View Poll Results: How do you feel about your private health insurance?
I have employer provided private insurance Ė I love it 46 23.35%
I have private insurance I obtained on my own Ė I love it 3 1.52%
I have employer provided private insurance Ė Itís OK 86 43.65%
I have private insurance I obtained on my own Ė Itís OK 15 7.61%
I have employer provided private insurance Ė It sucks 39 19.80%
I have private insurance I obtained on my own Ė It sucks 8 4.06%
Voters: 197. You may not vote on this poll

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  #51  
Old 02-23-2020, 10:47 AM
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Another issue with "do you like your employer-provided private insurance" is that your employer can change the health insurance options they provide you whenever they want. I had a job that offered a PPO plan and a high-deductible plan when I first joined, but then changed the options to a high-deductible and a very-high-deductible plan. I liked my insurance when I was able to choose the PPO plan a lot more than when I could only choose between high-deductible plans.

I like my insurance now (though it's another case of never having had to use it for a major medical issue) because it's an HMO, almost all the costs are on the employer side, and I get to just think about what healthcare makes the most sense for me, but choosing between the current system and single-payer isn't just "do I like what I have right now" because literally nothing could change as far as my situation and my employer can randomly decide to only offer crappy health care plans or plans that don't make sense for me.
  #52  
Old 02-23-2020, 10:55 AM
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Originally Posted by Yosh99
I know scores of people, including myself, who thought similarly, but woke up one morning to find their job was eliminated and their health insurance gone. Purchasing your own is very expensive, but at least you would no longer be denied for preexisting conditions because some politicians got that fixed a few years ago.

Having a government insurance option would be an added safety net. Regardless of who becomes the next president there is politically no way people will lose private insurance options, but there may be a chance to have an optional public option.

BTW, I've been on medicare with a supplement for four years now and I never had a corporate sponsored plan as good as the one I have now.
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Originally Posted by Broomstick
Yep, not until they lose that job and find out how much a COBRA payment is a month they have no real clue.
Yeah if nothing else it was enlightening. I worked for a company that had great benefits. The portion I had to pay was nominal. Hunky-dory. Then we got laid off and my COBRA bill was something like $2200 a month. Impossible of course, having no job and all. In case anyone was wondering, in the US COBRA allows you to maintain the sweet benefits you have at the time you are laid off but you have to pay for them yourself.

Now through my contracting agency I pay in the neighborhood of $1600 a month with a $3000 deductible. Itís ĎOKí for the purposes of the poll but still a huge expense, obviously.

i checked the health insurance benefits for a job I applied for: ~$1500 a month for a family of 4 with an $11,000 deductible. I couldnít believe it.

The post WWII economic conditions that spawned robust employer sponsored health insurance have come and gone. Itís not working anymore for too many and is now a luxury (I know, many consider this a good thing). Itís time to move on.
  #53  
Old 02-23-2020, 11:05 AM
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Originally Posted by septimus View Post
I do NOT approve of the American healthcare system, and would like to see a gradual move toward single-payer. But promulgating Fake Facts ó that few Americans like their health insurance ó may not be the proper way to get there.
How does one opinion about how someone else feels about their health insurance make the statement a "Fake Fact"?
  #54  
Old 02-23-2020, 12:51 PM
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While I agree that the US healthcare system is broken and that single-payer would almost certainly improve things for a very large number of people....

My healthcare plan is pretty damn good. My wife retired from employment as a (unionized) state worker and she gets her healthcare benefits for free. As her spouse, I pay $26/month for mine. When we enrolled in Medicare a couple years ago, the coverage which had been with BC/BS changed over to UHC. The UHC program is basically a Medicare supplement, so Medicare is the primary payer now. Each month the retirement plan reimburses my wife and I our Medicare payments, which is about $140 for me. We have no problem at all with providers. The coverage includes dental care and eye examinations, but not glasses. It also just started providing hearing aids, which I do use.

I might add that the benefits for more recent state employees are nowhere near as good.

So...I guess you may or may not consider this a private plan, since part of the expenses are covered by Medicare.

Last edited by ZonexandScout; 02-23-2020 at 12:53 PM.
  #55  
Old 02-23-2020, 02:07 PM
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Originally Posted by str8cashhomie View Post
Another issue with "do you like your employer-provided private insurance" is that your employer can change the health insurance options they provide you whenever they want. I had a job that offered a PPO plan and a high-deductible plan when I first joined, but then changed the options to a high-deductible and a very-high-deductible plan. I liked my insurance when I was able to choose the PPO plan a lot more than when I could only choose between high-deductible plans.
Oh yeah. This happened to me too. Used to be a PPO or HMO, can't really remember anymore. Then for a couple of years it was both that and a high-deductible plan. Now they've dropped the PPO/HMO option and all we can get is the high-deductible plan.
  #56  
Old 02-23-2020, 09:11 PM
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I have health insurance through my employer. I have no idea how good it would be overall; I'm a grad student, and I make so little that I qualify for wholly subsidized care through our local hospital/medical group. What my insurance doesn't cover, they write off. Without that, I wouldn't be able to get treatment or preventative care for the genetic connective tissue disorder that I have.

My boyfriend, however, has employer-based insurance. He had to quit PT for his wrist pain early because every session cost like $90. After insurance.

