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Ask Slashdot: IT Contractors, How's Your Health Insurance?
An anonymous reader writes "In the tech industry, as the economy continues its downturn, IT folks in my circles who were either laid off or let go are turning to contract work to pay their bills. Layoffs and a decline in tech jobs has affected older IT workers the most. Many of us find it more lucrative and enjoyable in the long run and leave the world of cubicles forever. However, there is much to be said for working for a large company or corporation, and health insurance is one of the benefits we value most. But what happens to those who find themselves in this position at mid-career or later in life? Hopefully they have accumulated enough savings or have enough money in an HSA to survive a major medical emergency. Unfortunately, many do not and some find themselves in dire straits with their lives depending on others for help. I have been working IT contracts mostly now for the past 11 years and I've done very well. I belong to a group insurance plan and the coverage is decent, but as I get older, premiums and copays go up and coverage goes down. If you work contracts exclusively, what do you think is the best plan for insurance? Any preferences?"
1 or 0
rm -rf --no-preserve-root /
Have UK Citizenship
Donte Alistair Anderson Roberts - hi son!
Karma: Chameleon
The only choice is to vote DEM / obama.
As the mitt romney plan is crap.
obamacare is not the best but better then today's plans.
Get married to someone who has a job that extends health benefits to their spouse.
Move to Scandinavia, I meet lots of people from the US who have a great time over here. Sure the pay after taxes is going to be less, and you will have to learn a new language, but in the end (of your life) you will have gotten the better deal over here.
Treat insurance as insurance, not as a health care account, buy critical illness with a high deductible (maybe 10-20K), but make sure it covers 5-10 years of your expenses for sure. For the normal every day stuff just pay out of pocket.
You can't handle the truth.
If you work contracts exclusively, what do you think is the best plan for insurance? Any preferences?" Canada, failing that, France. Seriously, we need to pass HR676, it would be the greatest economic stimulus ever.
I pay $90/month for a really sub-par insurance that caps payments to 2000. If I get hired full-time at the end of my contract, I will have a proper insurance plan.
I wish I had a public option, or better yet, medicare.
If your young, fit and trying make it the US might be the place for you. When you insurance is telling you that you are (actuarially speaking) no longer young or fit and your bank is telling you you haven't made it, it's time to get the hell out of Dodge. Emigrate while you still can to a more civilized part of the world.
If your in the position to plan your transition, start building up your HSA. IF you don't have an HSA now, taking a few years to contribute to one is exceptionally useful. Cover out of pockets and copays, converts to usable for non medical use after retirement age. Having this, while utilizing a group plan w/ higher costs, softens the blow.
My mother's basement is fully padded, she makes her own natural soda pop and the pizza is organic. I have nothing to worry about. I was born with excellent carpals.
the no pre existing condition/ no drop rule and exchanges (not tied to jobs) is a big boost.
My health plan is to avoid getting sick.
I wouldn't do that long-term, though. I'm only temporarily contracting and start a full time job with insurance benefits in two weeks.
Dewey, what part of this looks like authorities should be involved?
I found that there isn't any other good options other than to get a few quotes and write a big check. If you're in Washington state, you can join the Washington Technology Industry Association(WTIA), and get a price that's a little nicer. Unfortunately for me, I'm buying insurance for just myself so the yearly WITA fee doesn't justify the discount. If you have a group of three or more people, then WITA is a good thing.
The really sad thing is that even after paying nearly $50k lifetime for health insurance, I've never collected a penny of that back. The state government's oversight board of insurance here is full of former insurance executives so there is no oversight. Every single claim I've made has been denied, even the preapproved ones.
If you're worried about today, then you should be really worried about the next few years. Last year my insurance went up nearly 30%. In June it increased another 75%. Expect more large increases due to Obamacare.
I'm assuming OP is in the US, because in most other countries this is a non-issue.
This was the kind of situation that Obamacare is intended to address, by making the individual market a viable option for people who aren't getting insurance through their employment, eliminating exclusions for preexisting conditions and requiring no more than 20% overhead (for reference, Medicare runs at about 3% overhead and the VA closer to 1%).
Other approaches, while you're waiting for that law to fully kick in:
- If you're married, and your spouse is a full-time employee somewhere, use their group plan.
- If you've saved up a lot, which it sounds like you have, consider focusing on catastrophic coverage.
- If you're older than 50, consider the AARP. They provide all sorts of discounts, including on health insurance.
- If your life situation allows, you might be able to relocate to a civilized country. This is obviously a big change, so you wouldn't want to make this lightly.
- Put up with the higher rates and less insurance. It's not pleasant, of course, but it sounds like you can afford it.
I am officially gone from
Single-payer! The only way to control health care costs. Eventually the United States will have to go to a single-payer system. Otherwise, we will continue to have the most expensive and and worse health care system of any developed country.
Some non contract jobs work people 39.5 hours a week just to get out of offering health insurance.
I contracted for 2 years. During that time, I purchased health insurance for myself, wife and 3 children from a health insurance company. It's actually really easy. I comparison shopped online, picked an insurer with a plan that had good coverage at a rate I could afford, called them up and bought a policy. The insurer did a check of our medical histories, which took about a week, and involved them calling doctors. Fine. The policy took effect about 2 weeks after the medical checks were complete.
I was paying about $300 / mo for myself, wife and my 3 kids - and that includes a kid with autism, which the insurer could not turn down, thanks to the Affordable Care Act (GObama! Sorry, had to :) ). They did charge me $10 extra a month for my autistic child, but that seemed more than reasonable to me. $300 / mo might seem high, but it's only about $50 more than what I pay when getting insurance through an employer. The copays were competitive ($10 prescriptions, $30 doctor visits and such). The other deductibles, co-insurance, etc were a bit higher, but not insanely higher than what you'd see through a plan from an employer.
There was one thing that stunk about the plan, though - if my wife got pregnant, the insurer would drop her coverage. That sucks. In fact, I couldn't find a single insurer that would cover pregnancy - nor would they cover things like IUD, birth control pills, etc. Basically everything you'd typically associate with a woman's health was completely not covered, which is ridiculous.
