Health insurance

[kanshow]

Red, it really stinks... 

  My parents are self-employed and very healthy until Dad got cancer.  The insurance company paid for the first cancer surgery & treatments at MD Anderson but then tried to drop them after Mom fell and broke both legs which required surgery.  They'd had the insurance for years & years with no big claims and then two major claims within 6 months of each other.  They finally worked it out and were able to keep the insurance in place as it was only the premiums skyrocketed.    I think Dad was 2 - 3 years from being eligible for Medicare so that may have been a factor.    Dad has since had 2 more surgeries at MD Anderson & both were covered under Medicare.  The uncovered expenses were a huge eye opener to all of us & now DH & I have a cancer policy that will pay over & above what the health insurance does /does not pay. 

We feel pretty fortunate to have the plan we have now.. but dont' feel great about paying out the you know what for it.  The insurance policy is actually in my name with hubby & the kids being covered on my policy.  This is for tax purposes - I am listed as an employee with insurance being a benefit.     

 

[cattlejunky]

Red and all,  We are self employed and have Anthem BCBS direct thru Anthem.  You do not have to go thru another agent.  My husband and son are both asthmatics and take 4 meds each a month.  We have a Health Savings Account and coverage with Anthem.  We pay $471 a month for a 5 million dollar policy.  Our deductible is $4800 for the family.  after that the insurance picks up 80% until we have $6000 out of pocket then they pay 100%.  the great thing about Anthem is you get the PPO discount at several Dr. & hospitals.  This can save you some out of pocket money.  On a Health Savings Plan they are not as picking on conditions becasue you are paying the first $4800 out of your pocket.  You can also sock money away tax free.  The most important thing I can say is you need to make sure you get a plan that has a high lifetime max.  I also recommend you research co-pays.  Alot people think oh I just have to pay a $20 co-pay when I go to the dr.  Make sure you figure it up.  You co-pays do not fo towards your deductible so you can actually end up spending more money out of pocket.  Hope this helps

 

[BJN]

Reading these posts drives home the point that we are ready in this country for some type of universal coverage.  I watched cspan the other night and they had this guy (J. R. Reid - for what it is worth) who had researched all of the health care systems in every industrialized nation on earth.  He actually traveled to the countries, talked with the people in charge of administering these systems, got all the financial details and published the results.  It was an eye opener for me.  Of all of the countries he visited and studied, Switzerland had the highest per capital cost for their health care system.  And now for the interesting part . . . we right here in the U.S. spend twice as much per capita on health care that they spend in Switzerland.  He also said that 20,000 people die in the U.S. per year because they have no or inadequate health care.  These are people who are afraid to seek out help because of the cost.  There are almost 50 million Americans without health insurance.  Red, what are you going to do if your husband has a heart attack or some other serious health condition with no insurance?  You entire net worth can be consumed in very little time.

I am sure I will be labeled a "socialist", "communist", "tree hugger", "liberal", "democrat" or some other term just for bringing up the thought of universal health coverage, but I guess I think it is time we start having the discussion in this country.  We live in the greatest country in the world and we can't provide health care for all of our citizens.  Every other industrialized nation does it - why don't we?  As long as you are healthy, our system works fine, but when you are between healthy and medicare age you are simply at the mercy of an insurance company.

Just for the record, I am not a "socialist", "communist", "tree hugger", or "democrat".  I will admit I am definitely more "liberal" than the bulk of the people who will read this.  The conservative/liberal thing confuses me.  I don't believe for one minute that George Bush is a conservative.  The republican party of which I am a member used to stand for fiscal responsibility - that obviously is not the case anymore.

In view of the foregoing thread, I would be interested in hearing some opinions as to why universal health care coverage is either good or bad for us as a nation.

 

[JbarL]

its not really national health " care'' that is up for review..........its national health "pay".....that is at issue....what is the difference in a self employed farmers family health cost and needs  .....and a self employed illegal immigrants family helatlh costs and needs?......one worries deeply about it....and one doesnt......i think the difference in opinions are based on if yoiu believe what you here or what you have seen or believe....we have all "heard" that it just wont work...."socialized medicine, as many like to refer to it....simply sub standard care they say......maybe if we called it " congressional medical"  or "armed forces medical" folks may get the picture....and then you  have the opinons of the those that  have seen it in place and working..........can you imagine our present system  "  working" on 9/11 in new york?........"i'm sorry sir, but your going to have to sign this finacial wavier to remove that piece of glass from your arm.....your policy dosent cover surgery costs for that particular injury....oh by the way.....you'll have to go to jersey to get your re hab... that carrier is not on our list"....the only other hope is that your job becomes one of those that
" amercians won't do".....then you get the same national health '" pay" plan as they do ...dosnt make mcuh sense.  jbarl

 

[red]

Thanks CattleJunky but the hubby has been turned down just about everyone. Me I am taking8 med's each day. No, I'm really not a hypochondriac! One would think so!

