Health Insurance When Leaving the Corporate World? 1197
An anonymous reader writes "I've been working at a large company since I got out of college, so I didn't have to give much thought to getting my own healthcare plan. Now I'm thinking about leaving the corporate world and starting out on my own. I have a family now, so I need to make sure we're going to be covered should anything happen. Researching online turns up horror stories of people trying to get individual healthcare plans, or getting denied coverage on plans they thought they had. Does anyone else have experience going through this and what you've had to deal with, or am I making too big a deal of it?"
Easy (Score:3, Insightful)
Move to the UK or another country that cares
Step 1. (Score:4, Insightful)
Move to any 1st world country not the USA.
There is no step 2.
You got 2 choices (Score:5, Insightful)
1) Don't get sick
2) Die quickly
Re:Step 1. (Score:5, Insightful)
Truth. If you have a family, stay in your job, unless you're already rich.
One could argue that the US health insurance system is set up to avoid having people do what you're trying to do.
So where've you been? (Score:1, Insightful)
vote for democrats (Score:3, Insightful)
they'll give us universal healthcare ... oh, wait, nevermind.
Re:Move to Canada (Score:5, Insightful)
Depends on the province; it's often free no matter what your situation is. Contrary to Republican scare ads, it's also of excellent quality provided that you don't go to the emergency room for a cold or a stubbed toe.
Re:I did the same for a while... (Score:3, Insightful)
received full benefits (taking up most of that paycheck)
So your insurance cost you 15 hours per week. That seems potentially expensive, depending on how much you could earn spending that time doing something else.
Re:Step 1. (Score:1, Insightful)
Or stay in USA and pay $100,000 for it, where you can work five jobs to pay your debt while you recuperate.
Re:Step 1. (Score:5, Insightful)
You know, all the Canadian health care bashing really gets to me.
I needed a physical within the week since I was immigrating to the United States, and wanted to make sure that the actual immigration medical wouldn't reveal that I needed additional vaccinations (since the US doctors charge for it). My family doctor was able to provide it in three days.
Now, that's a fairly trivial story, but it highlights the fact that if you need care, they will prioritize you and give you the care you need when you need it.
My dad needed to have a stent put in as he had a buildup in one of the arteries near his heart. He was scheduled for it for a few months out, went in as scheduled, and had the procedure done.
A day later and he started having chest pains. The hospital told him to come back and they had another stent put in THAT DAY. He's fine now.
No questions about insurance, no bills, no nothing. He got the care he needed, when he needed it.
Single payer works. I just wish that people here in the US could be convinced of that... unfortunately they've been bashed over the head with the idea that it's somehow "communist" or "socialist", which translates to "evil" to most people here.
Missing argument in health-care debate (Score:5, Insightful)
Supposedly one of the strengths of the U.S. economy is its ability to rapidly adapt to changes. This has been used to justify the lack of job protections for workers. But as the poster has shown, having health insurance tied to your employer obstructs the kind of entrepreneurism that's part of our rapid adaptation.
I don't understand why this argument hasn't come up during the health-care debates. It would have let Democrats position themselves as pro-economy.
Re:you're screwed (Score:3, Insightful)
Are you on crack? Or do you just spend your time listening to liars without doing any fact-checking?
Insurance premiums for self-insurance are 100% tax deductible, provided you itemize your deductions and meet the minimum threshold (which is trivial considering how much insurance costs these days) -- they've been that way for decades.
Re:doesn't that make you boiling mad? (Score:3, Insightful)
No, they're resisting because they'll lose money.
Re:Step 1. (Score:1, Insightful)
Or stay in the US and not get an MRI at all because he has no insurance.
Or, hey, maybe he'll get "lucky" and get the MRI despite not having insurance (only because the hospital fears liability more than deadbeats). Then later he'll get an outrageous bill he can't afford to pay and have his credit ruined.
But God forbid he should have to wait!
When I became self-employed (Score:3, Insightful)
I'm damned glad that I did, too. My wife was diagnosed with breast cancer a couple of years later (she's fine now). We would have been wiped out if not for insurance.
Re:I did the same for a while... (Score:5, Insightful)
If this doesn't highlight the problems with the US health insurance system, nothing will. You had to trade 15 hours a week of your life simply to be able to live a healthy life. That sounds an awful lot like indentured servitude to me.
Your Best Solution: (Score:1, Insightful)
is to find a civilized OECD country with socialized medicine.
The U.S.A. is now a third-world country with a large population of neglected residents. It's NOT going to get better.
Yours In Riga,
Kilgore Trout
Re:-1 Troll and Uninsightful (Score:4, Insightful)
I'm sorry, I missed the bit where you had constructive advice to offer to the poster.
Re:Step 1. (Score:5, Insightful)
Single payer works.
...in Canada and certain other countries.
As a USA-ian, even I have had excellent interaction with the Canadian health system due to an unfortunate but minor accident a few years ago.
Given the lack of wisdom in Washington DC these days, the political power of the AMA, the AARP, the various Lawyers groups and the insurance industry, I can't imagine how a functional, usable equivalent could possibly get instituted here without screwing up healthcare (and killing people) for a decade.
Re:Step 1. (Score:3, Insightful)
.5. Call up your local congressman and say youhave to leave the country to get health care as he doesnt care about the people he represents.
Seriously the reason one in six americans don't have coverage is based on the lasttime congress tried to straighten up healthcare. I fully expect the republicans to screw it up thistime too.
Healthcare Business Model, and its politics (Score:2, Insightful)
The business model of the healthcare industry can explain why it's difficult for individuals to obtain policies.
Note, this is not flame bait, just what I understand about the facts. The healthcare industries are in biz to make money - your claims are their losses, so if you rely on a plan that is subsidized wholly by the healthcare company, you're more likely to have troubles than, for example, a policy under an plan in which the company is "self insured" -- self insured means that the individual company has a pool of funds that pays claims and the healthcare company (ie: Blue Cross) is the "servicer" on their behalf. Under that scenario, and in my own personal experience, you are less likely to have troubles.