Once the Affordable Care Act goes completely "live" in 2014, though, insurers won't be able to deny women health coverage if they're pregnant, and they'll have to cover basic women's health care. Anyhow, wasn't trying to make this a political statement, it's just interesting how broken the current system is for women.
When times are good, save up for times that will be bad. An HSA is one tax efficient vehicle for medical expenses but due to contribution limits you'll probably need more than that. Basically spend less than you earn and save the rest for the future. If you're smart enough to be in IT then you're smart enough to know that you will have medical expenses in the future and you're being paid better than the average worker now. Plan accordingly.
it didnt cover anything... so what was the point?
I pay a little over a $100 a month, to have insurance for just myself. That equates to having a $1,250 deductible.
My family is on a seperate plan, that is held individually by us. Ironically, it's with the same insurance company. It's $260/month for my wife and 3 kids. Granted it has a $5,000 deductible.
But it makes me wonder just how much my company is paying out. If I am paying $100 for myself, and $260 for four others?
In fact, to add my family would have been more than we currently pay combined. Plus more than the difference in my family's deductible. :-/
What health insurance?
I have been contacting for just shy of 15 years w/o health ins. I have a family of four. It’s not an issue. In reality it is an advantage. I can buy health ins for around $1500/m to cover my family. If you do the math that’s almost 100K in 5 year. I still would have deductibles before the ins kicks in. Plus the pain of dealing with Ins companies.
I self-pay everything! We go to the doctors like any family, but we go to the doctors we want, not one on a list. If you tell the doctor’s office yourself pay, they will usually take 30% off the price. My wife will even haggle with them and get more. We get the BEST care, I assure you.
My wife’s pregnancy in total including the hospital was less than 8K. That was the best doctors at the nicest hospital.
If you have decent income don’t sweat the health ins, just put away about 3% of your gross income for medical stuff.
Also eat healthy and walk a few miles each week.
In my experience, High Deductible Health Plans from *major* carriers are quite good. I'm not talking about those discount $50/mo. plans you can get through trade organizations. I'm talking about "High Deductible" plans from Aetna, Blue Cross, etc... You might have to cover the first $2k - $3k per year out of pocket, but after that you're often covered at the 90% to 95% level with no upper limit for major medical events like cancer, etc...
If you're self-employed, you ought to easily have $2k - $3k per year available to pay pre-deductible health expenses. It's really not that much money.
My observation is that most people seem conditioned to have this totally irrational expectation that ALL of their health expenses should be covered, with maybe a nominal $20 "co-pay" at every office visit. That's silly! Why not just pay for ordinary expenses out of pocket, and save your insurance premiums for the truly disastrous stuff (i.e. broken bones, appendicitis, car accidents, etc...)?
I'm just continually blown away by two income professional households with $120k+ income who just absolutely can not bring themselves to shell out a few thousand dollars per year out of pocket to pay the doctor. What's the big deal? 5% of your income is too much out of pocket expense? They'll happily blow $1500/year on mobile phone service, but $2k - $3k / year on pre-deductible health expenses are too much? But I digress......
High Deductible Health Plan from major carrier. The only way to go.
I have a great job and my company affords me a fantastic health plan. Unfortunately, a close friend of mine got laid off after a head injury caused a concussion and after six months of short term disability he was fired from the job where he'd worked for 13 years. He had been making about $60,000 a year. His wife didn't work. He lives in good 'ol Massachusetts, and his unemployment is too high to warrant MassHealth, so he's paying $1,300 a month for Cobra to cover his wife and two children. His savings are almost depleted and he's still recovering (headaches, dizziness, contant pain). While I fully support a national healthcare plan, the one we have in place -- get healthcare or pay the fine -- ain't doing it. More needs to be done to help those in need of health coverage so they don't wind up going into emergency rooms for chronic illness care. Any study worth its salt shows preventative care is cheaper than reactive care.
It sure is a boost. I'm going to drop my policy completely, pay out-of-pocket for general care, and then call up Aetna when I get really sick. Even with the fine (tax?) I'll save lots of money.
If only they'd fix car insurance, too. Then I'll buy my insurance after I've already crashed my car.
:wq
It's a pile of half-assedness; a roll of duct tape to fix a collapsing bridge. Mind you, it's better than what we used to have, and the "repeal and replace" crowd hasn't really answered the question "replace with what?".
Yeah, of course: moving to a country with a civilized public health system. Each and every first world country but USA, that is.
Once you are injured, sick or old, you are worn out. Once the capitalist, aynrandian system has no use for you anymore, you're supposed to just die and not bother your boss for handouts. I hear the best way to kill yourself is by inhaling nitrogen.
They will charge you double or more what they will charge an insurance company. Sad but true, they seem to be the one business that hates cash.
You are misinformed, they love actual cash http://www.ncpa.org/sub/dpd/index.php?Article_ID=21973. If you offer them real cash in hand (folding money, up front) and ask for a price based on that payment method you can even get a price that is lower than your portion of an insurer's negotiated price (depends on the procedure, individual doctor, etc)
What they hate is non-cash payments that aren't backed by an insurance company because of the uncertainty of collecting and the costs that are statistically associated with collecting post-paid. They're not even that enthusiastic about payments that are backed by an insurance company because of the same is it covered is it not covered headaches that consumers hate which is why so many docts, dentists and hospitals are willing to offer a lower price for when pre-paying for services in actual cash.
I'm in my early 50s in New Jersey, IT consultanting for 15yrs. Insurance would be running me about 1k/month, but i switched to a high deductable plan, about7k/year deductable, and now its only 600/mo. I argue enough with my doctor about cheaper drugs and other things, they said they wish i was on medicare. According to a article I read in NYTimes i should be getting about 3k/year from government to help pay once ACA is implemented... I almost got married a few years ago but issues with insurance stopped that. she didn't have & i would have been paying about 20K per year. I get no pension but i save like crazy and on track to save about 1 million. there was an investment article that said you could retire on a million but you would never be able to buy a new car and would have to eat early bird specials. The conclusion was it was not a life worth living.
