Health Insurance

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    Sep 21, 2007 4:22 PM GMT
    I stopped having health insurance a couple of years ago... how bad is it that I still don't have it?

    Secondly, what health insurance does everyone have?
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    Sep 21, 2007 6:24 PM GMT
    You might be okay without it for awhile, but it's a risk not to have it. Breaking a leg, arm can be costly if you don't have it. But I also understand that if you're paying for it yourself, it is quite expensive.

    In Massachusetts, you now have no choice, you are legally required to have health insurance, either through your work or purchased from a state-approved provided. There are different levels of coverage, but the differences are mostly on the size of deductible. Low-income individuals and families can receive free health insurance or are eligible for a deductible.

    The insurance I have is Tufts Total Health Plan. My employer, a university, lets us chose from 3 different providers (Tufts, Harvard Pilgrim & Fallon). My portion is about 25% of the premium, and I know the total premium is pretty high, so it's not a small expense for the university. If I wanted to, I could have my husband on my insurance, but it is cheaper for him to get coverage from his employer. My plan is pretty good. Office visits are $15, emergency room is $50. Rx drugs are 10/20/35
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    Sep 21, 2007 7:20 PM GMT
    I haven't had any health insurance for the last couple of years, and I did have to tough out an illness that should have been treated, at least once.

    Things started looking a bit less grim, and I asked my cousin the accountant how to get some kind of insurance. It probably varies from state to state.

    Here, the solution is a very-high-deductible policy, coupled with a health savings account. The monthly payments aren't much more than the TV & phone bills combined. Even though the deductible may be as much as $5000, things like office visits, immunizations, glasses, and prescriptions are covered with a relatively small copay. The big deductible cost kicks in if you are hospitalized or something. Meanwhile, you put what cash you can into a tax-free savings account, and gradually build up enough to cover the deductible. One advantage of this is that the money you save remains yours, and you earn interest on it - not some insurance company shareholders. A disadvantage is that once I finally got the paperwork put through, they hit me with a bill for three months premiums up front, to get started. That was kind of a high hurdle. The other disadvantage is that you are gambling that you won't need the deductible amount before you're able to save it up. But once you have it saved, the whole thing is better than employer-provided coverage.

    When I've had insurance through an "employer" it was a huge scam. My grants and projects were getting billed more than my salary to cover "benefits." One time I looked deeper into these "benefit" charges, and half of it was going to pay the salaries of the HR department. Another big chunk was going to a pension fund for which I wasn't eligible. The insurance premiums were so high that I had to suspect that HR was getting kickbacks. This happened at both a GOCO and a University.
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    Sep 21, 2007 8:57 PM GMT
    Interesting topic. I have relatively good health insurance right now, but it will be expiring in December since there is a 6-month grace period after you've been out of school. I will be starting a new job tomorrow, but there's no insurance with it, so I hope I don't get sick!! Luckily... where I live, there is a "community health center" that provides dental, optical, and other services free or nearly free. Just opened this year.

    Not to get too "controversial," but I'm wondering what everybody thinks about "universal" health care, since it is being mentioned every time we turn around. Especially for those of us who live in Iowa (with the first caucuses) the '08 candidates never shut up about it!! Support it? Oppose it? What do you think?
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    Sep 21, 2007 9:06 PM GMT
    This is an interesting topic. I am shopping around for coverage myself. Anyone over 40 have any input here? Mindgarden, what company are you with using the savings account method along with the higher deductible?

    As far as universal health care, there are a lot of things the government spends OUR money on now that I'd much rather see going to make sure everyone can afford health care when they need it than what it goes to now! Regular salary increases for our representatives in government for one while so many of their constituents struggle to keep afloat.
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    Sep 21, 2007 9:07 PM GMT
    well, you should have it, but for numerous reasons you may not. I myself have a PPO am happily pay more to have the convenience/freedom it offers.
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    Sep 21, 2007 9:10 PM GMT
    When I was with Southern California Edison, we had the Health Savings Account thing - along with the usual HMO/PPO choices.

    The catch is, once money was put there, it could not be used for anything else, and if you didn't need it all, you just lost it.

    Right now I'm with Blue Cross Small Group PPO, but their drug policies, rates and frequent denials of claims have forced us to look around. Pacificare is looking pretty good....

