Fucking employers, fucking health insurance, fuck all of it

The BBQ Pit
41

Quebec has a new government and has cut back its immigration quota by 20%.

En tout cas, the easiest way to become a Canadian through Quebec is by being an investor class immigrant, which basically means giving the government an interest-free seven-figure loan, or promising to create several jobs within a year of your arrival.

And there is no fucking way some American is ever going to learn enough French to pass the exams necessary to work in Quebec’s civil service. There are people from France with PhDs in French literature who cannot pass those exams!

42

We never should have had a revolution - take us back? I mean, you are screwed as hell yourselves, but at least you don’t go bankrupt before you die of a diabetes because you can’t afford insulin. The second Great British Empire could start right now…

43

And you’ve just summed up the problem with any state passing single payer. They won’t be able to afford the influx of people it would bring in. Its one of the reasons its so hard for Americans to emigrate to Canada, they don’t want people to move their for health care.

44

Wesley Clark, if you are considering Mexico, give San Miguel de Allende some serious thought.

I’ve lived without health insurance for 18 years, kind of lived well, actually. I just paid the penalty last few years, something that really rubbed me the wrong way, and I hope if the Democrats do get back in power, that don’t pull this stunt again to penalize those that refuse to be a part of the racket and force us to pay it for others.

Both parties suck when it comes to healthcare, they are both too busy playing partisan politics and caving in to the powers to be.

On the positive side, I’ve really learned to take care of myself even better, I have zero health problems. I’ve also learned health care insurance is pretty much a false sense of security, anyhow, although in certain situations would be nice to have, but I’ve learned to live without it, and also be prepared to also die without it also.

I read a survey once concerning a few hundred doctors, forget the exact number, but when asked if they were to get cancer, would they take chemotherapy, the vast majority said no, they wouldn’t. That should tell you something.

I’ve never been a burden to taxpayers, if I need to go for any check up or anything, I’ve always paid cash, which is what a lot still do in TX since our state is one of the worse when it comes to people not having health care insurance. If something really castatrophic happens, like cancer, I’m going to choose what most doctors choose, and not get treatment. If I have a major stroke or found unconscious in my home, all of my loved ones and friends know not to take me to the hospital. Just come back in about 7 days, that should just about do it.

Speaking of strokes, just had a friend of mine in TX that probably had one a few months ago, he was partially paralyzed on one side. He chose not to go, and just wait it out. He was lucky, it somehow passed, his paralysis went away, and he did absolutely nothing. I realize this is crazy, but this is what Americans are faced with on a regular basis. Keep what little you have, or take a risk with a hospital stay, and if you do pull through, possibly be homeless and out on the streets.

I’d rather die than be a part of a racket that could literally wipe out my entire estate. I’d like to leave something to loved ones for all of the labor, blood and sweat I’ve toiled all of my years. At 60, I’ve already had a lot of good years. I just got to make it to 65, which Medicare is supposed to take care of 80% of it, and a supplemental to take care of the other 20% is something like $200.00 or so a month, for now, anyway. I imagine in five more years, the supplemental will probably be about $400.00 a month, once again pricing it out of range for many people with fixed incomes, so many may not ever be able to retire.

45

Sorry you’re going through this, WC. However, some advice:

  1. You can still enroll in your companies health insurance plan for up to 30 days after your job status changed from “Part Time” to “Full Time”. So it’s not too late to enroll.

  2. If they argue that you were FT all along, then ask them to produce your benefits election form where you waived your benefits. Since they won’t have one (assuming PTers don’t get benefits as a matter of policy) and will have no record of them offering you benefits, they are no longer in compliance. In order to get back into compliance, they have to have you sign a benefit election form. And it’s illegal to backdate them.

Remember, the law they are concerned with doesn’t require them to make sure you have health insurance… it requires them to offer it (at “affordable” rates, which in TX means that if you work for a company with over 50 employees, the insurance (employee-only portion) can cost no more than $96 (±)/month). And they have to do this on an individualized basis, with you signing a document stating which benefits you are going to have/waive.