60 Minutes recently did an interesting segment on this, which included former employees ("Doctors") of large healthcare companies who came forward about some of the internal politics of this - and the horrors of the policies that favor denied claims, etc.
Notwithstanding other really good advice and info here, of course.
Also, if you'd like to see another viewpoint and comparison of the healthcare industries of the world, see Michael Moore's "SiCKO" -- tho there is obviously a bias there, I found it quite interesting.
This is partly why this so-called "public option" has people up in arms. It's (mostly) about the money :-)
I think that's great that you're looking to get out on your own; I wish you the best of luck.
Facts. (Score:5, Insightful)
Leverage Groups (Score:2, Insightful)
Look into any kind of groups you have membership in especially professional associations. For example IEEE members (I believe after a year of membership) can get group health insurance, although I have not looked into lately it it may no longer be the case. Also organizations like AAA (yes the auto club) have discount prescription programs. Basically look at any group you belong to see if they have leveraged the power of their membership base to negotiate rates with insurance companies.
Re:Move to Canada (Score:5, Insightful)
[Move to Canada] and enjoy universal health care for about $100 per month for a family of 4, unless you can show economic hardship, and then it's free.
With all due respect, and I really don't mean this as a troll, but you aren't just paying $100 a month -- you simply cannot afford any medical system for that sum (even if you weren't screwed like the States into paying stupid large administrative costs) . In reality, a large fraction of the money for the health care system comes from taxes which you are ultimately going to pay.
I am a big proponent of some form of public healthcare but I dislike the fact that many of the people here in the US that are arguing for it will not acknowledge that it's simply going to expensive. They point to the naive out-of-pocket expense in Canada or The Netherlands without acknowledging the true cost of the system in the form of higher taxes. My position is that we can and should afford such expense but one does not do any favors to the debate by dissembling about the cost. If anything, it's ammunition to opponents that can point to your dishonesty in selling the plan.
There is no free lunch and there is definitely no first-world healthcare for $100/family/month. The closer figure it probably $650/family/month. Again, I believe it's a fine way to spend that money (and we are affluent enough to afford it) so I'm not approaching this from a position of ideological opposition, only one of demanding honesty from everyone.
Cite: http://www.nationmaster.com/graph/hea_spe_per_per-health-spending-per-person [nationmaster.com]. The exact numbers are highly debatable, especially since we don't know how much various plans will change the cost structure here in the US but $100/f/m is simply unreasonable.
I voted against the neocons (Score:3, Insightful)
Re:Be methodical (Score:2, Insightful)
I know plenty of people who have their own businesses... who have excellent health insurance coverage.
Perhaps it is because they understand that this cost is a necessary component of running a business, and don't spend their time whining about how it comes out of their "disposable" income.
It's not "disposable" any more than your business liability insurance is... or even more disposable than your grocery bill.
Why is it that you feel fine paying for food, but seem to expect healthcare for "free". If you aren't happy with paying for insurance, don't. Nobody says you can't pay out of pocket.
Finally, the state of Western medicine in EU, CA, and UK, is largely subsidized by the fact that they can license procedures and drugs from the US. In fact, the US is effectively subsidizing our socialist brothers abroad. And we don't mind so much... but we'd prefer it if you wouldn't badmouth us while we do it.
Re:-1 Troll and Uninsightful (Score:5, Insightful)
These responses of move to "XYZ" or move out of the US that are modded "insightful" is simple flamebait and does not help the questioner or add anything new to the discussion.
We get it, lefties. You don't like the US's health care system. Get over it. This guy is not going to move out of the USA simply because of health insurance.
Pfft. So in your view the whole world is 'left', and the US is 'centre' or something?
Re:Step 1. (Score:2, Insightful)
I think it's hilarious that there are all of these complaints about what basically amounts to triage, which is a practice that nearly every developed medical system engages in. Even those used by Americans who are lucky enough to have insurance.
But, hey, single payer systems are bad because "big government" is going to "socialize your wealth" and "destroy the American dream." Seeing as the average American has no wealth and only debt (at 24.99% interest, despite the bank bailout -- thanks, guys), what would be wrong with socializing that? We already do it for AIG. ; )
In addition to some of them having been bashed over the head with the idea that good health care practices are bad, people have been gradually indoctrinated by billions of dollars in advertising dollars that were spent by the health care industry. These efforts reach at least as far back as the 1960s. More recently, it's gone completely unchecked as the media outlets that were supposed to work for us surrendered to the will of the machine. There are reasons our more "capitalistic" (i.e., greedy) tendencies used to be more heavily regulated.
Re:Move to Canada (Score:3, Insightful)
Are you really that stupid? because you sound like it.
The magical health-care fairies are TAXES you idiot.
Only a raging sociopath, or completely greedy asshole is against paying higher taxes to make sure everyone around him is in good health.
so which one are you?
except "they" (Score:4, Insightful)
are often exactly the sort of lower middle class folk who would benefit immensely from socialized medicine
its like in the town hall meetings last summer, the old man who stands up and yells "keep your socialism away from my medicare"
it would be hilarious if it weren't so horribly tragic
i think it just boils down to incredible, horrible levels of high propaganda: the government is out to get you! the government is YOURS. it serves YOU. really
Re:Step 1. (Score:4, Insightful)
I think it's hilarious that there are all of these complaints about what basically amounts to triage, which is a practice that nearly every developed medical system engages in. Even those used by Americans who are lucky enough to have insurance.
Of course people complain about triage. I mean, who wants a system where I can't just spend more money to be pushed to the front of the queue so I can get my non-critical surgery performed ahead of the guy who needs a heart transplant? What the fuck??? I don't want my freedom to fuck other people over limited! Granted, I'm not rich enough to take advantage of that freedom, but I might be some day!
Re:Move to Canada (Score:5, Insightful)
In the US the insurance profits aren't actually all that much money. The real issue is that there is overhead EVERYWHERE.
Your doctor probably employs 1-2 people to do billing, because of the complexity of reimbursement. Your doctor nearly employs a lawyer as well with their malpractice premiums.
Your insurance company has 10x more people than it really needs - those don't count as profit, but they certainly bring cost.
