Secular Confessions

[dana_renay]

Healthcare is an interesting political discussion, though it can get complicated. I never thought much about it really in a political sense, but through researching the bill and looking up a history of healthcare in this country, I found out that we are already paying taxes (a portion of FICA) for medical care for others - our "public healthcare expenditures." Basically you are paying for Medicaid and Medicare already for the poor and elderly and some of the amounts left over from ER expenses when uninsured patients can't or don't pay. Most people also purchase policies themselves - private healthcare expenditures. So in this country we are required to pay for healthcare twice, which is why our healthcare costs are so much more than other countries with single payer systems (universal care, they only have the "public expenditure"). They only get taxed once and everyone's money pays for everyone else. One of the largest public expenses in our country's budget is Medicare/Medicaid payments and the taxes that we pay for those (and all of us can't even use them) is pretty significant. For instance, my family's health insurance is around $4000 a year for the plan we have. So my family pays the $4000 for that, plus co-pays/Rx costs out of pocket. A percentage of our income is also taken by the government, and the amount for public health expenditures is pretty much the same $4000 as our private plan, so we are paying $8000 a year for insurance. It is an interesting subject, but like I said complicated so won't go into it that much as it would take up too much space and time.

Not only that, you actually pay thrice, because the hospitals and physicians charge insurance companies (and by extension, you) more to help cover the costs of caring for the uninsured and make up when Medicare/Medicaid fall short!!

[Cosmosmom]

I personally do not see that this is any different from my state imposing an 'uninsured motorist fee' for people that fail to carry insurance on their cars.

ITA with this.

Christina, there are some provisions that people really like. Like companies cannot deny you for pre-existing conditions. Like my sister got denied everywhere....because she had some ear surgeries in her past....more than five years in her past and it's not an ongoing issue. My coworkers daughter got kicked off her insurance because she had lap done for endo.
It is also nice that young people can stay on their parents plans longer. I was lucky and had until I was 25 but that was rare. I basically married DH when I did just so I could have his insurance.

There are some other interesting things going on...not sure that it's part of this act but it's a big push....like getting places on electronic medical records. This is going on where I work. So if I go to see doc A and get a test, all the docs can see the results and that can reduce repeat testing reducing costs. And there is a big push towards evidence based care....looking and see what the evidence shows....the newest flashiest thing (and most expensive usually) is not always the best. Another is an idea called medical homes....where you have a team based approach to chronic conditions and the hope is to keep things like say diabetes under control instead of letting it go until it's bad...and more expensive to take care of. There is a big emphasis on prevention recently...even since I started in 2003....instead of just focusing on curing things or managing them.
A lot of interesting things going on. I know my institution is pretty heavily involved in many of these things....I just wish that I had the time to read more than just scanning titles and sometimes abstracts before passing the literature searches on.

[Gwenn]

I am interested to hear what will happen in situations like mine. I am insured through my employer, and my benefit package basically allows me to insure myself at no cost to me (I voluntarily pay an extra $60/paycheck to bump up my insurance to a better plan, but I only pay the difference between the two plans). However, to insure DH i would have to pay the entire cost of his insurance, which would work out to $500 or more per month - basically it would be cheaper to self-insure. He is out of work and because he is a veteran and can use the VA services anytime for a sliding scale, we have chosen not to insure him. Medicaid is out of the question because I may way too much to qualify our family for any assistance, however with him out of work we are essentially living paycheck to paycheck because of our house. Another option available to us is to pay for Tricare because he is in the National Guard, and we have discussed that once I have a child we will insure him/her through Tricare. However, does DH being covered by the VA count as being insured? I suspect it doesn't. So we would either need to insure him or pay the tax if we can't - when he has access to healthcare without it.

[Smplyme89]

BTW, this is strictly my interpretation. Opinions expressed here are not the opinions of my employer blah blah in case anyone ever found out where I worked. Policies, you know...

Those darn lawyers!!

Ok... So no more you have to have children AND be impovershed to get Medicaid? That's good. At least that's something.

[Smplyme89]

ITA with this.

Christina, there are some provisions that people really like. Like companies cannot deny you for pre-existing conditions. Like my sister got denied everywhere....because she had some ear surgeries in her past....more than five years in her past and it's not an ongoing issue. My coworkers daughter got kicked off her insurance because she had lap done for endo.
It is also nice that young people can stay on their parents plans longer. I was lucky and had until I was 25 but that was rare. I basically married DH when I did just so I could have his insurance.

