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Is there such a thing as a reasonably priced health care plan for a family?


StaceyinLA
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And I don't know how many people realize this, but premiums are often determined based on the type of job the company business is mostly about. If they do a job notorious for causing injury, etc. or the employees are configured in certain ways (average age, etc.) that is related. So, places of employment with a larger number of older employees or where the job is more physically demanding the premiums might be higher.

 

So the factors are not straightforward.

Hmmm. Not sure that is true. DH works in an office with mostly 30somethings and a policy through them would be $2k/month.

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And I don't know how many people realize this, but premiums are often determined based on the type of job the company business is mostly about.  If they do a job notorious for causing injury, etc. or the employees are configured in certain ways (average age, etc.) that is related.  So, places of employment with a larger number of older employees or where the job is more physically demanding the premiums might be higher. 

 

So the factors are not straightforward.

 

Ours have always been high and DH works in IT, in desks jobs at companies that are almost entirely desk jobs, with a skewing to younger. 

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Ours have always been high and DH works in IT, in desks jobs at companies that are almost entirely desk jobs, with a skewing to younger. 

 

Weird so does my husband.

 

Just curious do you pay based on the number of people in your family or do they have categories like "family" where you pay the family rate irregardless of number of members in the family.

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At one point we paid $1100 per month, that plan didn't even cover well checks for babies. Then my husband's company started paying a larger percentage, it went down to $475 per month. It felt like a huge pay raise! He changed companies in January and now we pay $15 per month.

 

It's a pretty big company with offices in a few states, I think that helps. However, they were just bought by a foreign company, we will see if this inexpensive coverage continues. I don't expect our insurance will stay this cheap forever.

 

I will say we pay 100% of everything until we meet our deductible which isn't cheap (we did on all previous plans too). I think it's $2500 per person and $5000 family, we have an HSA which helps. We definitely think twice before going to the doctor. They have other plans with lower deductibles but higher premiums, this works out better for us.

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Hmmm. Not sure that is true. DH works in an office with mostly 30somethings and a policy through them would be $2k/month.

Is that an individual or family rate? Do they have other employees that work in the field?

 

Another thing that can jack up rates at smaller companies is someone with cancer or is newly diagnosed with a chronic illness. My husband worked in a company with 50ish employees. Two people got cancer in one year, rates doubled the following year.

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Weird so does my husband.

 

Just curious do you pay based on the number of people in your family or do they have categories like "family" where you pay the family rate irregardless of number of members in the family.

 

Family. It goes employee, employee plus spouse, and then family. 

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Another thing that can jack up rates at smaller companies is someone with cancer or is newly diagnosed with a chronic illness. My husband worked in a company with 50ish employees. Two people got cancer in one year, rates doubled the following year.

 

I wonder if this is part of the reason my dh's previous job started making things very unfavorable for him at work.  He got significant pay cuts and a lot of other things that were unwarranted.  He was at a small company (around 60 employees) and we have two children with ongoing expensive medical needs.  Before the pay cut, my oldest had two VERY expensive surgeries and one minor surgery and we adopted a child with medical needs and she had a surgery.  I always wondered if we were costing their insurance plan too much and they wanted him out.  He is now working for a company with a much larger employee base so the costs can be absorbed a bit better.  

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Oh, and of the $750/mo we pay, $250 is for the spouse (me).  Once I start working, I will have pretty good insurance for myself for free.  So, the cost will go down to $500/mo and I will just have my own insurance.e

 

We compared, and it is cheaper for the kids to stay on his than to transfer to mine.

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Four years ago we were paying $400 a month for healthcare for the 5 of us.  Now we're paying $1500 per month for healthcare for the 5 of us.  My husband has owned his own business that whole time.  He writes software, not a physically risky kind of business. None of is us chronically ill. As stated upthread, this isn't sustainable. 

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For us it is cheaper to buy catastrophic and just pay to go to the doctor for everything except catastrophes, as we would get no subsidies from the ACA and monthly premiums + deductibles are not worth it vs. catastrophic.

 

The only thing that doesn't make it worth it is the tax on not carrying "acceptable" health insurance according to the ACA.  The government costs us a lot of $, unfortunately.

 

We are, luckily, relatively healthy people.  I think the last time any of the 7 of us needed a doctor's visit (except pregnancy and etc.) was maybe 3 years ago when DD had stitches at the ER.  Oh, and DH was bitten by a bat, so we paid $4000 or so for the immunoglobulin stuff, that *sucked*.  Still much much cheaper than premiums, and we wouldn't have hit the deductible at any rate.

