strike if the employer wants to reduce some costs with a co-pay. Insurance companies have lept on this, too because by and large if you are working, you are healthy. Really sick people can't hold a job. It's in insurance companies' best interests to further such a system. People keep working in terrible jobs just to keep insurance. I have a buddy who could otherwise retire. I say to him, "Why not?" and he always says, "Insurance." Now that sucks.
4. Health care is not in the Constitution. On the one hand we demand government be responsible and take care of every individual every time he has a cold and winds up going to the emergency room for it, stupidly. We are so risk averse that we blame anyone we can for anything that happens to us. Government is a prime target, but so is anyone, including McDodalds with hot coffee. Then we turn around and say, well, government should not invade my privacy (which isn't exactly in the Constiution either.) The thing is, we have INVITED government into our lives on a very personal basis, then wonder why it is there. You can't expect government to NOT be in your life if you won't take responsibility for your own life in the first place.
I would prefer government NOT be in my life, or there as little as possible. I will trade that for taking responsibility for my own health and my own life. Just get out and leave me alone. We'll all be better for it.
Re:Quit being moral about it (Score:3, Insightful)
Corollaries (Score:2)
"If it sounds too good to be true, it isn't."
Ask your doctor which one he would choose, and just go with it.
The answer will probably consist of the plan that makes him the most money.
Re:Quit being moral about it (Score:3, Informative)
Oh, and the reason it "has to be so difficult" is because the companies purposely make it difficult. Their beancounters figured out long ago that the harder they make it to decipher the plans, the fewer claims they get because their customers can't figure out if they're covered or not, or how to file claims, or whether they can appeal denials of coverage. It's a serious racket. So let's not act like this is child's play.
Re:Baffled (Score:2)
Simple Answer: Over the course of your working career, let's say you save $1,000,000. That's great, if you don't have any major problems until well into your career. But what do you do if you get into an accident, or get ill, and need to spend a few hundred thousand early on, before you've saved it?
You either go into debt, if you have enough credit, or you carry insurance to pay for it. A savings plan with a high-limit credit card used just for healthcare emergencies and a health insurance plan are basically the same thing, financially. You'd have to do some analysis on the CC interest rate - savings interest rate vs the insurance premiums to figure out which one costs less. I predict they're both excessively expensive, though.
Re:Baffled (Score:2)
I take it you haven't been smacked with a six-figure medical bill yet.
I would also guess that you're not too old, and in fairly good health.
Re:Baffled (Score:2)
No. Pretty much any large surgery can get pretty close to that (especially in the US). If it's anything that requires some sort of specialist (cardiology, neurology, oncology), the price tag will start in the six-figure realm and go up from there.
Re:Baffled (Score:2)
I would guess the latter. It's easy to be naive (and easy to get really good-sounding health insurance) if you're young and healthy. Take one of the two away, and hell breaks loose.
Re:Baffled (Score:2)
2. Never mistake malice for incompetence.
Re:Baffled (Score:2)
Re:Baffled (Score:5, Interesting)
The insurance companies negotiate with all of your providers, including some you're not even aware exist, for lower rates. And while you can do some negotiation yourself, that is a very difficult thing if you're lying on a stretcher unconcious.
At my most recent physical, the lab billed $900 for all of the tests. The insurance company paid $300 and the rest was the "negotiated discount".
The medical system in the US is fundamentally flawed, and facing it WITHOUT insurance could easily bancrupt you.
Re:Baffled (Score:3, Interesting)
Actually, the nasty thing is that it can also bankrupt you WITH insurance. At a certain point, even 20% of the medical bill will be too much. Especially considering that you're not likely to start working immediately after a procedure that expensive.
Re:Baffled (Score:2, Informative)
A couple things to consider. - Shop for insurance looking for these items: Are my favorite doctors in net? Pharmacy? Are my drugs covered, must I buy a generic? Is Chiropractic covered? Mental Health?
