2014 Health Insurance Premiums - Ouch!

[msop04]

Closing corporate tax loopholes would be a huge step towards a more fair system of taxation in the US, IMO, in addition to a flat tax rate. I'm with you on that, msop!

AMEN!!!

 

[msop04]

Erica, I am liking your posts so much - bravo.

The specific point that stands out to me is one made upthread concerning the money - Gypsy, Beacon, I think you're both right. The problem IS the lack of oversight that gives large corporations free reign to chisel their customers, abuse their workers, and reward management and only management (and even a casual glance at the ever-growing division between rich and poor in this country shows that that goes for a lot more than the insurance companies, frankly). I will be curious to see how all of this plays out over the next five years or so. Will regulations be imposed on the insurance companies?

I am hoping beyond hope that this will be one positive outcome!! <fingers crossed>

 

[ruby59]

There is also another group that will be hit hard by this - healthy young adults who are too old to be on their parents insurance but have not secured their dream jobs yet. My son's friends are in that group. They checked the exchange in our home state and the premiuns were very high. They do not qualify for extra help. This group, with hundreds of thousands of dollars in student loans, just cannot afford to subsidize other people.

 

[msop04]

Money has been thrown at health care for years... if the government would monitor Medicaid/Medicare fraud and cut off those who are so openly abusing the system, then we may just be able to save enough to use toward a beneficial program for everyone, not continue to simply spend more and go into endless debt.

Yes! I have no problem paying a little extra so those who truly need health care can get it. Just like I have no problem paying for social programs for those who truly (and mostly temporarily) need them. What I don't like is having to pay a significant amount more towards what is likely just a band-aid in a broken system. Even if they said "hey, we are going to raise everyone's taxes for a few years because we are completely revamping the system and to do so costs money"...great!

And, speaking of fraud, has anyone out there read "Pimps, Whores, and Welfare Brats" by Star Parker?

I agree amc! I would totally be down to sacrifice for a few years for this!!!! It would make me feel like my money would be going toward "fixing" rather than to we have no idea where.

 

[recordaras]

If you are not a citizen of the US and do not pay federal/state income taxes, you should not share the right to vote. It is a clear conflict of interests.

AFAIK, only US citizens are allowed to vote in federal elections. Even a green card doesn't give you that right, only full citizenship.

 

[msop04]

There is also another group that will be hit hard by this - healthy young adults who are too old to be on their parents insurance but have not secured their dream jobs yet. My son's friends are in that group. They checked the exchange in our home state and the premiuns were very high. They do not qualify for extra help. This group, with hundreds of thousands of dollars in student loans, just cannot afford to subsidize other people.

Yes! This is very true... I was so fortunate to be on my dad's state educational insurance until I was 22, and then graduated at 24 with a nice salary. Most don't have this though.

 

[Beacon]

There is also another group that will be hit hard by this - healthy young adults who are too old to be on their parents insurance but have not secured their dream jobs yet. My son's friends are in that group. They checked the exchange in our home state and the premiuns were very high. They do not qualify for extra help. This group, with hundreds of thousands of dollars in student loans, just cannot afford to subsidize other people.

Ruby, this is the kind of group I was wondering about. I heard some numbers tossed around and they sounded like quite a burden for a young person to pay and that group generally will not be subsidized. In fact, it will be them who are subsidizing others. I feel bad for them because it's another burden on them and harder for them to save for their retirements. They are the "young, healthy" that will be paying to make up for others.

Really not sure how all this is going to play out in the long run. Lots and lots of room for cross generational stress. We have already seen on this thread people who feel that if you have any extra money you are selfish not to pay up the increased costs, an example of cross income stress.

Maybe ultimately people will nit pick their doctors and hospitals and demand lower costs by shopping around and pushing for change. Something has to give, that's for sure.

 

[ericad]

There is also another group that will be hit hard by this - healthy young adults who are too old to be on their parents insurance but have not secured their dream jobs yet. My son's friends are in that group. They checked the exchange in our home state and the premiuns were very high. They do not qualify for extra help. This group, with hundreds of thousands of dollars in student loans, just cannot afford to subsidize other people.