So, if they changed you to FT on Friday, you have 30 days from then to make your benefit selections. If they made a mistake when you first onboarded, resulting in them never offering benefits to you (remember, your refusal has to be documented!), they still have to offer you benefits as soon as the mistake was found… and you should have 30 days to decide.

Honestly, I would send an email to the person who changed your status asking for “confirmation” or “clarification” as to the change in your job status, making sure the date (12.13.18) the change was recently made/corrected is agreed-upon. Something like:

"Bob,

Just to confirm and make sure we’re on the same page: When you changed me from “Part Time” to “Full Time” this past Friday, am I “FT” starting from the change (December 13, 2018) or my hire date (September 20, 2018)?."

(He will respond by either answering the question or arguing the facts. If he answers the question, good. If he argues the facts and says shit like “YOU WERE ALWAYS FULLTIME, NOTHING GOT ‘CHANGED’”, etc, then ask for your benefit election form. They will have to produce it. And if they didn’t get one from you, it’s because they didn’t offer one to you. And if they didn’t make the offer, they’re required to make the offer, even if it’s after “open enrollment”.)

Now, as far as policy selection…

I have some spreadsheets which compare these things and, while all plans are different and I am not your agent and all that disclaimer stuff, I have found that, except within a narrow band of health expenditures, High Deductible plans offer the lowest total cost of medical care.

I understand that these plans “offer no benefits”, but in the case of a catastrophic illness/accident (resulting in $500k in medical bills, say), the maximum out of pocket difference between a HDHP plan and a “fully loaded” plan can be over $15,000/year, with the “fully loaded” plan being the far more expensive proposition. There are very few situations in which I can honestly recommend a silver or gold plan on the financial merits alone, because if you run the numbers, they just aren’t cost-effective. (Based upon other issues, however, they may be better suited for the insured. They’re just not a good deal financially, that’s all.)

46

By the way, the above should say “up to 30 days to decide”. Way it is currently written makes the 30 days seem engraved in law

47

WC, I feel for you, I really do. However, this totally cracked me up, especially being posted at exactly 4:20. (my time)

I’m also faking it through life. I’m in my 50s and don’t have the faintest idea of what I’m doing. Thank the powers that my wife has a clue.

48

I’m moving to Canada at the end of January, and one of the main reasons I took the job was because I’m really tired of my health insurance being tied to my job.

49

I salute you for your good health. I take good care of myself, too, but somehow neither lupus nor cancer, which I was diagnosed with 10 months ago, were very impressed with my workouts and healthy diet and moved in anyway. Brutes. I hope you live a long, healthy life and die in your sleep at a robust 102. if, however, you get cancer, you’ll probably wish you had health insurance. Cancer doesn’t necessarily mean chemo. Many types, if caught early, require only surgery (and sometimes radiation), which you won’t be able to afford without insurance. I’ve known people who went through hell with chemo and died anyway, and I’ve known people whose only side effect was fatigue.

And a funny thing…getting a cancer diagnosis may make you realize how much you want to live.

50

Wesley Clark, I’m infuriated on your behalf. My employer-provided insurance was crap and expensive, with a $3000 deductible and my share of the monthly premiums at $300, but at least I HAD it.

Unfortunately, I think your best bet is to get your boss to go to bat for you, as it was his screw-up that cost you insurance coverage. If you can get on that plan, bad as it is, then when this job ends, it’ll be a qualifying event, and you should be eligible for a subsidy. Still shitty, I know, but there’s no way off the suckmobile at this point. Medicaid is shitty, too, as few docs accept it–though if you’re healthy, that might not matter. And you have to be a citizen of Mexico to get healthcare coverage there. Citizenship requires 5 years’ residence.

You deserve a better deal than the one you’ve got. You deserve a better job than the one you’ve got. I hope you get both, and soon.

51

If you don’t mind my saying, nobody should have to ‘go to bat’ for the OP. He is entitled to health care coverage, they owe it to him as a condition of his employment.