Your hospital charges 10x what anything actually costs, because they have all the costs above and also have to provide "free" care to the indigent.
The tort and pay-for-service system guarantees that everybody is getting more treatment and especially more testing than they actually need.
Throw in another dozen issues similar to these and we can see why US health care is so expensive. Everybody likes to point at one thing and call it "the problem" but the whole system is one big mess. Most proposals to "fix" it amount to just shuffling money around so that people don't see the bills.
HSA - health savings account (Score:3, Insightful)
I have a individual (not group, not employer offered) HSA plan with a very low premium and a high deductible. Every month I put some money (about the difference between this plan's premium and a average premium plan) into my HSA account. Although the deductible is high, I save enough on the premium to basically put away twice the yearly deductible every year. The plan gives 100% coverage after deductible on everything covered (no coinsurance), and many things (annual checkups) are totally free even before the deductible.
In other words, in years when I have high medical expenses, my total costs work out about the same as a high premium, low deductible plan. However, in years when my medical expenses are low, I get to KEEP the money that I would have spent on premiums. The insurance company loves it because any expenses I incur come partially out of my savings, so there is a definite motivation for me to keep my costs as low as possible (which keeps their costs low as well, unlike other plans where there is no incentive for the insured to keep costs low).
And the best part is that everything I deposit in the HSA account is TAX DEDUCTIBLE and earns interest TAX FREE. When I retire I can withdraw from it TAX FREE as well. It is like the best parts of a Traditional IRA plus a Roth IRA, but I can use it to cover any health expenses I have at any time and with no penalties.
Bottom line is that I'm paying about 1/2 of what the equivalent coverage would cost from a regular plan, and in the best case I get to save a lot of money that would have been wasted on premiums and earn interest on it tax free, and in the worst case if I use up the whole deductible, I still get good coverage, lower my taxes, and earn some interest on the money. The only time I wouldn't recommend the HSA is if you get really sick a lot and have high expenses all the time, especially prescription drugs which aren't discounted as much in this plan.
The horror stories are all true (Score:3, Insightful)
As someone who's spent too much of the last decade out of work, everything you hear is true - like in Florida, over 13 mos between the end of '03 and the end of '04, when I ran out COBRA and got rolled into an "individual" plan, and the Republicans in charge of the state allowed, in two jumps, a ->ONE HUNDRED PERCENT- increase in premiums.
Consider finding a group to join that offers it - anyone know if either the IEEE or ACM offer plans?
mark "until we techno-peasants finally wake up, pull out the torches and
pitchforks, and ride the Republicans out of town on a rail, tarred and
feathered, and tell the remaining folks in Congress to pass single payer"
Re:I did the same for a while... (Score:1, Insightful)
Re:Step 1. (Score:5, Insightful)
And that's the real issue.
We in the US are not opposed to single payer health care per se; we are terrified of any possible implementation of it by our government.
Re:Step 1. (Score:5, Insightful)
You know how Mitt Romney et. al. are constantly talking about how the US has "the best health care in the world," WHO rating be damned? Well they're right - for people willing to pay you can receive better healthcare in the US than anywhere in the world. The question we should be asking is whether we want "the best" healthcare available to the rich, or really good healthcare available to everyone.
Re:Move to Canada (Score:5, Insightful)
Re:Step 1. (Score:5, Insightful)
"Some believe that it's an individual's responsibility to budget and take care of themselves."
Depends on where on the continuum you sit. If the state is is providing crucial services such as policing and fire rescue, why is it so hard to classify healthcare as one of these essentials that modern society needs to function?
There is no step 2 and no justice. (Score:5, Insightful)
The insurance companies hold all the cards.
Look at how the rates are climbing even as their profits are.
They are squeezing the last drop from your wallet because they know a single payer system is inevitable.
If you're going to be sick, you'd better not do it in the 'States. Its no place for you if you flinch at the thought of suing somebody who's only sin was being weak once (as we ALL are at least 15% of our lives.)
Other countries' health care systems may not be perfect but at least they exist.
The 'States have nothing even resembling a humane health care system.
What they have is health-don't-care systems.
Health care for profit is an oxymoron.
Re:Step 1. (Score:3, Insightful)
So we're apparently the only developed country in the world whose government can't be trusted to coordinate basic health care for its citizens. I guess that we have to conclude that the US government and its constitution don't live up to all the hype about their alleged greatness.
The US government sucks too much to handle a government function that is standard in every modern country, so we handle it privately to get less-than-average results at almost twice the cost of any other country.
Mod parent up (Score:5, Insightful)
The doctors could even make house calls if you had a sick child. A wonderful system, and about half the cost of our monstrosity.
Re:Move to Canada (Score:3, Insightful)
All true, and don't forget about adverse selection costs - as health insurance premiums have *doubled* over the last decade, more and more individuals and small businesses that have healthy, young employees opt out of health insurance entirely. Since this removes relatively healthy people from the pool, only the sicker and more costly insured parties retain their insurance, driving per capita costs of insured persons up. The numbers of uninsured are now significant, but there are tons of *less* insured people as well, or rather, those who have switched or been switched by their employers to high deductible plans.
Together, this is the health insurance death spiral that Paul Krugman wrote about this week in his NY Times Op-Ed. Though this doesn't really increase total costs directly, it clearly reduces the amount of preventative care younger, healthier people receive and probably eventually decreases aggregate health levels and will eventually increase systemic cost. It also causes the overuse of emergency rooms as clinics by the uninsured.
Then there's the costs of defensive medicine - though I've seen estimates that these are only something like 5% of total health care system costs, other estimates show they may be higher.
I'm sure we could come up with several more items like this if we tried.
Re:Step 1. (Score:3, Insightful)
You know, if the teabaggers were parenting this line, instead of just "UGH OOOGA GOVERNMENT BAD," I'd almost agree with them.
Re:Move to Canada (Score:4, Insightful)
Brainwashed socialists
Only Americans, can, after cutting their taxes on the upper class thereby shifting the burden of society onto the lower and middle classes, and then giving the upper class big bonuses for almost destroying the country, only Americans can complain about socialism for the middle and lower classes.