Are they working full time but not receiving insurance via their employers?

 

[msop04]

If you are not a citizen of the US and do not pay federal/state income taxes, you should not share the right to vote. It is a clear conflict of interests.

AFAIK, only US citizens are allowed to vote in federal elections. Even a green card doesn't give you that right, only full citizenship.

Yes, you are correct -- I should be more clear. I feel that it is a conflict of interests to allow those who choose not to work (whether it be due to laziness or not willing to "lower oneself" to work a lesser paying job -- NOT due to TRUE disability) and/or accept welfare from the government to vote in any elections (federal or local). These people do not pay income taxes. I feel it is a conflict of interests for them to vote at any level, since it all starts locally. It's no secret that these people will vote for whichever party or representative promises to or has a record of giving them more free stuff -- at taxpayer's expense.

I feel it's wrong to give voting power to those who do have not contributed.

 

[ericad]

If you are not a citizen of the US and do not pay federal/state income taxes, you should not share the right to vote. It is a clear conflict of interests.

AFAIK, only US citizens are allowed to vote in federal elections. Even a green card doesn't give you that right, only full citizenship.

Yes, you are correct -- I should be more clear. I feel that it is a conflict of interests to allow those who choose not to work (whether it be due to laziness or not willing to "lower oneself" to work a lesser paying job -- NOT due to TRUE disability) and accept welfare from the government to vote in any elections (federal or local). These people do not pay income taxes. I feel it is a conflict of interests for them to vote at any level, since it all starts locally. It's no secret that these people will vote for whichever party or representative promises to or has a record of giving them more free stuff -- at taxpayer's expense.

I feel it's wrong to give voting power to those who do have not contributed.

But not every single person receiving assistance is a bloodsucking leech gnawing on the government teet (my words, not yours, I'm just being cheeky). There are many who are receiving much needed assistance in the manner in which these programs are intended, who are not taking advantage. Don't they have a right to vote their interests, like everyone else? The group you reference is a teensy tiny portion of the population as a whole, and still just a fragment of the micro-population who are receiving entitlements. What about senior citizens? They don't contribute in the same way that the rest of us do - maybe they shouldn't vote either? What about full time students who aren't paying any taxes because they don't work. Take their votes away too?

We have to make decisions based on the greater good - do that which will benefit the majority of the target audience of any given law or entitlement.

Don't misunderstand - I agree that our entitlement systems need reform. But I still see it as an issue that's separate from health care. Access to life saving medical treatment should have nothing to do with what one contributes via taxes (I know that's not the point you were making, but I've heard many people say this). That's when we walk that dangerous line of valuing a person's life by their wealth, or lack thereof. People will die because they're poor. Will that make our country great? Should we not judge a country's greatness by the condition of its weakest and most vulnerable citizens? To me, access to quality health care should be a constitutional right. We spend far more time, money and energy protecting Americans' constitutional (debatable) right to own guns with far more gusto than we do trying to save people's lives with something as simple as health care for all.

PS - when it comes to the mandate, I actually think that this is the wrong approach. I would have preferred to see the purchasing of health insurance incentivised, rather than what many perceive as a punitive approach. I understand why the mandate was needed, in order to make everything else "work" but I think there might have been a better way.

 

[ruby59]

There is also another group that will be hit hard by this - healthy young adults who are too old to be on their parents insurance but have not secured their dream jobs yet. My son's friends are in that group. They checked the exchange in our home state and the premiuns were very high. They do not qualify for extra help. This group, with hundreds of thousands of dollars in student loans, just cannot afford to subsidize other people.

Are they working full time but not receiving insurance via their employers?

One is self employed and a few are working 2 jobs, but each is part time so there is no health insurance. My home state (Think Curt Schilling mess) still has high unemployment and a government imo that is too loose with our tax dollars. A lot of companies are cutting hours. Some of his friends are taking anything they can to get a foot in the door. My son, to get a decent job with health benefits travels 3 hours daily to work in a neighboring state.

Many of these kids cannot afford an extra cent of expense and not all have family they can turn to for help.