I'm pretty sure that, were it not for the local program and the fact that I barely make any money, I'd not have been able to get PT the times I've needed it (largely for neck issues related to the above-mentioned connective tissue disorder; my neck vertebrae are too loose and stuff gets pinched a lot).

Neither of us have any choice in our coverage. We both have to stay in-network for doctors, either because of plan restrictions (him) or because only one medical group in town subsidizes costs (me). There are doctors in town that would be better for both of us that we can't go to without paying money that him and/or I do not have.

It's ridiculous, honestly. But I put "It's okay" for mine because...well. I've had worse.
  #57  
Old 02-23-2020, 10:14 PM
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Every major medical issue I've had involved not just rapid medical care but the ability to bypass any delays.
  #58  
Old 02-24-2020, 12:47 AM
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Originally Posted by mack View Post
Yeah if nothing else it was enlightening. I worked for a company that had great benefits. The portion I had to pay was nominal. Hunky-dory. Then we got laid off and my COBRA bill was something like $2200 a month. Impossible of course, having no job and all. In case anyone was wondering, in the US COBRA allows you to maintain the sweet benefits you have at the time you are laid off but you have to pay for them yourself.

Now through my contracting agency I pay in the neighborhood of $1600 a month with a $3000 deductible. Itís ĎOKí for the purposes of the poll but still a huge expense, obviously.

i checked the health insurance benefits for a job I applied for: ~$1500 a month for a family of 4 with an $11,000 deductible. I couldnít believe it.

The post WWII economic conditions that spawned robust employer sponsored health insurance have come and gone. Itís not working anymore for too many and is now a luxury (I know, many consider this a good thing). Itís time to move on.
I'm having trouble determining how your current $1600 a month insurance plan qualifies as "'OK' for the purposes of the poll." It's not you, it's that "OK" is very, very vague. Other responses of people qualifying their "OK" poll replies bear this out.
  #59  
Old 02-24-2020, 05:46 AM
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My company provides me with an extremely good benefits package* including insurance. The insurance itself is at best OK, I should probably have voted that it sucks. It is confusing, ever changing and stress inducing if something actually happens. I don't really know what is in network and out of network, and when I had surgery, I had to spend a lot of time working with the bills that came months after the procedure was done involving doctors I didn't know.

Compared to what the typical American experience is with medical insurance, I should be in the "I love it" category, but that's just my company's support of the insurance package. The insurance itself, what I get from interacting with Anthem or Cigna or whomever, the "user experience" if you will, that's not fun at all.


*the benefits package is REALLY good. Medical, dental, vision, I don't pay for any insurance and the company covers my 'high deductible' with cash deposits into my HSA. It's hard for me to say any of it sucks when I think it's in the top tier of US benefits packages.
  #60  
Old 02-24-2020, 07:59 AM
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I voted I have insurance through an employer and it sucks, but currently I have Medicare as my primary insurer thanks to kidney disease / transplant. I use my workplace insurance for prescription copays (not covered through Medicare).
When I was on dialysis, my insurer wanted to consider every treatment as an urgent care visit, so quite expensive. It took numerous phone calls and letters to get them to lower my OOP to a standard clinic visit. Still cumulatively expensive, but obviously necessary. After the transplant, due to a gap in Medicare, my workplace insurance did their magic. And I received bills totaling almost half my yearly gross income.

I look at what my daughter is dealing with for insurance. She is working what is considered full time for a grocery store, so 30-36 hours/week. Low pay. They offer medical/dental insurance, but it would be over 30% of her gross income. She applied for MNSure (state insurance exchange), discovered she is eligible for medical assistance. Luckily for her, at the same time it was approved, she caught Influenza B. She was freaking out over one hospital visit, four urgent care visits, and a few clinic visits. When she was on my insurance that right there would've been $500 OOP. Under medical assistance, she has paid $6.00 for prescriptions.
She and her boyfriend have discussed getting married. He has decent insurance, $100/biw premiums, $2500 deductible, through his smallish employer. Were they to get married and add her to his insurance, it would balloon up to $500/biw with a $10k deductible. Basically, almost her entire net income would pay for their medical insurance.
  #61  
Old 02-24-2020, 08:30 AM
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I have private insurance through my employer. It costs quite a bit, but there is no deductible and a wide network. It covers my family as well. Without going into much detail, we have gone through some fairly serious health problems with no difficulty from our insurance company.
  #62  
Old 02-24-2020, 08:39 AM
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I have pretty good coverage from my husband's employer's plan but I abhor our current system of health insurance. I have an issue that requires an ongoing medication, one of the expensive biologic medicines. All of the insurance plans hate how expensive it is, and I don't blame them but I hate the way they deal with it. For example:

Years ago insurance plans implemented copays on the theory that if patients had "skin in the game" they would be more likely to shop around for lower priced care/medications. Then more recently they implemented pharmacy benefit managers, ostensibly to help them, again, manage costs. So what do the PBM's immediately do with expensive drugs like biologics? Mandate that you can only ONLY fill them at their chosen specialty pharmacy. No, you may not shop around or use Goodrx.com.

And they implemented a tiered coverage system so if your drug is on their Tier 2 list the copay is X+Y, and if it's on their Tier 3 list then the copay is X+Y+Z. Remember the concept of copays was to encourage us to shop around, but since they won't let me, now it's just punitive.