This IT contractor would have a "major medical emergency" dealt with for free.
(OK so I am actually covered by some private insurance that goes with my wife's job and I do use it from time to time, but in the UK this mostly only covers elective stuff as the private sector isn't set up to cope with emergencies.)
It's a big fat mess of corporate welfare is what it is.
The 5% or so of people that would actually be punished and encouraged to buy health insurance under the plan are simply not that significant. They certainly aren't enough to completely trash our long established rules about the limits on the federal government.
It's like popping zits with a riot gun.
A Pirate and a Puritan look the same on a balance sheet.
No, you are the minority.
It's in the FAQ: Slashdot is an American run, America-centric, primarily American visited website. It's easy to get the wrong impression the way people talk though. Between the attitude and the English as a Second Language commenting I would probably assume the same thing.
I prefer to live healthy and die when it's time. Health insurance companies are making a fortune off of people's fears while simultaneously providing little to no tangible benefit. Keep your money. Live sensibly, and let the doctors rot in hell.
Didn't RTFS, but I know all my society memberships love to push their health plans on me.
Ask Slashdot: Which credit card is provides you with the most rewards and security?
For the self-employed, the non-group insurance market was really drying up in the early 2000's (premium increases beyond group, preexisting condition exclusions, absurd caps and other loopholes). RomneyCare made it easy: just log into the exchange, there's about 30 family plans offered by 5-6 different insurers, the tiers aren't too complicated (still some fine print to be careful of, but it's standardized between insurers), the prices are public and comparable (no better pricing available through direct or brokers or secret channels). Premiums have gone up, but remain competitive with group insurance. We got a rebate for premiums this year because our insurer exceeded 15% limit on salaries, marketing, and overhead.
I think ACA will extend most of these benefits to other states by 2014.
I've always thought that the biggest problem WAS insurance. There is no other area where the consumer generally has *no idea* what the cost is of what they consume. They just care about their copay or out of pocket and don't usually know (or care) what the real costs for the services they consume are. It follows that when someone else is paying for it, people tend to consume more than they really need, which drives up costs for everybody.
Running a close second is malpractice liability and the host of "cover my butt" testing now done by doctors. With the patient not really knowing what all this stuff costs and the doctor facing increasing malpractice insurance costs the pressure to do tests "just in case" is huge, even if the test is unlikely to ever catch anything and is expensive. You know that a good percentage of medical testing falls into this category, and this simply drives up medical costs and insurance premiums.
I suggest that we attack this problem on two fronts (once we get the current "Affordable Health Care Act" off the books.)
First, I think the expansion of HealthCare Security Accounts (HSA) is in order. Make it possible for folks to buy catastrophic health care plans (with very high deductibles) but allow them to put pre-tax money into HSAs up to the max out of pocket per year. Structure them like 401Ks and encourage folks to save though out their lives for medical expenses and allow these accounts to be passed down to others upon death. This will put the patient back into a position to care about costs and make it easier for them to refuse unnecessary testing.
Second, we need to put caps on medical malpractice awards for pain and suffering and make the looser pay legal fees in medical malpractice cases. Awards need to be for actual damages (i.e. for past/future medical expenses, lost earning potential etc) but pain and suffering and punitive awards need to be capped. The "looser pays winner's legal fees" will effectively eliminate those who are gaming the system by filing frivolous suits and their lawyers who are looking for a lucky million dollar award from a jury. All this would serve to lower malpractice insurance costs and lower the pressure on Doctors to perform unnecessary testing that drive up costs.
All in all, we need to get back to a system where the patient can take responsibility for the cost of their care. Only then can we hope to contain the ever expanding costs.
"File to fit, pound to insert, paint to match" - Aircraft Maintenance 101
Seriously.
When health insurance and health care are sold as a for-profit products, it is inevitable that some people will go without insurance and/or care. Why? Because they can't pay enough to make it profitable to sell to them. The market is fine and all, but it can't survive without profit.
Your best bet now is to look very hard for some form of group insurance. The older you are, the greater the probability you will succumb to somthing that requires surgery and/or long-term treatment/rehabilitation. i.e., things that generate 6-figure bills. (Think about things happening that cost $500,000 to deal with. Think about pills that cost $100 a pop.) Better to have good coverage for that eventuality and poor coverage of things like routine doctor visits than vice-versa.
-- Slashdot: When Public Access TV Says "No"
A lot of the insurance companies are rolling out straight to consumer health insurance to be compliant with the affordable care act.
And this right here folks is what is wrong with our country, the "fuck you, I got mine" in the flesh.
This is why we have to force people to get car insurance, because this asshole wants to ripoff society. He can't possibly be expected to actual like a responsible adult.
One feature of Obamacare is health exchanges, which will allow individuals to get the shared-risk benefits of belonging to a group plan. These will start appearing in 2014. The one for my state is planning to offer plans that will cost $200 a month, assuming you're over 30 and have an income of no more than $30K.
That's why in many countries public healthcare comes from taxes. In effect some people pay for everyone's healthcare. In some places you still have a choice to go for private healthcare (and private health insurance) but you can always fall back on public healthcare.
These systems may not sound great to many taxpayers in the USA. But fact is, you pay ANYWAY.
Guess who ultimately pays when some poor uninsured person sits in ER till he/she gets treated? You usually end up paying more for them since this is not efficient, I also suspect this might be a factor in why many hospitals are shutting down their ERs. The fewer ERs there are the worse it is for you if one day you need one.
So the rational thing to do is to either let more people die and suffer, or do healthcare better. The civilized rational thing to do is to do healthcare better. You might end up actually paying less, and there's less misery around.
That is pretty much implemented already, with all pre-existing-conditions and purchase-exchanges left for 2014. The other part of Obamacare- the expansion of insurance to half of those who lack it now, also starts in 2014. Expansion includes the mandate, looser medicaid requirements, and insurance grants for the less well off. This second part has invoked big politcal controversy we dont need to talk about here.