From another post -
They don't contribute in the same way that the rest of us do - maybe they shouldn't vote either? What about full time students who aren't paying any taxes because they don't work. Take their votes away too?


Senior citizens have worked decades and have earned their benefits. We are not quite there yet, but my huband and I worked two jobs each since we were in our early 20s and raised a family. We did it all on our own. We did our part and more.

Full time students are staying in school and doing their part in getting a good education so they can be contributing members of society. Give them time and they will be paying their fair share of taxes and more.

These two groups are not the problem. Maybe it is not PC, but yes there is a segment out there that wants something for nothing. And there are enough of them out there that is causing a large waste in our tax dollars. In fact, I read, that for now, those seeking extra help for Obama Care will be on the honor system. We already have enough people scamming the system imo which is why I feel that we should have waited to get all the bugs out of it before its implentation.

 

[Smith1942]

This is a very complicated debate and I am not familiar with every provision of the Affordable Care Act, except its main components that most people know about. I am of Justginger's frame of mind and support the changes, and I support government-sponsored healthcare overall. (Being from the NHS system, this is not surprising, since most of us are products of our culture, and I did not leave that culture until I was a fully-formed adult of 32.)

So, the reason I'm posting is to share what my husband and I pay in premiums. I always think it's interesting to know what others pay and what they get for their money.

The ACA has not affected us because we are both now self-employed, so we are already paying premiums that are in no way subsidised by an employer.

Being residents of Massachusetts, we are beneficiaries of RomneyCare, which is basically similar to Obamacare. When my husband went self-employed a while after I did, with neither of us then having access to employer insurance, we were able to shop around (which you could only do if you had no employer insurance), choose from many, many plans, and if we had had pre-existing conditions, it wouldn't have mattered in Mass.

We ended up with what I believe to be an excellent plan from Blue Cross Blue Shield MA, and I looked into every nook and cranny of multiple plans from different companies, even to be told that I was asking too many questions by BCBS! I don't like surprises, so there's no such thing as too many questions when buying insurance. Naturally I was not deterred, and ferreted out the best plan with my questions. Example: one plan did not cover medical formulas. Well, what's the difference between a medical formula and a prescription drug? I drove the sales team insane with my phone calls, I think. But it's our health potentially at stake so I didn't care. (Example: I saw some plans that wouldn't cover diabetic care. Imagine if you were diabetic and hadn't read the plan's small print.) Then, after accepting us for this plan, they tried to raise the rates!! I made all kinds of threats and they backed down.

So, after a few fights, we got this great plan with BCBS, and we pay $1,100 a month for the two of us. This covers medical, dental, and vision. It's got great maternity benefits - only 1k for a straightforward birth, as opposed to 7k on some other plans. There is a 1k per person deductible, whereas many other plans had 5k and 10k deductibles. The deductible only kicks in for lab tests and surgery - we don't have to use up that deductible before office visits are covered. Chiropractic care and prosthetics are covered, unusually, and so is mental health. Prenatal care and routine care is free.

IN the UK many people supplement the NHS coverage with private insurance. Our BCBS premiums are not far from what my parents pay for their private insurance on top of NHS care.

I think that, for everything we get, our premiums are not so bad. We have had excellent care on our plan, fast tests, fast results, and although it's a lot of money, we make sure there is money for it, the same way that you make sure there is money for the mortgage each month. It also means that we are not beholden to employers.

However, actually choosing the plan was a total nightmare. They are so complex and there are so many. I guess you just have to be your own best advocate and I really fought to get the best plan. I reckon I spent at least a full workweek on just the choosing - so about 40 hours of sifting through plans. That's how I got something I'm happy with. I guess you can do this on Obamacare, too? I want to say that it was a TON of work, but I have peace of mind because I was able to choose a plan that suited us as a couple, our particular health concerns, and a plan that suited our life stage (e.g. possible kids) instead of having an employer choose one for us. I guess we've kind of made our peace with the four-figure premiums, and we do feel we get what we pay for.