Socialism for the upper class is entirely acceptable in their brainwashed "Liberty to die" culture.
Re:Step 1. (Score:5, Insightful)
Now imagine that your uninsured 26-year old son gets leukemia instead of a sprained ankle. I'll bet you change your tune.
BTW, he's *not* being responsible. If he gets leukemia, he's not going to be able to afford the bills on "freelancing", but somebody else will have to pay after he goes bankrupt and ends up in the emergency room. You seem like a typical libertarian who socializes their risks and external costs by ignoring them.
Re:Step 1. (Score:2, Insightful)
1) Social Security - going broke - FAIL
2) Medicare - Corrupt and going broke - FAIL
3) Fannie and Freddie - Almost brought the world to another great Depression - FAIL
4) Department of Education - FAIL
5) Stimulus Package - FAIL
6) War on Drugs - FAIL
The list of government incompetence goes on and on. This is not a Republican or Democratic thing, it is a Government thing.
Why should anyone believe that the US Government could fairly, honestly, and effectively manage the Healthcare?
Re:I did the same for a while... (Score:3, Insightful)
Actually, in America, per-capita healthcare costs are thousands of dollars higher than countries such as Canada or the UK.
So we're all spending more on healthcare, but our coverage is less, and we don't live as long.
If we could make our system as efficient as Canada's, we'd spend less and everyone would have coverage.
Unfortunately, the Democrat's plans seem to be extending our existing bloated system to cover more people.
And the Republicans will occasionally give lip service to healthcare costs, but don't seem interested in acting on it.
Re:Step 1. (Score:3, Insightful)
The disingenuous Canadians know that rationing exists in the Canadian health system.
Uh, duh, of course rationing exists. Unless you have a doctor, surgeon, and nurse for every single person in your country, not to mention supplies, equipment, etc, rationing *must* happen. The question is, how do you ration? In the US, rationing is done based on income level: if you have the money, you might get treatment immediately. Maybe. 'course, that depends on where you live, the hospital facilities available, etc... after all, queues aren't exactly unheard of in the US. But in general, you might not wait as long for non-critical treatment.
In Canada and other nations, rationing is called "triage", and it's done based on who needs treatment first. ie, you'll get your knee surgery performed after that guy's heart transplant is completed and the operating room is freed up.
Now, which you prefer seems to be a matter of ideology. *I* happen to believe that healthcare should be delivered based on a system of triage. You apparently believe it should be delivered based on who can pay more.
Re:Step 1. (Score:1, Insightful)
Capitalism is the best, as long as you're in the high 6 figure or higher income range.
Re:Mod parent up (Score:3, Insightful)
You know what I find the most amazing aspect of American health care? The complete lack of house calls. If someone's sick in the US, they better have someone available who can drive them to the doctor, wait with them in the emergency room, then drive them back.
In France, a sick person can call up their family doctor, and, depending on the urgency, the doctor will be over within a day or two.
Granted, the fancy and high-quality medical procedures would cost you extra in terms of additional coverage through a private insurer. But at the core, no one was worried about breaking a leg at work, getting the flu or an infected appendix.
Compare that to the US, where I postpone doctors visit until the year rolls over, because otherwise my deductible will damn near bankrupt me.
To answer your question... (Score:2, Insightful)
"how the hell did we arrive at this retarded status quo and why the hell do teabaggers and republicans oppose simple common sense reform of a horrible stituation?"
1. Excessive pork: Cornhusker medicare, the "Louisiana Purchase", etc.
2. Insurance "mandatory purchase" likely to hit middle class. The same people lack coverage now will be forced to buy what they already know they can't afford.
3. Federally-subsidized abortion funding. Some are 100% in favor, some are 100% opposed. It's a polarizing issue, no doubt.
4. Taxation on "Cadillac" health plans; looks like a "redistribution of wealth" scheme directed largely at the middle class.
5. Special union exemptions from the "Cadillac tax". What happens when an employer has both union and non-union employees and offers the same plan to both? Oops.
6. No significant relief from the downside of relying on employer-sponsored insurance. Most of the population gains nothing under the House or Senate bills.
7. No increased competition for the healthcare industry, the insurers, the lawyers, etc. This means no price breaks will be coming anytime soon.
8. No public option. Combine this with #7 above, and we have a plan that offers less than nothing, at excessive cost.
The Democrats placed themselves in the position. Most of the time, compromise between Democrat and Republican yields a product that nobody likes. But in this case, the Republicans were ignored because they lacked the votes to do anything. Therefore, Democrats negotiated with themselves and their campaign contributors (the healthcare industry and insurers) and this is what they came up with. Strategically, it make sense to force the Democrats to play the lousy hand that they dealt themselves. Hold them accountable -- on election day.
Re:Easy (Score:4, Insightful)
Re:I did the same for a while... (Score:3, Insightful)
"As opposed to what? Somebody else trading 15 hours of THEIR life simply so YOU can live a healthy life?"
"Why should money I earn be taxed and used to pay for benefits for you?"
Uh, if you pay for your own insurance and file a claim, where do you think your insurance company acquires the money to pay for your claim? Do you honestly believe they simply pay you with the money you already gave them?
No matter what insurance you pay into, you *will* be paying for somebody else's benefit, as they will be paying for your benefit as well. That is the *very nature* of insurance.
If you *still* feel different, you should put your money where your mouth is and cancel all your health insurance policies and simply put those monthly payments into a self-guided investment account. ... and good luck with *that*.
Re:Step 1. (Score:2, Insightful)
You need to do better research. Evidence matters. Your gut is wrong.
1) Social Security isn't going broke.
2) Medicare is the highest rated insurance plan in the country, and is more efficient than every private insurance program - every single one. And it isn't going broke either. Republicans won't even touch it with all their anti-government bullshit campaigns.
3) Fannie and Freddie were fine until they were privatized. Please look it up.
4) Department of education has problems, but is mostly state run. Primary problem is it's regional funding, which is retarded.
5) Stimulus Package worked so well, the Republicans are running around taking credit, even though they voted against it.
