<p>This thread highlights the reasons why the current healthcare system in the U.S. must be reformed. Private and/or employer sponsored health coverage that is market based simply does not work. Too expensive, too many people uninsured or underinsured, and too many people excluded from coverage for preexisting health conditions. Government’s job is to step in and regulate when market forces create these conditions. It’s inevitable, and it has been way too long in coming.</p>
<p>Fyi, for everyone on this thread…we just went through the same issue…BCBS was going up 30% on March 1st. My husband is self-employed with 4 employees…we met with a broker who introduced us to the HSA concept…I don’t want to give you all the info because it’s important that a professional explain it to you, but briefly our insurance premiums were supposed to go up tp $20,000/year under the old plan(for a family of four, adults both 50 years old, one 18 year old, one 15 year old)…with the new HSA under the BCBS umbrella, our total annual out of pocket will max out at approx $16,000 and that’s if we use up all our out of pocket expense…the actual premiums were reduced to $8000…it is an unusual plan that has quirky things that go along with it, but the bottom line is lower under any circumstance…</p>
<p>Actually, 80% of total healthcare costs occur in the last 6 months of life according to Medicare. They also say 20% of people cause 80% of health care expenses.
Health insurance companies want you to pay more in premiums than they will pay in benefits.<br>
One of the things people like to talk about is to allow 55-64 year olds to pay into Medicare. It that was around, the calculated premium for all three parts, A, B, and D, per month would be over $800.</p>
<p>After my $800/month for a single parent insurance turned down a third claim due to fine print, I canceled my insurance. Until more people stop playing the game, the game will go on.</p>
<p>And I live in a state where health insurance (playing the game) is required by law. $250/yr penalty is better then $800 - I’ll self-insure with the saved money.</p>
<p>toadstool, what happens if you get a catastrophic illness?</p>
<p>toadstool, I wish you good luck with that scenario. One major diagnosis or injury and you’ll be declaring bankrupcy.</p>
<p>For most people most of the time, insurance is not a good deal – we pay more in premiums than we get out. But it’s insurance – the “just in case” something major happens. </p>
<p>Many of us also pay for life and disability insurance, but we never get anything back on those policies either. </p>
<p>If something major happens – or even something not-so-major-but-still-significant, like an appendectomy or a broken bone – having insurance is well worth the cost. </p>
<p>One person with a catastrophic expense of $1 million requires 100 people with no expenses to pay $10,000 for coverage. If you’re the million-dollar claim, you’re happy with the finances of it (altho you might not feel happy about your health!). But if you’re one of the 99 people with minimal claims, you feel gypped.</p>
<p>Just remember it’s insurance. So in case you’re that million-dollar claim, you’re financially protected.</p>
<p>I can’t wait to see what Obama and Congress come up with this year. Finally, we’re going to get something done!!</p>
<p>Edit: The problem with insurance is that, as healthy people drop coverage because of the cost, the million-dollar claims keep happening. So instead of collecting $10,000 from 100 people to pay it, now the ins co needs to collect $12,000 from the 83 people who keep their insurance. The fewer people in the system, the more it costs those who remain.</p>
<p>I live in a farily small community. One year a couple I know were both diagnosed with cancer. They had no health insurance. Let’s just say it wasn’t pretty. As an employer when we started our small business we were committed to make sure that scenario didn’t happen to one of our employees. In the first few years we paid the employee and all of the dependents insurance 100 percent. A couple of years ago we dropped the dependent coverage and now only pay 100 percent of the employee.
Not sure we can continue it going into this next year. It looks like an HSA may be in our future.
