What would you be willing to co-pay for a Public Option?

[DrZeeLit]

According to the most reliable sources I could find, 44 million Americans were uninsured in 2005 (1).

Let's face the music and dance. That figure has changed way upward, but I'm willing, for the sake of argument, to use the conservative number.

44 million Americans

Let's say 40 million join a public plan. Yes, I know the numbers would be higher, but I'm rounding off for the stubborn, the unresponsive, and my own math prowess (which was once great, but has diminished with time and attrition, just as my algebra teacher predicted... but I digress).

40 million join the fray. 40 million new faces at clinics and doctor's offices all over the country. And then.... they pay, probably in cash, a little co-pay. You know, just for the office visit. Just to show faith. In general.

What would you be willing to pay for an office visit co-pay? Figuring that perhaps we should fork over a nominal fee, which seems courteous in the partnership where the other almost-100% is going to be paid by the other partner.

Let's say $5. Five dollars. I can do the math with that one.

5 x 40 million is 200 million dollars. For one office visit. For those new-on-the-rolls patients.

But let's say we were being really generous and said, "Oh, I'd be willing to pay $10." Now, of course, I'm probably speaking of people like myself -- college adjunct with no insurance and no guarantee of a job semester to semester. But still, $10 -- I could come up with $10 for an annual physical if the other partner in this plan would pick up the tab for... say... the blood work. That would be okay, wouldn't it?

So, that's 10 x 40 million is 400 million. For one office visit. With blood work.

That's not gonna pay for the program, but it can't be something to overlook.

The question is... this being simple math...

What would you be willing to pay for a reasonable co-pay?

And if we could check off a box on our income tax, what else might you be willing to pay to be covered in a Public Option?

I'm not saying to compare to what you have now, though everyone will -- those who have a plan and those who don't.

But.... what would you be willing to pay to be covered?

Co-pay? Yearly? Individually? Family? Per child? Sliding scale?

What do you think?

Because it always does seem to come down to money. And then all we hear is millions and billions and not really what each of us might be willing to do.

I'm thinking that what we are not hearing is our willingness to be part of this plan. Our willingness to say that we want to be part of the plan -- we want to help and we want to be healthy and we want to bear responsibility.

I'm not saying we haven't been responsible...no, I'm not saying that. But I am saying that we are not children who want candy for free. We are adults who are capable of being part of the plan.

So, with that in mind, what would you be willing to pay?






(1) http://www.pbs.org/newshour/extra/teachers/lessonplans/health/uninsured/

[JeanGrey]

1. Right now I am paying around 50 for most office visits and

most of my drugs are high priced cancer drugs and they are 50 as well.

[Historic NY]

2. I pay them now, except each individual medical procedure is subject a co-pay...

[extractorks]

3. you would lose money

You might bring in 400 million dollars, but if a typical medical visit costs 100 dollars the government would have to pay an additional 4 billion dollars to pay for the rest.

[stray cat]

4. $20 per copay - plus $10,000 per year premiums (but hopefully employer subsidized)

Right now I think the employer pays about $10-12,000 per year per person toward health insurance.

[stray cat]

5. In reality - there is talk about a 20% copay but a cap

now that could get tough fast - but the truth is someone has to pay and health care is expensive.

[bkkyosemite]

6. HR 676 has no co pays.

http://www.johnconyers.com/healthcare

snip:

What health care services are covered?

The program established by H.R. 676 will cover all medically-necessary services without charging co-pays or deductibles. The services covered will include: primary care; inpatient, outpatient and emergency hospital care; prescription drugs; durable medical equipment; hearing, dental and vision care; chiropratic treatment; mental health services; and long-term care.

snip:

No co-pays or deductibles-- what's the catch? Will I actually pay less for health care?

There is no catch. Both families and employers will pay significantly less for health care.

Currently, the average family of four covered by an employer-provided health care plan spends roughly $4,225 on health care each year, including premiums, services, prescription drugs and supplies. This figure does not include the annual Medicare payroll tax, currently at 1.45%. Under the plan created by H.R. 676, a family of four making the median income of $56,200 would pay about $2,700 in payroll tax for all health care costs. No deductibles, no co-pays, no worrying about catastrophic coverage.

