I think we should all be on something like what I'm on. It's a high deductible insurance with a health savings account. My company makes deposits through the year totaling about $1,000 into my account and I can contribute up to a certain amount tax-deductible. I think I put in about $25/paycheck.
All of my health related expenses (except for dental and opthalmology) comes out of this account. I do get discounts through my insurance but not much. This year the deductible is $3,000, next month when our year starts over it'll be $4,000. So once that $1,000 or so is spent then the next $3,000 will come out of my pocket. After I hit the deductible then it's all co-pays until I hit $5,000. at that point it's all paid for with no co-pays even.
The good thing about this plan is if you don't use it the money accumulates tax-free in the account and you can use it in case of emergency. Or in case you are laid off you can use it to pay your COBRA premiums.
Oh! and I don't pay any premiums. The company pays those.
Why I think everyone should be on something like this is because now I actually think about how much I spend. I won't let a doctor put me on $100/mo medication if there is a cheaper alternative. Before, I didn't care. When you have some skin in the game it starts to matter. This way it also is apparent how much stuff actually costs. Before I didn't even know I was on a $100/mo medication because all I paid was $30 and the real cost was not shown to me.
If we were all on this type of system we might actually get some real bargaining power with doctors. They might have to compete a bit on prices. And they wouldn't have to deal with as much insurance company red-tape...at least until you hit your deductible.
Also, premiums for companies might not increase so much every month because the insurance companies wouldn't be paying so much out. Because my company is going with this plan our premiums didn't go up anywhere near as much as they did for most small businesses. It's still not good, but better than regular HMO or PPO premiums would have been.
I think this kind of system is only fair though if companies (or maybe the government in cases of the unemployed) pay the premiums. To have to pay a premium on top of the $4,000 deductible (after the first $1,000 the company puts in) would be impossible for me to afford.
See... I agree with high deductable insurance for catastrophic events.
But for basic care - for allergy meds and appointments to treat diabetes or MS or whatever - no. There was something I heard somewhere recently about how health care costs are escalating, so the medical industrial complex reduces the number of people under their care.
Well, to me, the question is how do pharmaceutical companies justify charging the prices they do for medical care they specifically engineered to save lives? There shouldn't BE $100 medicines. I'm sorry, but there just shouldn't be.
The argument Big Pharma uses is "But we incurred a lotta r&d to make this, and now we have to make all of it back." Well, if you're making medicines that work, for the purpose of improving health care... You will make those monies back. 'Cos there's that whole "supply and demand" thing.
Then again, there are a lot of things along these lines I don't think should be in the private sector. How come my health care is being mandated by stock holders? How does that make sense?
And dental and optical - dental particularly - need to come into this debate, especially given research in the last 10-15 years that indicate dental health has a measurable impact on cardiac health. Also, if I can't chew, I can't eat. If I can't eat, my health goes down the tubes, and... Hey! Lookit that! Self-perpetuating downward slide.
(For the record, this is actually something I am dealing with right now, because "dental" also doesn't cover "orthodontics" -- but at this juncture in my life, my teeth have shifted so badly from my grinding, they barely meet anymore. The only place my teeth connect at all is at my furthest molars. I have concerns, but since ortho is generally only covered for a certain age range - which I have well passed - I really don't know what to do.)
Yeah, teeth and vision are kind of important, at least I think so. I don't know why they don't count as health care either. Stepping on and getting bitten by a snake because you can't see it could be hazardous to your health. And bad abscesses can actually kill you.
You would think that medically required dentistry or orthodontics would fall under health care...but it doesn't. I found that out the hard way when I had to have my impacted wisdom teeth removed.
I guess put off the surgery as long as you can, try to save up as much as you can, and put the rest on credit.
Life is decidedly unfair and getting more so for the regular people every year. I try to take solice in the fact that at least I'm not a peasant in Africa or something that can't even afford a toothbrush and toothpaste.
I just think it's dumb that we are equating insurability with health care.
NO.