I used to have health insurance. I paid for it, of course, since I was self-employed. But then back in the mid-1990's our state government decided to change the game and kicked out all but one of the insurance companies. The remaining one, BCBS, with its monopoly power raised rates tremendously. I went from insuring our family for a few hundred a month and a $500 deductible to paying well over $15,000 a year and a $60,000 annual deductible-copay combo. It changed from being affordable health insurance to being unaffordable disaster insurance. After five years or so of that I dropped it and just paid cash for health care. It was a lot cheaper. Since then prices have only gone up.
Contrary to the popular opinion the uninsured are not a burden on society. The hospitals make sure we pay. When you go in you sign documents so they can come after you if you don't pay and for the most part they take their money upfront. This is true of the Emergency Room care too. Free health care via the Emergency Room for the uninsured is a myth. The uninsured being a burden on the insured is also a myth. If you don't have the money then they take it out of you weekly. I know many people without health insurance who end up paying weekly to the hospitals and doctors. That is reality.
Talking with doctors, of which I know several, the big issue from their perspective is the greedy lawyers and the enormous paperwork associated with insurance. They like us paying directly because then they don't have to deal with the insurance companies or government to get payment. They tell me that about 20% of the cost is paperwork and about 15% is malpractice insurance to protect themselves from the lawyers bringing frivolous suites. That's 35% of the bill that is getting wasted. Health care costs could drop that much with some good sense. This does not include the savings associated with profits for health insurance companies. I do not expect things to improve on any of these fronts with the government involvement.
Quite frankly we were better off before government got into the role of over regulating the health care and driving out the insurance companies from our state. Now that it has happened things will never go back to where we could buy our own insurance so we must move forward into a new model.
No, I can't afford health or life insurance. I live very, very carefully. That is the best assurance.
Or more. There are two components tot he increase. First is medical inflation, doubling premiums every 7-10 years. Second is age increases, doubling every 10-15 years. Toss in a few doubling cycles until you are in late pre-Medicare years (60s), and its easily going to be triple figure monthly premiums, if not already.
Your sarcasm detector is broken, another obvious failure of the US healthcare system.
"National Security is the chief cause of national insecurity." - Celine's First Law
Unless you ask for cash discounts before receiving services. Then you will pay about what the insurance companies do.
No. You pay a hell of lot MORE if you don't ask for a discount and actually get it.
The insurance companies negotiate huge discounts with doctors to be a part of their plan. The insurance companies get the docs to give them discounts by promising them more business than they can handle.
Depending on services and the specialty the discounts range anywhere from 30% to as much as 90% in some rare cases. I have seen patient negotiate well in advance of giving birth getting 75% off of their child's delivery. That's over a $10,000 savings because doc's business is so down. This economy is hurting them to.
And that's the frustrating thing - none of this is transparent. The insurance companies say that their pricing is a "trade secret" and therefore they won't share and doctors don't want to say either. Our medical system in the US is so fucked up and the only people who do like it are the insurance companies. More then half the docs I know don't like it either - but you''ll never hear that in the media - especially on Fox News.
You have to call around and be persistent in getting prices. Anyone says "no" doesn't get your business - and it IS a business.
-Just an ex-insurance guy with a wife in medical ....
Great, until they decide that your $100 pill is not on their preferred list and you pay full MSRP, or maybe a few percent off.
Happened to me with meds I was on for two years, then poof. Really hoping a generic is released soon, but copyright prevents that here in the States.
I was buying insurance for the family for about $800/mo. Then my State passed a law that said that all preexisting conditions had to be covered. Two family members had "them" - one was controlled by a $4/mo prescription from WalMart, and the other is a "grow out of it" situation, but the rate to insure against all potential outcomes of those conditions was an extra $600/mo. With me trying to be a decent dad and my wife a stay at home mom, we've been just getting by financially, and there was no magical $7200 per year sitting out there. I looked into real insurance (against catastrophic illness), but again the State has so many requirements on insurers that it can't exist here. I was worried about medical bankruptcies so I looked into that and found out that over 80% of people who go into medical bankruptcy had insurance. So, we went uninsured.
Instead of spending $9600/yr, we now spend $1200/yr on a gym membership and lots of produce and have gotten back in shape. That knee that was aching me is now 'cured' and I feel like an idiot for wondering before if I should be looking at surgery and steroids (no, stupid, lose weight and strengthen the joint muscles).
Now, doctors visits are out of pocket and we visit with skilled nurses unless we really need a doctor. The local hospital charges $430 for a Vitamin D titre, but I found it available elsewhere for $75 including draw with just a short drive. Recently we had a condition that would be treated the same either way whether an expensive diagnostic was run, so we just skipped the diagnostic. None of this is "insured" thinking.
If the worse should happen? That same State that screwed up the insurance market here will force the hospitals to provide care. I don't like it at all, but that's the hand I'm dealt. Let me buy real health insurance and I'll sign up again tomorrow.
Obamacare? Pfft, I make over $29K per year, so they'll 'force' me to buy so-called insurance at the $17,000/yr rate. That money does not exist. They say I'll need to pay a fine of $1300 a year for not having that $17,000 per year (and get nothing in return). But the law is plainly unconstitutional and has no enforcement teeth, so they can pound sand - I'm not cancelling my gym membership to pay these morons a fine just so I can get sick.
My God, it's Full of Source!
OUTSIDE_IP=$(dig +short my.ip @outsideip.net)
If type 2 diabetes is your first major medical expense, you'll be fine - you can self-diagnose long before it becomes a problem.
If it's cancer, you'll also do OK - because you'll self-diagnose way too late to have a good prognosis. So it doesn't matter whether you got insurance or not.
If it's a heart attack or a stroke that's your first warning of medical issues, you're toast. It's difficult, if not impossible, to get to the computer, log in, request a quote, apply online, and get the insurance while you're doubled over in pain. Even if your heart attack is mild enough that you can pull this off, the 10-20 minutes it may take to do so may render the matter moot. (And if you can't complete the application before the ambulance arrives, you could find yourself on the hook for six digits, possibly more, by the time you get out of the hospital.)
I don't suffer the misfortune of living in USA. My country has a half way decent free public heath system and being self employed I pay less tax to replace some public cover with private. I end up only paying an extra $500/yr to get full private heath insurance and life insurance for myself and my wife.
