I am 32, why should I care about health care benefits at work?

Great Debates
1

That was my attitude until a few months ago. A 26 year old friend of mine woke up one morning with what felt like a pulled muscle in his shoulder. He makes $1,600 a month driving a delivery truck for a department store.

He ended up in surgery, and had to lay out $1,000 on the spot which he scraped together. NO $1,000, no surgery. NO surgery, no truck driving. How many of us tweens have $1,000 in savings?

My bud negotiated his medical bill payments down to $600 a month, and his rent is $850 a month for a studio apartment. He has crap health coverage with a $5,000 deductable, but he has no savings. As he has been off work, he has only received 60% of his pay check for the last three months. Now that has ended, he gets nothing.

Over the weekend came the knockout bomb. Pay $375 a month to continue his health and dental insurance. And, there is no guarantee he will get his job back, (this is a good job by L. A. standards these days). That just blew him out of L. A. and his life as he knows it.

It is pretty clear bankruptcy is coming if he does not catch a break. The soonest he could go back to work is this February. Looks like he will be heading back to Keokuk, Iowa to live with mom and dad. We will all miss this great guy.

While The Affordable Care Act, (Obamacare), would have prevented this, the thrust of the legislation does not go into effect until 2018. Too bad for my bud. Republicans are trying to scuttle the Affordable Care Act in order to provide more tax breaks for the rich. I just think it is important that we tweens know how this can work - failed - sucks!

**Hypocratic Oath my ass, these guys are the worst kind of thieves **http://en.wikipedia.org/wiki/Hippocratic_Oath

I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.

I will not be ashamed to say “I know not”, nor will I fail to call in my colleagues when the skills of another are needed for a patient’s recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given to me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.
If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

2

I feel a need to point out that your beef is not with doctors and health care professionals. It is with the insurance companies. That’s who the doctors typically get paid by.

I really don’t know enough about the details of Obamacare to comment on whether it is a good thing or a bad thing. But I think one of the biggest problems with the health care system is that your health insurance is tied to your employer.

3

Yeah, the OP’s anger is misplaced, it’s not the medical profession that’s shafted your friend, it’s the medical insurance system you have.

As a citizen of a country (New Zealand) with a workable (albeit imperfect) public health system I find these threads somewhat shocking. It’s pretty much a truth universally acknowledged here that the health system is one of the core functions of government, to be paid for out of general taxation. I guess the closest analogy I can think of for US dopers is hearing strange tales from a far-off land where you have to have ‘law and order insurance’ in place if you want to call the police when you’re a victim of a crime.

4

I’m so sorry about your friend! I really hope he will feel better soon, and that he catches the break he deserves after all this so he can move on to better things!!

For people outside the US (uhm… me), these things just seem absolutely bizar every time we hear them. How can a place like the US knowingly force its citizens into this catch-22? There are many places in the world where the healthcare system, though far from perfect, functions so much better. I wish I could tell politicians to just look around and learn. :frowning:

I agree with others, the problem is the whole system of healthcare, not the doctors. I think it must be horrible to be a doctor in a place where you are told you may not help people in need, despite your oath. It would go entirely against their gut feeling, I’m sure.

5

Forget this “a place like the US” business. We are rapidly devolving into just another Third World country run by a wealthy oligarchy with absolutely no concern for the average citizen.

6

Are we quite sure about this, folks?

If so, then how come US per capita health care spending is 50% higher than that
of the 2nd highest, and how come it is more than double most EU countries, and
how come it is almost triple Japan???

Per Capita Health Care Costs Selected Countries

Have US doctors and hospitals found a cure for hypertension, cancer, stroke and
a few other things and I just missed it? Are Americans living a lot longer than the
people in all these other countries and it went right by me?

Nope, we are paying more, a lot more, for treatment which is not prolonging our
lives more than in other countries where the patients aren’t getting soaked nearly as bad.

7

Tell me about it.

I am self employed. My daughter was diagnosed with a condition that requires I spend lots of time caring and advocating for her needs, which is the socially responsible thing for me to do.

By doing the socially responsible thing, taking time to care for my daughter’s health needs, I can’t afford health insurance for my wife and I.

Now, I have to stop helping care for my daughter and go get a job so some employer can provide my wife and I health insurance. If I don’t get a job soon enough, we could be screwed.

There has to be a better way.

8

1,600 a month is below the poverty line in the U.S. (20,800 a year is what that comes out to) It is not a good paying job, especially by L.A. standards.

9

Because a massive proportion of the health care costs (I’ve seen estimates of up to 40%) are eaten up by the bureaucracy engendered by your byzantine health insurance system.

Yes US doctors probably are paid more than doctors in most other countries, but the real difference is the armies of insurance adjusters, billing departments at hospitals and the like taking their cuts along the way.

10

What, do you have a thirteen-month year in the US now?

I thought it looked pretty low to, but assumed this was after taxes etc.

11

The OP is a 32 year old tween?

12

Don’t be silly. His friend is a 26 year old tween.

The part where children can be on their parents insurance up thru age 26 went into effect last year.

13

D’OH.

That’s why I don’t have a good L.A. standarsd job!

14

Well, the Op’s whining about being young and why need health insurance is a bit much. Tween? Seriously? You should have started your retirement fund a long time ago. You’re 32, with even less of an excuse than the 26-year-old friend.