Make it easy and affordable for me to go to the doctor without it having to be an insurance event. If I require special care, FINE. But... To get a check up shouldn't be something that has to be financially prepared for if insurance costs are too high.
I think we should all be on something like what I'm on. It's a high deductible insurance with a health savings account. My company makes deposits through the year totaling about $1,000 into my account and I can contribute up to a certain amount tax-deductible. I think I put in about $25/paycheck.
All of my health related expenses (except for dental and opthalmology) comes out of this account. I do get discounts through my insurance but not much. This year the deductible is $3,000, next month when our year starts over it'll be $4,000. So once that $1,000 or so is spent then the next $3,000 will come out of my pocket. After I hit the deductible then it's all co-pays until I hit $5,000. at that point it's all paid for with no co-pays even.
The good thing about this plan is if you don't use it the money accumulates tax-free in the account and you can use it in case of emergency. Or in case you are laid off you can use it to pay your COBRA premiums.
Oh! and I don't pay any premiums. The company pays those.
Why I think everyone should be on something like this is because now I actually think about how much I spend. I won't let a doctor put me on $100/mo medication if there is a cheaper alternative. Before, I didn't care. When you have some skin in the game it starts to matter. This way it also is apparent how much stuff actually costs. Before I didn't even know I was on a $100/mo medication because all I paid was $30 and the real cost was not shown to me.
If we were all on this type of system we might actually get some real bargaining power with doctors. They might have to compete a bit on prices. And they wouldn't have to deal with as much insurance company red-tape...at least until you hit your deductible.
Also, premiums for companies might not increase so much every month because the insurance companies wouldn't be paying so much out. Because my company is going with this plan our premiums didn't go up anywhere near as much as they did for most small businesses. It's still not good, but better than regular HMO or PPO premiums would have been.
I think this kind of system is only fair though if companies (or maybe the government in cases of the unemployed) pay the premiums. To have to pay a premium on top of the $4,000 deductible (after the first $1,000 the company puts in) would be impossible for me to afford.
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But for basic care - for allergy meds and appointments to treat diabetes or MS or whatever - no. There was something I heard somewhere recently about how health care costs are escalating, so the medical industrial complex reduces the number of people under their care.
Well, to me, the question is how do pharmaceutical companies justify charging the prices they do for medical care they specifically engineered to save lives? There shouldn't BE $100 medicines. I'm sorry, but there just shouldn't be.
The argument Big Pharma uses is "But we incurred a lotta r&d to make this, and now we have to make all of it back." Well, if you're making medicines that work, for the purpose of improving health care... You will make those monies back. 'Cos there's that whole "supply and demand" thing.
Then again, there are a lot of things along these lines I don't think should be in the private sector. How come my health care is being mandated by stock holders? How does that make sense?
And dental and optical - dental particularly - need to come into this debate, especially given research in the last 10-15 years that indicate dental health has a measurable impact on cardiac health. Also, if I can't chew, I can't eat. If I can't eat, my health goes down the tubes, and... Hey! Lookit that! Self-perpetuating downward slide.
(For the record, this is actually something I am dealing with right now, because "dental" also doesn't cover "orthodontics" -- but at this juncture in my life, my teeth have shifted so badly from my grinding, they barely meet anymore. The only place my teeth connect at all is at my furthest molars. I have concerns, but since ortho is generally only covered for a certain age range - which I have well passed - I really don't know what to do.)
Reply
You would think that medically required dentistry or orthodontics would fall under health care...but it doesn't. I found that out the hard way when I had to have my impacted wisdom teeth removed.
I guess put off the surgery as long as you can, try to save up as much as you can, and put the rest on credit.
Life is decidedly unfair and getting more so for the regular people every year. I try to take solice in the fact that at least I'm not a peasant in Africa or something that can't even afford a toothbrush and toothpaste.
Reply
NO.
Make it easy and affordable for me to go to the doctor without it having to be an insurance event. If I require special care, FINE. But... To get a check up shouldn't be something that has to be financially prepared for if insurance costs are too high.
Reply
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