Wow! You should take a look at the comments on this post over at Get Rich Slowly. J.D. asked readers to report on how much they pay for health insurance. It’s just gut-wrenching. One reader remarked that she had paid tens of thousands of dollars for healthcare coverage but never made a claim; another said after she’d paid for the insurance, she couldn’t afford to go to a doctor. Another reader, who used to work for a company that did business with health insurers, described the insurers’ strategy of submitting requests for double-digit rate increases every few months, so they could settle for regular, steady single-digit increase targeting specific zip codes.
Meanwhile, if that doesn’t frost your cookies enough, the comments from Canadians—and from the guy in Japan—certainly will. One Canadian woman had cervical cancer…the only cost to her was the parking fee at the clinic where she had to go once a week for treatment. Other Canadians do remark that health care in that country is far from “free” for your taxes. But pretty clearly few or no Canadians can expect that a major illness or accident will pauperize them.
Really. You just can’t imagine why anyone who’s not a congressional representative and in the pocket of big donors and lobbyists would oppose a national health care plan. Medicare’s not cheap—largely because of the ever-increasing rates charged by insurance companies that have managed to get their fingers in that pot, too. But at least it’s marginally affordable and does cover most conditions.
Back at GRS, comment number 234 mentions something kind of interesting. It’s a healthcare co-op for folks whose feelings about forcing women to bear unwanted babies are so strong they won’t subscribe to commercial insurance lest their morals be contaminated when some other subscriber gets an abortion to save her life. Or to have a choice about what her and her family’s life will be. It’s called Samaritan Ministries.
For a family, according to this reader, monthly cost is $320. Coverage is rather skimpy: you pay out of pocket for medical costs under $300 a month (so if you come down with a chronic ailment, your monthly cost is now $620 a month, minimum—not counting drugs, vision, and dental), pre-existing conditions are not covered, and the most it pays out is $250,000. Get yourself a case of cancer or a heart attack, and that $250,000 will be gone in a trice…you’ll soon find yourself paying a lot more than parking fees!
In the absence of a national health care plan, though, it’s an interesting scheme. If you were young and healthy, it might be worth considering. It certainly is better than nothing, and far more affordable than commercial plans that gouge you thousands of dollars for limited coverage or for insurance you can’t afford to use.
Incidentally, Samaritan Ministries publishes a guide to finding healthcare providers. One of these is an outfit that, for a fee, will collect bids from doctors for you.
Meanwhile, a Christian blogger in Alabama casts a jaundiced eye on this outfit. Writing as DrAbston, this observer points out that it functions as a loophole for Americans to get out of buying the required insurance under the new Affordable Healthcare plan, that requirements skew the membership toward cherry-picking, and that its ballyhooed Christian philosophy contains an inherent contradiction.
So it appears that the faith-based (or anything else-based) health-sharing scheme, while perhaps useful for a limited number of special-interest groups, is not a viable answer to our country’s health care issue.
When you read the responses to JD’s post—245 and counting!—you realize something has got to be done.
$400.00 a month for me. It used to be $336.00 a few months ago, but they raised it to $400.00. I wonder how much it’s going to be in ten years.
It must be on all our minds this week; I just wrote a post about it as well, without having seen this particular one. I’m amazed at just how much debt you can get into quickly *with* insurance. For example, my son’s insurance company won’t pay one penny towards the cost of his recent MRI. I do the best I can with prevention and diet, but what happens when things just “happen”? 🙁 Sigh.
@ Budget Glamorous… LOL! I just came from your post! 😀
Medicare also is a potential debt trap: the basic plan is a 20/80 deal. Doesn’t sound so awful until you think about what medical care costs these days. Twenty percent of a million bucks (which you could easily run up with a stroke or cancer) is $200,000!!! If you’re not paying through the schnozz to get as much coverage as possible, you’re at terrible financial risk, all the time.