- 'In Network' is golden. if you prefer to leave the network, you will pay that doctor's standard rate, often even after your 'Out of Network Max' has been exceeded, because Insurance company's set a 'Usual and Customary' (U&C) value for every procedure, and only pay that amount... MDs, since they are discounting services paid for by insurance companies, up their normal rates to cover the difference (if 20% are paying cash, and 80% are paying via insurance 80% of the 'real costs, the 20% are paying for their costs plus paying for the discount given to the 'network' patient)
- If you are young, healthy, good cash flow (real paying jobs) and have good investing habits... do a High deductible PLUS an HSA... and be disciplined to invest the difference in premiums between the low deductible/HMO and the HDHP in the HSA. Your HSA becomes both your rainy day health fund, but if you maintain good health, eventually it kicks into a retirement fund vehicle.
- Look for these perks
-- 100% coverage on annual exams
-- 100% coverage on immunizations for children
-- Nurse Line (avoid unnecessary trips to the doctor)
-- A good web site, that allows you to track your claim history, medical record, has a real procedure cost estimator and a good network physician lookup
Finally,
- Insurance buys you 'insurability', ie, your current insurance must provide you a certificate of coverage which is the chit that gets you into most group plans even if you have a chronic condition. So being continuously insured when you are diagnosed usually gaurantees you if you ever want to switch plans that you can get insurance (albeit maybe at a higher rate, but at that point coverage is important, not price).
Re:Baffled (Score:3, Interesting)
My rather extreme example of this negotiated discount:
I have BCBS of NC. My daughter was born 6 weeks early, and in the NICU for 5 weeks 2 days ("apnea of prematurity" meant she had to stay monitored). The hospital bill (not counting the neonatologists) was $58000. They wrote off $52000, BCBS paid their 90% at $5.mumblek, and I paid $662.
So BCBS can get all that care (1/4 of a nurse, 24 hours a day, 37 days), for $6k. I would have had to pay $58k had I not had insurance (=years-to-a-lifetime of bankruptcy). The socialist in me is disgusted that it's that much more expensive to be poor. The poor person in me is glad that I didn't have to pay $6k for my 10%, though.
Re:Baffled (Score:2)
Yep. "I want 50% off everything, or I'm going to die right here."
Re:Baffled (Score:2)
And you can negotiate with providers before you receive services to lower their prices if you're paying for it out of pocket. i.e. if you don't have insurance.
My point wasn't about negotiating insurance policies, but negotiating the actual price of specific services, which, as I pointed out, can be problematic in some circumstances.
Re:Baffled (Score:3, Insightful)
Insurance companies, in advance, negotiate discounts.
The comparable action for an individual (which is of course impractical) is to negotiate, in advance, discounts, while not in critical condition.
So if you were to go without insurance, then you would instead be calling all these hospital to arrange advance discounts -- not in critical condition.
There's a reason why that wouldn't work -- it's impractical and hospitals couldn't justify the expense of negotiations for just one person. The reason it wouldn't work has NOTHING to do with difficulties in negotiating while in critical condition.
The reason I belabor this point is because on another health insurance thread, a moron kept switching between talking about paying the hospital, and talking about shopping for insurance, when you'd be in critical condition in one but not the other, which made it impossible to rationally discuss the issue with him. So, I have to be careful that people don't continue that error.
Re:Baffled (Score:2)
Note that the original post was not about negotiating with the insurance company, but with the service provider (doctor, hospital, etc).
Re:Baffled (Score:2)
Read your own signature and apply it to other people's posts (oh, and add "and try to understand" after the "read" part). It would save you from some embarassment.
Re:Baffled (Score:2)
Re:Baffled (Score:4, Informative)
I hope you have a lot of money saved up. Heart attack: over $10k including drugs, a few days in ICU or the coronary care unit, and an angiography. Oh, and if you need bypass surgery, the going rate was around $35k last time I checked. So we're up to about $45k. We're still not talking about the $200 in medication you'll be spending every month, plus the semi annual visits to your cardiologist at around $300 each, and the yearly stress test, etc.
