I've been thinking a lot about healthcare lately. When we lived in CA, we had Kaiser Insurance, and I loved it. It was convenient; all the services were in one building. It was simple; there was no red tape to navigate. It was affordable; the monthly premiums were reasonable, and since it was an HMO, the co-pays were small. I had two of our kids with Kaiser, and Will had his appendix out. The cost of these events probably was more than the premiums we paid, but somehow their system works. It was a blessing for us!
When we moved to Texas, we had the option to get insurance through Will's school district. The problem was that the only plans available were PPO's, with high deductibles. So, the first year, we paid $600 per month for a high deductible plan, and we had to pay to see the doctor with food money, which was already tight after that big monthly insurance premium. There was no chance we were going to get anywhere near the deductible, and we couldn't actually pay to see a doctor!
The next year, we cancelled the health insurance, except for Will, who was mostly paid for by his employer. Suddenly, the kids and I could afford to go see a doctor again. That was nice. A couple of years later, we signed up for a flexible spending account, which takes pre-tax dollars off our paycheck, and makes them available to use for dental, vision, and medical expenses. Since our girls were getting braces, we had the maximum deducted, which was close to $5000. This was great because it lowered our monthly taxable income, and, unlike a Health Savings Account, it was all available right up front, so we could go get glasses and dental work and all that right away.
Side note-we did sign up for Dental Insurance for the whole family because it was inexpensive, and drastically reduced the costs of the dentist. Definitely worth the money. And it reduced the price of braces.
This year, because of the Affordable Care Act, we were only allowed to deduct $2500 for our flexible spending account. We decided to bite the bullet, and sign up the kids for insurance this time around. That cost about $350 per month. I didn't sign up, because that would have brought the cost up to $900, and the just wasn't going to happen. All this for a plan with a $4800 family deductible.
So, here is the story that has gotten my wheels rolling. I needed to take Abby to the doctor because she felt like she had a lump in her throat, and was having trouble swallowing. We went to our usual practice, where I normally pay $70 per visit as a cash/self-pay patient. I gave them my new insurance info to see how it was going to help us. When I got ready to pay, they said, "Because you have insurance, the office visit cost is $108. What??? And, that didn't include the three lab tests we decided to do, to rule out a few random things. Remember, I'm paying all this with my reduced flexible spending account. So I said, "OK, never mind the insurance. Can we pretend I'm just a cash payment like before, and not worry about reporting this to the insurance company? I doubt we'll ever reach the deductible anyway." They were very kind, and shredded the insurance information. With the three lab tests, and the office visit, I ended up paying $120 total.
A couple of days later, I got a bill for $206 from the company who did the lab tests. I took the bill over to my doctor's office, and asked to double check what I had paid for the other day. They were very nice, apologetic, said, "Oh, we forget to tell them you were self-pay. We'll take care of this. Sorry about that!" I left the bill with them and went on my way. How many people would have paid that without a fight? And if I had used my insurance, you can bet that would have been my cost!
Here is what drives me crazy. If I had used my insurance, this doctor's visit would have cost me $315. All of which I would have had to pay from my inadequate flexible spending account. That is an eighth of my entire budget for the year! And I haven't bought glasses for all of us yet! If I had the $300 monthly premium we are spending for this useless insurance, I could save it for medical expenses and be rolling in money to spend on any whimsical health issue that I can imagine wanting to check out.
Its true that if something catastrophic happened, we'd be glad we have health insurance. Coming up with $4800 for the deductible would be nothing compared to $100,000. But, is it right for me to be bled dry today, just in case something big happens tomorrow? Health Insurance doesn't keep me healthy. It doesn't prevent catastrophe.
I don't think people who support Obama Care realize the implications of what it means to have this kind of health insurance. Do they realize that it costs more to function with it than with out it? How is this going to affect our economy when people's extra money gets sucked into the costs that happen below the deductible, along with the premiums? I'd rather pay the penalty, I mean, tax, because it will cost me 1/12 of the price of premiums. And then I can actually afford to go see the doctor with the other 11/12's.
With the ridiculous roll-out of the new Obama Care website, I can't help but wonder if this fiasco of ineptitude was planned. Its so bad! How could it not be? Let Obama, the puppet, take the fall for the clumsiest rendering of nationwide healthcare possible, and pave the way for Hillary to come in and save the day in 2016. After all, she was trying to get nationwide health care coverage going years ago. Surely she's learned something new since then!
If the Republicans don't figure out that the Democrats and the media are making them look like the Party Who Doesn't Care About Helping People See A Doctor, and start making some good arguments for how they can fix things, Hillary is a shoe-in for the next president. I think it would be safe to say that most Americans think there is a problem with the outrageous costs of healthcare in this country. I personally think that there is a huge racket going on in the background, and some people are making a whole lot of money on inflated test costs, unnecessary procedures, and deceptive practices by unscrupulous players in the health insurance and medical industries. If Kaiser can run a lean, efficient system in California, why can't it happen elsewhere? Notice, there is no insurance company involved in Kaiser's system.
3 comments:
I am very nervous about getting our next premium check...I am thankful for some aspects of the new law, but someone is going to have to pay for all these changes and it won't be cheap.
Wow, that is ridiculous! Gpa sent out an email (chain email so I can't verify its accuracy) from a constitutional lawyer who read the whole ACA cover to cover and realized that it's not at all about health care, but about Americans giving up fundamental rights given to us in various parts of the Constitution. Hmmm... Honestly, I don't feel comfortable buying a house until this whole ACA shakes down and we see what it does to the economy!
Thank you Heidi for sharing your story. I was surprised that the health insurance industry, AARP, the AMA all came out in favor of the AHCA. Looks like they are making our quite nicely with their billing fees. Sad. Dad
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