Even worse, the insurance plans often require a pre-authorization for these meds which means additional bureaucracy between the PBM, the doctor's office and the insurance plan which causes weeks or even months of delay. I've given accounts in other threads on the SDMB of my situations of having to go 6-7 weeks without taking my meds because of this very issue.

I haven't even had a catastrophic illness (yet), but they make dealing with them so much trouble that I kind of hate our insurance. And over the last 10-15 years, between job changes and employers changing plans, I've used nearly all of the major insurance providers. And every one of them are nearly the same, just varying degrees of aggravation.
  #63  
Old 02-24-2020, 08:47 AM
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Originally Posted by Moriarty View Post
I don’t understand the concept of “loving” health insurance. That’s like asking if you love the tires on your car.
I think its because as Americans we have been conditioned to realize our health care could be a lot worse, and we consider ourselves lucky if we have insurance that actually pays the bills.

So it would be more like if tons and tons of people were driving around on shitty tires that always go flat, but yours work. Yeah you'd be grateful, but there are countries where everyones tires are always inflated and in good condition too.

Its a testament to how fucked up our system is, that a small % of Americans who are currently in a good position are deeply grateful for something that people in other nations take for granted and consider a birthright. I'm sure in Africa, there are minorities of people who are deeply grateful for clean drinking water since so many people around them don't have clean water and they realize they could lose their own clean water at any time. In most other nations we just take clean water for granted as a sign that you live in a civilized nation.
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Last edited by Wesley Clark; 02-24-2020 at 08:49 AM.
  #64  
Old 02-24-2020, 09:14 AM
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I have insurance through the Marketplace, since the company I work for is small and doesn't have insurance you can get through them (there is an option you can use, though I forget what it's called. It works similar to insurance, but it's run through a faith-based organization, and I didn't want to risk not being able to get bc or something like that). They're looking into getting some, but in the meantime I'm okay with the insurance I have. My job does give me $100 a month to put toward health expenses, so I opted for a plan I pay less than that for every month. So far all my bc has been free, and any additional drugs have been $10 or under. I don't have any gripes about them that I wouldn't have toward any other insurance option, or the one I had prior (which was through work).
  #65  
Old 02-24-2020, 09:24 AM
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Originally Posted by Kovitlac View Post
I have insurance through the Marketplace, since the company I work for is small and doesn't have insurance you can get through them (there is an option you can use, though I forget what it's called. It works similar to insurance, but it's run through a faith-based organization, and I didn't want to risk not being able to get bc or something like that). They're looking into getting some, but in the meantime I'm okay with the insurance I have. My job does give me $100 a month to put toward health expenses, so I opted for a plan I pay less than that for every month. So far all my bc has been free, and any additional drugs have been $10 or under. I don't have any gripes about them that I wouldn't have toward any other insurance option, or the one I had prior (which was through work).
Is your plan subsidized because of your income? If it is, I think that's really relevant.
  #66  
Old 02-24-2020, 09:31 AM
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Originally Posted by Riemann View Post
(2) Many people who say they like it do not understand what it's costing them. When insurance is paid for by an employer, they think it's free or inexpensive to them. It doesn't feel like a huge payroll tax, but it is. People's expectations might be different if their paycheck showed a gross pay figure before health insurance costs, with the amount that their employer is paying for their insurance subtracted.
I'm curious if those under a universal healthcare system get similar notifications of how much their healthcare cost themselves and fellow taxpayers. I'm not really for or against either systems - just curious.
  #67  
Old 02-24-2020, 09:37 AM
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Originally Posted by Manda JO View Post
Is your plan subsidized because of your income? If it is, I think that's really relevant.
I get $400 from the government due to my income, and my plan cost me about $458 (just me, no spouse or dependents). Originally, anyway - it supposedly went down to about $38 when the new year started, but I only started the insurance in October, so my monthly bills have kind of been all over the place.

It is a little cheaper than I got through my previous employer, which cost be about $80 a month. That also included super cheap dental and vision, which I no longer have.

If I didn't get that money from Marketplace, I'd have to go with as cheap a plan as possible. Or do the odd faith-based insurance my job currently offers. I've been on catastrophic insurance before and it's far from fun. Fortunately, I'm generally a healthy person.
  #68  
Old 02-24-2020, 09:46 AM
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Originally Posted by str8cashhomie View Post
Another issue with "do you like your employer-provided private insurance" is that your employer can change the health insurance options they provide you whenever they want. I had a job that offered a PPO plan and a high-deductible plan when I first joined, but then changed the options to a high-deductible and a very-high-deductible plan. I liked my insurance when I was able to choose the PPO plan a lot more than when I could only choose between high-deductible plans.
Thats not universally true. My employer can not legally change health care on us whenever they want because itís part of our contract.


Our plan is very good with no deductible, a small co-pay and not cheap but reasonable premiums.
  #69  
Old 02-24-2020, 11:45 AM
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We have employer provided insurance and it's ok. The best insurance we had was a Gold level Obamacare plan a couple of years ago, it was wonderful the current plan is a little more expensive and doesn't cover quite as much (we only get glasses or contacts every other year). My parents are on Medicare and their insurance is much worse then ours. It takes them longer to get stuff done and it costs them more money out of pocket. I'd be grumpy if my current plan was removed and I ended up with longer lines and spending more money.