ETA Notes:

1 - Just read some other parts of the thread. 30% tax is low, in my opinion. In the UK the top rate is 50%, which kicks in at GBP150k. BUT, you only have to be earning GBP32k to pay 40%. Yes, you are taxed 40% on approx $52k. Plus 20% sales tax, etc etc. France's taxes are much higher, and Scandinavian taxes can be higher still. From a European perspective, 30% being pretty much the top rate is incredible.

2 - An interesting historical comparison to this ACA debate is when the NHS was set up in the UK shortly after the war, I think in 1947. No one wanted it. Doctors said they would not be able to earn a living. People were against it. And now, it's about the most precious pillar of our culture and its existence is never in question. People don't like change, and certainly not huge changes like this one.

 

[amc80]

Smith, thanks for sharing. I, too, find it interesting to see what others are paying.

Here is my info (this is through my company):
My existing plan is an open access HMO, meaning you don't need a referral to see a specialist. Copays are $15/$30, no coinsurance, no deductible, $100 ER visit, $150 hospital admission (which means my entire maternity/birth costs were $150, plus the $15 copay at each appointment). Cost for my, DH, and DS = $422/month

New plan as of 1/1/14-
Same concept, open access HMO. $30/40 copay, no coinsurance, $500 family deductible, $200 ER visit, $150 hospital admission. Cost = $589. The odd thing about this new plan is it covers infertility at 100% (including IUI, IVF, GIFT, ZIFT, etc.). Hopefully I'll never need to use that benefit but I find it strange that it's now included.
For fairness, I should add that copays are potentially less ($15/$20) if you go doctors that are considered "super preferred" or something like that. But there aren't many in my area who fall into that category (out of the 49 OBGYNs, only 5 had that designation; zero allergists did and only a couple of pediatricians).

I'd love to hear what those on national healthcare systems pay for private insurance and what private insurance adds, benefit wise.

 

[Beacon]

Smith, yours are the kind of numbers I've seen: 1100-1200 per month.

You know, that is a ton of money. For many that is more than rent. It is great you have a plan you like and that you can afford it. Many people are going to get a surprise when they have to pay this stuff.

My sister lives in the UK. She pays for NHS also buys private insurance on top of that and when she needs something special she goes to the high class docs who take cash only. It is very expensive.

We'll see what happens here. It's going to be quite jarring for some.

 

[ericad]

There is also another group that will be hit hard by this - healthy young adults who are too old to be on their parents insurance but have not secured their dream jobs yet. My son's friends are in that group. They checked the exchange in our home state and the premiuns were very high. They do not qualify for extra help. This group, with hundreds of thousands of dollars in student loans, just cannot afford to subsidize other people.

Are they working full time but not receiving insurance via their employers?

Senior citizens have worked decades and have earned their benefits. We are not quite there yet, but my huband and I worked two jobs each since we were in our early 20s and raised a family. We did it all on our own. We did our part and more.

Full time students are staying in school and doing their part in getting a good education so they can be contributing members of society. Give them time and they will be paying their fair share of taxes and more.

You don't know that every senior in America has worked for decades and contributed their share. And you don't know that every person who is currently in school will graduate and become a contributing member of society. There are students who will wind up on welfare. There are seniors who have used welfare in their lives. And there are most certainly welfare recipients who were working before hitting hard times, or who were students at one time in their lives.

I just can't fathom the thought of taking away the vote of a US citizen based on how much taxable income they earn. Sorry, but that's a shocking prospect to entertain.

And who gets to decide who does and doesn't get a vote, because that could be kind of complex. Maybe we need some sort of panel? And I assume their salaries would be paid for by the taxpayers...

 

[Beacon]

This is a different topic than health insurance premiums and should be on a different thread.

 

[Smith1942]

You're welcome, amc. You've reminded me of some other plan features to share: Co-pays are $20 per office visit, no coinsurance, no hospital choice cost sharing (the latter means that some plans only let you go to the less illustrious hospitals), $150 per ER visit until the deductible is used up, but if you are admitted, that fee is waived.

Having no deductible is incredible - I did see some plans like that, but they cost about $300 a month more.