6) War on Drugs is absolutely FAIL.
1 out of 6 ain't so bad - yeah it is. Seriously, the biggest problem in the US right now is people like you.
Re:Step 1. (Score:1, Insightful)
Only in America do we have a party that says the government can't do anything right, and then actively campaigns to be put in government. Turns out to be a self-fulfilling prophecy since they go on to sabotage government systems.
Re:Step 1. (Score:5, Insightful)
People willing and able to pay can receive the best healthcare in the world no matter where they are.
Re:Step 1. (Score:4, Insightful)
I resent that I might be taxed more to pay for medical procedures for some of my friends that could afford health insurance
The irony with this oft-cited opinion is that in the USA you *are* already being taxed more. The USA, on a per-capita basis, pays more for health care than nations with single-payer systems, yet millions go without coverage and find themselves bankrupted if they need a heart transplant.
It's the "No Fact" zone (Score:2, Insightful)
The US has been pillaging health care and education for years to fund it's overseas military adventures. They've shed the government of the responsibility of keeping markets competitive, the middle class is largely destroyed, and the top 400 households in the US have seen their tax rate go down, and income skyrocket. We are basically in the same socio-economic boat as pre-Revolutionary France.
So decades later we have a extraordinarily stupid populace, saddled with debt, but their only source of information are the corporations that are robbing them blind. They've "won" the debate by repeating lies, and even have people called teabaggers marching against their own values, for reasons they cannot even define. (Really, is there any better place than America for political irony?)
It's a cycle that will only be broken by major catastrophe. I was hoping the oil spike and the collapse of the market would be it, but it looks like it's going to get much worse before it gets any better. God knows I'm not sticking around for it.
Re:The grass was denied individual insurance due t (Score:4, Insightful)
Please, please, tell the Europeans about this. Our media try all the time to convince us that private is the best and socialised healthcare is crap.
People complain about our healthcare system all the time, they don't realise how worse it can be. The private corporations are taking over. We still have a solid healthcare system, but stuff like public-private contracts are rising, with disastrous financial consequences for the State, and loss of service quality. Now they're talking about giving the freedom to opt out of the public system, or choosing your private provider at the expenses of the State. If we don't stop this madness we'll be like the USA in a few years.
Umm (Score:5, Insightful)
If you can't afford to help your countrymen get health care, how can you afford to fight multiple major wars and lower taxes at the same time?
The only problem with the Republican viewpoint on government spending is that it doesn't make any fucking sense.
Re:-1 Troll and Uninsightful (Score:1, Insightful)
Honestly, that's the most ironic thing about American "conservatives"
They see themselves as center, and that any viewpoint deviating from their own is far to the left. Frankly, there's an element of truth to it, but only because nothing exists further to the right, so left is the only direction to go... still, they are unrelenting in their assertion that they are mainstream, center, and they know just the way everything should be with their so-called common-sense approaches to governance (or, more realistically, non-governance.... unless some gay guy winks at them and makes them uncomfortable enough to make some wingnut legislation to prevent it from happening again). They leave no room for compromise, because their opinions aren't opinions at all... they are undeniable god-given facts which are beyond question or reproach.
Re:You got 2 choices (Score:3, Insightful)
Congressman Alan Grayson (D-FL) argued [youtube.com] exactly that point on the House floor. Although I prefer this version [youtube.com] (about 50 seconds in) of the same speech.
Re:Step 1. (Score:3, Insightful)
However, are any of those government failures worse than their equivalent in the private sector?
1) Social Security: companies are dropping pension plans, and now, even suspending 401k's. Private investment (Wall Street) = a negative return over the last 10 years (unless you work at Goldman Sachs. Call me when govt. SS administrators are writing themselves checks for multi-million dollar bonuses).
2) Medicare: companies are reducing and dropping health plans or increasing rates, almost universally.
3) Fannie and Freddie: did no worse than any of the banks, i.e. terrible.
4) Dept of Education: not even sure what to compare to in the private market. Without public education the US would truly revert to the dark ages.
5) Stimulus: without govt backing the banking sector followed by the rest of the economy would have collapsed, period. The rest of the stimulus succeeds in proportion to how much is spent, but it's small relative to the whole economy, so the effect is small.
6) War on drugs: yes it's a fail, but it's also a very hard problem. Just legalizing pot wouldn't fix it all.
Re:Step 1. (Score:2, Insightful)
You do see the stupidity of this situation when you start looking at the fact that you are dealing with your life and the lives of those you love. If the doctor confronts you to tell you that your wife is dying, and that he can save her, but the procedure is very expensive and you could not afford to pay it even if you worked the rest of your life, what do you say? Of course you don't say no, you insensitive clod! Hence, the reason why a personally "responsible" system will never work well (which is what we have right now in the US) as long as there is room for someone to profit off another's misery. The key word is profit.
We can look at it from an economic perspective, if you will. Currently, with our system, if someone is unable to afford health care, they go to the emergency room. Once in the emergency room, the health provider is obliged by law to provide service until the person is no longer in threat of losing their life. Since the person has no means to pay the bill, the amount ends up being "written off" by the provider. The provider then increases the amount they charge to all the other patients who are able to pay to offset the loss from those who are unable to pay. At emergency room prices. So in the end, we are paying for other people's care anyway, at the most expensive price possible.
But, economics aside, we have to ask ourselves the age-old question, "Am I my brother's keeper?" It comes down to a moral argument whether or not, in a society, we are not only responsible for ourselves, but for each man and woman our lives happen to touch. I for one believe this to be very much true, and that if it is within our means to make the burden easier as a society, then we should do so. Just as we provide police forces to protect the innocent and fire departments to minimize the risk of losing large amounts of property to uncontrolled infernos, we should provide a mechanism that allows everyone access to health based upon need, not wealth. Every other major industrialized nation has already responded to this question, and they have all decided that it is better for society as a whole if society as a whole is healthy.
This is good advice if you're healthy (Score:3, Insightful)
If you have prescriptions or a chronic condition like diabetes, move to somewhere with socialized medicine (seriously). If yuo're pretty healthy, give the HSA a shot.