I've been a contractor on and off several times during my career but am now working for IBM (via purchase).
Last year after a freak go-cart accident I ended up in the local ER for a CT scan to check for internal bleeding - they found a large mass. It ended up being the same type of tumor Steve Jobs had but in a much better place. I had a pancreaticoduodenectomy (same as Jobs) but my expected outcome is much better (because I was lucky to find it and aggressive to rip it out).
The list price for all of the tests, surgery, support and complications was almost $400k - we ended up paying a bit over $17k. I was also on short term disability for 3 months with full pay.
I may have had the same outcome medically if I were contracting but financially I doubt it.
The 5% or so of people... not that significant.
15,000,000.
"The death of one is a tragedy..."
Stalin would be proud of you, comrade.
"Require you to buy some" is hardly an insurance plan.
I think every state requires you to buy auto insurance and all mortgage companies require homeowners insurance.
Wrong. *NO* state requires you to buy auto insurance by itself. They require that *IF* you by a car AND drive it, you have insurance.
If you don't own a car, you don't need auto insurance. There is a condition and people can (and do) weigh the cost of insurance when purchasing a vehicle.
With the "Require you to buy it" health care bill, there is no way to opt out. You can't say "I can't afford the insurance so I'll ride a bike, or take the bus instead". This is a dangerous and slippery slope we are on with this. It's the first time the government required you to buy something, with no way to opt out, no per-requisite purchase (if you buy X, you must also get Y). If you are breathing, you must buy it or face a tax (and per SCOTUS, it is a tax). Ask yourself who will pay that tax? The rich? Are they uninsured? No. The poor/middle class that can't afford the insurance, so they will get slapped with a tax.
I was really hopeful about Obama's original plan for health insurance... getting Democrats, Republicans, Doctors, and Insurance companies together and debating the problem, and having the debates online/on TV. What we got was HillaryCare with "Hillary" scratched off and "Obama" written over it... and funny thing is Obama flat out said that requiring somebody to by insurance then fining them if they can't afford it was going to make the poor worse off... and that is what we got.
You can get the quote here.
if (it != oneThing) it = another;
Hardly elective. about 18 weeks ago, my NHS doctors misdiagnosed severe ligament and bone damage as simply 'tennis elbow'. My private medical has so far covered 3 orthopedic visits and 9 sessions with the hand therapist. They are also going to cover the surgery to adress the bone damage (with no deductible / excess) as well as all rehabilitative care.
None of this is elective surgery. When it's done, my nose will still be bent, my ears will be flappy and I'll still look like some kind of scary freak, but I'll be able to bend my elbow by more than the current 20 degrees.
If your HSA account can hold out for the next two years, you'll then be able to buy insurance for a sane price from the mandated marketplaces.
"Who is the Journal of Quantum Physics going to believe?" --Stephen Hawking
So, the govt should force me to be my brothers keeper? Where is that in the constitution?
I'd rather take care of myself, my family and friends....not have my money taken by a large faceless govt, and given to who knows who, and waste who knows how much doing it.....
Light travels faster than sound. This is why some people appear bright until you hear them speak.........
Per the slashdot FAQ, slashdot is an American centric site, and you should assume that in any unclear case that we are talking USA.
"Who is the Journal of Quantum Physics going to believe?" --Stephen Hawking
Even with the fine (tax?) I'll save lots of money
depends on the fine (tax). Seriously. For the first couple of years you're probably right. When someone wises up to your scheme and moves a decimal point, not so much.
The way the provision works is you will have to (eventually) pay an annual penalty of 2.5% of your income (beyond the filing minimum, not 100% sure what that means but probably the minimum amount before you have to file your taxes), if you don't buy insurance. If your income is more than 133% of the federal poverty line, *and* you can't find insurance for less than 2.5 % of your income beyond minimum filing then yes, you *might* be better off not buying insurance and paying the penalty.
http://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act actually has a handy chart, and you can see where the penalty fits in compared to where your income is. Keep in mind that for 1 person the federal poverty line is like 11k
So you do highlight one thing wrong with the system, someone with 40k income could have an insurance plan costing a maximum of 4 grand, or they could pay the $1000 penalty until they need insurance. Guess how long your plan is going to last before the government moves the decimal place from 2.5 to 25%.
"what do you think is the best plan for insurance?"
Move to Europe, or to any other civilized country.
When I lost my last salaried job in 2003, my health insurance went with it. It was completely impractical to get insurance as a contractor for the next nine years. As it happened, my luck held. I didn't need care during this time, and became eligible for Medicare at 65 last month.
When I was contracting in the early 1980s, I had absolutely no problem whatsoever affording health insurance.
You make an interesting point...
There seems to be a good cross section between the people claiming "Personal responsibility" the people saying "Fuck you, I've got mine" and the people who's plan is "I'm lawsuit proof."
The US has become a corpocracy with just two parties that only marginally differ in reality. The only real difference is how much the companies pay the representatives in "election funds" and not in what they actually decide. If you want change, change your legal representation and make sure actual good laws get passed. Obama's medicare bill wasn't the best on the planet to start with, it got worse with all the compromises, but at least it's an attempt and it may actually proof itself in the future. It is evident that this is the best that the USA can come up with and that this is what the USA voters chose.How about making an actual change and not complain about how bad the government the US chose themselves is doing? If you don't like your government, change it, don't whine that they can't do it right. You chose them, you deal with the consequences. The USA should be able to get every inhabitant of the USA proper medical care for less than what is spent now, there's plenty of proof in other countries. If they can't establish that, they have only themselves to blame.
I was promised a flying car. Where is my flying car?
I'm a contractor through a medium-sized employer of about 1000 people. My family of 5 (wife + 3 kids) pays about $1200/mo for our BCBS group medical+prescription PPO. Dental is another $50/mo. No vision coverage -- paid out of pocket for laser surgery about 5 years ago. My employer pays half and I pay the other half. We have no deductible, $10 co-pays, and $10 generics prescriptions. We are a generally healthy family, eat well, and exercise (triathlons!)