Oh - and the annual out-of-pocket maximum you could possibly pay is, I think, 10k. That's not so bad when you think how much things can rack up if you have a truly catastrophic event and need a quadruple bypass, or something. It's comforting to know that there is some kind of a cap in a worst-case scenario - i.e. months in hospital, transplants, etc etc.

Oh - my plan also includes months of nursing, rehab, home care, etc.

As a grim kind of exercise - but I wanted to get to know my new plan - I calculated what my healthcare costs would have been if I'd been unlucky at the marathon that day, being from Boston. Surgery, prosthetic limb and a few months of nursing and rehab would have ended up costing me about 3k. It's not so bad, really, for what you get, which is the key. We actually use our health insurance loads, so we feel the cost is OK. After all, that $1,100 is for two people, and we are aged 38 and 45 - I am very soon to turn 39. We are not in our twenties.

You ask what extra benefits private health insurance confers for people like my parents in the UK who have national healthcare. Much nicer facilities, faster treatment for some things, and peace of mind. Private rooms, instead of being on a ward with curtains separating you. I'm not sure how it affects drugs.

 

[ericad]

I don't think it is a different topic, Beacon. It should be, but it's not. Many people lump health care in with other entitlements. They think health care should only be for people who "contribute" and "pay their share". Unfortunately I think that for many people, the two issues are closely knitted together. They don't want to pay more to subsidize health care for people who are on welfare and are gaming the system. It doesn't seem to matter that this doesn't apply to the majority of people who will benefit from health care reform.

 

[ericad]

I'll be interested to see what the rates comp out at on the exchange for high deductible plans. I would think these should be fairly affordable, even for young people who aren't earning a ton of income. That is if I can ever get onto our exchange - they've had so much traffic that the system keeps crashing, lol.

 

[Beacon]

I don't think it is a different topic, Beacon. It should be, but it's not. Many people lump health care in with other entitlements. They think health care should only be for people who "contribute" and "pay their share". Unfortunately I think that for many people, the two issues are closely knitted together. They don't want to pay more to subsidize health care for people who are on welfare and are gaming the system. It doesn't seem to matter that this doesn't apply to the majority of people who will benefit from health care reform.

It is a different topic.

 

[ericad]

I disagree. Like I said, it should be, but it's not. People will always tie the two together. But if we're done talking about that, and want to stick with just healthcare, that's a-ok with me. I was responding to posts made by others on this thread.

 

[Beacon]

Very high deductible plans have been a mixed bag from what I heard. Of course this is under the current system, maybe different under ACA.

For example a woman I know with breast cancer has a high decductible insurance plan and does not have the funds to pay the deductible. The hospital provider wants her to pre pay her portion before they continue her treatmemt. This is for the radiation, she already had chemo. She doesn't have the funds and may have to skip the radiation.

She is frustrated because if she had NO insurance, she would be eligible for the various free clinics, but they are turning her down because technically she is insured.

 

[JGator]

Interesting video by an economist on US expenditures on healthcare being so much more than any other country in the world - all tied to inelastic demand. "In the US, providers charge whatever they think they can get away with..."

http://www.upworthy.com/his-first-4-sentences-are-interesting-the-5th-blew-my-mind-and-made-me-a-little-sick-2?c=ufb1

 

[Smith1942]

Smith, yours are the kind of numbers I've seen: 1100-1200 per month.

You know, that is a ton of money. For many that is more than rent. It is great you have a plan you like and that you can afford it. Many people are going to get a surprise when they have to pay this stuff.

My sister lives in the UK. She pays for NHS also buys private insurance on top of that and when she needs something special she goes to the high class docs who take cash only. It is very expensive.

We'll see what happens here. It's going to be quite jarring for some.

Yeah, it is. But in another way, it's not. Had I been a single self-employed 26 year old with the kind of robust health that I did indeed have at that age, the premiums would have been much lower. They quote based on your age, and I am 38 - soon to turn 39 in this plan year - and my husband has just turned 45. So this plan is for two people, and two middle-aged people at that. Part of the reason I'm happy with the cost is that we both use this insurance a lot, and it's also poised to pay for some pretty heavy-duty stuff, like a possible bilateral prophylactic mastectomy for me should I want one (long story, not to go into here, strong family history of breast cancer including mother) and other treatment for both me and my husband.