    Joey
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    Sep 21, 2007 9:24 PM GMT
    My policy is with blue cross/blue shield and it is a PPO. (It doesn't really make much difference, since every real doctor in the area is a member of the PPO network.) BS has a special health savings account policy plan which actually has less coverage and higher rates than some of their other plans, so I steered clear of that.
    I haven't yet managed the health savings account, but the plan at my local bank looks OK. You never "loose" the money - if you don't use it it just stays there and earns interest. And you can withdraw it for other purposes, though there may be some tax penalty similar to the rules for an IRA. This according to the brochure, anyway.
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    Sep 21, 2007 9:45 PM GMT
    I havent had insurance for a couple of years which has sucked. I broke my foot And yeah.. office visit have sucked. Luckly my doc. has been the same one Ive had since I was a kid so they usually give me a discount ($55 instead of the norm.) and they usually give me the medications samples and such so its not bad. Granted I could possibly go to county for health care but screw that shit. I had Principal Financial Group health insurance through my mom when I was in school and damn... I totally miss thoes days.
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    Sep 21, 2007 10:27 PM GMT
    I've been with Kaiser for over 10 years and, while they attract a lot of criticism, I've had nothing but good experience. Every now and then I compare the plan to others but nothing comes close. I have the best plan they offer to self-employed people.

    Then again, I pay just over $600 a month. Hospitalizations have a $500 deductible, office visits are $30, meds are $17, labwork, imaging, etc., is all no-charge. I was tempted to go to a higher deductible, but I had three surgeries in the last 2.5 years. I'm not taking the risk.

    I like Kaiser's emphasis on preventative care and it's cool that I can access my records online. I have had, with one exception, really good doctors.

    Before Kaiser I had an independent Blue Cross plan and it didn't come close in benefits and at the time cost a good bit more. They don't offer anything now that approaches Kaiser's plan.
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    Sep 21, 2007 10:35 PM GMT
    Would you call 600 bucks a month outrageous?
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    Sep 21, 2007 11:12 PM GMT
    Well, yeah, I think it's astounding, considering that I don't think I was paying even $200 a month when I started out and had NO deductibles for anything.

    I note today that Preznit Boosh is issuing new threats to veto the bill extending health insurance to more uninsured children. Whatta fucking monster he is.

  • cacti

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    Sep 21, 2007 11:18 PM GMT
    Vote for John Edwards.
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    Sep 21, 2007 11:47 PM GMT
    I think it depends on your personal situation how bad it is that you dion't have health Insurance.

    It's one of those things that you don't need, until you REALLY NEED IT.

    A few years ago my employees were faced with reducing/eliminating benefits or cutting salary increases, bonuses, and raises.

    I gave them the problem by allowing them to form a committee and decide what was most important to them given the amount of funding available.

    They chose a top of the line HMO, disability insurance, and a matching 401k (1:1), as being more important to them than large raises and bonuses. I have extremely happy, loyal, and dedicated employees.

    I have always thought my health insurance was very important; I have been sick/hospitalized a couple of times where the bills could have been disasterous if I had been caught unaware.
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    Sep 21, 2007 11:53 PM GMT
    I wish Edwards could get the nomination. Hillary's new health plan is basically his in slightly different language.

    I love this quote from Ezra Klein, cited in Paul Krugman's column Friday:

    “The Republican vision is for a world in which the sick and dying get to deduct some of the cost of health insurance that they don’t have — and can’t get — on their taxes.”

    Here's a link to Krugman's column:

    http://tinyurl.com/2trd2l
  • cacti

    Posts: 273

    Sep 22, 2007 2:20 AM GMT
    I think he WILL get the nomination. :)
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    Sep 22, 2007 3:46 AM GMT
    I went w/o health insurance for about a year. I missed it the entire time! Fortunately nothing happened but there was that constant "What if..." especially on all my travels marathoning...

    Luckily my new company offers benefits to management at no cost to us, its a Blue Shield policy with full coverage and very low premiums/co-pays for anything. I think my annual deductible is something like $150

    I'm very happy with it- its a PPO and like has already been mentioned, most all doctors are members.
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    Sep 22, 2007 4:49 AM GMT
    My coverage is with Aetna, but I get it through my job at UPS. For free, no less. I'm happy that I don't have to pay a dime for it, and there's only a $100 deductible before it pays 100% of just about everything.

    It's come in very handy since I've been applying to the Peace Corps. After the deductible, it's covered all my lab work and visitations to get paperwork filled out, at no cost to me. I feel very lucky, and I just can't imagine what it's like for people that don't have insurance to have to worry about it. I'm sure, though, that I'll be in that situation someday.

    Also, I'm all for universal health coverage. The insurance industry is simply set up for market failure, as we've seen over the past decades, especially with less and less employers offering health insurance to their employees. Here are a few statistics on health care from the World Health Organization.