How much did you say you have saved up? Make sure you don't have a heart attack at 40 years old or you are screwed.
Not paying is suicide (Score:2)
Some people become no longer healthy despite their best efforts. Are you telling them to just kill themselves by not seeking medical help?
Re:Baffled (Score:2)
Now I do have savings, as well as a mortgage. Still not nearly enough to pay for what cancer would have cost me. Unless you've already had a chance to save up quite a lot of money, I'd never recommend anyone cancel their health insurance and depend on savings.
Re:For better health coverage? (Score:5, Interesting)
While a humorous comment, it highlights what makes the American health care system so unique. We are so fiercely independent, that a good majority of Americans don't like having the government telling us what to do, and this includes how we take care of our body and our health. This system allows for many benefits as well as problems. The most visible problem is the ever-increasing cost of health care, and the number of people like yourselves who are falling through the cracks because good health insurance is only available through employers who can command group rates. On the flip side, because the state is not dictating how health care is conducting itself, American health care is a hot-bed of new procedures and techniques that push the limits of health care because people are willing to pay for an unproven technique even if it has even a small chance of success if the alternative is not acceptable. For example, the second son of a friend of mine was diagnose with Spina Bifida [wikipedia.org] and instead of accepting that his child would be born paralyzed, was able to find a surgeon who was willing to perform surgery on the child while he was still in the womb! [fetal-surgery.com] (notice that of the four hospitals in the world that perform this unique and complicated surgery, all of them are located in the United States)
As a graduate student, I am faced with paying for a cut-rate, we-don't-pay-for-anything-unless-you-get-hit-by-a- bus student plan, or a much more expensive individual plan. There are very few national health care providers, and you would be well suited to search for and find a regional health insurance company. In the mid-west, I have been leaning towards Anthem [anthem.com] as my insurance provider, and hope to have a plan from them to help me start off the new year.
Re:For better health coverage? (Score:2, Informative)
The government loves telling us what to do and as long as most voters don't disagree vehemently, they will.
On topic, I run my own business, a two-member LLC (my wife and me) doing consulting (mostly Linux stuff) and we are screwed royally as far as insurance goes. We have a child with a disability so: (a) being w/o insurance is not an option, and (b) we get the highest rate they can legally charge us: over $1,000/month. (imagine goatse man here, that's how disgusting it is)
Oh, and good luck with Anthem. They're great! (That's sarcasm...two guesses who my insurance provider is...and the first one doesn't count.)
Re:For better health coverage? (Score:2, Insightful)
I realize that you would get better rates if you were hidden in a large employee pool, which is why I like the idea of socialistic baseline care(the US is filthy rich, we can afford it), it makes the cost sharing pool as large as possible.
Re:For better health coverage? (Score:3, Insightful)
Frankly, I'm lucky I could even get insurance. The government, through threat of force, has to make insurance companies cover us. Because the CEO and BoD for Anthem, et. al., look at (as you said) "large, probable expenses" and essentially say, "we choose not to insure your son, let him die, it's not our problem" except the laws of the land say, "no, that won't do" and require coverage...but only if you know the hoops you have to jump through to get accepted. Forgive me for seeing that as dispicable.
Do I trust the government to run socialized health care? NO. They screw up most things they put their grubby paws into. Frankly, I don't know WHAT the solution is. Thank God I'm not in charge because I'd probably royally screw it up for the entire nation.
Re:For better health coverage? (Score:3, Insightful)
A corporation is a legal entity... a legal individual... who's sole purpose is to do what is best for that corporation (and in modern America, this is to make a dollar value profit). Its purpose is not to do what is best for any other individual (shareholders are by extension a part of the corporation). It is by nature a sociopathic entity. It cares about others only if they help the corporation to get what it needs. Now while corporations keep us employed, which is a good thing, they are not benign friendly entities who care about us. Call Ronald a clown and he'll likely rip your heart out.