He needs to go to HR today and inquire about his options for coverage. Not ask about whether or not he is entitled, and would they be kind enough to bend the rules for him, but to state that his employment status has changed as of 6pm Dec 14, and he is now eligible to sign up, and would like to sign up now, thankyouverymuch.

Changes in employment status is a qualifying event on its own, and entitles him to sign up outside of the typical enrollment period.

52

Thanks for the kind words, and certainly hope things work out for you. I will continue to try to put the odds in my favor by trying to eat mostly good foods, a certain amount of daily activity, but like you, I realize none of it is bullet proof, some of it is just plain dumb luck.

I do enjoy life, a lot, but that’s easy when your health is good. Even if my health declined a bit, I think I’d still be good. If diagnosed with cancer, I guess it depends on what stage, and what my options were.

I’m still convinced I will never want or get health insurance in America ever again though, even if I got cancer. The special interest groups on the left and right have become too corrupt and too powerful for me to have any hope it will be corrected in my lifetime, and the costs will still be, the sky is the limit. I refuse to be a part of it even if it does costs me my life. At a younger age, maybe I would think differently, at 60, I can accept it. I certainly don’t blame any in the least that still chose to get it, and gosh, I hope your doctors can really do you some good.

I’ll take the $150,000+ or so I’ve saved by not having it over the last 18 years, and consider the option of outsourcing if it’s something that might be serious that happens to me, and if it looks like doctors and hospitals could probably do some good and have some answers for me. Last my older brother checked, who is a few years older than me, policies were running about $1,300 a month. He too, has opted to go without, and shooting for 65. It’s a roll of the dice.

I’d actually probably already be living out of the country now, but I’m taking care of an elderly parent, and it would be impossible to take my dad in the physical and mental condition he is in. If he lives another five years, my only hope would be to have Medicare when I’m 65. But I feel like the other 20% to supplement is going to be so high by the time I’d like to retire, that living outside of the US is still going to be the only viable option. And many doctors are refusing to take Medicare payments anymore due to the stringent and more bullshit policies that Washington dishes out, so who knows what it will be like in another five years. Judging from past history, it’s won’t be anything positive.

53

Thanks much. The docs said they got it all (breast cancer). I didn’t have to have chemo, and they wouldn’t do radiation because of the lupus. Now I have some suspicious symptoms the docs are concerned about, but I’m hoping those turn out to be a false alarm.

I admire your principles and determination. I can’t imagine paying $1300 a month for insurance. Was this through the exchange? At that rate, I’d HAVE to do without. I had to go on disability (vision loss and lupus) this past year, so I’m now on Medicare even though I’m not 65. My supplemental insurance premium is $0 a month, with a small co-pay for docs, and most of my meds are free. (My sister, who IS over 65, has the exact same policy with the same company, so it’s not some special disability thing.) It’s an HMO, and I hate HMO’s, but I’m relieved to have coverage. I’m also angry that people like Wesley Clark have to go without. It’s stupid and wrong on every level.

Kudos to you for putting your own plans on hold to care for your dad. I hope you find a new country you’re happy in. I’m going to go down with the ship, ranting all the way.

54

I hoped that his change in employment status would qualify him for Special Enrollment, but alas, going from part-time (officially) to full-time status is not a qualifying event. All the employer-related qualifying events are for people who had insurance but lost it–for instance, going from full- to part-time and thus no longer qualifying. I even checked to see if he qualified as a “complicated case,” but no-go there, too, unless his boss is also the person in charge of insurance enrollment.

I agree that Wesley Clark SHOULD be able to get an exception made on his own, but the open enrollment gods don’t work that way. I’m not sure his boss could do anything either, as the company itself doesn’t establish the open enrollment period. I just figure if there’s some sort of little-known loophole, his boss’s clout might persuade the company to find it. Still a long shot, though.

And boy, would I love to be wrong on all this.

55

Wesley Clark, I get it. The system sucks. My employer pays my insurance, my husband’s employer pays about 10% of his insurance, and we have a plan for our daughter through ACA. We all have different plans and doctors and networks. It’s a nightmare.

