Health Cost Concerns, Despite Insurance

[MineralMan]

For many millions of people, having health insurance doesn't mean real freedom from worries about the costs of health care. That fact was brought home to me very sharply this week. I have Medicare and a supplement that covers pretty much everything without any deductibles or co-pay, but my wife is younger and is covered by an individual policy. It's really expensive, and has a deductible, copays, and a fixed limit on total payouts.

This isn't usually a problem, since her health is OK, but it can turn into a problem very quickly. My wife had noticed some numbness and tingling in her jaw that had lasted for a month or so. So, she visited her doctor at the clinic, just to see what might be going on. The next thing we knew, she was scheduled for an MRI of her head. Naturally, we began worrying about the possibility of cancer. Logically, that didn't seem likely, due to a history of problems with her cervical vertebrae, but the worry was constant. Worry about her health, and worry about what any treatment would cost, if cancer had been found. Between the two, we've been pretty frantic with worry.

Like many people, we're living on the edge these days. Our income can barely keep up with expenses most of the time, and we've had to get a lot more frugal over the past couple of years. Our reserves are minimal. If there was a bad result from that MRI, it was obvious that we'd be in deep financial trouble, added to the health issues.

Fortunately, the results of the MRI showed nothing, which was an enormous relief, but that isn't always the case for everyone. The costs of medical care beyond what most health insurance covers can be astronomical. Many families with what is considered to be "good" health insurance are bankrupted in a matter of months when someone becomes seriously ill.

This is where the current system breaks down and insurance isn't assurance of anything at all. Sure, you get treated, but you end up bankrupt. How is that a good thing? No doubt, we'd have had to sell our paid-for house if the news had been bad.

The answer is obvious. We need single-payer medical coverage, paid for by taxation. There should be protections built into that system that prevent a catastrophic illness from ever bankrupting a household. Anything less is insufficient.

The story of our household has a good ending. But, what of all the households where the diagnosis is more dire? We've had a week of constant worry, followed by enormous relief. Many people have no such relief. We need a new system. The only way I can see that we might get it is if we can get enough progressive legislators in place to ensure that such a single-payer system is created. We can do it, I believe, if we stop bickering among ourselves and engage in the slow process of remaking the system using the existing tools. It will take hard work, patience, and more hard work. Are we willing to do that work? I don't know. I'm beginning to wonder if we really are.

[Autumn]

1. My Husband had a heart attack five years ago,

with insurance, we spent about 15,000 out of savings on our share. When Obama started health care, I wrote, and called all my reps, the White House on a regular basis for single payer or at least a public option. We got insurance finance reform. I have a health insurance plan which takes a good chunk of his pension. I can't afford to use it. When we work our butts off and they don't listen, who is to blame? I'm beginning to wonder.

[MineralMan]

2. 20 years ago, I got viral encephalitis, and spent three weeks in

hospitals, most of the time in a coma. I had health insurance, but my out of pocket costs hit about $20,000, despite a $5,000 out of pocket maximum on my policy. How did that happen, I wondered? Well, some of the things turned out to not be covered by my health insurance, so I was responsible for their full cost. The air ambulance, alone, that took me from the Arizona desert to Palm Springs wasn't covered my my insurance. $5000. There were more things not covered, like the second MRI they had to do because I kept moving in the first one while comatose.

There's always something.

[Autumn]

5. When Obama was in Pueblo I got to shake his hand

and speak to him. I said we need health care reform, single payer or at least a public option. You know what he said? Yes we do, yes we can. Well we didn't. So that begs the question. Where do we go from here?

[MineralMan]

6. Real reform couldn't make it through Congress.

There was no chance at all. So we got the hodgepodge we got. My solution, described in the last paragraph is the only one that will work. If we don't do that, things will just get worse. That's my opinion. And that's why I'm deeply involved in Democratic politics here in my district in Minnesota. That involvement has worked, in my area, anyhow. I've seen it work. Our congresswoman is committed to single payer.

I know that many people disagree with me, but that's how we have to change the system, and it's not going to happen quickly. It will take years, and we've already had a setback in 2010. All that's required is to look at the turnout in those congressional elections to see what happened. The numbers don't lie. We mustn't let that happen again.

[Autumn]

7. Public option was given away in a deal , that is

a reported fact. I don't think that chance is coming back. Calling and writing does not seem to work. The only voice we have is our vote. We can't match the special interest and lobbyists.

[Lydia Leftcoast]

14. I don't buy that

Obama twisted the arms of the Progressive Caucus to make them vote for this monstrosity.

Why couldn't he have twisted the arms of the Blue Dogs to make them include a public option?

Why did he meet in closed-door session with the insurance execs? (Just like Cheney met in closed-door session with the energy execs?) Since when do people covered by a law get to choose what's in it?

Why didn't he mobilize all the people who busted their butts to get out the vote--organize them to do sit-ins in the offices of reluctant Congresscritters? Go on TV a la Reagan and tell them to phone their Congresscritters about single payer?

Answer: He was more concerned about pleasing the corporations than about doing what was right for the American people.

Really, that's the conclusion I have to come to.

[MineralMan]

15. I don't believe it was ever for sale.

I never thought that single payer was possible in the last Congress. In fact, I'm very sure it wasn't. When you can't get something, you move on. The President has very limited power to coerce Congress on anything. Single payer was introduced, but never voted on. It had its supporters, but they were far to few to carry the bill through to passage.

If you look at what happened even to the public option, that is very clear.