    The Ten Healthiest Countries in the World

    1. Japan
    2. Australia
    3. France
    4. Sweden
    5. Spain
    6. Italy
    7. Greece
    8. Switzerland
    9. Monaco
    10. Andorra

    (The US is 24th)

    The Countries that pay most for healthcare

    1. United States
    2. Switzerland
    3. Norway
    4. Germany
    5. Canada
    6. Luxembourg
    7. Denmark
    8. France
    9. Australia
    10. Japan



    The overall list (Quality / Cost)

    1. Japan
    2. Switzerland
    3. Norway
    4. Sweden
    5. Luxembourg
    6. France
    7. Canada
    8. Netherlands
    9. UK
    10. Austria

    All the countries on those lists have universal health coverage, except for the United States.
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    Sep 22, 2007 5:01 AM GMT
    Chewtoy
    All the countries on those lists have universal health coverage, except for the United States.

    All you have to do is go to an emergency room! George Bush said so.
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    Sep 22, 2007 5:06 AM GMT
    Damnit! Of course! How could I have forgotten? That's it, next time I don't have insurance and get the flu, I'm totally waiting until I'm near death and then getting me a free hospital visit. Score!

    Take that, Japan.
  • cacti

    Posts: 273

    Sep 22, 2007 8:55 AM GMT
    If you vote for John Edwards, you won't even have to wait for the companies to fail. He's the only one(unless Hillary's stance has completely changed with her new plan?) who wants to completely remove their power, forcibly. :)
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    Sep 23, 2007 3:13 AM GMT
    I just graduated from college and with bills and loan repayment starting soon, it doesn't seem like I can afford health insurance. I take good care of myself and feel like maybe I can wait it out until I find a job that has it (I'm going into teaching).

    I got this brochure for post-grad insurance: I can pick 60, 90, 120, or 180 days of insurance coverage. There are rates for a $250 deductible and rates for a $500 deductible -- but, um, what exactly are the deductibles?
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    Sep 23, 2007 3:39 AM GMT
    Thanks Joey and Mindgarden, I'll look into those.....and yes, Preznit Bush IS a monster!
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    Sep 23, 2007 4:27 AM GMT
    Atlazeia,
    The deductible is how much you have to pay on your own before the insurance kicks in. Of course, it's almost never as simple as that.
    Usually, the plan with the higher deductible is somewhat less expensive, because the insurance company expects to pay out somewhat less, on average.
    One thing that may help is to find out if it is some sort of group plan or an individual plan. If it is a group plan, the rates are probably somewhat lower, and it may well be a good deal. Individuals represent a greater risk for the insurance companies, so they charge more for them (it might be a good deal even if it's an individual plan).
    One way to think about the whole thing is this: It is very unlikely that anything super outrageously expensive will happen to you. But, if it does, and IF your insurance will cover it (a big if), then you get to walk through the other side relatively unscathed financially. If you don't have insurance, and something awful happens, you've got a couple of options. One is to beg and plead for free/low cost care, which is generally pretty hard to come by. Another is to saddle yourself with the debts (in a hospital, one tylenol pill costs about $20-$30!). A third is to declare bankruptcy, which will only set you back seven years from being able to pay for anything except with cash. So even though it's expensive, it's a good idea to pay for it if it is at all possible.
    BTW, going into teaching means you'll never have to worry about insurance again. People can grumble all they want about teacher's unions, but without them we (in the teaching profession) would be totally screwed. But that's another topic entirely.
    Good luck with your endeavors!
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    Sep 23, 2007 4:53 AM GMT
    And as far as whether I support or oppose "universal health coverage", to be honest, I'm not a big fan. I think it would be an important advance over where we are right now, but I think people have grand hopes that it will somehow fix the major problems Americans have getting health care.
    I like to make an analogy to the highway system. Imagine a situation where EVERY road was a toll road, and that there are various companies selling various services to make paying the tolls easier. That's what our health care system is like now.
    And as inefficient, corrupt, and wasteful as our government programs to build and maintain the roads are, as a system, it is much more efficient than it would be if every stretch of road were privately managed.
    So it should be with health care. I wouldn't claim that single payer solves all our health care problems, no more than I would claim that government funded maintenance of roads prevents any potholes from developing (or the occasional bridge collapse), just that it is SO MUCH more efficient than piecemeal private ownership.
    And, it's not like our government agencies aren't already paying through the nose precisely because of the huge inefficiencies of the private marketplace approach to health care.