I think the same kind of plan for my younger single self would have been about $500 - but then, I would have chosen an altogether cheaper plan because I would not have been needing maternity benefits and other health issues I have now would not have been issues then - I'm just trying to say that I think that $1,100 a month for two middle-aged adults who use the insurance a lot and which includes dental and vision, I don't think is too bad. We get seen immediately and test results back within hours or days, which sometimes isn't the case on the NHS, which you do pay for through your higher taxes, and then possible supplementation with private insurance too. The cost of living and taxes are so dramatically lower here than in the UK so that helps with putting our USA health premiums in perspective. For us, I guess life is so much cheaper here than at home, and the healthcare is so much more fast and responsive, that in comparison to life in the old country, we kind of feel as if we're getting a fair deal. Not a steal, but a fair deal.

 

[msop04]

Yes, you are correct -- I should be more clear. I feel that it is a conflict of interests to allow those who choose not to work (whether it be due to laziness or not willing to "lower oneself" to work a lesser paying job -- NOT due to TRUE disability) and accept welfare from the government to vote in any elections (federal or local). These people do not pay income taxes. I feel it is a conflict of interests for them to vote at any level, since it all starts locally. It's no secret that these people will vote for whichever party or representative promises to or has a record of giving them more free stuff -- at taxpayer's expense.

I feel it's wrong to give voting power to those who do have not contributed.

But not every single person receiving assistance is a bloodsucking leech gnawing on the government teet (my words, not yours, I'm just being cheeky). There are many who are receiving much needed assistance in the manner in which these programs are intended, who are not taking advantage. Don't they have a right to vote their interests, like everyone else? The group you reference is a teensy tiny portion of the population as a whole, and still just a fragment of the micro-population who are receiving entitlements. What about senior citizens? They don't contribute in the same way that the rest of us do - maybe they shouldn't vote either? What about full time students who aren't paying any taxes because they don't work. Take their votes away too?

We have to make decisions based on the greater good - do that which will benefit the majority of the target audience of any given law or entitlement.

Don't misunderstand - I agree that our entitlement systems need reform. But I still see it as an issue that's separate from health care. Access to life saving medical treatment should have nothing to do with what one contributes via taxes (I know that's not the point you were making, but I've heard many people say this). That's when we walk that dangerous line of valuing a person's life by their wealth, or lack thereof. People will die because they're poor. Will that make our country great? Should we not judge a country's greatness by the condition of its weakest and most vulnerable citizens? To me, access to quality health care should be a constitutional right. We spend far more time, money and energy protecting Americans' constitutional (debatable) right to own guns with far more gusto than we do trying to save people's lives with something as simple as health care for all.

PS - when it comes to the mandate, I actually think that this is the wrong approach. I would have preferred to see the purchasing of health insurance incentivised, rather than what many perceive as a punitive approach. I understand why the mandate was needed, in order to make everything else "work" but I think there might have been a better way.

I agree with the points in bold. I made the point of saying that I am referring to those who have chosen not to work, not those who are truly in need or those who have worked their entire lives and paid taxes. These very people are why reform is needed. It's a mind-set of entitlement that seems to infect the next generation of these blood-suckers. (I liked your reference, BTW...)

It is a separate issue, but as I stated before, it's all money... better reform would make more of it to spill over to other worthwhile things -- like healthcare. ...I understand that is a whole different thread!! Access to healthcare should be a constitutional right -- to tax-paying citizens. I don't mind picking up the slack for those who've been dealt a worse hand in life, but I do not agree that it is right us to continue to pay for those who do not care to try to better their situations after years, decades of living off of the government.

Maybe it's regional (I live in AL), but I'd say that of my patients (and from what I've heard from others in my field), a good 20% or more abuse the system. That's a lot. I will also say that it makes me very sad to see people struggle to make ends meet because they are not eligible for any assistance at all because they may actually have a job and be trying. I have had people tell me that they were told by welfare services to lower their work hours to part time or to quit altogether and come back for food stamps. However, they won't fall into that mentality because they are too proud and have work ethic. I admire them for that, even though I know it's a very difficult decision to have to make.