BJN- I'm sure Knabe will have a field day w/ this topic. Too be honest I've never felt I've gotten the straight story about universal coverage & were it will come from.

BTY, I whole heartily agree w/ your comment on Bush. I thought we'd have a strong conservative that would stand up for what he said. That's why I'm also very skeptical of McCain.

Red

 

[Dusty]

The reason quality goes down with socialized medicine is that there is no incentive to do better.  I have distant relatives that still live in Denmark and the consensus from them on socialized healthcare is that if you want worked on by a good doctor and not have to wait 6 months you open your checkbook or you have private health insurance.

I do find it interesting that medical procedures that are considered elective or cosmetic (plastic surgery, botox, lasik surgery etc), and subject to the forces of the free market, get better every year and get cheaper every year for the most part.... 
Compassion doesn't cure diseases....  Capitalism does...

 

[BJN]

I just don't understand how Canada and the UK (I think) have socialized medicine and it is obviously not working but our government for some dumb reason thinks it can work for us.  Yeah, the same government that can not even run a restaurant thinks they should be in charge of our health care.  What is even scarier is that people think this socialized medicine is a good thing.  Seriously if you think that is a good thing- we need to talk 

Fluffer

How do you know that the health care systems in Canada and the UK don't work?  I know we have some friends from Canada on this board.  Maybe they will give us their experiences.  Just so we have a benchmark:  I spend $495 per month on health insurance for my family of four.  That buys me a $5,000 per person deductible and an 80/20 copay after the deductible is met.  That is a per person deductible.  I think there is an out of pocket maximum per year of $15,000 for the family.  There are two riders on my policy for health conditions that my wife and I had before we had this insurance, so if we have any ongoing problems with those conditions, we have zero insurance coverage.  I am insuring only against the catastrophic health problem as long as it isn't covered by a rider.  If we have problems with the excluded conditions, I suppose we will just deed the farm to the hospital.

I would be interested in hearing from our friends from Canada regarding the cost of their health and exactly how it works.

 

[JbarL]

I just don't understand how Canada and the UK (I think) have socialized medicine and it is obviously not working but our government for some dumb reason thinks it can work for us.  Yeah, the same government that can not even run a restaurant thinks they should be in charge of our health care.  What is even scarier is that people think this socialized medicine is a good thing.  Seriously if you think that is a good thing- we need to talk 

Fluffer

How do you know that the health care systems in Canada and the UK don't work?  I know we have some friends from Canada on this board.  Maybe they will give us their experiences.  Just so we have a benchmark:  I spend $495 per month on health insurance for my family of four.  That buys me a $5,000 per person deductible and an 80/20 copay after the deductible is met.  That is a per person deductible.  I think there is an out of pocket maximum per year of $15,000 for the family.  There are two riders on my policy for health conditions that my wife and I had before we had this insurance, so if we have any ongoing problems with those conditions, we have zero insurance coverage.   I am insuring only against the catastrophic health problem as long as it isn't covered by a rider.  If we have problems with the excluded conditions, I suppose we will just deed the farm to the hospital.

I would be interested in hearing from our friends from Canada regarding the cost of their health and exactly how it works.

......bjn....your policy is about identical to mine....premium/ co pay/ dectudable /80/20/ out of pocket, stop loss ,ect  .......about $5500.00 yr.....and of course thats even if we have a "healthy year" and dont even use it....one of the ironies is.....in todays standards  these are "great" policies we have....i dont no of any that are much better...coverage wise or price wise.....but the one greatest ironies for me is ..living if fl.....there are probally more doctors in the citrus co phone directory than there are car dealers  and restaurants in the franklin co ohio phone directory.....they are everywhere...unfortunattly......there are only 2 in the county that take my insurance.....so not only is the costs/ with all the "non coverage" and rider exclusions and bit hard to swallow......but we cant even go to the doctor we prefer .......how  many other folks face  that as well ?..........kinda makes me feel like i already have a socialist health care plan.....i am quite interested as well to here from our canadian members...jbarl

 

[knabe]

Hey BJN, i'm not put off by your comments at all.

my health plan at work allows me to sock away pretax dollars and accumulate forever, and i keep the money when i quit, (though i haven't investigated how to transfer it to a new plan), sadly not the plan, though why one can't do that i don't understand yet.  i'll read this over on monday and respond more.  these are great posts, as good as the bull posts.