Here's the thing about healthcare - it's only stupid expensive if you're uninsured. That sounds odd, but it turns out that if you don't get negotiated rates with providers, they will charge you an outrageous amount. Often the "rack rate" for a procedure is between 3 and 10 times what large payers like Anthem have negotiated. A $2000 exploratory ultrasound in the hospital might only be $250-$300 allowable charges once Anthem applies their discount. Wart removal? $200 rack, $40 negotiated.
The HSA has two parts - you pay for your "routine" healthcare, but at the Anthem (or whomever) discounted rates. Often you get a physical for no charge each year. If you mess yourself up, or you contract some serious problem, you pay out up to your deductible (usually $3000-4000 for an individual) and - this is the good part - the insurance company picks up 100% of your bills after that. And for all this, your premiums will be about half what they would be under a co-pay plan, plus you get to put away money tax free.
I'll tell you, If you get hit by a bus, that 80/20 plan you have with your employer will eat you alive. It's very simple to rack up $100k in medical bills for a major life event.
Now, it's not perfect. As an individual, your insurer has the chance each year to decide you're too expensive and cancel your ass. (This is where group policies are better, but for healthy people will double your premium) Also, there is no defined prescription coverage - you pay what the insurer would have paid. For "regular" prescriptions, it's often LESS than the oh-so-advertised $4/prescription that many chains have now. For name-brand drugs, though, you could be in for serious costs. So if you have maintenance meds, check to see what the insurer's negotiated rates are before you jump.
Personally, I like the HSA. I get to get whatever care I want, I pay discounted rates for what I consume, and if I have a stroke or a heart attack my maximum out of pocket costs are going to be capped pretty low. And those costs - it turns out - I get to legally hide from the IRS if I'm a saver. Quite honestly - if you and your family are healthy - you can likely cover your whole family, plus the maximum IRS deduction - for the same amount as a group plan would have cost. After two or three years of being healthy, you should have enough in your HSA account to cover practically any major medical catastrophe with little to nothing out of pocket.
And, hey, isn't that really what insurance is about? Protecting you against the major loss?
Re:Step 1. (Score:3, Insightful)
The only reason the US government would fuck up healthcare is simply because the citizens don't care and aren't as educated enough to be voting but they do and for stupid reasons.
The government isn't at fault when they cock up, it's the voters who are.
Re:The grass was denied individual insurance due t (Score:2, Insightful)
I do wish we could go back to how medicine was a few years back...where you didn't depend on insurance for EVERYTHING, it was for emergencies (something catastrophic like a heart attack or car wreck). In those days, costs weren't too outrageous, you paid for your routine care, usually with a family physician you had for most of your life. That indie GP doctor could and often would charge based on a person's ability to pay.
The HMO's and bean counters with insurance co's kind fscked that up. I think we could go a long way to having the best of all worlds if we could first allow medical insurance to be sold across state lines. I'd like to see the Geico gecko pitching medical insurance just like he does motorcycle insurance. That competition alone would help drop prices. Make it easier for private individuals to band together to get group rate insurance.
And lastly...make it MUCH easier than it currently is, for everyone to be able to open and fund a Health Savings Account (HSA) pre-tax. Make the requirement to have a high deductible go away...that way, people can save year after year (with savings rolling over) for their routine medical care. I love the HSA...and I've often used that with doctors, when telling them I'm paying for the procedure or office visit rather than insurance, they usually cut me a 15% break on the price right on the spot.
The part about pre-existing conditions...that I'm not sure how best to handle. If we *did* have to have a govt. sponsored thing to take care of those that were uninsurable, that might work..lump them in with the Medicaid people maybe. I really don't want a public option because of what it can turn into.
The current nightmare of corruption and inability to contain costs that are Medicare and Medicaid right now, are perfect examples of how the govt. can fsck health care up.
Frankly before they can even start looking at socialized healthcare here in the US, I'd like to see them clean up the Medicare/Medicaid mess they currently have.
Re:Easy (Score:1, Insightful)
I'm going to call BS on this. Your friend found a NHS(free) dentist? They havent been seen in years...
On a serious point, UK health care can be patchy. For every horror story you'll find an amazing one and in general it will be in the middle. Getting ill, breaking a bone will not lead me to fight with an insurance company, or worry about hospital bills. Hell all I need to worry about is parking costs, and thats alot less than $1000 a month...
And if you can afford it you can still go private, or get insurance so its not like your stuck with the NHS.
Re:Step 1. (Score:2, Insightful)
Um, Canada is significantly MORE invested, at the federal government level, in "advancing social agendas" than the US has ever been. What Canada does not have is one major political party that sees demonizing government as their royal road to power. Canadians see value in using public resources for the public good- they may disagree about what that good should be, but the basic principle holds- as it did in the US until recently.
Before you wax too poetical about the glories of unfettered free markets and how government screws everything up, please reflect that there are many things we do through government exactly because it is the most efficient way to accomplish the task. Not perfect, surely, but most efficient. Police and fire protection, most emergency services, public works like water and sewer, roads and bridges, public safety agencies like the FAA, and the courts come to mind. Those are actually pretty good analogs to the heath care system because they are either not everyday needs of most people or exist in the background and are taken for granted, and most of us are not expert enough to chose from "free market" alternatives. So we collectively- through our government- provide for important public needs. Think having everyone hire their own private police would be more efficient?
Health insurance and health care are examples of markets that don't work well, because of fundamental problems of asymmetry of information, and because when consumers opt to save money on health care they often do so in ways that cost the overall system more and create worse outcomes (not getting that mole checked). On the flip side the push to consume excessive services it not that great ("think I'll just go have another colonoscopy, after all it's free"). Health care is just not the same sort of commodity as groceries or computer hardware. The health insurance market is a market that has failed to deliver what "free market" fundamentalists promised, because we don't consume health care the way we do other consumer goods.