Health insurance and the cost of it seems to be on many people’s minds these days. It has become SO expensive, even when insured by one’s employer. The spouse’s employer used to pay for EVERYTHING, we never even paid one single premium but, over the past few years, we have gone from that scenario to the one we have now in which we pay $7000 a year for one of the employer’s health plans. Crazy.
I just left a job with the worst health insurance I’ve ever had. I paid $190 a paycheck just for coverage for myself, the deductible was $2500 a year, and NOTHING was covered until the deductible was met unless something catastrophic happened. So, basically, I paid $5000 a year to have more medical bills than I would’ve had without insurance. I will say the prescription coverage was okay, though many times the pharmacy didn’t bill insurance because it was cheaper for me to pay out of pocket.
Since I’m young and (luckily) have no health problems, I can now buy a private insurance plan with better coverage for less than half what I paid before. Our system is ridiculously broken but I’m not sure it will ever get better – too much money floating around from drug companies and insurers for our reps to do much about it.
I can’t believe you Americans have to pay so much for health insurance. I pay far less social security here in Ireland. The cost of a hospital visit/stay is basically free though most people do pay something towards accident and emergency visits. The elderly and the poor pay nothing as it should be. Doctors, nuses and other health care professionals whilst being well paid are paid far less than in the US. On the downside there are waiting lists for certain procedures though no one would ever be bankrupted for a serious medical condition/illness,
@ Ash: {sigh} It’s hard to escape the conclusion that we’re looking at the results of years of graft. And that many of the doctrinaire fools we have in office were put there by interests with enough money to recruit fools and get them elected. I personally see no easy way out of this mess. But if I were a young person today, I’d be looking at emigrating to more humane developed countries.
I hate the sounding like an apologist for the insurance industry (I’m not), but I do have one question for all the insurance company bashers. If they were making so much money, why wouldn’t there be more companies getting into the business? The answer is actually pretty simple – they really aren’t. And there are many reasons for that. One big reason is the dramatically escalating cost of health care resulting from advancements in medical knowledge. Today, we can treat many conditions for which we simply didn’t have treatments years ago. But this knowledge and understanding has come at a very high cost. And that cost is not limited to just the cost of curing people (although that cost is often astronomical) We are now able to keep very sick people alive by utilizing incredibly expensive – and long term – treatments. I’m certainly not advocating that we stop trying to find new treatments and cures. But people have to understand there are tradeoffs for all the new medical marvels. And we have to understand that the resources simply do not exist to provide the best healthcare available today to everyone who needs it. Unfortunately, many people can’t seem to accept that. It’s much easier to just demonize the insurance company who doesn’t want to pay $10,000 a day to keep your 90 year old grandmother alive. Don’t get me wrong, I certainly wouldn’t want to be the one making the decisions as to who will and who will not get that $10,000 a day treatment. But those decisions need to be made. And if you’re wondering how countries with nationalized medical care manage to give everyone the best care available, the answer is that they don’t. They can’t afford to. For what it’s worth, I’m very much in favor of nationalized health care, because I believe it offers the greater good for society. But I’m not so naive as to think that national health care is a panacea. It’s not going to mean everyone in the US who needs an organ transplant is going to get one. What I hope it will mean is that people won’t die from things like diabetes complications or treatable infections.
Of course, medical advances aren’t the only reason for escalating costs. One other significant factor is our out of control litigation culture. Right now, medical malpractice and product liability insurance coverage (for drug and medical equipment providers) is enormously expensive. And that cost must be included in the amounts that doctors, hospitals, drug companies and medical equipment manufacturers have to charge. We live in a country where there is no longer any such thing as a natural bad outcome. I suppose there is some element of karma involved, considering all the years medical professionals covered up colleague mistakes and manufacturers turned a blind eye to the damages their products might cause. But the fact remains that it is no longer actually necessary to do anything wrong in order to be sued. Any bad outcome must be someone else’s fault, someone with good insurance or deep pockets, that is. And as long as our politicians are almost exclusively lawyers, I don’t see that changing anytime soon. (Although, in a few years when there are no practicing obstetricians left, which is where we are headed, perhaps someone will figure out something needs to be done.)