 

[Beacon]

Totally understand Smith. Your plan sounds great for you. Don't get me wrong.

Thing is, that cost would break a lot of people. They simply couldn't do it even if they wanted.

Yup, things are much cheaper here than in the UK and the health care delivery is excellent by comparison. I had some issues
To deal with in 2009 and my sis came to be with me. She was dazzled beyond belief at my hospital facility at Stanford hospital.
She told me it was better beyond compare to the UK situation.

 

[Smith1942]

Very high deductible plans have been a mixed bag from what I heard. Of course this is under the current system, maybe different under ACA.

For example a woman I know with breast cancer has a high decductible insurance plan and does not have the funds to pay the deductible. The hospital provider wants her to pre pay her portion before they continue her treatmemt. This is for the radiation, she already had chemo. She doesn't have the funds and may have to skip the radiation.

She is frustrated because if she had NO insurance, she would be eligible for the various free clinics, but they are turning her down because technically she is insured.

Yup, when I was researching our plan, my husband and I decided that high deductible plans were not the way to go. Choosing your plan is a gamble. High deductible, resulting in lower premiums, is great if you are pretty sure you won't get sick or have an accident, and if you have enough savings not to miss the deductible. I would only have one of those if I were young, healthy and rich. Since many people have their health when they don't have their wealth, and vice versa, (I mean many of us start out young and poor and then become wealthier as we get older) the high deductible plans aren't a great choice for most.

I feel terrible for your friend. I'm guessing the high-deductible plan wasn't her choice, but her employer's. Poor thing. Could she get a bank loan, or if she owns a house, could she put it on the mortgage? Not ideal, but better than not getting treatment.

 

[Smith1942]

Totally understand Smith. Your plan sounds great for you. Don't get me wrong.

Thing is, that cost would break a lot of people. They simply couldn't do it even if they wanted.

Yup, things are much cheaper here than in the UK and the health care delivery is excellent by comparison. I had some issues
To deal with in 2009 and my sis came to be with me. She was dazzled beyond belief at my hospital facility at Stanford hospital.
She told me it was better beyond compare to the UK situation.

I hear you. My husband was born in the US and lived here until he was nine. At that point, his parents divorced and his mother, who is British, took him back to the UK and brought him up there. He always said he wanted to go back to the US, so got a good job offer and moved back at age 36, when we had only known each other for a few weeks.

BUT. Here's the rub. My husband has money. Had he not had any nest egg, any savings, but each paycheck was taken up with rent/mortgage and daily living, making it difficult to save - basically, the way my parents started out when young, with really nothing but each other and a determination to get there in the end - if he had no family money to fall back on, would he have moved back to the States? I think perhaps not.

And me. If he suddenly left me, or died, and I was alone in this country, much as I love it, would I stay here, with the healthcare costs? Maybe not. I don't know - I'd have to do a massive calculation taking into account taxes, property prices, etc etc. But you're right, we can afford those premiums and if that ability was taken away, we might well scoot back to the UK because of US healthcare costs.

 

[amc80]

Yup, when I was researching our plan, my husband and I decided that high deductible plans were not the way to go. Choosing your plan is a gamble. High deductible, resulting in lower premiums, is great if you are pretty sure you won't get sick or have an accident, and if you have enough savings not to miss the deductible. I would only have one of those if I were young, healthy and rich. Since many people have their health when they don't have their wealth, and vice versa, (I mean many of us start out young and poor and then become wealthier as we get older) the high deductible plans aren't a great choice for most.

The high deductible plans for us ($5k I believe) were around $500/family; the lowest deductible plan ($750) was about $1100/month. Huge difference. I'm with you, though, I'd rather have predictable expenses each month and be covered than risk having to pay out of pocket. It's a no brainer for me, since I will likely have a baby next year. Plus our one year old is the "hey I can dive off the couch" type of kid.