I am a very "productive person", as you put it, but I am screwed by the health insurance system in the US. As an independent entrepreneur designing technology products that will employ many people in US manufacturing, I am acutely aware that the monolithic health insurance companies do not want my business, that as an individual I must pay far more than large companies pay and receive worse coverage, that I could be shut out altogether at any time, and that I have zero leverage as a consumer. That is a huge disincentive to the kind of risk taking entrepreneurship we need more of. The original poster is up against a real dilemma- probably solvable if he is young and healthy, but if he has a child or spouse with health problems, or is over 40, forget it.
In the real world public health insurance is a policy experiment that has been carried out many times. Other industrialized countries cover everyone, spend a fraction of what we do, and have, by any rational measure, better overall outcomes.
Even F.A. Hayek used health insurance as an example of an area where government should intervene- because it is genuine insurance against individual catastrophe, NOT managing an industry or determining outcomes: “Nor is there any reason why the state should not assist the individuals in providing for those common hazards of life against which, because of their uncertainty, few individuals can make adequate provision. Where, as in the case of sickness and accident, neither the desire to avoid such calamities nor the efforts to overcome their consequences are as a rule weakened by the provision of assistance – where, in short, we deal with genuinely insurable risks – the case for the state’s helping to organize a comprehensive system of social insurance is very strong Wherever communal action can mitigate disasters against which the individual can neither attempt to guard himself nor make the provision for the consequences, such communal action should undoubtedly be taken,” – The Road To Serfdom (Chapter 9).
Re:There is no step 2 and no justice. (Score:4, Insightful)
Why don't people have a right to health care? Nobody's sufficiently answered that question to my satisfaction. Clearly we have the technologies today to give healthcare to everyone when they need it, so it's not a problem of scarcity or anything. Is your only argument that you don't want your money to help anyone but yourself?
And I also note the way you stated that, that someone "who works" shouldn't have to pay for other peoples' healthcare. Are you so naive that you believe only the unemployed are uninsured, or that conversely, everyone who works has access to immediate, affordable healthcare that won't drop them upon an expensive illness?
The resistance (Score:2, Insightful)
The resistance to it (outside of pure ideological) is coming mostly from people seeing how other federally run programs work or, more accurately, don't work. The US has tons of government "things" that just don't work, are a big fat waste of time and money, say for instance, the entire federal department of education, and the war on some drugs. We got by swell when the fed dept edu didn't exist.
As to medical, as an example, talk to some older combat vets how their federally run health care has been handled. For every one good story you'll hear ten horror stories. For instance, I have a good friend who had to wait over *thirty years* for the government to admit that yes, he did in fact have pretty nasty dioxin poisoning from agent orange. He then got a lot of back disability and some proper care. Not like his obvious bad chloracne he had the whole time was any clue to the docs there...
Health coverage in the US used to be cheap and affordable for most, even with low paying crappy jobs. I mean I distinctly remember this. I'll skip prices, mostly because you won't believe me, and just relate hours worked, 5 hours a week at a lower paid blue collar job covered it fully. Not mid middle class or higher, lower near entry level wages. It changed to way more expensive after medicare and medicaid got started.
We could stand some health care reform here, but European or Canadian styled just isn't going to work very well. And especially in this economy where they have been hell bent for leather to kill off wealth creation manufacturing jobs. No money=I don't care how many laws they pass, they won't be able to afford it. The US is *already* freeking bankrupt now as it is. Just *servicing* the debt we have now is hugemongous. We just don't need a single penny more government expense. We need to get a handle on that before we go thinking up more new ways to spend money. We need real wealth creation JOBS as the first ten priorities before we need anything else from the feds. Not service jobs, not more government employees, solid real wealth CREATION jobs.
Cheaper healthcare here could be garnered a number of ways, right off the bat, open up the dang medical schools, get those costs down, and start pumping out GPs, and get them in little towns all over, so people don't have to rely on expensive hospital visits for minor stuff. Maybe come up with a new classification for entry level minor care doctor that is an easier and cheaper schooling option, a first call care guy. Get more nurse practioners out there, which are similar. Open up insurance to more competition. Open up the generic drugs. Open source ANYTHING that uses one penny tax dollars for research. Make that open source viral. Stop letting the pharmcos get away from shifting one minor molecule on drugs to get perpetual patent extensions.
Stuff like that. I even thought a big national daily lottery with half the proceedings going to pay out the winners and the other half to fund open source medical research would be spiffy. I bet they could rake in tens of millions of bucks daily just with that, all voluntary. How about X-prizes for actual *cures* instead of symptom treatments?
Re:The grass was denied individual insurance due t (Score:4, Insightful)
I thought making profit was a corporations job, not the governments?
The government has no incentive to save money. There are no fat bonuses waiting for government employees who excel at saving money.
Now, if you were talking about a for-profit corporation, I'd see your point. They'd happily deny you coverage if they see the slightest chance of weaseling out of it just to improve their bottom line.
Re:Easy (Score:4, Insightful)
And earlier this month Rep. John Murtha of Pa., while in the care of the most expensive health care system in the world, died after a simple gallbladder operation was botched.
Fixed that for you.
Re:Step 1. (Score:2, Insightful)
Re:Step 1. (Score:2, Insightful)
Indeed, who to trust?
(a) A for-profit company where the CEO and board gets kicked if their bottom line turns red. Denying treatment after you have made the payments is by far the most profitable (unfortunatly for you).
or,..
(b) The society at large, ultimately represented by the government, which has a huge incentive to cure you and get you back to work as soon as possible so that you can pay taxes again instead of living off what others pay.
The government fails in the case of the US of A because you have insane politicians who care more about their wallet (health industry and medical company payoffs ("campaign contributions")) and their impending retirement benefits than they do about the normal man on the street.
USA is a very nice place to be rich im sure. Unfortunatly that only applies to 1-2% of the population.
USA is going down the toilet sooner or later. I think (and hope) sooner. (The world doesnt need another police state)
Re:The grass was denied individual insurance due t (Score:2, Insightful)
The government has plenty of incentive to save money.
Healthcare costs are rising faster than GDP across the western world, it's either sve money, or increase taxes, which is a sure fire way of losing the next election.
There's a hell of a lot of money wasted on people who are going to die in the near term anyhow, sure it's tough to say that we can't afford to keep granny going, but there's got to be some ratioinale behind it all or all you end up doing is continually patching up the same crumbling sand castle.