This was literally going to be my next question. My mom has a number of pre-existing conditions (she could very well manage her own pharmacy ) and private insurance is impossible for her to get

[missychrissy]

I really don't think this will impact New Yorkers very much. Not only have we had Medicaid (even available to single men without children) but we have Child Health Plus as well as Family Health Plus available through the state. They're income based. My SIL had insurance available through her work, but it cost over 1/2 her paycheck. She made too much for Medicaid, so she had CHP for her kids for something like $9/month plus copays and FHP for herself for $13/month plus copays.

[Smplyme89]

Not only that, you actually pay thrice, because the hospitals and physicians charge insurance companies (and by extension, you) more to help cover the costs of caring for the uninsured and make up when Medicare/Medicaid fall short!!

BUT who is going to pay for the increase costs of Medicaid?? If more people qualify for Medicaid the cost is going to increase, or at least that is my line of thinking.

This sounds like it has a good core, obviously there are going to be some kinks. Hopefully in the long run it will be beneficial for everyone

[missychrissy]

This sounds like it has a good core, obviously there are going to be some kinks. Hopefully in the long run it will be beneficial for everyone

Ultimately, that is the goal. Right now, we're all paying for people that don't have insurance but run up unpaid medical bills. When they go years without treatment, those expenses related to treatment are easily in the 10's of thousands. Doctor offices and hospitals pass those expenses on to us (those with insurance and who actually can afford to pay their self-pay bills). It's a cycle that needs to stop.

[Gwenn]

The argument is that with more people paying for healthcare, it will cost less per person. I think it remains to be seen whether it is financially sustainable, but I don't think anyone really knows at this point.

[missychrissy]

The argument is that with more people paying for healthcare, it will cost less per person. I think it remains to be seen whether it is financially sustainable, but I don't think anyone really knows at this point.

That already is true with private insurance. Larger businesses, like Cornell, can offer their employees more affordable health care than small businesses can. Because they're bigger and have a much larger pool of employees purchasing the insurance. The more people in 1 plan, the cheaper per person the rates are. That's why having at least 1 insurance plan available to EVERYONE is a good idea.

[Smplyme89]

I really don't think this will impact New Yorkers very much. Not only have we had Medicaid (even available to single men without children) but we have Child Health Plus as well as Family Health Plus available through the state. They're income based. My SIL had insurance available through her work, but it cost over 1/2 her paycheck. She made too much for Medicaid, so she had CHP for her kids for something like $9/month plus copays and FHP for herself for $13/month plus copays.

We have Florida Healthy Kids (which Nolan is signed up for). Our portion is only $20/month With like $5-10 copays! My premium would have almost tripled each bi-weekly paycheck and my copay is $60 through my Insurance so I was SO relieved when we qualified. Plus my Insurance doesn't cover hardly any blood work, testing or anything until you hit the yearly which is 5,000 and I HAVE to maintain my Insurance through week. It is required.

[Gwenn]

Oh, I understand that logic. I just don't know that the prices will even out enough that prices will truly be that affordable. My employer has over 9000 employees, but I pay more for insurance through them than I did when I worked for a company of less than 300 people. The question is really how many more people will be paying into the system and how much will what they pay help to level out the difference in premiums? I don't know that anyone has shown the actual numbers involved (they couldn't).

[Smplyme89]

Ultimately, that is the goal. Right now, we're all paying for people that don't have insurance but run up unpaid medical bills. When they go years without treatment, those expenses related to treatment are easily in the 10's of thousands. Doctor offices and hospitals pass those expenses on to us (those with insurance and who actually can afford to pay their self-pay bills). It's a cycle that needs to stop.

Just because you have Insurance doesn't mean you can afford to utilize it though. Even if people are forced to get Insurance whose to say that it'll be something they can put to use.

Like I said, kinks, but hopefully it all works out in due time.

[Smplyme89]

Oh and thanks for helping me get a better grasp on this. I really appreciate it, ya'll are awesome

[missychrissy]

Oh, I understand that logic. I just don't know that the prices will even out enough that prices will truly be that affordable. My employer has over 9000 employees, but I pay more for insurance through them than I did when I worked for a company of less than 300 people.