 

[rosetta]

This is a very complicated debate and I am not familiar with every provision of the Affordable Care Act, except its main components that most people know about. I am of Justginger's frame of mind and support the changes, and I support government-sponsored healthcare overall. (Being from the NHS system, this is not surprising, since most of us are products of our culture, and I did not leave that culture until I was a fully-formed adult of 32.)

So, the reason I'm posting is to share what my husband and I pay in premiums. I always think it's interesting to know what others pay and what they get for their money.

The ACA has not affected us because we are both now self-employed, so we are already paying premiums that are in no way subsidised by an employer.

Being residents of Massachusetts, we are beneficiaries of RomneyCare, which is basically similar to Obamacare. When my husband went self-employed a while after I did, with neither of us then having access to employer insurance, we were able to shop around (which you could only do if you had no employer insurance), choose from many, many plans, and if we had had pre-existing conditions, it wouldn't have mattered in Mass.

We ended up with what I believe to be an excellent plan from Blue Cross Blue Shield MA, and I looked into every nook and cranny of multiple plans from different companies, even to be told that I was asking too many questions by BCBS! I don't like surprises, so there's no such thing as too many questions when buying insurance. Naturally I was not deterred, and ferreted out the best plan with my questions. Example: one plan did not cover medical formulas. Well, what's the difference between a medical formula and a prescription drug? I drove the sales team insane with my phone calls, I think. But it's our health potentially at stake so I didn't care. (Example: I saw some plans that wouldn't cover diabetic care. Imagine if you were diabetic and hadn't read the plan's small print.) Then, after accepting us for this plan, they tried to raise the rates!! I made all kinds of threats and they backed down.

So, after a few fights, we got this great plan with BCBS, and we pay $1,100 a month for the two of us. This covers medical, dental, and vision. It's got great maternity benefits - only 1k for a straightforward birth, as opposed to 7k on some other plans. There is a 1k per person deductible, whereas many other plans had 5k and 10k deductibles. The deductible only kicks in for lab tests and surgery - we don't have to use up that deductible before office visits are covered. Chiropractic care and prosthetics are covered, unusually, and so is mental health. Prenatal care and routine care is free.

IN the UK many people supplement the NHS coverage with private insurance. Our BCBS premiums are not far from what my parents pay for their private insurance on top of NHS care.

I think that, for everything we get, our premiums are not so bad. We have had excellent care on our plan, fast tests, fast results, and although it's a lot of money, we make sure there is money for it, the same way that you make sure there is money for the mortgage each month. It also means that we are not beholden to employers.

However, actually choosing the plan was a total nightmare. They are so complex and there are so many. I guess you just have to be your own best advocate and I really fought to get the best plan. I reckon I spent at least a full workweek on just the choosing - so about 40 hours of sifting through plans. That's how I got something I'm happy with. I guess you can do this on Obamacare, too? I want to say that it was a TON of work, but I have peace of mind because I was able to choose a plan that suited us as a couple, our particular health concerns, and a plan that suited our life stage (e.g. possible kids) instead of having an employer choose one for us. I guess we've kind of made our peace with the four-figure premiums, and we do feel we get what we pay for.


ETA Notes:

1 - Just read some other parts of the thread. 30% tax is low, in my opinion. In the UK the top rate is 50%, which kicks in at GBP150k. BUT, you only have to be earning GBP32k to pay 40%. Yes, you are taxed 40% on approx $52k. Plus 20% sales tax, etc etc. France's taxes are much higher, and Scandinavian taxes can be higher still. From a European perspective, 30% being pretty much the top rate is incredible.

2 - An interesting historical comparison to this ACA debate is when the NHS was set up in the UK shortly after the war, I think in 1947. No one wanted it. Doctors said they would not be able to earn a living. People were against it. And now, it's about the most precious pillar of our culture and its existence is never in question. People don't like change, and certainly not huge changes like this one.

I'll just add a big ditto to all of this. I picked medical school in the UK over the US because of the NHS. I earn a lot less here than I could there but I have overriding belief in the principle of universal healthcare. Yes it's not perfect, but I don't have to turn anyone away from even very expensive cancer drugs, and that makes me very happy indeed. It doesn't affect me of course, but the ACA is a step forward in the right direction for the US IMHO.