Your Health Care coverage status:

[marmar]

Poll question: Your Health Care coverage status:

My inspiration for this poll is my company's health care plan, which continues to devolve into extreme suckage. I won't name the provider (except that it's a five-letter word that begins and ends with the letter A).
The level of suck began to increase last year when they introduced a health savings account plan (ala McCain) and started requiring annual check-ups at this little in-office clinic they set up once a year. The clear motivation for those was to discourage people from visiting the doctor, and to "weed out" people whose cholesterol levels, blood pressure etc didn't improve from year to year.
They dropped our $5 copay on prescriptions, but that turned out to be a Trojan horse. They're introducing all kinds of little back-door fees and surcharges now.
Anyway, how satisfied are you with your coverage or lack thereof?

[Warpy]

1. No health coverage for almost 21 years and no hope of getting any

because partial disability is not considered an adequate reason for state coverage and Medicare is a long way away.

[ananda]

2. TRS-Care 3 purchased through TRS with Aetna as insurer.

Not all that great, but OK.

TRS is Teacher Retirement System of Texas.

My policy is $280 per month off the top
of my pension.

[krispos42]

3. Through employer and it's so-so, I think

Haven't really tested it, thank God. The kid and I are pretty healthy. Yeah, I'm a fat couch potato but my BP and cholestoral are both normal and I have no chronic problems or medications.

The rates keep going up, though. They cut back on our "circle" of providers this year to offset at 48% (!) increase in price over last year.

Actually, after I got a checkup a couple of years ago I told my boss about my low cholestoral level. While munching Doritos from a "Family Size" bag.

He choked on his ham-and-lettuce sandwich (no cheese or mayo) and sputters "The way YOU eat???"


I just crunched a Dorito and said "Yup" with a smile on my face.




I think he thinks the universe is unjust! :rofl:

[cbayer]

4. Actually, there is some merit to HSA's and annual screenings.

HSA's often give patients more options and control over what services they access and where they get those services. The big drawback is the concern that people will not seek care when they need it because they want (or need) to keep the savings account money.

Patients whose diabetes, hypertension, high cholesterol, etc. are picked up early have much less morbidity and mortality. This is particularly good for men who, even when they have insurance, often do not get annual checkups or screenings. I am no fan at all of the for profit health insurance companies, but there are certain programs being installed by larger companies that make good medical sense.

At any rate, I have no coverage at all and live in mortal fear that of being injured or getting sick. As an individual, insurance would be out of the question at this point. Even getting these annual screenings you reference would cost me a lot and if they showed something that needed attention, I don't know what I would do.

I am very interested in the results of your poll. Thanks for doing this.

[Oregone]

5. HSAs suck.

You'll never really be able to afford an emergency, unless you are rich enough to pad them, in which case, you probably don't need an HSA.


Look, you want options and control? Universal Health Care is the way to go for that. I don't have a bureaucrat (rich elitist keeping me poor) telling me what health care I can and cannot receive, and what doctors or hospitals Im allowed to goto to receive it. I also don't have a savings account with a dollar limit to my ability to live.

[cbayer]

10. I fully agree that Universal Health Care is the ultimate solution, but it's going to be awhile.

Most HSA's are set up such that the amount in the HSA is equal to the deductible. So, if you have a $2000 deductible policy, that first $2000 is placed in your HSA by your employer (or by yourself if you purchase it as an individual). You can either use it or not, but if you have an emergency that exceeds your deductible, the insurance should kick in. I have never heard of an HSA that had a donut hole, such as you describe. Not saying it doesn't happen, just never heard of it.

Look, I am not making the case for private health insurance and I agree with everything you say in your second paragraph. I am only making the case that in the system we currently have and considering the options available, HSA's hold some advantages for some people.

[Lydia Leftcoast]

9. All an HSA does is make you prepay your deductible

and in Minnesota, at least, the monthly premium for an HSA is higher than for a conventional plan with the same coverage.

[cbayer]

11. When I was an employer, I switched to HSA's for myself and my employees.

My employees were anxious at first, but ended up really liking it. I paid the deductible amount into their accounts, then they were able to use is at their discretion. It also allowed them to use it for things that weren't previously available like glasses, certain meds and even some alternative treatments like accupuncture for smoking cessation. If they went over their deductible, the policy kicked in. If they didn't reach their deductible, they could keep the money in their account or take it out.

Even after paying the deductible into their accounts, the overall monthly cost was much less than a regular policy. I am sure other people have had different experiences, but I don't think this option should be totally dismissed at this time.

My overall goal is for universal healthcare in this country, but it's not going to happen soon or easily, IMO.

[REACTIVATED IN CT]

18. I agree with you about HSA's - IF the HDHP is fairly rich in benefits

and if the employer funds the HSA. Mine has 100% coverage after the fully funded deductible of $1000/$3000. And my employer is still saving money vs. the HMO/PPO options. The only downside is the cash flow issue if you happen to incur bills early in the year.

I have seen plans where there was a donut hole - where the coverage was 80/20 or 70/30 and the employer was not funding the HSA. Even my plan has a donut hole on the Rx coverage - I think I have pay $2000 out of pocket.

[Lydia Leftcoast]

20. Yes, YOU paid your employees' deductible

I'm self-employed. I'd be paying my own deductible PLUS all the monthly premiums. Since I'm over 55, that's a chunk of change to come up with every month.

