What kind of medical insurance?

[ejb]

>>What do we have to look forward to?

In my opinion, it is inevitable that sooner or later we will end up with something resembling universal coverage in this country. (and I am not advocating it, just beleive its inevitable). The current system is broke for a LOT of people (i.e. a LOT of votes). If you have a good secure job, and your employer picks up the cost, or most of the cost, of coverage...you don't really have a problem. If you are not, you do have a problem.

Premiums for many people are going up 8-10-15-20% per year with no end in sight, and the cost of care is so high that if you have any assets at all, you really cannot afford to gamble and go without. Maybe you will be lucky, and maybe you will lose everything you have work your whole life for.

I am relatively young (under 40), and healthy, and besides basic preventitive care, have had no major medical costs...but I still need to pay close to $1000 per month (out of pocket), to keep coverage. Lucklily I can afford it, at least for now.

But if you are unemployed, or work at a low-paying job (say even at $30K per year which isn't bad) and don't get benefits, how can a family afford to pay $12K per year from a $30K salary and still live? They can't.

I definitely don't have a solution, but I feel very confident that within a decade universal coverage will be here (and probably won't be as good as those advocating believe, but also probably won't be as bad as those opposed to it believe either)...just my two cents.

 

[ejb]

>>One party has always been known as "Tax and Spend", the other is rapidly becoming "Cut Taxes and Still Spend".

Or call it "Tax and Spend" versus "Borrow and Spend"...personally I'd prefer "tax and spend", maybe then the voters would realize how much that "spend" part is costing them instead of just putting it on the old credit card and leaving it to future generations to pay back.

 

[MadReferee]

Don,

I am approaching 55 and in pretty much perfect health (I can still keep up on the field with the college soccer players). I am also self-employed. I would like to semi-retire before age 60. My wife is 2 years older and we have coverage thru her employer but rates keep going up while coverage keeps going down.

I am starting to do some homework now hoping to have something in place when I do hang up the keyboard. FACT/Golden Rule looks good on the surface but there are problems as you have mentioned. In addition I would have to move to a state that they write policies in but that is no problem since we have pretty much settled on AZ or FL.

I also agree with others who have said that something will have to be done sooner rather than later with respect to overall coverage ability at the national level. Votes speak loudly and there will soon be enough to hopefully make a difference and force some changes, whatever they may be.

 

[Henro]

Don,

This won't make either of us feel better...but it amazed me and my brother...

He quit his job in Ohio and returned to Pittsburgh about a year ago with his wife and kid. He is pushing 50...he decided to take a bit of time off and not look for a job right away. He owns his own home here...formerly my parents place.

Anyway he got himself into a situation where he was required to go to some counseling classes. Domestic disturbance thing. They told him he had to apply for public heathcare...he said that did not make sense because he quit his job on his own and came back from Ohio...they said apply anyway, you have no option. Do it or else.

So he did. He went [this was a few months ago] and said I am being forced to apply for free health care from you, even though I don't qualify. That is why I am here.

The woman said...what is your phone number? I will call you tomorrow.

Next day the phone rings...Mr Henro's brother...yes you qualify. Medical, dental, vision...no charge to you, no deductable, prescription coverage...everything 100 percent, nothing out of pocket...

Now he only used it for a few months. Got a job in his field a couple weeks ago...did get 14 teeth fixed and maybe some new glasses...some other medical checks done since it was free...

The system forced itself on him!

Yet, me and you have to pay for ourselves...

And who can we blame? Probably ourselves...we elect the guys that make and enforce these laws we live under... /forums/images/graemlins/frown.gif

 

[BradK]

Hey Don I got the same problem as you with Mutual of Omaha. I had to take their policy in 1999 due to cancer and garenteed insurance cause my parents were with them. I am now at almost $300 a month for me alone and have not had any major claims in the past few years. Now i gotta find new insurance that will accept me. My dad has a permanant postion and is paying over $2500 a month for their insurance.

We are both trying to find new coverage. We are talking with an agent and found out that there may be some kind of law in Florida that will allow covered with upto double normal premiums if you get the new insurance within 45 days to the cancelation date. Still looking into this with my dad he is being canceled 4 months before medicare would take over.

BradK

 

[OkeeDon]

Brad, every time I get myself worked into a sate about this, I find someone else who is worse off. The previous administration at least tried to do something about it. Whether it was any good at all, at least it was something, which is more than we've had from anyone else for the past 22 years or more. But, it was shot down by scare tactics from the opposition. The current administration is more concerned about the well being of Iraqis.

Oops, I may have stepped over a line, here. But, I don't care.

 

[Bob_In_MN]

ejb,

The threat (or opportunity depending on your point of view) for national health care is talked about frequently.

I personally don't believe national health care is the answer for a number of reasons, but I use the following examples when discussing this with my clients.