Employers who provide health insurance currently pay, on average, 74% of employee health premiums. For a family of four, the average employer share is $8,510 per year. Under H.R. 676, the employer pays a 4.75% payroll tax, not a premium to health insurance companies. For an employee making the median family income of $56,200 annually, the employer would pay roughly $2,700.

Estimates taken from: Employer Health Benefits 2006 Annual Survey, Kaiser Family Foundation and Health Research and Educational Trust; Consumer Expenditure Survey, U.S. Department of Labor, Bureau of Labor Statistics; and Study by the Center for Economic Research and Policy.

[Sgent]

18. I thought HR 676 was Medicare for all?

Medicare most certainly has co-insurance and deductibles (though not technically co-pays).

[Warpy]

7. You're assuming all uninsured people are poor and will all

go to the doc's office every month.

Lots of people are uninsured because they can't get private insurance, period, either because private insurance premiums are jacked up to the stratosphere, far higher than per person company premiums, or because they've been declared uninsurable due to a chronic illness, my own problem.

You're talking about small business owners who are far from poor. They just can't afford a third of their income going to some dodgy for profit plan that probably won't cover catastrophic illness, anyway.

People also don't go to the doctor's office unless they absolutely have to unless they're hypochondriacs or have Munchhausen's. That's a very small percentage of uninsured people.

Something like 72% of people who have tried to get private insurance have failed to find a plan and are uninsured. Clearly this is obscene.

Wailing about cost is a losing game, in any case. No one expects a public option to be free. There will be premiums to pay, probably on a sliding scale to insure as many people as possible. The savings on administrative costs alone will make it highly competitive with private plans.

Our present patchwork system of insurance companies engaging in outright fraud is irredeemably broken. Unless they are given real competition in the form of a public option, they will have no pressure to change their practices and reduce their administrative overhead.

Reform without a public option is simply not reform, at all. The incessant yammering about cost is nothing but a red herring.

[DrZeeLit]

14. Actually, no. That wasn't my point or my question.

I was just curious.
Because cost is a factor with many people.
I didn't say where I laid out on this and I didn't say who I was talking about -- I never mentioned small business owners.

You are presuming to tell me what I'm thinking? Whoa.

First of all, I was hypothesizing (familiar with the term?) about ONE doctor visit. Not who was going. Not why they were or were not insured. One doctor visit. Maybe an annual physical with blood work.

I never mentioned nor was I even thinking about "groups" of people, like small business owners. Nope. I was just thinking one-person-at-a-time... hypothetically.

I wasn't even say "what could you afford to pay"... I think I just said what WOULD you be WILLING to pay.

I really do GET that lots of people are uninsured because they can't get insurance. And I know all that stuff you are rattling off -- I KNOW WHY WE HAVE UNINSURED AMERICANS. I GET IT.

As you might have noticed, I mentioned that I am a college professor who does NOT have health insurance coverage via my state job. Because over 50% of the college professors in the USA are adjuncts -- one of those "cool" state ideas whereby the give the job a slightly different title with nearly all the same responsibilities, but they get to pay the employee way less and offer no benefits. At all. So, I totally GET the "no insurance" stuff.

I was just asking a question. Period. I was curious. I didn't need some lecture. I'm quite conversant in the argument(s) and the groundwork for this situation.

And for the record -- I'd have to say that probably (and I'm visualizing my 83 year old mother and my 55 year old brother and a few of those) most people arguing about this ARE thinking about COST.

So, cost is not a red herring.

A red herring is death panels. They don't exist. Cost will always exist.

Again... it was JUST a hypothetical question.

[Warren Stupidity]

8. I want healthcare funded from a shared payroll tax.

I already pay. I pay larger copays than you seem to be aware of. I have deductibles and caps. I pay out of my paycheck for 20% of this 'insurance' on top of the copays and deductibles.

I pay and pay and pay. Meanwhile the insurance companies provide NO HEALTH CARE AT ALL. They add no value other than transferring funds. And for the 'service' of transferring funds they take in something like 300 billion dollars a year in profits.

And the solution: we should pay some more.