 

[worthabit]

I just don't understand how Canada and the UK (I think) have socialized medicine and it is obviously not working but our government for some dumb reason thinks it can work for us.  Yeah, the same government that can not even run a restaurant thinks they should be in charge of our health care.  What is even scarier is that people think this socialized medicine is a good thing.  Seriously if you think that is a good thing- we need to talk 

Fluffer

How do you know that the health care systems in Canada and the UK don't work?  I know we have some friends from Canada on this board.  Maybe they will give us their experiences.  Just so we have a benchmark:  I spend $495 per month on health insurance for my family of four.  That buys me a $5,000 per person deductible and an 80/20 copay after the deductible is met.  That is a per person deductible.  I think there is an out of pocket maximum per year of $15,000 for the family.  There are two riders on my policy for health conditions that my wife and I had before we had this insurance, so if we have any ongoing problems with those conditions, we have zero insurance coverage.  I am insuring only against the catastrophic health problem as long as it isn't covered by a rider.  If we have problems with the excluded conditions, I suppose we will just deed the farm to the hospital.

I would be interested in hearing from our friends from Canada regarding the cost of their health and exactly how it works.

we may have our problems up here (long wait times, doctor shortages etc.) but I wouldn't give up universal health care for anything. It is so comforting to know that whatever happens to you or your family, you will be taken care of.

There are lots of costs such as some drugs and travel costs that you would be responsible for but that is nothing compared to the tens of thousands (maybe more?) that surgeries cost.

we have a family health insurance through our federation of agric. that costs us approx 250/month and covers things such as drugs, eyeglasses and dental.

Two years ago I nearly lost my thumb in a sawgear accident. It happened in November on a weekend. We only have one plastic surgeon in our province and he was off that weekend. The next closest doctor/ hospital was not accepting out of province patients so I ended going to Halifax, Nova Scotia (approx 3 hrs.) The surgery was set up for January when I got there, the surgeon had been in emergency surgery all night and mine was put off till the next week. That week there was a snow storm and they couldn't get any patients home to free up a bed for me and his operating time was oing to be cut in half due to cutbacks!  My mother works in the local doctor's office so he got me an appointment with a plastic surgeon in Moncton, New Brunswick (approx 1hr away but in the next province) and finally had the surgery in April.

So yes it is not a perfect system, but I don't mind paying a few taxes for it.

 

[knabe]

http://www.ibdeditorials.com/IBDArticles.aspx?id=299282509335931

"We thought we could resolve the system's problems by rationing services or injecting massive amounts of new money into it,"

(i might add that the massive amounts of money is ALWAYS taxpayer money and with it's always bloated infrastructure compared to private solutions.  i might also add that government employees always have lifetime benefits as opposed to a private sector solution that is usually not lifetime, but is shared contributions between the employee and employer or completely financed by employee, especially if self employed)

http://www.ibdeditorials.com/IBDArticles.aspx?id=299282509335931

if this isn't the democrats solution to everything, i need to see examples otherwise

 

[JbarL]

does anyone remember what the amercian health system was like in the 1960's??  ? as i recall in the 60's....the only health "insuranced" were governtent/state  employees and those with "good" jobs..( ie  dupon,union carbide, general electric, ohio power..trade unions...ect )...tht was the gig then..." go out and get you a job that has health insurance.....jsut exactually what kind of "insurance" did or our grandparents have?  i believe mine called it "egg money"....how did they affored these 40 pounds cysts..cancer, lung diease, arthritis, carpal tunnel, and a host of other dieases back then and how mcuh does it cost for them now.....both in the us , britian and canada...  the 60's is when our "systems" were started in the united states ( ironiconally the same time mr cantonguay in canada seen a need for a health system)........health insurance was incentive for employment, employers could attact a better long term employee with benifits........you remember...back when yo bcame an employee of a company and workded for them for 30 yrs, and you added some money and they matched....and when you retired...you had money to live on....heatlh insurance worries  back then was simply a "consideration, we never expected could get to this extent"..i believe a 40 year old system of any kind can go stale in any country.....mr cantonguay's system seems to have lasted about as long as ours ...kinda courious as to how they address it this time, compared to how we address it this time....knabe...your analogy of "maintaning stamina in a sword fight in mud" describes how we seem to be addressing so many of our problems today....not sure if those words were yours  or a quote....but wise words for sure.....jbarl

 

[Dusty]

does anyone remember what the amercian health system was like in the 1960's??  ? as i recall in the 60's....the only health "insuranced" were governtent/state  employees and those with "good" jobs..( ie  dupon,union carbide, general electric, ohio power..trade unions...ect )...tht was the gig then..." go out and get you a job that has health insurance.....jsut exactually what kind of "insurance" did or our grandparents have?  i believe mine called it "egg money"....how did they affored these 40 pounds cysts..cancer, lung diease, arthritis, carpal tunnel, and a host of other dieases back then and how mcuh does it cost for them now.....both in the us , britian and canada...  the 60's is when our "systems" were started in the united states ( ironiconally the same time mr cantonguay in canada seen a need for a health system)........health insurance was incentive for employment, employers could attact a better long term employee with benifits........you remember...back when yo bcame an employee of a company and workded for them for 30 yrs, and you added some money and they matched....and when you retired...you had money to live on....heatlh insurance worries  back then was simply a "consideration, we never expected could get to this extent"..i believe a 40 year old system of any kind can go stale in any country.....mr cantonguay's system seems to have lasted about as long as ours ...kinda courious as to how they address it this time, compared to how we address it this time....knabe...your analogy of "maintaning stamina in a sword fight in mud" describes how we seem to be addressing so many of our problems today....not sure if those words were yours  or a quote....but wise words for sure.....jbarl