That being said I'm generally a fan of a single payer system and realise that the societal benefits are greater than my personal costs.
  #70  
Old 02-24-2020, 12:09 PM
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As US health insurance goes, mine is ok to good. I pay about $600 a month with a 1500 individual/3000 family deductible, so it's not terribly expensive as such things go. It's through a major insurer, so the negotiated rates are pretty good and the network is pretty large.

What I don't like is the general pain in the ass actions required to navigate the system and get the best outcomes. It's not unique to my insurance- it's the way all of them are. They may require a certain test to be run before they'll ok a different one, even if your doctor has an educated hunch that it's your gallbladder and not your colon. Or your doctor may want to prescribe you one hypertension medication, but they require them to prescribe some first-line drug off their specific formulary and prove that it doesn't work before they'll pay for the second one that your doctor actually wants. Or you may end up in the ER needing emergency surgery and later get a bill finding out that the guy who the hospital assigned to you isn't actually in-network, despite the hospital itself being in-network. And having to argue that point with them that you had no choice in the matter- it's not like you could go home and research and come back a week later for the emergency surgery. Or having a test done in an in-network facility for an in-network doctor, and getting a $200 bill, because the price of the test was $750, the negotiated rate was $225, and the insurance portion is $25, leaving you on the hook for the other $200 because your deductible hasn't been met.

It's all that crap that drives people insane.

What people fear about single payer health care is that it will cost more, reduce choice, and depersonalize the process. Proponents need to gin up a bunch of examples, or maybe a website that would explain how it would be cheaper for your average middle-class family of four making about $70-80k a year, and how it won't prevent them from seeing the doctors they like, when they like, etc... Nobody's quite stupid enough to think it'll be absolutely free for anyone, except maybe the indigent, but proponents do need to show that whatever tax increases will be necessary will offset the aggregate premiums, copays and deductible payments for most people.
  #71  
Old 02-24-2020, 12:55 PM
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...whatever tax increases will be necessary...
Well, the first thing to point out is that the notion of large tax increases derives from the fact that what employers currently pay is not classified as a payroll tax - which, in effect, it is. Your middle class family making $70-80k a year is really making $100-110k a year with $30k deducted by their employer that goes to pay for their current private insurance. Their breakeven point is that this $30k is now simply reclassified as a tax and goes to the single-payer public insurance pool rather than a private insurance company.
  #72  
Old 02-24-2020, 01:35 PM
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Originally Posted by Kovitlac View Post
I'm curious if those under a universal healthcare system get similar notifications of how much their healthcare cost themselves and fellow taxpayers. I'm not really for or against either systems - just curious.
Other than my annual tax bill, you mean?

But the non-facetious answer is that Iíve lived in three different provinces in Canada and have never got a statement of what my health care has cost that year. Thatís because we donít think of it as insurance. Itís a government service.

I donít get a statement showing how much the police services in my town cost me each year, or the cost of the roads, or the cost of fire services, or the cost for the Cubís public schooling. Those are all government services, paid for from our taxes.

Health care is just one more example of a government service paid for by our tax dollars.
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  #73  
Old 02-24-2020, 02:08 PM
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Other than my annual tax bill, you mean?

But the non-facetious answer is that Iíve lived in three different provinces in Canada and have never got a statement of what my health care has cost that year. Thatís because we donít think of it as insurance. Itís a government service.

I donít get a statement showing how much the police services in my town cost me each year, or the cost of the roads, or the cost of fire services, or the cost for the Cubís public schooling. Those are all government services, paid for from our taxes.

Health care is just one more example of a government service paid for by our tax dollars.
Why couldn't I have been made Canadian?
  #74  
Old 02-24-2020, 02:53 PM
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Originally Posted by nelliebly View Post
Ah, yes, the classic conservative "Sucks to be you" mentality. You don't care about what it's doing to other people or the bigger picture, as long as you've got yours, right?

I voted, "I have private insurance, and it sucks" because there was no Medicare option to choose, and before I got on Medicare, I had crappy private insurance. If I were still employed, I would have selected the via-employer-and-it-sucks option, because I was a public school teacher in Wyoming, which opted out of expanding Medicaid out of sheer hatred for Obama.

However, even if I'd had excellent employer insurance, I'd still be for single-payer because I can see beyond my own interests, and I'm not a jerk.
It's a poll. The question was how do *I* feel about *MY* private insurance plan. NOT what do I think is best for the "big picture." That's how polls work.
  #75  
Old 02-24-2020, 03:10 PM
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I’ve lived in three different provinces in Canada and have never got a statement of what my health care has cost that year. That’s because we don’t think of it as insurance. It’s a government service.
As someone who grew up in the U.K., I concur.

However, there's a real sense in which, unlike most other government services, it is much more like insurance. People's individual requirements for healthcare vary much more than (say) their use of roads or the benefit they derive from defense spending. And I think framing it as public insurance gives insight into why private insurance is a terrible approach to healthcare.

The benefit of all private enterprise is efficiency gains motivated by competition. In the insurance business, a company with better a model for risk estimation can out-compete a company with a worse model. And risk estimation requires looking carefully at your historical behavior as an individual. In auto or home insurance, the contract usually only lasts for a year, then your risk is reassessed. If you're a driver with a good safety record, an auto insurance company that can accurately place you in a low risk pool can profitably sell you cheaper auto insurance. And our society generally doesn't have any ethical problem with the idea of dangerous drivers being forced to pay more for auto insurance, or if they can't afford it to take the bus. Because there's a feedback effect, it's under your control - the risk of higher insurance premiums encourages you to be a safe driver.