1. In 1965 44% of national health care expenditures came in the form of out of pocket expenses (i.e. the people paid for many of the expenses themselves). Another 25% came in the form of government spending and 25% more came from employer spending. In 2001, the numbers changed to 14% personal expenses, 45% government and 35% employer.
(source--CMS, Office of the Actuary, National Health Statistics Group)

As a percent, individuals are not spending as much as they were 35 years ago. If you think about it, in 1965 (I was about 3 years away from being born), my parents had a major medical $500 deductible plan. Now, we have a $15 copay for office visits, free preventive coverage and a small deductbible for hospital visits. I realize not everyone has this type of coverage, but 95% of my clients do.

2. My company provides insurance for another country's local office. This country has national health care and cannot provide benefits that are as good for less money than I can provide in the open market.

3. Presciptions are driving a lot of the increases we see. In 1991, when an individual paid their copay at the pharmacy, they covered (on average) 59.2% of the cost of the prescription. In 2002, the number decreased to 18.4%. (source--National Institute for Health Care Management)

If there's an area we could use government(and I say this with some hesitancy), it may be to better regulate the prescription drug pricing.

Since we are close to Canada here in MN, we see the bus loads of older individuals heading to Canada to get prescriptions filled. We also run into a few Canadians coming to MN to get care in the US. I know we have a few Canadians on this board and would enjoy hearing their opinion on their country's health care program (pluses, minuses, costs, waiting times, etc.)

Prescription drug advertising in 1991--55 million. In 2000 it went to 2.5 billion. (source-National Institute for Healthcare Management)

When I review a clients prescription usage, the top 10 drugs are the ones we see advertised on the TV, radio and in magazines.

4. I have many clients who are large enough to pay their own claims (meaning they hire a third party to process claims, but they self insure the actual claims). Their costs aren't much less than my fully insured clients because claims are claims are claims.

The simple fact (with the exception of price gouging on prescriptions) is that thanks to medicine, people are living longer and as a result they are around to consume more (get hip replacements at age 80, etc.). It's a wonderful thing to see this happen, but it does cost money.

There definately is room for improvement, but I'd like to see the old system fixed before we hand this thing over to the government.

Sorry for the long post--if it's outside the bounderies of this forum, please feel free to delete it.

Bob

 

[fivestring]

Don, it's already been mentioned by someone else, but, our Government does not need to be in the health care business. Almost every country that has tried that route has failed miserably. Do you think ours will do any better? I don't think so. Think about it... everything our government has tried to manage has been a failure, starting with the welfare program (the raw deal).
I don't have an answer either, but, one thing the health industry needs is more competition. Competition usually means lower prices. One only needs to look at the tractor industry. More brands means better prices.
The 7 year waiting period on prescription drugs before a generic can be marked... this needs to be reduced to 1 year. After 2 years, the drug should be sold over-the-counter, thus promoting competition and lowering prices.
There is no competition in healthcare coverage where I work... you get two choices. Aetna(bad) or Wellpath (worse). We lost Cigna and Prudential. These choices are controlled by who??? That's right, government.
There is one thing that I believe the government will have to do is step in and put caps on lawsuits. That's right, because of lawyers, our insurance premiums are so high.
My .02.

 

[Henro]

<font color="blue"> our Government does not need to be in the health care business. Almost every country that has tried that route has failed miserably. </font>

Interesting comment. Is this really true? I don't know myself. That logic could extend to any number of things that are controlled by the government in any country.

Canada, the UK, and Japan are three countries that have national health care...I think there are more...as a matter of fact I heard someone once say that the US was the ONLY advanced country that did not have some form of national health care for its citizens.

I really don't know...but my GUESS is that a lot people might be happy with those government run systems, and don't consider them "misrable failures."

After reading some of the posts in this thread one could easily conclude that unless you are either rich or poor [on paper], the system here is a misrable failure... /forums/images/graemlins/frown.gif

 

[Bob_In_MN]

Henro,

At a recent training seminar the speaker said "National Healthcare is great--if you don't get sick".

I don't have any statistics on cost, effectiveness, waiting times or mortality rates as they relate to our private insurance compared to other countries national programs. As I only have singular examples to go on, I don't want to offer any blanket statements.

There are some great things about our current set-up. For instance, in Minnesota if you work a company that chooses to use Blue Cross for their insurance, you have open access to the Mayo Clinic. This is available whether you make $8 or $100 an hour.

Persoanl Example--My employer pays for my health insurance, but I have to pay for my wife's. It costs $300 per month. Several years ago she had back to back years of $60,000 plus health care costs. During those same years, I used less than $1000. Our entire company paid less than $20,000 in annual premium. During that same time, my partner's wife underwent cancer treatment--cost of drugs--$3000 per week. My company will need to pay premium for many many years to even things out. That's where insurance comes in--one company may pay too much, but they balance out the heavy users.

Here's a question I ask all the time? If we went to National Healthcare, would people still be able to get to the Mayo Clinic (or the doctor of their choice)? I don't know the answer to that, but when you have someone you are close to going through serious health issues, you want THE BEST. I just don't know if that would happen if the government ran things.

I'd really like to hear from some TBN members from other countries with national healthcare.

Bob