You want something that is socialistic, something that likes to work with society and help others, specifically your kid in this case, but you want it delivered by something that is a sociopath. While I am not a doctor, I think you might be developing some sort of self induced bi-polar disorder by the forced realization that corporations while an important part of a capitalistic society, are not about benefiting a society in a 'humanistic sense'; only themselves. It is a kind of symbiotic thing.
For you, a possible solution would be to make the argument to the (sociopath) corporate sector of society (since you prefer them to run the medical system) that your kid will ultimately be able to output more dollar value in productivity for the corporations than the money they will put into him/her. While you quite rightly love your child, a sociopath does not, and will not ever. They need to see some benefit. That is their efficiency. And if you cannot make this proof, don't be surprised if they don't care to help you out. It is not in their interest.
I know this sounds harsh, but it seems to me that as how you seem to prefer sociopathic medicine over social medicine, you probably wouldn't give a rat's ass about a decent society if you didn't have a crippled child and extra medical bills because of him/her. So my suggestion is to stop your hand wringing, revel in the system you prefer, and quietly eat the cost. Too easy. It is one or the other. You either want society's input and the slight inefficiency that it brings (and I am not convinced government handling contributes any more ineffiency than corporate profit making/taking does), or not. And if you do want it, would you want it still if you didn't have the added cost of a disabled child (take a cold hard look). Are you really just like the corporations? All efficiency and no heart. I am making no judgement here, this is how they work. And that is why they have to be forced to provide you insurance even with the added cost. You know they wouldn't even do that if they could get away with it.
Don't get me wrong, I believe for the most part, the way our capitalistic western society operates seems to work quite well (though there is always room for improvement)... sociopathic corporations and all. The biggest problem I have with social programs is that they are often screwed up by the amnesty international crowd (e.g. in Canada when they tried to make chronic welfare victims put something back into society by sweeping the streets a couple of times a week, this was shot down as some sort of human rights violation... bullshit if you ask me). However, I believe in some cases social values are required. Medicare is one area. I think we should look to parts of Europe and other places that have integrated public/private health care (this brings in more government control than in the United States) as they seem to be working better than either Canada's system (which has too much government control) or the United State's (which has too little). I have been in both of the latter two's systems, and they desperately need some sort of help... especially Canada's (mainly because most Canadians are in a state of denial about it... more money won't help).
I find it hard to understand people who want it all but don't want to pay the cost. Or want it all because they realize that the system they asked for just turned around and bit them.
Re:For better health coverage? (Score:3, Informative)
I would like to point out, that anytime you make a bet that you won't get sick, that is a supremely stupid bet, unless it is a very very short term bet. The chance you will need doctor services in the next 10 years is 100%. It's only 'nearly 100%' if you eschew routine things such as yearly checkups.
The problem is that health insurance is being run as an INSURANCE company. The point of society and government is to spread large individual expenses over portions of the population. That road you drove on - you could never pay for it, nor could you and everyone who drove on it pay for it via tolls. Sames goes for healthcare.
Also not every HMO (which is not traditional health insurance - not the same as indemnity insurance) is a for-profit institution.
By the way, I view the health insurance situation in the US as a global competitive liability. The healthcare system reduces individual employer flexibility - you can't just change jobs if you are relying on it for healthcare coverage. Your parting shot in your post was "quit your job and get a new one". Why should one choose their employer based on something tangential as healthcare?
The employer lockin caused by health coverage also impedes the free market of workers. It provides artificial barriers for workers to move from bad companies to other companies or to work for themselves. Strangely enough, you aren't really toeing the standard line of American Entrepreneurialism. After all, isnt the ideal to work for yourself? One that is impossible apparently...
One of the GP posters said that they didn't trust the government to run healthcare, that they would screw it up. Well, certainly with that expectation, yeah they would screw it up. The problem isn't that government screws up everything it touches (it certainly ruined the nuclear weapons programme in the 50s, lost that war apparently), it's just people expect the government to be screwups, thus when they are, people don't complain. After all, the overall health of Canadians with a government run healthcare system is higher than Americans, so clearly the concept of government can't be all that bad - it works for our friends up north, no?