The equivalent kind of risk analysis for health insurance requires analysis of your likely future requirement for healthcare. Private companies obviously want to insure only healthy people! Since we find that ethically unacceptable, U.S. private insurers are generally not allowed to terminate their contracts with people who get sick (although they will jump at the just if they have a legal justification), and they are not allowed to consider pre-existing conditions. So we're letting private insurance companies exist, but banning them from competing with one another in assessing individual risk. They just sit there, not competing because we don't want them to compete, gathering money and taking a big cut.

The correct ethical model for healthcare insurance is that the customer and the insurance company both commit to a contract for an entire lifetime, and unlike auto or home insurance your risk is not reassessed every year. You commit to it with a Rawlsian veil of ignorance about whether your individual lifetime healthcare needs will be higher or lower than the average person. In other words it's a part of the social contract.

And if this is the correct model for healthcare insurance, private competition has no place in it. It should be a single obligatory insurance pool that everyone must contribute to. And the simplest and cheapest way to administer such an insurance pool is to fund it through general taxation. This is what "single payer" means.

Every nation on earth except the United States understands this.

And as others has emphasized, this relates solely to the funding of healthcare, it has nothing to do with the provision of healthcare. Private enterprise and the benefits of free market competition are absolutely part of the efficient provision of healthcare.

Last edited by Riemann; 02-24-2020 at 03:14 PM.
  #76  
Old 02-24-2020, 03:13 PM
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Why couldn't I have been made Canadian?
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  #77  
Old 02-24-2020, 03:48 PM
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I voted "love", although I'm not sure that's an accurate description. My employer covers the full cost, which is great. The insurance seems to be good? The only major medical expense I've had in the past decade was several days in the hospital for which I paid $100 out of pocket for the emergency room visit.

There is occasional wrangling with the insurance over not paying something, but they've always eventually either paid it or provided an acceptable reason (to me) for why it's not covered. It is disturbing to me that this process seems to be as arbitrary as it is, though.

Example: When our second baby was born, our insurance didn't pay for CA's newborn genetic testing, which is required by the state. I asked about why, and the insurance person said it's not covered. I pointed out that they had paid for it for my first child, and they said, maybe you had different insurance. I pointed out that I had the same insurance, and also inquired about how it could be that the state required this, but the state insurance commissioner didn't make sure that insurance covered it? I escalated this to HR and now I had HR, and the insurance company, and our insurance broker telling me that it was common that insurance didn't cover this, but no one could provide any documentation of that. I submitted the bill again and the insurance paid it.

The whole thing is bullshit. If this is really not covered, then it should be really easy to point to a document that says so, and they shouldn't pay it. And if it is covered, they should pay it. At no point in the process should I have to send 20 emails and make 4 phone calls to get them to cover an event that happens 400,000 times a year in California. It's not like the state-mandated testing of a newborn was this weird unlikely event that no one had run into before!
  #78  
Old 02-24-2020, 05:22 PM
rbroome is offline
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I didn't read the OP post before I answered the poll.
I am benefiting from a Medicare Advantage plan funded through my (wife's) employer.
So most of the cost is covered by Medicare, but the Advantage part is covered mostly by the retiree health plan. The cost is spread out among 3 entities: Medicare, Employer retirement system, our individual premiums and copays.

Given the spread, no one entity is paying a huge amount for the benefits we receive. And while our cost is not high compared to most people, if you add up all the different payments we make, it is a noticable amount.
  #79  
Old 02-24-2020, 06:52 PM
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I used to have excellent company-provided health care. Low cost, low deductibles, and it was a very nice thing.

Then, Seven (?) years ago, Obamacare came up, and our lovely healthcare had to be gutted to meet the standards. It went to a high cost, high deductible. My prescriptions went from a $20 copay to nearly $200 each. I lost access to my longtime doctor - I chose to pay his fees rather than being forced to switch doctors.

Our plan is merely OK now. $3k deductible is the lowest plan, 80/20 split.

I wish they'd left our company healthcare alone.
  #80  
Old 02-24-2020, 07:04 PM
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I'm reasonably happy with my employer-provided Kaiser plan. My primary care doctor is great, the urgent care center is convenient, and the premiums and co-pays are reasonable. I recognize that there are gaps in coverage, especially when it comes to mental health care, but those issues haven't affected me personally. My favorite thing is never getting a surprise bill for thousands of dollars for a test or procedure my doctor insisted on but my insurance decided not to cover, as happened several times when I had a PPO. Incidentally, my husband is currently unemployed and purchased a nearly identical Kaiser plan through Covered California for much less than it would have cost to add him to my plan, so that's been working pretty well for us. But it was still a hassle for him to have to change providers. I'm very much in favor of universal healthcare, and would be happy to pay twice as much out of my paycheck for a system that would always be there for me, even if it was otherwise exactly like the plan I have now.
  #81  
Old 02-24-2020, 07:04 PM
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There's no option for me. My employer provided insurance is great , for private insurance. I pay about $500 in premiums, my copay is $25 for an office visit ( higher for urgent care or an ER) and my deductible for out-of network coverage is $1500 per person. But - my insurance costs my employer another $24K. I'm not sure it's worth over $30K , considering that I may or may not be able to keep my doctor if I like him- just because the doctor was in-network last year doesn't mean he will be next year. And while I might not have a problem paying my primary ( who no longer participates) $70 for an office visit rather than my $25 copay, that doesn't mean the same will be true if the GI doctor stops participating and I have to pay $2675 for a colonoscopy rather than $25. Of course, I don't know if he'll charge me $2675 if he leaves the network - according to the claim form, he billed $2675 but accepted $642 from the insurance company. The whole billing system doesn't make sense- I read someone that one of the reasons doctors bill so high is because insurance companies naturally won't pay more than the bill so the doctors bill higher than any insurance company will pay. I still have to worry about whether I will end up with a non-participating provider in an emergency room situations , although my state provides some protection against balance billing. I can't help but wonder how much less expensive the whole process would be if doctors didn't have to have billing services and office staff to deal with the insurance companies - and whether taxes for a decent public healthcare system would be more than the over $30K I'm essentially paying now. ( Sure, my employer pays $24K, but that's part of my compensation just like my paycheck)
  #82  
Old 02-24-2020, 07:22 PM
doreen is online now
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Originally Posted by Noelq View Post
I used to have excellent company-provided health care. Low cost, low deductibles, and it was a very nice thing.