I know you do. But Christina has admitted that she hasn't kept up on it as much as we have been.

Just because you have Insurance doesn't mean you can afford to utilize it though. Even if people are forced to get Insurance whose to say that it'll be something they can put to use.

Like I said, kinks, but hopefully it all works out in due time.

The goal is to make medical care affordable for all...even those that are at the lower end of the financial spectrum. This might not do it by itself, but it's a step in a positive direction.

[missychrissy]

Oh and thanks for helping me get a better grasp on this. I really appreciate it, ya'll are awesome

You're welcome. I think this is one topic where most of us are relatively on the same page and feel pretty strongly about. I think we're all (or most of us) liberal or lean that way.

[Gwenn]

I don't know what I think of this system. I hate how insurance companies work. A Britain-style system where your taxes truly do go to pay for your healthcare makes more sense to me than this does.

[Smplyme89]

I tend to tune out all things political. It's one of those things where my feelings on the subject are not going to matter in the end, so I just go with the flow. Nothing is perfect in the beginning and that is true for all new things, I just hope that the Insurance companies do not take advantage of people being forced to be insured. That is my primary concern at the moment.

[Bridget]

I look at this as as step in the right direction. Change never comes easy. But we need change.

[missychrissy]

I don't know what I think of this system. I hate how insurance companies work. A Britain-style system where your taxes truly do go to pay for your healthcare makes more sense to me than this does.

I look at this as as step in the right direction. Change never comes easy. But we need change.

Agree with you both. I'd love to have a Canadian/British healthcare system.

[Suja]

However, does DH being covered by the VA count as being insured? I suspect it doesn't. So we would either need to insure him or pay the tax if we can't - when he has access to healthcare without it.

I think the answer to your question is YES.
http://www.healthcare.gov/news/facts...-care-act.html
http://www.fas.org/sgp/crs/misc/R41198.pdf

[Bridget]

Dbf is Canadian. So we can escape if need be

[Gwenn]

Thanks for the links, Suja.

[Smplyme89]

Dbf is Canadian. So we can escape if need be

Can I come?? Pretty please

[Cosmosmom]

I don't know what I think of this system. I hate how insurance companies work. A Britain-style system where your taxes truly do go to pay for your healthcare makes more sense to me than this does.

I agree with that. I think that this is better than nothing but not really wanted I wanted. Why pay a middle man if you don't have to? And I hate that some people seem to be "valued" more just because they are LUCKY enough to have good coverage.

Interesting enough....the UK was way ahead of the US in terms of actually using evidence based medicine. I subscribe to a number of their journals....

[Bridget]

I am feeling irked by all the fb stati acting like this is about deadbeat welfare recipients. It's so much more complex than that. Like your sister, for example, Jennifer. Even my parents were pretty worried toward the end of my mom's life that she would lose her insurance if she stopped working. She was far from a deadbeat. *sigh.

[Smplyme89]

I am feeling irked by all the fb stati acting like this is about deadbeat welfare recipients. It's so much more complex than that. Like your sister, for example, Jennifer. Even my parents were pretty worried toward the end of my mom's life that she would lose her insurance if she stopped working. She was far from a deadbeat. *sigh.

This is exactly why I asked you ladies and not anyone I know. People tend to look at things as so black/white without considering the numerous angles to a topic.

[missychrissy]

Dbf is Canadian. So we can escape if need be

would that apply to you as well, or would you have to marry him first?

I am feeling irked by all the fb stati acting like this is about deadbeat welfare recipients. It's so much more complex than that. Like your sister, for example, Jennifer. Even my parents were pretty worried toward the end of my mom's life that she would lose her insurance if she stopped working. She was far from a deadbeat. *sigh.

That's the real kicker...people that do everything 'right' their whole lives, then develop a serious illness like your mother and either max out their major medical, or have to quit working due to the severity of their illness and thus lose their health coverage. It's utter BS if you ask me. If anyone thinks that system 'works' they should be ashamed of themselves.

[Bridget]

I'd likely have to marry him. But the kids get to have dual citizenship which I love for them!

[missychrissy]

I'd likely have to marry him. But the kids get to have dual citizenship which I love for them!

That really is great. For life, if 'something' happens, they can be treated. I want that for my kids too.