[dkofos]

6. I don't want health insurance. I WANT HEALTHCARE!!

[OmmmSweetOmmm]

7. Exactly. Health insurance companies have to GO-------->

[Christian30]

8. Mine is...

okay for medical stuff, but the psychiatric benefits suck. At my last job, I was reimbursed for about 75% of my mental health costs. Now, working for a much smaller organization, the HMO that we have will only pay about 15% AFTER deductible of about $2,500.

[ayeshahaqqiqa]

12. I have no coverage, and don't want any the way it is handled now

I write up the insurance claims for a doctor, and I see how the insurance companies try their best to weasel out of paying ANYTHING. Blue Cross/Blue Shield is the worst, but none are exempt from practicing medicine without a license.

[magellan]

13. Didn't have it, then finally could afford it, then lost it when rates increased out of our reach

All within a couple of years.

[cabluedem]

14. these mini checks sound illegal to me. Your employer has no right to see your info.

and the nurse or doctor are breaking your privacy rights IMO.

[sutz12]

15. I have Basic Health..

Which is the State "Medicaid" plan here in Washington.

Cheap, and coverage has been good so far. The clinic I go to is only about 3 miles away. I'm currently unemployed, so it will change when I find work.

I also have Veteran's coverage. That's been good, too, even though I'm a category 7.

[rainbow4321]

16. Work for the county hospital and it has great coverage

Three tiered system thru Aetna.

First tier (use our own hospital/system services)
Xray/labs/treatments have no co-pay, hospital stays are $100, ER visits = $100 (if you are admitted with that visit the $100 ER fee is waived).

Prescriptions = $10. Office visits = $30. Specialty doctor visit =$50 (you don't need a referral by your primary doc)
The county hospital also now owns the once-private hospital next to it so if employees don't want to go to the actual county ER/hospital itself, they can go next door to that hospital and still get the same benefits. I got my gallbladder out back in June at that hospital next to ours (still in "our" sytem) and out of my $13,000 bill, I will pay $100.

The only thing is, if you go to the "2nd tier" of the plan and go to, say, a hospital near your house, you get stuck with a "you pay 30% of you hospital stay bill".
But so far I have been pleased at the first tier, using our system. has saved me a shitload of $$ since it kicked in (Nov 2009).


To cover me and my 2 kids my portion of the premiums is $180/month.
The monthly premium amount the hospital makes you chip in is on a SLIDING scale, so what you pay is determined by how much you annual salary is...everyone gets the same benefits, though.

[Selatius]

17. In France, the health insurance scheme is infinitely simpler in comparison to the US buckshot system

Each health insurance company has its own policies, and they also have policies dealing with denial of coverage based on pre-existing conditions. Then you have these new HSAs that were set up under Bush. You have Medicare and Medicaid and the problems of underfunding that go along with them, and then the rules that govern how you qualify.

In France, you have only one insuring entity Sécurité Sociale that covers all regardless of age or pre-existing conditions or income level and so on. Therefore, it is called single-payer health insurance because the government pays for medical procedures and prescriptions of its population. Because it is a government program, it operates in a non-profit fashion, so it doesn't pinch people to generate profit margins. Because it is the only ensuring entity, you can see any doctor without asking for permission, as opposed to the US system where the private insurance company tells you which doctors you can or cannot see on pre-approved lists.

And because Sécurité Sociale covers everybody, it has tremendous bargaining power in negotiating with pharmaceutical companies on keeping down the price of prescription drugs and on the price of medical procedures with private hospitals. This means huge savings for the people of France who pay taxes. With the recent Medicare Part D changes under Bush and the Republicans, Medicare no longer has the ability to even negotiate down prescription drug prices with pharmaceutical companies. This will only mean even higher Medicare costs in the long-run.

Even using out of date statistics here, we find that France spends HALF of what the US spends per individual on health care, yet they can cover everybody, and here you have the United States with the largest economy in the world unable to give cheap, affordable health care to its citizens even though it spends twice as much per individual on health care in general:

http://www.nationmaster.com/graph/hea_spe_per_per-health-spending-per-person

I prefer single-payer because it is cheaper for individuals and because it covers everyone.

[cabluedem]

21. I was impressed by the French system as well, when I viewed "Sicko" by M. Moore.

they even make house calls there.

[cabluedem]

22. I was impressed by the French system as well, when I viewed "Sicko" by M. Moore.

they even make house calls there.

[NightWatcher]

19. I'm eligible from my new job on November 1st cough cough a pretty good PPO

[wildbilln864]

23. none, nada, zip! nt

[juno jones]

24. Have none.

My yearly medical expenses are far lower than monthly premiums would cost. I would love to have access to healthcare but I refuse to go broke doing so. I spend the money that would otherwise go to insurance companies on high-quality food and preventative alternative care which keeps me healthy enough.

Interesting to see the results of this poll, thanks.

[Ewellian]

25. I have coverage through

my employer that blows...but I'm not allowed to say that because my employer is the health insurance company.

[Thothmes]

26. Navy Retiree

No problems. Uncle Sam looks after us very well when it come to health care. Wife had 2 massive strokes, 150,000 dollars worth of care, cost to me was about 2,500 in co pays.