Re:For better health coverage? (Score:2)
Hell with my state employee plan if you add what the state pays to what I pay its $800 a month or so.
You get what you pay for (Score:5, Interesting)
Now it's 2-3 weeks later. Often the X-Rays are lousy, not the right ones, etc. If they have a broken bone it means that I'll have to re-break it to set it straight. If they have a tumor, then that's just another 3 weeks that it has a chance to metastasize.
If an HMO patient has a broken bone, then I have to use heavy plaster casts, instead of light fiberglass, because what the insurance pays me means I'll actually lose money on the fiberglass cast.
HMO's are O.K. if you don't get sick - do yourself a favor and get a PPO.
Re:You get what you pay for (Score:2)
Re:For better health coverage? (Score:2)
It's like winning the anti-lottery. Worse, you're much more likely to win it than you are the actual lottery.
I don't know about anyone else, but it's the main reason that I'm absolutely terrified at the idea of having a kid in the US, and it's the single biggest reason that I want to move to Canada.
Re:For better health coverage? (Score:2)
But then you have to add the copays, which is at least $15 every time you visit your doctor, plus medicine.
Either way, yea kids are expensive, though you can get cheaper insurance and only take them to the doctor when absolutely needed. Though if your poor enough to get Medicaid it helps a lot.
Re:For better health coverage? (Score:5, Informative)
I call bullshit (Score:3, Informative)
I grew up in the US, lived there for 30 years, but moved to Canada in 1997. The care of me and my family under the Canadian system has been outstanding at every stage, and really points out what a perverse, sadistic farce the U.S. "system" is. In the US, doctors have to have an army of back office monkeys to do battle with the HMO overseers, who fight every step the doctor wants to take.
Here in Nova Scotia, we are charged NOTHING above what we pay in taxes for hospital care, ER care, and office visits. Not One Dime. We don't pay for insurance of ANY KIND for basic medical care. I'll say that again - our monthly cost we pay out of pocket for hospitalization and doctor visit coverage is ZERO.
Examples:
When I went to find my first family practice MD here, I found one within minutes, got in the next day, doc ordered blood work which I got same day, and results came the day after that. By the end of the week I was in his office talking treatment options and getting a prescription. Company drug plan paid for that, but even if it hadn't, the drugs are so much cheaper here than in the US that it wouldn't have been a show-stopper. I paid ZERO DOLLARS for the office visit and lab tests, by the way. In fact, when people in Canada refer to a "health plan" or "health insurance" they are talking ONLY about prescription drug coverage, or coverage which gives them additional amenities, like a private room, or an ambulance with a disco ball and an 8-speaker sound system. In other words, shit you don't need anyway.
In Nova Scotia, my stepdad got a hernia diagnosis, had a CT scan within one week, and got surgery within one month. World-class care facility. In the US, you'd be fighting for insurance company approval for three months, minimum. He got NO BILL OF ANY KIND.
Three times our daughter had to go to the ER when growing up (she's 21 now) she was seen immediately, treated promptly (with tests varying from x-ray to blood work), and we went home with ZERO BILL OF ANY KIND.
My wife last year was feeling dizzy and nauseous one morning, so we took her to the hospital, where she was seen immediately, given an EKG with cardiologist consult, thankfully pronounced okay, and... can you guess? Got NO BILL OF ANY KIND.
Nothing came in the mail, and we didn't have to skip a mortgage payment to afford any kind of treatment or visit.
People here may have minor gripes about the system as it performs here, but these are people with no perspective of how bad it can get - people who have never lived in the U.S. or Calcutta. There are people in the U.S. who would kill to have the coverage that some Canadians gripe about on a daily basis.
If the U.S. insurance industry manages to dismantle Canadian Medicare and turn it into a for-profit system, then Canadians WILL have something to gripe about.