Then, Seven (?) years ago, Obamacare came up, and our lovely healthcare had to be gutted to meet the standards. It went to a high cost, high deductible. My prescriptions went from a $20 copay to nearly $200 each. I lost access to my longtime doctor - I chose to pay his fees rather than being forced to switch doctors.

Our plan is merely OK now. $3k deductible is the lowest plan, 80/20 split.

I wish they'd left our company healthcare alone.
Can I ask you what part of the ACA caused this ( if you know) ? I've heard people complain that they could not longer get the plan they had before because the ACA didn't allow cheap plans with low coverage limits ( plans with yearly limits of $2K or $5K) and I've heard people say their costs went up because the compliant plans were more expensive but I've never heard anyone say that ACA required their company to change to a plan that was more expensive for the employees and had worse benefits.
  #83  
Old 02-25-2020, 12:24 AM
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Thats not universally true. My employer can not legally change health care on us whenever they want because itís part of our contract.


Our plan is very good with no deductible, a small co-pay and not cheap but reasonable premiums.
I thought about bringing up unions, which are an exception to my previous comment in that they have a contract for several years, and negotiations have much more long-term consistency even beyond that. They are a pretty small minority though.
  #84  
Old 02-25-2020, 01:10 AM
needscoffee is offline
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Originally Posted by Noelq View Post
I used to have excellent company-provided health care. Low cost, low deductibles, and it was a very nice thing.



Then, Seven (?) years ago, Obamacare came up, and our lovely healthcare had to be gutted to meet the standards. It went to a high cost, high deductible. My prescriptions went from a $20 copay to nearly $200 each. I lost access to my longtime doctor - I chose to pay his fees rather than being forced to switch doctors.



Our plan is merely OK now. $3k deductible is the lowest plan, 80/20 split.



I wish they'd left our company healthcare alone.
I'm skeptical, having worked in billing for healthcare insurance. If your company's plan had to be gutted to meet ACA requirements, that means it either had extremely high deductibles and out-of-pockets, which you state it didn't, or it didn't cover any pre-existing conditions. All the plans my own family members were on were viable ACA-worthy plans. Most decent plans were.

It sounds a lot more like the company was trying to save money in the face of rising insurance costs (due to insurance companies jacking up their rates) by switching to a crappier plan, and then blaming it all on Obamacare. I saw this happen over and over again. Sadly, people believed the companies when they blamed Obamacare. If your company's previous plan was any good, it would have remained a qualified plan, as did many, many insurance plans.

If you can point out what part of your old plan didn't qualify under the ACA, please do. Because otherwise, it sounds like you were lied to.
  #85  
Old 02-25-2020, 04:51 AM
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Question: If I was self employed and purchased a plan on my own, would I be able to write it off my taxes as a business expense?
  #86  
Old 02-25-2020, 06:38 AM
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My husband's new employer offers insurance that would cost us 25% of his salary. Not worth it.
We are members of a concierge clinic for a PCP and maintenance, and will join a Christian cost-sharing group for critical care.

What I find frustrating are the attitudes about the whole system:

I don't like mine, so I won't believe anyone else likes theirs.

I don't like mine, so no one should have a choice.

Taxes? Costs? *fingers in ears* "la la la I can't hear you!"

I guess every penny that is now spent on the system will somehow magically end up in the hands of the government bureaucracy that will always make wise and sensible decisions, will never have a problem with fraud, and won't siphon off a huge chunk in administration costs.

Your employer can change it at any time! As if the government would never arbitrarily make changes or cut coverage.

Realities like the numbers of doctors and other personnel, and the number of facilities are blissfully ignored. Everyone seems to assume that upon passage all will be right and there will be no miserable lag time for the system to catch up to demand.
  #87  
Old 02-25-2020, 07:43 AM
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My husband's new employer offers insurance that would cost us 25% of his salary. Not worth it.
We are members of a concierge clinic for a PCP and maintenance, and will join a Christian cost-sharing group for critical care.

What I find frustrating are the attitudes about the whole system:

I don't like mine, so I won't believe anyone else likes theirs.

I don't like mine, so no one should have a choice.

Taxes? Costs? *fingers in ears* "la la la I can't hear you!"