I would never gamble with being uninsured as I have personally seen the fall out.</p>
<p>DH is self-employed & we’ve seen our premiums climb every year, but the increase this year is ridiculous (30% seems abour right). We’ve been spending the last month researching different plans & options…we considered having college age S get insurance through school so we could just get couples insurance, but his school’s plan leaves alot to be desired. We know we have to have insurance & wouldn’t consider doing without, but other than tuition, insurance is our largest expense (even greater than our mortgage).</p>
<p>toadstool, you’ve hit on something that is the biggest thorn in my side.</p>
<p>DH & I own our own business, and the monthly premiums are astronomical. But when the insurance company won’t even pay a claim, I consider it legalized theft, endorsed by lack of legislation.</p>
<p>We had a claim denied because…get this…we visited the in-network doctor at his satellite location, instead of his main office.</p>
<p>Somebody throw me a rolling eyes icon, quick.</p>
<p>heyalb, you need to appeal that claim. And fast – first to your insurance company. If your plan is insured (versus self-insured), then you can also bring it to the attention of CT’s insurance commissioner.</p>
<p>To me, its become something of a shell game. My personal insurance co raised rate 240%, and still barely paid a mammogram. Of course, I’ll appeal.</p>
<p>When I bill certain insurance companies for patients, I expect to have to appeal. Similarly, most of the newer medications are not covered by insurance plans. I also have less faith in some generics.</p>
<p>The unfortunate side to this is that I avoid all yearly exams, even tho colleagues are courteous about co-fees. Nonetheless, just lab work can be $1000.00+. My son spent new year’s eve in ER, and I dread when the bills start coming in. There was a time when annual check-ups were the norm, and people didn’t live in fear of medical costs.</p>
<p>heyalb–Having 2 offices is truly a problem for some companies, but not for others!!
I so look forward to an alternative plan to our current system.</p>
<p>Yep, my husband had regular annual lab work 4-5 years ago and it was $750, I can buy him a life insurance policy for that and get a copy of that lab work, which is more extensive, and you know the life insurance companies are not paying anywhere near that rate.</p>
<p>Our coverage just keeps going up and up, we have had an MSA/HSA since they were only a trial plan. We haven’t accumulated much in the account, after 6 sets of orthodontia treatment, and other health bills we have paid, but I do think every one ought to spend one year paying their bills in cash, then being reimbursed- we would have a nationwide revolt!</p>
<p>Hold on, folks, because the health insurance industry is next to implode. Banking was bad, but what is going to happen with the implosion of the health insurance industry may be at least as devastating, if not more so. And the government will step in to nationalize that too, just not in a sensible way. It will also cost ten times what a national health care system could have cost, had it been implemented properly, and not in an emergency (of course, I still think that they will privatize those gains too, so that that the health insurance execs continue to get very rich, and everyone else gets worse and more expensive care).</p>
<p>Amthem Blue Cross has just increased my 23 year old’s premiums FIFTY NINE PERCENT.</p>
<p>Luckily she works for another health care company and will not be using Anthem.</p>
<p>These increases are outrageous.</p>
<p>gop.com
About GOP
Party Platform 2008
Healthcare <a href=“http://www.gop.com/2008Platform/HealthCare.htm[/url]”>http://www.gop.com/2008Platform/HealthCare.htm</a></p>
<p>
</p>
<p>According to the GOP Platform, DSTARK, you are a Republican, just like me. :)</p>
<p>I am a registered republican. 
I don’t vote that way too often anymore.</p>
<p><a href=“http://www.nytimes.com/2009/02/03/us/03insure.html?hp[/url]”>http://www.nytimes.com/2009/02/03/us/03insure.html?hp</a></p>
<p>“The recession has accelerated the pressure on small-business owners to cut employee health coverage.”</p>
<p>LOL. x10. :D</p>
<p>Where does the money go? Are health insurance companies marvelously profitable?</p>
<p><a href=“http://www.pnhp.org/physiciansproposal/proposal/Physicians%20ProposalJAMA.pdf[/url]”>http://www.pnhp.org/physiciansproposal/proposal/Physicians%20ProposalJAMA.pdf</a></p>
<p>Health insurance companies are very profitable when they can convince you not to get care, or can find ways to avoid paying for it. Once upon a time, they used to make a profit by investing the profits even further, but now they generally own the same junk as the rest of us.</p>