As to the health care industry, yes, it became just a money-making machine for the insurance companies. People forget that for the most part, even if you do pay into your employer’s plan, it’s a fraction of what’s actually being paid to the insurance company. For instance, I pay $60 a month toward my HMO. That’s not the entire cost - my employer pays the rest, for a total of about $350 per month being paid in for me. So my health insurance is actually $4200 a year, and that’s discounted group insurance. Individual would be much more.

So the insurance companies accumulate all this cash per employee from all these employers. They gamble on how many will actually need payouts, and pocket the rest. Wonder why one tablet of Tylenol costs $6? Or why a box of Kleenex is $10? Ever read an itemized hospital bill? It’s like that because the hospital knows the insurance company will pay it. Ever see a hospital bill for someone without insurance? It’s at least half if not a quarter of an insured patient’s bill.

I had a brief ER visit in August of 2010. The total charged to and paid out by the insurance company was $5,000. My co-pay was $150. Sounds like a deal, right? I asked the hospital what the cash bill would have been. $1500 was the answer. This was for pain meds, antibiotics, a steroid injection, a head CT scan, IV fluids, a room for 7 hours with a nurse taking stats every 30 minutes, and full panel bloodwork.

What the ignorant politicians who have their own government doctors and have no idea how HMO’s work, it seems, what they don’t “get” is that if insurance companies go away, the bills will no longer be padded, and health care costs will suddenly be what they actually cost - which is probably (my guess) a third to a quarter what the stats say they are for the US right now - all because of insurance padding.

I feel that many Americans are woefully ignorant as to what really gets paid into and out of health care plans with employers. I’ve run into many people who pay a similar cost to mine and seem to think that’s their insurance premium. Then they don’t understand why COBRA is so much. I’ve worked in both huge companies and small, and somehow got involved enough with HR and health care plans that I generally understand them.

It angers me to no end that our Representatives in Washington don’t have to deal with the same health care issues as the rest of working America, yet are the ones voting for us. They can run to the House doctor at every little sniffle, and have no idea how much of a calculated decision most of us have to make before going to a doctor. They should have to pay into a health plan and deal with an HMO before getting to vote for us. The whole insurance industry would be ended quickly if that were the case.

15

Tweens? Isn’t that, like, a 12 year old?

And a doctor is a thief because he doesn’t work for free? Does your friend drive trucks for free?

16

Yes, that is the point. Not only are we paying more money for less service, those services don’t cover millions of people.

I did come across this site that offers quotes and lists health care laws by state. Maybe the OP’s friend can find a better deal.

17

A better analogy would be one where law enforcement doesn’t even bother to investigate and prosecute crimes when the victims are poor, or where the entire system is designed to avoid providing services and throw up roadblocks instead when people need help most. Or one where they won’t sell you a ‘law and order insurance’ policy if you have pre-existing conditions (you have been mugged, raped, or assaulted in the past). Speaking of mugged, some state insurance boards consider being a victim of domestic violence to be a pre-existing condition, and can use that to deny health coverage. We have a very effed up system. Luckily the endless propaganda we are subjected to where we are constantly told to think our system is enviable and the best in the world is wearing off and people are figuring out how screwed we all are. No idea if that means we will be able to do anything about it though, the oligarchy is pretty cemented at this point.

18

Explanations I have heard include:

lower overhead in countries with UHC (they spend 2-5% on overhead vs the 20-30% we spend here). I think medicare for all is projected to save $300-400 billion a year (which would still give us the most expensive system on earth, but it would cut 15% off our total health care costs).

Central health boards promote the most cost effective treatments in other countries, whereas in the US pharma and hospitals promote the most expensive treatments (since it is in their economic incentive to promote expensive treatments). Basically in most of the developed world the incentive of health care revolves around making it as affordable as possible. In the US the incentive is to make it as expensive as possible, push lipitor at $60/month instead of zocor at $4 a month, etc.

Bulk negotiations of medical products (medical supplies, Rx drugs), we pay more for the medical supplies.

Lower wages for medical professionals (ours make more).

I’m sure there are more but I think those are the big things.

Vermont recently passed a universal health care law designed by William Hsiao, who helped redesign Taiwans system in the early 90s and works extensively on health care policy in countries around the world. The plans he designed for Vermont, he predicts will provide a savings of up to 25%.

If the US gets nationwide universal health care it will probably come from a state by state domino effect where the cost savings and moral superiority of a universal style system make it the best option. Supposedly states like Pennsylvania, Montana, California, Illinois, are looking at UHC systems. But who knows if that is just bunk to win votes with no intent to follow through. So far only Vermont has actually passed a law creating one, and theirs doesn’t start until 2014 or 2018.

19

That doesn’t sound right; on most every bill / insurance statement I get, there’s the “price”, and then there’s the insurance-adjusted price, what the insurance pays, and what part is mine.

For example, I go to the hospital and have some procedure done. The price all said and done may be $5000. However, the insurance company will have negotiated discounts on just about every line item for their members. So after the insurance discounts the price is down to $1800.

Then, they may actually pay say… 80% of that, so they pay $1440, leaving me with a bill of $360.

Even with deductibles, you generally only pay the insurance-adjusted price, not the list price for the service/item/procedure.

20

And you can be sure that every last health insurance company in the US will be doing all they can to be sure the Vermont experiment is a failure. Including spending tons of money.