We had one kid, it was going well and thought "lets just have one more"... ended up with twins. Our twins were born last year, 10 weeks early due to an emergency c-section after the wife got sick from our oldest kid. It was $10k each for the c-sections (you'd think there would be a discount to get the second one out!) After all the delivery expenses plus wife's week in the hospital the total delivery cost $30k. The girls then had to stay in the Level IIIC NICU for 6 weeks. Total amount that the insurance company PAID ended up being just over $300,000. The providers asked for about $500,000. Only thing they didn't cover was the $500 ambulance ride to the hospital. We spent about 3 months getting them to pay for the c-sections due to an incorrect billing code that neither the provider nor the insurance company seemed to care about fixing.
Overall it seems pretty expensive, but I hardly ever have any problems with them. I've never tested it for anything serious besides the twins, however. When comparing prices, make sure to factor in both the employer and employee payments. I have no idea where these $300/mo plans for a family of 5 are coming from. I looked for an individual health plan 2 years ago when I was thinking about going out own my own and at first BCBS said they wouldn't give somebody an individual plan after they had been on a group plan. Finally they gave us a price of $1500/mo.
I often review the claims when the insurance company sends them to me. It is almost universal that the provider asks for 2x to 4x more than insurance ends up paying. I'm not sure if I'd get a discount or not if I offered to pay cash before a regular visit.
I live in France and health insurance is paid by global taxes.
There is no lawyer problems here, so it's much cheaper.
I had a cancer 15 years ago. Stayed in the hospital for 6 monthes. I did not pay a cent. Only the meals.
US system looks really crazy from here.
Single-payer! The only way to control health care costs.
That is absurd. We all know the government cannot control costs to save its life. That's true of any government agency...
The real way to reduce health care costs is to loosen some of the regulations that are strangling them. Drop restrictions on insurance, let private industry reduce costs where they can. We already have one of the most efficient health care systems on the planet, there's no reason it cannot also be the cheapest.
Additionally, what you are not seeing is the massive inevitable failure of many of the world's "free" healthcare plans, as population declines and the baby boomers continue to age. A lot of the single-payer systems are going to get really bad, very fast.
"There is more worth loving than we have strength to love." - Brian Jay Stanley
No such insurance exists.
If someone claims it does - they are lying, whether they know it or not. Within one year of expensive bills you will be dumped with no recourse.
That is why ONLY government backed, guaranteed and country-wide single payer will work. Like Medicare/Medicaid (Which your hero Ayn Rand wound up using, real role model there!)
Anything else is the ravings of a delusional, Randian, Smith-misunderstanding lunatic.
Take your meds. And for gods sake stop posting your blathering idiocy.
I was aware it it American run, but thought the American-centeredness was just de-facto. So are Americans really in majority here? Feels hard to believe that they would be even 1/4 of the worlds English speaking geeks...
Won't it?
Wrong. *NO* state requires you to buy auto insurance by itself. They require that *IF* you by a car AND drive it, you have insurance.
If you don't own a car, you don't need auto insurance.
Okay then, if you want to make that distinction, if you're not alive then you don't need health insurance. Okay?
There is a condition and people can (and do) weigh the cost of insurance when purchasing a vehicle.
With the "Require you to buy it" health care bill, there is no way to opt out. You can't say "I can't afford the insurance so I'll ride a bike, or take the bus instead".
This would be a simpler discussion if people would educate themselves in the area of discussion vs looking for the easy out. I've yet to see a plan where indigent or people in the lower income classes are required to pay much, if anything at all. So the rest of your argument is invalid. Sorry.
Agree that it'll be better once we get rid of the health insurance companies altogether.
I contracted for about a decade in the USA earning over $140k/yr while taking 8-12 weeks off for vacations and travel.
In 2007, my sugar daddy company decided that I needed to be an employee, so they told me 6 months before, that I was being converted to employee. They never asked. About a month before, they told me my salary would be $100k. They never asked if that was ok. The Friday before the conversion, the guy who signed the timesheets said something like, "I won't have to do this anymore." I responded that he wouldn't, I was leaving. He was shocked and started freaking out. When I left that day, I turned in my laptop, cell phone and keys to my desk to him.
I don't think he believed me. On Monday, they called me at home around noon wondering where I was. I'd missed the new employee training and paperwork. That was 5 yrs ago. I've been contracting at different places ever since - earning more money for even less time working.
I signed up for health insurance through e-health insurance.com in 2007 for about $200/month for an HSA plan with $3000 annual deductible. Every year, that cost increased about $50/month. Last year it was going to be $370/month and be raised to a $5000 annual deductible. I have zero health issues, but I'm in my mid-40s. The costs were going up, up, up, so I needed to find an alternative.
Costco started offering health care to small businesses in my state. i think they do 8 states now. The plan is a little different due to Obama-care, but I'm paying $148/month. The deductible is less than before. The exact same insurance company is providing the coverage. What a racket. Basically, nothing changed, but I'm paying 1/3rd the cost. Same doctors, same network. This should be illegal. A guy in my small company was paying $1000 month due to prior conditions and they refused to cover his wife at all.
We are going to pay for this stuff one way or another, but pricing should not be that varied. That should be illegal. Pricing should be no more than 20% different between the cheapest and highest rates. Pricing must be published for all plans to ensure we aren't being ripped off.
Voluntarily non-existent. I've yet to work a contract where the insurance isn't about 200 dollars a month for one person - excluding the half the employer pays. I work around this and I rarely ever have any health issues that I cannot solve myself.
So, the govt should force me to be my brothers keeper? Where is that in the constitution?
Somewhere right about the part where they force me to support armed forces so that Communists can't move in and carry you and yours off to re-education camps.
Years ago scientists figured out that the body's stress and sex hormones are made from LDL cholesterol. If the conversion from LDL to Pregnenolone isn't working as well as it should (vitamin deficiency, or other cause), the body ramps up production of the steroid prohormone precursor, LDL.