Re:I call bullshit (Score:3, Informative)
Re:I call bullshit (Score:3, Insightful)
I doubt that BC would go down the path of US-style multi-payer health care. I'd say alberta is the most likely province to do so.
But in BC, it is true, if you are wealthy you are expected to pay into MSP (medical services plan) - this essentially acts like a healthcare premium in the US. There is usage fees (co-pays), which does suck, but the argument was to reduce medical overusage and waste (parents taking children to the doctor just for a cold, etc).
I doubt that the BC population would allow the dismantling of the healthcare system - most the country regards medical care as a basic human right. The only people that disagree are neo-conservatives who want to introduce an American-style "free" market system. My suspicion is that the people arguing for this are hoping to form their own Canadian HMOs and rape the living shit out of the country. Every dollar in a healthcare system not spent on Doctors or actual real medical care is wasted.
Re:For better health coverage? (Score:2)
Except that isn't true. I know that the Royal Brompton Hospital in London do surgery on babies in the womb, and it wouldn't suprise me if it was done elsewhere.
Re:For better health coverage? (Score:4, Informative)
It's true for the spina bifida surgery (I was tempted to disagree, but I re-checked).
However, this is because the operation is still in a trial phase. It still has to be proven that the intrauterine operation gives a better outcome than a postnatal operation. I guess that all other hospitals around the world are waiting for the outcome - they don't want to be the ones to have performed complex and risky procedures that later turned out to be no better (or worse) than the conventional, tested approach.
Re:For better health coverage? (Score:2)
About 50% of the money spent on health care in the USA is government money. The other 50% comes from people competing for health care services with those the get government money. This race for services is the number one reason prices keep going up. Rising prices are continually reallocating services from one group to another.
Our hero, the small business owner that's looking for help, had his share of health care reallocated away from him long ago.
I think some retired senior living in Miami got it.
Re:For better health coverage? (Score:2)
While a humorous comment, it highlights what makes the American health care system so unique. We are so fiercely independent, that a good majority of Americans don't like having the government telling us what to do, and this includes how we take care of our body and our health. This system allows for many benefits as well as problems. The most visible problem is the ever-increasing cost of health care, and the number of people like yourselves who are falling through the cracks because good health insurance is only available through employers who can command group rates. On the flip side, because the state is not dictating how health care is conducting itself, American health care is a hot-bed of new procedures and techniques that push the limits of health care because people are willing to pay for an unproven technique even if it has even a small chance of success if the alternative is not acceptable. For example, the second son of a friend of mine was diagnose with Spina Bifida [wikipedia.org] and instead of accepting that his child would be born paralyzed, was able to find a surgeon who was willing to perform surgery on the child while he was still in the womb! [fetal-surgery.com] (notice that of the four hospitals in the world that perform this unique and complicated surgery, all of them are located in the United States)
As a graduate student, I am faced with paying for a cut-rate, we-don't-pay-for-anything-unless-you-get-hit-by-a- bus student plan, or a much more expensive individual plan. There are very few national health care providers, and you would be well suited to search for and find a regional health insurance company. In the mid-west, I have been leaning towards Anthem [anthem.com] as my insurance provider, and hope to have a plan from them to help me start off the new year.
You're listening to too much talk radio.
The "ever increasing" cost of health care is largely a result of the law not permitting Medicare/Medicaid to do things like implement fraud control systems and negotiate for drug pricing. The lack of primary care also tends to crowd expensive emergency rooms with patients that have to be treated without regard to their ability to repay.
If we had a coherent national health system, costs would be much more reasonable.
And the only "fiercely independent" parties are the insurance & pharmaceutical industries that are enriching themselves on the government trough.Re:For better health coverage? (Score:5, Insightful)
Actually I don't listen to talk radio, mostly because radio talk show hosts are there to entertain you and they do so by espousing their view on different subjects, without regard to the facts. In academia, what we learn is based on studies and fact, and exploration of ideas and questions about what we observe. While we may have opinions about why things are as they are, those opinions may drive us to study why we think what we think, and explore other options in coming up with a reasonable conclusion.