I know it’s not very popular to swim against the tide of insurance company hatred, but how can we ever hope to fix our healthcare system if we’d rather blame the insurance companies than make an honest assessment of the issues.
For what it’s worth I have the VA and the Mrs. got into a pre-existing plan that was spawned from Obama Care.
That’s costing her/us about $400 a month.
I still expect to die at home without any benefit from any form of advanced healthcare just as my grandfather did.
We’ve come a long way haven’t we.
Those that are not in medicare need to establish a Dr. patient relationship now and not wait until they enter that magic window where they can apply for medicare and then find out that no clinics are going to accept any new medicare patients.
Congress and the trial lawyers have destroyed our medical system.
@ George: You got that right! I about croaked when my doc told me the Mayo was not accepting Medicare patients. They’ll keep you on if you’re already in their rolls, but they won’t accept you as a new patient. He also said you have to use their services at least once a year to stay on their rolls.
Consider: the Mayo is considered one of THE best health care providers…it’s where you go if you have certain types of cancer and certain other ailments. That means if you get that particular ailment, you cannot get the best care available.
Dunno who’s responsible for this ruination, but I think we can all agree that whoever they are, we wish they’d go away.
Canadian here. Please, please God, don’t screw up the Canadian health care system before I really, really need it. There are signs of erosion around the fringes, and make sure you get sick, not old – nursing homes are as expensive here as anywhere else. But for the big wallet-killing illnesses and treatments, yup, more or less free as air. Parking is expensive, though.
After the smoke clears, Canadians pay approximately the same percentage of GDP for health care as Americans do – but it’s out of the public purse. This is only possible because 1). Canadian spending on defense and other military expenditure is a rounding error on American spending, and 2). income tax rates (if you are middle-middle class or better) are a glorious 40% of gross, with fewer loopholes and shelters.
Meh, I’m good with that as long as I can get a free heart transplant in a few years.
Will Obamacare make things any easier for Americans when it eventally comes in?
Ash, hard to say, but aspects of it are already here. Many of my students (and their parents) are pretty pleased with the ability to stay on their parents’ insurance until they’re 26. That’s been available for a while now. Not sure about the other stuff.
@ Ash: Dubious. Insurance companies have lots of money and so have hordes of handsomely paid lobbyists. They will put up a stupendous fight to resist anything that cuts into their business. Plus possibly as much as half of the voting public objects to socialized medicine.
If Obama loses the next Presidential election, the healthcare plan will go away instantly. If he wins, the Republicans will keep their heels sunk in the sand for the next four years and then, as soon as they can move the Democrats out of the White House, they’ll get rid of it. One way or the other, I don’t see much hope of an effective one-payer or national healthcare plan.
The basic problem is that there are finite dollars that can be spent on healthcare, but an practically infinite demand for care. Scientific advances have made it possible to prolong life with an organ transplant – at a cost of about 1million dollars a patient. How can any health care system afford that? The British and Canadian systems deal with that by refusing organ transplants to anyone over 65, an intervention that is routine in the US. I don’t know what the solution is, but we have to make a decision about who gets to decide which people get health care. Is it the government? Insurance companies? Or just a function of who has the money to pay for what they want.
Good points, M Doats!
IMHO, as a practical matter those decisions are being made by insurance companies in this country. Or we could say, by market forces: if you can’t afford insurance (or you were unfortunate enough to get sick while uninsured or before you lost a policy), you’re not going to get those treatments. To some degree, even if you are insured, you’re likely to find your insurer refusing to cover expensive procedures, or capping benefits so that you can’t afford them without going bankrupt or pauperizing your family.
It’s easy to say we should refuse organ transplants (and other expensive treatments) to people over 65. But what happens when it’s our own mother who’s set adrift on the iceberg? Or you, or me?