Anyway, I’m confused about what happened, maybe because of the terms “employer” and “boss.” Why does the ACA enrollment deadline matter if it’s employer-offered health insurance? Companies hire people all year long and offer them insurance policies immediately or after 90 days or whatever.

As of 4:00 Friday, what was your situation? Had you enrolled with the temp agency?

Regardless of the code change, if you knew full-time employees were eligible for insurance through the employer, and you knew that you were working full-time, didn’t you wonder about this before Friday?

56

I have long been skeptical of Bernie Sanders’ proposal to implement a Medicare for All type system, but with the ACA under constant legal and political attacks, it’s clear that the patchwork that is Obamacare is doomed to fail. We might as well do what other industrialized countries have done and just force the oligarchs to pay their taxes and have a national healthcare scheme that covers 75% of costs, and then use private insurance (for those who can afford it) to cover the gaps. Private care would actually be just as profitable for insurer shareholders - maybe even more so - in that type of system.

If there’s any reason for hope, it might be that the more conservatives hold out and try to undermine political ‘compromise’ plans like the ACA, the more popular ‘radical’ ideas (like so-called socialized medicine) become. Conservatives will say “See, socializing medicine doesn’t work” but they’re not going to fool anyone. People have had enough of income and wealth inequality, especially at a time when automation threatens to take away whatever is left of the middle class, which incidentally is why the oligarch and donor class who used to be friendly to immigration, legal and otherwise, are now using anti-immigration as a gambit to distract from their plans to murder the weakening middle class.

57

This is maybe the dumbest part of American healthcare: the networks of doctors which make it impossible in some cases to schedule timely appointments. Some doctors aren’t even taking new patients. Like what the hell is that all about?

In a lot of other industrialized countries, you don’t need to make an appointment. You call the doctor ahead of time, tell him/her you’re coming in, you come in, you wait to be seen either by your preferred doctor or another one on duty, and you get seen - that day. If it’s an emergency, you just go to the emergency room. You don’t need to go to the emergency room just to be seen by a doctor for a painful or uncomfortable non-emergency.

But again, a lot of people in this society just roll around in their own ignorance and seem to enjoy the bliss of not knowing what a real healthcare system (a truly democratic and fair society to be honest) looks like. They don’t think about it until they really need to - and by then it’s too late.

58

I work for a social service organization and there are jobs such as hotels, where you can work three days a week and get insurance.

I have place quite a few displaced older workers at jobs in clubs, hotels and resorts and they keep their old jobs without insurance and work this part time job for the insurance.

The problem is people saw Obamacare as Universal Health Care, which in no form was it ever, nor was in any form meant to be.

So people think it IS UHC, but it’s not, and they get mad when they are told this.

If you need insurance, you need to structure you goals to getting a job, even a low paying job and obtaining it. Then you can work around getting better paying jobs or taking a second job.

It may not be the solution you want but there are solutions out there. Too often, I spend hours talking to people what are less concerned with a realistic solution but hung up on wanting what they can’t have.

59

Plus, you get to move away from mysterious water pipes in your backyard! :wink:

60

Glad you didn’t have to go the chemo route. There is an excellent book I think will ease some of your concerns. It’s called Overdiagnosed. Some doctors have went to review it on Amazon. If you don’t read the book, take time to read some of reviews.

The Psalmist (Psalms 90:10) made an observation in his day that people were living into their seventies and eighties. I’m sure the majority didn’t make it to that age, but still not bad before germ theory and modern day antibiotics and vaccines.

I’m not sure where my brother went to get that rate, as far as any exchanges, I don’t believe any of us qualify for any reduced rate, due to our income.

I’ve got a friend in CO, whose friend is a multi-millionaire, but yet somehow he only has to pay $300 a month through I guess some exchange. I’ve asked her twice to try to find out more about it, but she hasn’t, so I won’t ask again.

I believe some states have better exchange rates than others, or it may be that he didn’t report all of his rental income, and that is the reason he was able to get it so cheap.