Re:Easy (Score:2, Insightful)
That operation occurred at Bethesda Naval Hospital which is controlled by the US Federal government.
Re:The grass was denied individual insurance due t (Score:3, Insightful)
Citation needed.
If that is true, you are in bigger trouble maintaining a purely private health system. With public health insurance you have reduced operating costs due to no need for marketing, sales, corporate bonuses or dividends. With private health insurance you have the same costs plus marketing, sales, corporate bonuses and dividends. Pay attention to the last one, dividends, the primary drive of any private company is to deliver higher dividends (plus higher divs equal a higher bonus) so they can only do this in one of two ways, reduce costs or increase prices. Given a monopoly over distribution be it natural or artificial there is no impediment to raising prices.
So public health is cost + administration. Public health is cost + administration + sales + marketing + (dividends + bonus > last year).
I pay A$750 a year for complete cover (this is the Medicare levy from my tax, shock horror it's a separate line item on my return). How much is your employer paying, remember this may as well be taken directly from your wages as it's not coming out of the kindness of the employers heart (Read: if they could get away with not providing it they would).
Re:It's the "No Fact" zone (Score:1, Insightful)
Re:The grass was denied individual insurance due t (Score:3, Insightful)
The problem is, at least in the UK- presumably the same elsewhere, governments are getting ever more sloppy, coming up with new schemes that no one wants or gives a shit about, the schemes always over-run and end up costing more, so money has to be found and is taken from elsewhere.
So it's not that they have to make a profit, it's simply that they have to take money from the important services, to pay for their fuck-up pet projects.
So by "saving money", what they mean is that they're taking money from things people do want, to give to 0.0001% of the population some shitty little scheme that allows them to get away without having to work for a living like everyone else or something similar to that- that's the general pattern in the UK at least.
Re:There is no step 2 and no justice. (Score:4, Insightful)
"Why don't people have a right to health care?"
The same reason people don't have access to a socialised police force, fire brigade, or military.
Oh wait.
You're right, the argument against socialised healthcare in the US is utterly irrational, because the same arguments could be applied to the police force, but the idea of having to pay police insurance, fire insurance, military insurance should your house get robbed/set alight/attacked by North Koreans is obviously equally stupid. Imagine quibbling over filling in the forms for your fire insurance as your house burns down or is being robbed only to be told you're not covered after all, Fun! But still that's the reality of what those arguing against socialised healthcare would expect if they were to stop being hypocrits and applied their same arguments rationally to all public services and not just the one the talking heads on TV told them was bad because it is and they say so because it'll turn America into communist Russia.
Does your son carry a DNR on him? (Score:4, Insightful)
I hope your son carries a DNR on him, because that's what a responsible uninsured person would do.
Your son chooses not to carry insurance. If he has an accident, like say FRACTURING HIS ANKLE, and that fracture throws a bloodclot, which leaves him screaming in frantic pleading agony for a while before he passes out from the pain, then some spendthrift schmuck might call 911 and get him an ambulance.
Have you priced an ambulance ride followed by ER treatment lately? The last time one of MY INSURED and therefore RESPONSIBLE children ended up in the ER -- no ambulance ride mind you -- two hours of occassional treatment, a grand total of 10 minutes with a doctor, came to more than $3,000, paid for by my money.
But your clumsy, irresponsible blood-clot-throwin' welfare-queen son, just racked up at least 10, probably more like 20 grand of debt. You know what he's gonna do? He gonna declare bankruptcy and stiff that hospital on that bill, cause twenty-something kids who can't find a real job don't have 20 grand laying around. Then MY TAXES, MY MONEY are gonna get pulled in to cover the slack because your boy doesn't want to get up and go to work in the morning.
So, if he wants to redeem himself and stay responsible, he can at least carry a DNR rejecting care and demanding that the ER doc let him die screaming and solvent.
Wake the hell up, man. You're too old to keep buying this crap. Your twenty-year-old kid didn't wisely negotiate medical care with the hospital and force them to alter their billing practices. He was the recipient of some form of charity, but you're too thick-headed and vain to admit it to yourself.
And I'm glad he was. I'm glad he got the care he needed, and I don't mind that some of my taxes probably went to pay for it. I don't mind my taxes paying for your boy because one, I've got a working heart, and two, I understand the health of the herd affects my health too. A sick cow in a healthy herd will eventually make the whole herd sick, so I don't mind keeping your boy in good health, because in doing so I deny sickness a place to take hold in the herd I live in.
Let me put that in plainer terms for the benefit of the slow. If the busboy at your restaurant is sick, then you're about to be.
But hey, John, as someone right there beside you, let me tell you about your health. You ain't as young as you used to be, and you can feel it. You wake up slower in the morning, but you don't sleep as well. Stuff breaks, and it takes longer to fix. Trying to stay in shape gets harder and harder, and no matter how hard you work, you're still losing ground. You don't quite hear as well as you used to, but no one notices it yet. You ain't seeing quite as good, but you ain't gonna let on. You've had that scary moment when you couldn't quite catch your breath, even when you know you should have already.
We ain't even gonna talk about your prostate yet, are we? :-)
We're playing a good game, we got everyone fooled, but we get the scent in the wind. Dying ain't a theoretical possibility like it was when we was 17. Well, we think we got everyone fooled. Our wives know it. Well, mine does at least. Why do I get the feeling you're divorced?
Cancer. Heart attack. Diabetes. Stroke. That's what you and I got to look forward to John, and it's as scary as hell, looking down the barrel of words like that. Diapers and Dentures will eventually get us all.
Ain't it time we put down the macho bullshit and see if we can't take care of our kids yet? Two or three more decades, you and I are both gonna be gone, but our kids will still be here. Ain't it time we find a way to give them the same level of care we'd give to THE DAMN ANIMALS IN THE BARN?!
Re:The grass was denied individual insurance due t (Score:3, Insightful)
Re:Step 1. (Score:3, Insightful)
Sounds just like here in the US, except you'll get a bill for $6000 or so.