The National Health Service in Britain has its faults, but because it’s there and I have asthma, Bill and I decided we really couldn’t afford to return to the US, something we always assumed we would do. It’s easier to just visit every few years and still have money to go see Bill’s sister in Sydney – warm places are high on our priority list. What’s amazing to me is that even people living on the very edge financially will condemn ‘Obama care’ and curse social programmes and all sorts that I would have thought they’d welcome (my uncle and some friends in OKC amongst them). Britain is tightening its purse strings a bit here and there, but I expect the NHS will remain ‘free at the point of service’ for some time (hopefully the remainder of my life).
@ Shelley: Politics shares much with religion in this country. We have doctrinaire sects in both branches of thought. Remember, our school system is weak in almost every region of the country, and that affects voters’ ability to think logically and make reasonable decisions (Arizona’s is among the worst — and take a look at our elected leadership!).
Truly, I do think a smart young person could do a lot worse than to build a life elsewhere. Not that I don’t love my country; but I do think it serves its citizens poorly in important areas like healthcare, wages, and education.
Here via the Grumpies.
Brain drain in the US is certainly happening due to the health care issue — whether on a scale large enough to be a problem or not, I don’t know. My brother, his wife, and their 2 children live in Europe (in her native country) precisely because of the cost to them of health insurance (and health care) in the US. They are healthy, educated, and employed. I can think of 1 other similar couple I personally know that’s done exactly the same, and another individual as well.
@ bogart: There’s the question, too, of whether young, well educated people can earn enough to maintain a middle-class lifestyle in this country. In my observation, this is no longer a given, certainly among my son’s generation.
@funny — True, though, in fairness, I think we sometimes forget how much has changed in terms of what the middle class does (and doesn’t) have. As a kid growing up in the mid 1970s, my solidly middle class family did not have central air or cars with air-conditioning or working radios or power windows or locks (or rear seatbelts) — living conditions that would seem entirely intolerable today. Cable television came into existence in our area (we did not get it) in my teenage years; we got our first microwave (my mom was a holdout) and computer in my teenage years also. Conversely, my mother had ready access to cheap household help at least in the first decade of my life because into the 1970s the remnants of the Jim Crow South provided a context where white people (a category in which my family fits) could hire black maids readily and cheaply.
Naturally we all walked uphill to school in the snow both ways, year round (except when we were out for summer to grow and harvest the crops, of course).
I do agree with (and worry about) your basic point; at the same time, I think we look back at those halcyon days through rose-colored glasses.
@ bogart: Yes, that’s sure the truth. What was considered middle-class in the good ole days was way different from what we consider middle-class…that the good old days weren’t is one of my favorite hobby-horses!
We did have radios, though. Always. But TV, no. And except in California, where it wasn’t needed, I’ve never lived in a house without central air & heat…most of my life has been spent in extremely hot climates.
The purchase of other “improvements” was an option: I considered cable TV to be an incredible rip, and do to this day. The airwaves belong to the public; the public should not be made to pay for use of what belongs to them. To add insult to injury, you’re blitzed with ads and the content is not significantly better on cable…why pay for a hundred channels with nothing you want to watch? Like your mom, I resisted the microwave oven, too — it looked like something designed to train us to eat lots of frozen TV dinners. Finally was won over when a department store was giving them away as a come-on to install carpet. 😀
@funny — right, right, sounds like we’re on the same page (For the record, I live, and grew up, somewhere where not having a/c would be considered nuts today — but of course a/c itself if a relatively new invention…). And I’m totally with you on cable. Even, of course, health care (to return to the original point) offers much more today than it did then.
None of which is to say that I challenge your basic point (I don’t), nor that I don’t despair at finding myself in a nation that — apparently — sees little or no value in investing in the health or education of most of its citizenry (I do).
I just quit my job to relocate to another area with family, and to escape the BS and madness, and am on COBRA. My premium is $844 a month for one son and me. My complaint is that it’s $844 if you have one child or seven. If the medical insurance companies were non-profit corporations, I wonder if that would make a difference to the premiums and also to the coverage.