I guess every penny that is now spent on the system will somehow magically end up in the hands of the government bureaucracy that will always make wise and sensible decisions, will never have a problem with fraud, and won't siphon off a huge chunk in administration costs.

Your employer can change it at any time! As if the government would never arbitrarily make changes or cut coverage.
The point about employer-based coverage not necessarily being a guarantee that nothing will change is mainly a counter to the argument against switching to universal healthcare which is that people who like their current healthcare would lose it. The point is OK sure, but the current system has little to no guarantee as is.

I happen to like my health insurance, but overall the system is both extremely inefficient and failing too many people. Medical bills are still the number one reason for bankruptcy in the US, and as has been mentioned in this thread, a lot of people are satisfied with their insurance until they actually have a major medical problem and they find out that they weren't as well-insured as the thought they were.

Personally as far as taxes go, I think single-payer will only work if we continue to tax it similarly to social security and medicare are taxed now, with a separate tax fund that's a mandatory part of the budget (as far as details, increasing medicare income and payroll tax would probably make the most sense IMO). Otherwise the public option would be a safer long-term bet.

Last edited by str8cashhomie; 02-25-2020 at 07:44 AM.
  #88  
Old 02-25-2020, 07:54 AM
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Well, the first thing to point out is that the notion of large tax increases derives from the fact that what employers currently pay is not classified as a payroll tax - which, in effect, it is. Your middle class family making $70-80k a year is really making $100-110k a year with $30k deducted by their employer that goes to pay for their current private insurance. Their breakeven point is that this $30k is now simply reclassified as a tax and goes to the single-payer public insurance pool rather than a private insurance company.
And what's really terrible about the way it works now is that the employer portion of the premium is, essentially, paid in company scrip, like if you worked in an asbestos mine owned by a gilded era robber-baron. You either buy your insurance from the company store or you lose all of that money. If another plan would work better, tough shit, because your employer will pay nothing toward it and will also give you nothing for saving them on premiums.

Last edited by Lord Feldon; 02-25-2020 at 07:55 AM.
  #89  
Old 02-25-2020, 10:16 AM
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Well, the first thing to point out is that the notion of large tax increases derives from the fact that what employers currently pay is not classified as a payroll tax - which, in effect, it is. Your middle class family making $70-80k a year is really making $100-110k a year with $30k deducted by their employer that goes to pay for their current private insurance. Their breakeven point is that this $30k is now simply reclassified as a tax and goes to the single-payer public insurance pool rather than a private insurance company.
So wait... you're basically advocating a payroll tax on employers to make up for this shortfall? They're going to LOVE that, especially if they're paying less than whatever this payroll tax costs. And I suspect that'll be passed on to employees via lower pay in a lot of cases.

There's no such thing as a free lunch. Someone is going to have to pay for it- the trick is going to be to readjust taxation in the absence of insurance premiums such that the tax burden isn't higher on anyone but possibly the rich. And IMO, that's a tall order.
  #90  
Old 02-25-2020, 11:53 AM
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So wait... you're basically advocating a payroll tax on employers to make up for this shortfall?
Nope, he's proposing to make an explicit payroll tax out of what is already a de facto payroll tax.

Quote:
Originally Posted by bump View Post
They're going to LOVE that, especially if they're paying less than whatever this payroll tax costs.
I think you're missing the point that this money is already being paid out.

Quote:
Originally Posted by bump View Post
There's no such thing as a free lunch. Someone is going to have to pay for it
We're all already paying for it - but it's be rebranded so many many people are not aware of the true costs of our current system, or how it's being paid, or the pitfalls that don't show up until you have an emergency.
  #91  
Old 02-25-2020, 02:05 PM
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Nope, he's proposing to make an explicit payroll tax out of what is already a de facto payroll tax.


I think you're missing the point that this money is already being paid out.


We're all already paying for it - but it's be rebranded so many many people are not aware of the true costs of our current system, or how it's being paid, or the pitfalls that don't show up until you have an emergency.
The thing is that it's a de facto payroll tax for which employers control the payment and the amount. I don't see a lot of support for a de jure payroll tax out there.

For example, I'm sure that my employer pays more of my total insurance cost than the people who pay $1000/month in premiums and have a $5000 deductible. I don't think either employer would like the idea that they're now mandated to pay the same amount- one would probably view it as the removal of a perk they can wield to attract better employees (at a cost), and the other would view it as unreasonably increasing costs. Whether or not it's morally right or wrong doesn't much come into whether employers will support this tax.

And do we KNOW that this mandatory payroll tax will actually foot the bill? That's the kind of thing I'm talking about- before this will get traction, someone's going to have to show that between rejiggering the amount of money paid for insurance vs. UHC and whatever savings can be had by simplifying/unifying the current byzantine system, that we can have UHC without any larger out-of-pocket increases in tax to the average middle class person.
  #92  
Old 02-25-2020, 02:37 PM
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...one would probably view it as the removal of a perk they can wield to attract better employees (at a cost)...
It is a bad thing that employers can wield this power. One of the benefits of implement UHC is that people are no longer beholden to their employers for healthcare. This is a feature of UHC, not a bug. Losing a job is traumatic enough already, it's truly horrific if that also means losing your insurance. It's a significant drag on the economy that healthcare is such a major consideration for somebody switching jobs, and most especially for an entrepreneur who wants to start a small business.