But science doesn't make Pfizer et al $billions, so it gets stuffed in a burlap sack and kicked to the side. There is good health advice out there, for people who choose to search for themselves, and who have a bit of luck. Just be careful when talking to medical professionals, as their training has been excessively influenced by those profiteers...
Learn the rules so you know how to break them properly.
www.teslabox.com
"Okay then, if you want to make that distinction, if you're not alive then you don't need health insurance. Okay?"
The Supreme Court recently had something so say about the retardedness of that logic. States are different from the Government, and regulating an optional activity (you can live w/o a car) and a non-optional activity (you can't live w/o living) are two different things.
"Agree that it'll be better once we get rid of the health insurance companies altogether."
Why? I don't want government-provided healthcare any more than I want to eat in a government-provided cafeteria.
I pay for my own health care (HSA + out of pocket until I hit a deductable). I buy insurance for the same reason ANYONE buys ANY KIND of insurance: evaluating the risk, financial coverage for catastrophic incidents is more valuable to me than the average financial loss I'm expecting to take (by paying into a pool regardless of use). I expect the insurance company to come out ahead because I expect my insurance company to be solvent enough to pay for my needs under the policy if/when I need it to.
Hire a Linux system administrator, systems engineer,
Insurance companies were like bankers, they will lend you an umbrella when it isn't raining, and the moment it starts to rain, they will want it back.
My situation was rather bleak. When you are young you think you are healthy and that you can forgo insurance. To make a long story short, I ended up in the emergency room, and my blood pressure was through the roof. They suspect it was a virus of some kind. I spent 5 days in the hospital, racked up a bill totalling 40k. So, after taking care of that bill, I decided to get insurance. I tried several insurance companies, most denied me because of pre-existing conditions, this is before Obama care. One letter basically said, they are denying me, and don't bother to try again.
One company finally accepted me, BCBS. They have been great. They have places where you can go and ask questions, and they can run scenarios and find out more about your situation. They even have programs to help you get back in shape. They cover 100% of the med costs, which is a big plus for me, or I would be billed 200 a month without their help.
I think Obama Care is a step in the right direction, but hospitals charging a grand a room is ridiculous, and stuffing the bill full of things they didn't even do (this happened to my son's bill) is another issue that needs to be addressed.
IT Contractors, How's Your Health Insurance?
Uh...I'm a *contractor*, therefore I'm in charge of my *own* insurance.
Also, thanks to the idiotic Obamacare/Romneycare system I don't need insurance. I can drink myself stupid, smoke 3 packs per day, eat terrible food and when it comes time to pay the piper for my poor choices, everyone else will 'share' the bill...
There's no place like
Premiums in group plans have more than doubled with most family plans running more than 2K per month for coverage - up about 100% since 2008 and it's going to get a lot worse... Someone has to pay for all of the hand-outs... Guess what? If you have a job, it's you...
While there may be upsides to contract labor, they are reserved for the few that do well in any system. For the larger part, contract work is used to dodge benefits and to generally make life hell for workers in the name of "uncertainty". In addition, the two-tier workforce generates more backstabbing from the large amount of people in less-than-voluntary contractorship due to desperation.
The better thing to do would be to penalize contract labor while rewarding direct hires for all skill levels, as well as ensuring that liabilities/benefit requirements cannot be dodged or passed to some staffing agency or contractor. This way, the US heads off the European "contractor-for-every-job syndrome" by rewarding direct-hire, long-term work. No exceptions, no excuses.
As for HSA's, they're fine only if you can throw thousands at them and never consume them. Otherwise they make care worse off for the Rest of Us that cannot treat $5k as if it was pocket change. Conventional plans as a part of a full-benefit package (from a proper direct-hire job) do a better job than the HDHP nightmare.
The sooner that both contracting (as a standard practice) and HSA's DIAF, the sooner things get better. I'll probably get flak for it, but not everyone wants to be a disposable resource.
Twitter supports and protects racists - by smearing their critics with the "Hate Speech" label.
Bring the anti-structuring laws from banking to remedy such a problem. Kills the 49 Employee Disease, contractor abuse, 32/39.5 hour abuses, and other things businesses do to try to get around the law.
If a reasonable person can see that someone is attempting to circumvent a regulation, treat the business as if it passed an minimums or met any requirements w/o regard to their actual status.
Twitter supports and protects racists - by smearing their critics with the "Hate Speech" label.
My inlaws are visting from outside the US and don't have US health insurance. We have had various routine visits as well as x-rays and prescription medication. It was surprisingly affordable, Doctors visits were $40, x-rays were $80, anti-biotics were under $10. I expected it to be very pricy.
Now I think catastrophic care would have been another story, but routine was surprisingly cheap. It may make sense then to pay for routine care out of pocket, and merely get catastrophic coverage.
Bring back the old version of slashdot.
Here are the immigration rules for self employed workers in Sweden: http://www.migrationsverket.se/info/177_en.html
When I did contract work it was through other companies. In those cases there were no benefits unless the customer kept me more than a specified time. It was amazing to work at customer sites where the contractor staff was "disappeared" just before they hit the magic date where they could get benefits.
I never found enough business independently to justify all the work of incorporation.
I live in Canada, and so have no idea what you are talking about. If I get sick, I go to either the doctor or the hospital. They don't have cash registers in the emergency wards here. They don't take your gold fillings to fix your appendix. It would suck to be asked for cash when in pain and/or dying. "Transaction Denied" because the network is down, then it comes up and you get a "Transaction Approved" about the time you expire. Tell me how that system is better again?
and train to be a doctor yourself?
what you are proposing is a combative relationship with your doctor: "why did you order that test?" "i thought it was best" "but i can't afford it"
or "why didn't you order that test?" "i thought you didn't need it" "let me look up on wikipedia and make an uninformed opinion about your area of expertise..."
the point is, you are proposing a capitalist system where the usual supply/ demand creates discipline in a marketplace. except healthcare doesn't work like a capitalist system. some people, or some conditions, may require an expensive outlay
so then you require insurance, to spread the average costs out so one event doesn't decimate you financially. then you require everyone to have insurance, so uninsured don't avoid the bill and the rate for the insured (who get it because they are sick) isn't too high
"we need to get back to a system where the patient can take responsibility for the cost of their care."
no! this is insane, financially unsound, and destructive
we need compulsory universal insurance
intellectual property law is philosophically incoherent. it is your moral duty to ignore it or sabotage it
what happens when mr. young stupid and poor ayn rand acolyte with no health insurance breaks his arm?
he avoids the bill or declares bankruptcy
then the hospital passes the unpaid bills on to the state and feds and WE pay, with our taxes, for the moron's "choice" not to be financially responsible for his own healthcare
to "choose" not to have health insurance is to choose to be freeloading shortsighted irresponsible asshole
health insurance must be mandatory
because too many assholes think freedom means freedom from responsibility
intellectual property law is philosophically incoherent. it is your moral duty to ignore it or sabotage it
I wouldn't know - as I live in Australia.