There are many factors that are contributing to the increasing cost of health care in the United States, however medicare and medicaid are not reasons why Joe Citizen is paying more for health insurance. As those are government programs, the taxpayer is paying for any fraud. If you are talking about Medicare Part D, and the federal government not being able to directly negotiate drug prices, of course they don't negotiate drug prices, that is the job of the health insurance companies who operate under the Part D rules, they directly negotiate with the drug companies so that they can offer a drug plan that is less expensive than the other Part D plans, so they can attract the seniors, disabled and the poor to their plan! The more they attract, the more clout they have, and the lower the price they can get from the drug companies. Medicare is only reimbursing the health insurance companies depending on how many people have signed up for their plan. For every person they have signed up for their plan, they get a set amount of money from the government. No more or no less than any other health insurance company.
Part D is a good plan that utilizes the skill-set of an established industry, and doesn't mandate government control over the pharmaceutical industry. As a result, government spending for this program has been much less than originally estimated. Because of Part D more senior citizens, disabled, and poor are able to receive prescription drugs for chronic problems. Also, Part D has been able to actually lower the cost of health care for this particular group of people (compare Part D plans to other prescription drug plans).
Depends on what you mean by a coherent national health system. Hilary Clinton proposed a coherent national health system in the early '90s but there was too much resistance to the idea. If you mean a nationalized system like Canada or the United Kingdom, the lower cost comes at a loss of growth in development of new procedures and techniques. Consider my earlier example, where if my friend had been in a country with a nationalized health care system, his son would have been born paralyzed, and the government would have had to pay for his care for his entire lifetime. Without investment in new techniques and procedures, he would not have had the opportunity to walk or care for himself. Surely a smaller investment up front is better than a lifetime of costs? However, developing those techniques and procedures can be very expensive, and it is very hard to justify those expenses in a nationalized health care system when the primary focus is on keeping costs low, and utilizing proven techniques and procedures rather than experimental ones.
While every business is in business to make money, most would take the 2% over cost that medicare and medicaid grant over the alternative; patients without the means to pay for their own health care who default on payments, or declare bankruptcy. There are a lot more stakeholders involved in the United States health care than just insurance and pharmaceutical companies.
Re:For better health coverage? (Score:2)
Ah, anthem = wellpoint (Score:2)
Re:For better health coverage? (Score:2)
Yes, we much prefer having insurance companies tell us what health care we can and cannot have.
It would be more accurrate to say 'large business interests prefer not to be burdened by government regulation except when it is in thier favor'.
Re:For better health coverage? (Score:3, Interesting)
Re:For better health coverage? (Score:2)
Alex
Re:For better health coverage? (Score:2)
You obviously don't appreciate the humorous value of these news, and the nice warm "I'm so glad I don't have to deal with this crap" fuzzy feeling afterwards.
Re:Go public. (Score:2)
Re:Go public. (Score:2, Funny)
Re:Go public. (Score:2)
Medicare kicks in only after age 65. Medicaid is a state-managed program; the version available in Indiana is available only to families that make less than $1,000 per month total. Given what families must spend on rent, food, and utilities, and given the earlier quote of $1,000 per month health insurance alone [slashdot.org], that leaves no room for those who make just above the cut-off to afford health insurance.
Makes money != makes enough money to afford health care along with rent, food, and utilities. This would require giving the employees a hefty pay raise, something that would likely put the business clearly into the red.
Re:The European side of this is... (Score:2)
Depends on what country you're actually in.
Here (Germany), your only "bullied" into health insurance if you are a) an employee and b) make less than X Euros a month. If you don't fulfill both conditions, you're free to go uninsured, pick up private health insurance, or stay in the public plan. And even if you're bullied into the public plan, there's different carriers to chose from.