I was asking my grandpa one day if they had health insurance back in the day.  My grandpa farmed and my grandma took care of the kids, house, butchered chickens, canned food etc....  So he didn't have any through work.  He said it wasn't until the kids were all in school that he finally figured he better go buy some health insurance.  It wasn't a big deal then like it is now.  People weren't near as concered about trying to live forever like they do now.  He said it was important for the father to have life insurance than it was to have health insurance for the family.

 

[angusboy1]

im glad im still young and aint got to pay or deal with that crap

 

[knabe]

in hawaii


Gov. Linda Lingle’s administration cited budget shortfalls and other available health care options for eliminating funding for the program. A state official said families were dropping private coverage so their children would be eligible for the subsidized plan.

“People who were already able to afford health care began to stop paying for it so they could get it for free,” said Dr. Kenny Fink, the administrator for Med-QUEST at the Department of Human Services. “I don’t believe that was the INTENT of the program.”

anyone remember what the INTENT of the dept of energy launched under the carter administration?

16,000 employees
100,000 contract employees
a budget of 25 million

it was launched to reduce dependency on foreign oil.  anyone ever take a gander at what they fund? 

what about the dept of education, also launched under carter with thousands of employees and decades of failure.

it's clear the govt wants consolidation of everything, repubs and democrats, and of course the public buys it and think there is a real battle over ideology, when in fact, we are being played for fools.

the intent of ANY govt program is lost and always grows bigger, and faster than inflation.

just to be fair, i was employed under one of those DOE grants, but we sequenced our project  50% under budget, sequenced for 2x the number of years and clones and still came under budget.

 

[chambero]

This issue is so complicated and is in my opinion probably the biggest anchor hanging around this country's neck.

I suspect our real problem is that our health care system is half private and half government controlled (medicare and whatever other programs are out there).  We'd probably be better off going one way or the other.

I generally think most insurance companies are pretty much evil.  They all look for any reason in the world to cancel you. 

My wife and I have very good health insurance (expensive, but good with very low deductibles) from our employers.  However, my mom is a self-employed widow and couldn't afford to keep hers a couple of years ago.  She is coming eligible for medicare this fall thank goodness.

The doctors aren't the ones making most of the profit.  Its the insurance companies and the paper pushers.  If we can't get rid of the bureaucracy and the lawsuits that make insurance companies more money through malpractice premiums, we might as well have Medicare for everyone and be done with it.  There are ways it could be done.

 

[knabe]

The doctors aren't the ones making most of the profit.  Its the insurance companies and the paper pushers. 

that's why med school enrollments are down, and when obama is elected, they'll go down further, until tuition is subsidized, which of course obama will do.  there isn't an inequity that can't be subsidized.

i wonder what the ratio of imported versus created doctors are.

also, remember, we are importing pakistani doctors, and some of these have proven to be terrorists, which of course is racist, or culturist, on their part i might ad, and proof that these terrorists are not limited to the stupid.

 

[Dusty]

I have high deuctible health ins. $2000 or something like that....  I've been to the doctor once in the last 2 years and that was because I used to do the whole be sick and lay there until you die or come out of it, but I couldn't be away from work that long so I went to the doctor to get some drugs.  I went to one of those walk in clinics, saw a knowledgeable doctor and got a prescription.  1 hour out of my life and $50 for the doctor visit.  I only have insurance in case of a catastophe.  Not as a personal maintainence plan. 

We spend more money in healthcare in this country and than anywhere else in the world and we don't live any longer.....  I still haven't figured out either why the goal is to live absolutely as long as possible no matter what kinda shape you're in.  Kind of makes me wonder how many christians "really" believe in heaven, because we spend a lot of money on trying put off going there as long as possible.... 

Also, how did America become the most powerful nation in the world without national healthcare???  I think we need to reflect on what got us to the top and try to do more of those things than worry about all the little crap that we fight about now.

 

[red]

I am terrified to see what all my hospital, ambulance & surgeries will cost. We had to pay for 2 days at the nursing home because it only covered 20 days.

Red

 

[KYsteer]

I am a full time farmer and did the same search for health insurance.  I found the best deal to be on the internet at ehealthinsurance.com  It has a ton of plans and something there for everyone.  Give it a look as it worked out well for me.