[ejpoeta]

9. I know when I had independent health it was $10 copay.... now it's probably $20.

I'd say $20 would be a decent copay. And even if they adjusted it for income, like my daughter has no copay for her child health plus... so if low income folks had no copay or a smaller copay.... the same could be true for meds.... but i think that there shouldn't be the tiers... start people on a generic if there is one and if that doesn't work, go to the name brand. and the copay could be based on income as well.

[sandnsea]

10. Depends on the premium, drug costs, blood work,

Even with my subsidized insurance, and half our prescriptions costing $4, there have been months we didn't refill because of the cost of treating other illnesses. If we'd had to include $10 co-pays on top of that, it would have been rough.

But we've got to start talking about the cost and bankruptcy and job security and the economy. That's what this is about. How health care hits each family smack in the pocket.

[Bonhomme Richard]

11. $25.00 = Physician, $45.00 = Specialist

Close to what I pay now.

[frazzled]

12. There would be a monthly premium for the public option

Just like any of the private insurance plans on the exchange ... which the uninsured would be able to buy into, on a sliding scale. The public option is just a not-for-profit insurance company run by the government. It's not like Medicare, because you don't pay into it with payroll taxes over time. It's an option.

The co-pays (what you pay for an individual doctor's visit) is fairly incidental to the monthly premium.

[Laelth]

13. I shoudn't have to co-pay anything.

They don't in the U.K.

:dem:

-Laelth

[mopinko]

21. yes they do.

they just don't pay for it at the time of service. they pay for it in taxes. everyone who has an income pays for it. that might be the best way to do it, but it ain't free, so please stop saying that.

[katmondoo]

15. With Medicare I pay about $100.00 per month for the insurance

Medicare pays 80% but this can change depending on the treatment. They pay according to what they list for each type of treatment. Some doctors charge more than Medicare will pay. In that case you would have to pay the difference. Some people have supplemental insurance, good if you can afford it. All in all I am happy to have Medicare, without it I would surely have died ten years ago.

[frazzled]

16. But you also paid taxes into it, your entire working life

That is different than the public option being proposed.

The public option envisioned by Congress is predicted to be about 10% cheaper than a for-profit, commercial health insurance policy.

[DrZeeLit]

17. So, my original question was basically what would you be "willing" to pay.

I was merely curious.

If you're happy paying what you are now and would do so on a Public Option, okay.

In general, I can afford up to $200 per month, plus some sort of low co-pay. This is just off the top of my head, but I can visualize my bills and I don't have kids or a huge house payment. And car insurance is really low in Vermont. So, I feel I can contribute to a Public Plan. I'd much rather "over-contribute to a Public Plan and feel like I was helping others, than pay too much and have it all go into some insurance company's spa day.

[ffellini7080]

19. Of course I would

anything to help the needy

[mopinko]

20. right now

even tho most of the cost is paid by DH's employer, we still pay $600/mo premium, plus rx copays of about $200. our deductible is $500/person. after that, there is a $300/person wellness benefit, but that usually ends up with a balance, because you can't really get the blood tests, vaccinations, and all for that money. beyond that, we end up paying about $20 out of pocket for doc visits.
all and all, it is a lot of money. we are high utilizers here, with a couple kids plus me with chronic illnesses. it could be way, way worse. i had surgery last year that was $100 k, plus a lot of before and after tests, etc. it cost us about $2k.
even with good coverage, it adds up. luckily, dh has a good job and although we could be havin' more fun with that money, it isn't cutting into the food budget.
but insurance is one of the things that has kept DH from going into consulting for ooodles of money. for this family, i would honestly expect to pay a monthly premium of at least $1k, plus a co-pay of $20-50 for docs, and $10-25 for rx.

[ffellini7080]

22. Of course I would

It's worth helping others.

[mgraveman]

23. Full Price

I would pay full price. I would condition that medicare and other insurance companies don't get to negotiate with the doctor on the price, and everyone including cash customers pay the same price. But insurance should not be there to pay for all expenses. It should not cover routine doctors visits or routine medications. These things are curently overpriced and hard to afford without insurance - but insurance shouldn't be paying for routine stuff.