In any event, I'm not advocating any particular implementation. I think funding UHC out of income tax is probably preferable. But I'm pointing out the arithmetic - that there is already effectively a $30k payroll tax that goes to private insurers, so if this $30k is simply redirected to a public insurance pool, nobody's economics have changed.

Before UHC:
Employer pays $70k to employee plus $30k to insurance company
Employee receives $70k

After UHC:
Employer pays $100k
Employee receives $100k minus $30k in some form of tax that funds UHC

To call this a $30k tax increase is misleading - everyone is economically exactly the same.

Last edited by Riemann; 02-25-2020 at 02:41 PM.
  #93  
Old 02-25-2020, 03:20 PM
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It is a bad thing that employers can wield this power. One of the benefits of implement UHC is that people are no longer beholden to their employers for healthcare. This is a feature of UHC, not a bug. Losing a job is traumatic enough already, it's truly horrific if that also means losing your insurance. It's a significant drag on the economy that healthcare is such a major consideration for somebody switching jobs, and most especially for an entrepreneur who wants to start a small business.

In any event, I'm not advocating any particular implementation. I think funding UHC out of income tax is probably preferable. But I'm pointing out the arithmetic - that there is already effectively a $30k payroll tax that goes to private insurers, so if this $30k is simply redirected to a public insurance pool, nobody's economics have changed.

Before UHC:
Employer pays $70k to employee plus $30k to insurance company
Employee receives $70k

After UHC:
Employer pays $100k
Employee receives $100k minus $30k in some form of tax that funds UHC

To call this a $30k tax increase is misleading - everyone is economically exactly the same.
It's not going to work exactly like that because employers aren't going to pass along their savings to their employees until competition or other factors requires them to. But those that have been offering health insurance will see a boost in profitability under single payer and we can recoup some of that in our tax collections.

We can do this and the naysayers are wrong.
  #94  
Old 02-25-2020, 03:31 PM
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It's not going to work exactly like that because employers aren't going to pass along their savings to their employees until competition or other factors requires them to. But those that have been offering health insurance will see a boost in profitability under single payer and we can recoup some of that in our tax collections.

We can do this and the naysayers are wrong.
My primary point is the basic arithmetic that this $30k is already being ďtaken outĒ of the current system, even if itís not nominally a tax. So if $30k taken out somewhere in taxes (income, payroll, corporate, whatever) to fund UHC, itís not some huge new net subtraction from the overall pot.
  #95  
Old 02-25-2020, 03:38 PM
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You still didn't answer my question, and went off on a right/wrong tangent. Can it be funded without raising taxes on people or not?

And my point was that employers aren't going to like it even if it's the right thing to do, and are liable to apply intense lobbying pressure to prevent it. Remember, this isn't going to happen by presidential fiat- whoever champions this is going to have to get a majority of the House and Senate on board, as well as the President. And more than likely fight off lots of lawsuits as well. Building consensus and explaining how it doesn't unduly screw anyone in particular is going to be critical, regardless of the rightness/wrongness of anyone's positions.

I'm not at all against UHC, but I also think that it's going to take some convincing beyond "it's the right thing to do", and a lot of that convincing is going to have to take the form of proving to people and employers that they're not going to pay more for less under this system, even if it does help other people. The public in aggregate aren't concerned about "other people"- they want to know first and foremost how it'll affect them and their families. And if they're like most people, they're not going to take kindly to change that is going to cut into their current financial situation.
  #96  
Old 02-25-2020, 06:25 PM
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Well, I guess an example of it working better than the U.S. system would help, right? Do you have an atlas and a pin?

Last edited by Riemann; 02-25-2020 at 06:26 PM.
  #97  
Old 02-26-2020, 07:42 AM
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And my point was that employers aren't going to like it even if it's the right thing to do, and are liable to apply intense lobbying pressure to prevent it.
My guess is that major corporations will fight it because it's one way they lose leverage over their workers. However, small businesses will be very in favor of it because it really brings their costs to employ workers down dramatically. The smaller businesses tend to not be able to afford the better health care plans, so it's a real drain on both their bottom line and the "perk" of attracting good help.
  #98  
Old 02-26-2020, 09:55 AM
EscAlaMike is offline
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I love my employer-provided private insurance.

It costs less than $200/month for my entire family. My wife has had two minor surgeries, and we've had 5 children born under our current plan. We've paid very close to $0 out of pocket.
  #99  
Old 02-26-2020, 11:03 AM
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You still didn't answer my question, and went off on a right/wrong tangent. Can it be funded without raising taxes on people or not?
That's a misleading question to ask. The right question is whether or not this will raise costs to the average citizen.

Yes, most employed people are going to pay more in taxes in a single payer US.
  #100  
Old 02-26-2020, 01:49 PM
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I'm having trouble determining how your current $1600 a month insurance plan qualifies as "'OK' for the purposes of the poll." It's not you, it's that "OK" is very, very vague. Other responses of people qualifying their "OK" poll replies bear this out.
It's 'Ok' because even though I pay a lot, it works pretty well and we don't get much hassle from the insurance companies when we need to have something done (mostly dental, prescription meds and my basal cell carcinoma visits and surgeries).

I don't 'Love' it because I pay so much. Now, the insurance I had where I paid maybe $100-$200 a month for insurance that actually cost $2200 a month (this was in the 2000s) - that's something I could love.

It doesn't 'Suck' because it mostly works when we need it. It's not like we're paying a ton of money and getting nothing out of it.
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