Australia has a "Commie plot" style collective medical system called Medicare. They pay for me if I need major life-saving surgical treatments.
Unlike the more enlightened US, which attempts to fuck people over and offer them no safety net..
I think I like Australia more...
You put Belgium before The Netherlands? How dare you deny our rightful claim to this tear away province... what... belgians want to join Holland? eeh... the French, they belong to the French! Belgium? Never heard of it. Where is it?
MMO Quests are like orgasms:
You may solo them, I prefer them in a group.
Have you been to Japan? They are TINY! You can fit three inside a single MRI and no bits sticking out. Hell, if they bent their knees a bit, they can walk through.
Mean while the average American needs to go to the docks to get x-rayed in line with shipping containers.
MMO Quests are like orgasms:
You may solo them, I prefer them in a group.
As a free lancer I could choose private or public insurance. However, the public variant provides one plan. And you have to dependent to your income. The public plan includes automatically all your family members, as long as they do not have their own income. For any normal employee the cost is half because the other half has to be paid by the employer. The service, however, is the same. So normally you do not have to discuss the health care plan if you do not really, really have fun doing it.
If you life in the USA, the picture is quite different. Then you are doomed. Obamacare is only a weak little brother of European health care systems.
Yeah that venn diagram would almost be three circles stacked right up on each other.
If you want that health care to be a govt function, there's a way to do it legally....amend the constitution.
Light travels faster than sound. This is why some people appear bright until you hear them speak.........
I'm sure that is sarcasm - something lost on most of your replies, and on most of those arguing over the forced-insurance issue.
You can have it one way or the other, but not both:
1. You can allow providers to deny coverage for pre-existing conditions.
2. You can force everybody to have insurance (private or public or whatever).
The problem with #1 is that it leads to massive abuse, like post-claim underwriting. I see #2 as the lesser of two evils, and it lets you have more of a market for insurance. The only problem with the US implementation of #2 is that the fines for not having insurance aren't high enough - they need to be comparable to the cost of having insurance, or the government will end up having to bail out insurance companies (that is also a legitimate option - view no insurance as a form of partially-taxpayer-funded catastrophic insurance).
If you try to do both you get the scenario described in your post. To some extent that is what the too-low penalties accomplish.
If you're a member of IEEE or any other large society there's probably a health insurance pool which you can tap into that way. It'll probably be cheaper than buying individual insurance...
You can avoid 100% health problems and cure existing problems by eating less and eating healthy. Only thing then you have to worry about is accidents. Eat one meal comprising of just fruits. Preferably the last meal of the day and eat it before 6pm after that eat nothing till the next day. Also always eat raw vegetables along with whatever cooked food you are eating.
If you get fever,cold,stomach upset or vomiting just avoid eating food altogether and just live on fruit juices or honey water or salted water till the problems goes away and then start eating again slowly.
Thats it you will live healthy till you die.
Although I was being sarcastic, I do believe that a vast number of people are going to take the "fine" instead of coverage and then pick up "insurance" when they do get sick. In this way, Obamacare is designed to bankrupt the health care industry. In a few years when that mission is accomplished, then-President Pelosi can step in and socialize the entire healthcare industry, not just the insurance industry. So it's part of a larger conspiracy.
:wq
If you're self-incorporating, the smaller you are, the worse the deal the insurance companies will give you. You have no volume discounts... and that's assuming they don't demand a medical exam.
For example, if I had no insurance through my employer, no insurance co in the US would give me any.
Let's just say I had serious medical treatment 11 years ago. A year and a half later, on COBRA, I called around to try to find something cheaper, and was told by a rep from IL BC/BS, presumably recorded, that no company in the US would even talk to me until at least five years had passed.
In late '08, with a contract ended and temporarily on COBRA again, I called around, and was *refused* any coverage by two more companies.
And someone mentioned "high deductable", and then said $1200. Whoever said that is an idiot. My company, which has excellent benefits, offers a high deductable of two levels, and the "lower" of the two is $5000 deductable.
The only real answer is Medicare-for-all, and defenestration of medical insurance companies execs.
"I require it due to having moderate to severe Psoriasis."
See the movie "Fat Sick and Nearly Dead". Your psoriasis may be from stuff like vitamin D deficiency and vegetable phytonutrient deficiency and omega 3 deficiency and so on.
That might be the case.
Honestly, I think this is inevitable anyway - but not for a while. I think what will really disrupt the industry is improvements in genetic testing/analysis.
If I can fully understand my risk profile at an early age then I have an information advantage over the insurance company and can play games like the one you just outlined. That means they go bankrupt. If they can use the same information against me, then you have huge classes of disadvantaged people, which won't be socially acceptable. The only solution for either is mandatory universal coverage, either via public or private funds.
"Been to the driver license office lately? That will be your doctors office if we go down this path."
they don't love their healthcare in other rich industrialized nations (they all have universal healthcare), but they would not in a million years trade it for the nightmare that is the USA
governments are famous for mismanagement and bungling. and this is still better than the system we have
i don't look forward to government managed healthcare because it will be utopia, i look forward to it because it is clearly better than the nightmare system we currently have
we will pay less, live longer, and not worry about our healthcare. like every other modern industrialized nation
intellectual property law is philosophically incoherent. it is your moral duty to ignore it or sabotage it