The only way single payer is ever going to become law in this country is if we elect an overwhelming majority in both the House and Senate. And by that, I mean at least a 70-75% majority. The time to start working on that is yesterday. When will it happen? Well, I'm 65 years old. Probably not in my lifetime, but it's still my goal.

One thing's certain, though: We won't get it by running down the Democrats we have. That trick never works.

[Lydia Leftcoast]

17. You mean we tell them, "Good job, guys" when they blow it so completely?

Lyndon Johnson would have gotten a public option, I'm convinced of that. He would have horse-traded like crazy and threatened any stubborn holdouts with loss of support for reelection.

He managed to push through a civil rights bill, for heaven's sake, at a time when half the nation was against it. And Obama can't push a policy that has majority support?

Reagan would have gotten a public option in an alternative universe in which he was a liberal. He would have gone on TV, explained it in simple terms, and told the TV audience to phone their Congresscritters. That's how he got his tax cut bill that actually raised taxes on the middle class by eliminating the deduction for charitable contributions for non-itemizers and eliminating the deduction for consumer interest.

In other words, he got people to advocate for something that was NOT in their best interest.

I still maintain that Obama did not do ANYTHING to promote a public option.

He just through his hands in the air and said, "Sorry, not feasible!"

This "we didn't have the votes" is just another in a long line of lame DLC excuses for going along with the Republican agenda.

If he had really TRIED hard and failed, then I could deal with that.

If he had really TRIED hard and failed, then he could have gone and said, "Look, I know that the majority of you want a public option or a Medicare buy-in, but the Republicans and the Republican Lites in my own party are blocking it. Remember that at election time."

But he didn't try--except for trying to appease the Republicans and the insurance companies.

Sorry. I didn't have high expectations of him, because his campaign speeches were so vague, but when he doesn't even TRY to push something that was part of what he DID say in his campaign, then I'm out of patience.

[bemildred]

3. Our health care system has been turned into a racket to transfer money to the rich. nt

[Lydia Leftcoast]

4. Welcome to my world

I dropped my high-deductible individual policy after the premiums kept rising a minimum of 10% per year, even though I NEVER used up my $5000 deductible.

When I suffered the double whammy of an injury and a slow period in my business, I ended up with medical bills that were more than I could afford but STILL didn't meet the deductible.

I realized that I couldn't keep paying premiums and also pay off the bills from my injury.

I dropped the insurance after I received a notice that the premiums would go up 30% on my next birthday, because it was one of those ones that ends in a "5" or a "0."

It took 7 months to pay off the bills.

This is why I was so disappointed and angry about HCR. I knew that even in other countries with private insurance systems, there are NO DEDUCTIBLES and premiums based on income rather than age or state of health.

I really, really wish I had taken those chances I had in the 1980s to move to Japan, Norway, or Australia, because I wouldn't have faced that situation in any of those countries. (I would have had significant copays in Japan, but NO DEDUCTIBLES, and if my copays had exceeded a certain percentage of my income, I could have applied for a refund from the government.)

[Autumn]

10. I'm joining your world in March

My premium has gone up, there is an extra 50 dollars coming out of our pension check for taxes, my property taxes have gone up, our PERA cost of living raises were legislated away by a "Democratic" Governor two years ago and I have decided the money I use for my insurance premium, can better be spent else where. Things are NOT getting better.

[Yo_Mama]

8. And for many, the situation will not change much under the health care reform bill

I don't think it is adequate. 70/30 split along with relatively high out of pocket limits would bankrupt a lot of people with moderate incomes. If not, a huge number of people would lose their homes.

Just like now, people will not get some health care because they can't afford it. And just like now, older people won't be able to afford health care when they really need it.

I ran through the Kaiser health calculator and I just don't see how the average 55 year old with a medical condition and an income of 35K can afford to pay $3,325 in medical premiums plus a cost-sharing of $4,167. In total, that's $7,492, which is going to be more than 25% of after tax income. It's the 30% that the insured has to pay that kills them. That's a huge cost-sharing percent. One car accident or operation will put you there, or a two-night hospital stay, or an expensive diagnostic test.

The truth is that the situation won't be much better for many than it is now. A lot of people will find themselves losing their savings and their homes later in life, because they won't have real health insurance when they get ill.

A 55 year old making 50K would have to pay an annual premium of $8,495 PLUS an out of pocket cost-sharing of $6,250. And any health condition will get them to that max, because the split is only 60% paid by insurance, with the insured paying 40% until he or she reaches the out-of-pocket cost of $6,250. So that's a total annual cost of $14,745. Again, a person who gets ill at that age will burn through all their savings and lose their home. A couple of years of that and they are toast. If it's just appendicitis, then they can recover, but if it is a chronic illness, they can't.

I give the Democrats credit for trying - I really do. But this is not the answer. People are willing to pay into insurance only if it means they really will be insured for their lifetimes. A direct tax of 15-16% on top of Medicare tax might seem high, but if it means that you will really be insured for your lifetime, it's a better deal.

[Lydia Leftcoast]

12. As I've said many times, it's "affordability" as defined by millionaires

:grr:

[w8liftinglady]

9. my co-pay last year = $30K

granted, my medical bills exceeded $300K
My drugs exceeded $7K

I'm one of the lucky ones who could pull it off(it wiped out my savings)
Think about those who couldn't.They would not have had the same treatment as I received... or the same outcome.

[CreekDog]

11. yes, single payer works

:hi:

[woo me with science]

13. Kicked and strongly, strongly recommended. nt

[Mimosa]

16. K&R We're always being lied to when they say single payer isn't doable. n/t