 

eta: we're self-employed, so there's no employer to cover part of the cost.

Edited by ananemone
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For pregnancy, I either pay cash (if I get pregnant too late to buy into health insurance for the year) or buy the highest premium, lowest out-of=pocket max (since I will hit the out of pocket with a pregnancy) if I get pregnant late enough in the year to buy insurance for the year of the delivery and most prenatal care.

 

My last cash pregnancy (normal delivery, etc.) was approx. $7000 altogether.  This pregnancy should be something like $5000 ($450 premiums for 5 months, $2500 OOP max, I think).  

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I really hope you don't take this the wrong way, but is it possible that this has more to do with whom you speak to than with actual nationwide trends?

 

I've been HSing for a decade now and an active churchgoer for longer than that. It's not like my social circle is any different now than it was prior to Obamacare.

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Right now dd's husband pays $160/week for coverage for their family of 5. They've just been told it is going up $30 per WEEK. They don't have a huge income, and are pretty much living paycheck to paycheck as most young families (they are a one income family).

 

Are there any options? I don't even know what's out there because we've been insured so long through dh's company I haven't had to think about it.

 

That's... very low.

 

There are not options lower than that, that I know of. When I last paid for private health care, not through a university or job, it was about $150/week for just me and one child. I was under 35 at the time.

 

That was in the PNW's non-profit Likewise Insurance company.

 

It costs more now for a variety of reasons, primarily because of inflation, since they never had crappy plans.

 

 

 

We pay a bit less than $100 per month to insure all four of us.

 

The rest must be taken out of your husband's paycheck.

 

Nobody is paying that little. Either you are paying $100 as a symbolic health care cost because having skin in the game helps the employer and insurance company to manage behavior, and you are getting about $1,000 out of his pay each month, OR you are getting a subsidy from the government.

 

Nobody is paying $25/month per person. Not even the military. It is all included.

 

That's why, when you have government salaries vs. costs (these are verifiable, vs. private which are not public information), they don't match.

 

Salary of $65k is a cost to the government of about $100k with taxes and insurance and all.

 

This is not to say you are not benefiting from the group plan at work. The whole point of insurance is that we all benefit from a group plan. The healthy pay in, the sick take out. However, it is not true that you are only paying $25/person, not really, not when you count lost wages.

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I've been HSing for a decade now and an active churchgoer for longer than that. It's not like my social circle is any different now than it was prior to Obamacare.

 

Yes, but what I'm getting at is that your social circle may not be very similar to the majority of the country, and you can't assume that because this is catching on with the people you know and speak to that it's actually popular with people in the mainstream.

 

I mean, my social circle is very pro-neurodiversity, very pro-LGBT rights and if you ask them their opinion on the Pledge of Allegiance you'll get a strongly negative response. This is not because the entire country is like this, but because most of my friends are some combination of a. autistic b. gay or bi c. transgender d. atheist.

 

In MY social circle, conversations about health insurance almost immediately coalesce around "ugh, it's so stupid, why don't we have universal health care and join the mid-20th century already!?" I'm fairly confident that if I brought up healthcare ministries, I'd get a completely baffled response until I provided an explanatory link. I've certainly never once heard it anywhere outside of news articles and this thread.

Edited by Tanaqui
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These threads always seem so foreign to me. We pay a bit less than $100 per month to insure all four of us. Our deductible isn't low but it also isn't ridiculously high. The insurance is through dh's employer and they put half of that deductible in our HSA every year as well so it never seems that big. We actually met it around February due to an issue with oldest dd so we've been paying very little for meds and appointments since then. :

Am I reading this correctly, your DH employer gives you half of the deductible?

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Am I reading this correctly, your DH employer gives you half of the deductible?

 

Sounds like it. My partner also had that option with his (health-related) job.

 

It was a sweet deal!

 

I used to have an option somewhat similar to that with the government, but it was a much higher premium to get that option and I chose the higher deductible. Still wasn't bad but was reflected in a MUCH lower salary.

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Looking at the costs posted above, I now understand why many are not happy with health insurance changes in the past few years.  I grew up in the States, but our family was lucky that my father's work provided 100% health/dental coverage.  When I began working health insurance was provided as a benefit of my teaching job.  When I went overseas health care was provided for all in the 3 different countries where I lived over the years.  If there was any co-pay, it was minimal (usually under $20) & prescription costs were minimal as well (currently I pay $5/prescription).  I have had prenatal care in 4 different countries & found the level of care to be acceptable in each country.  Surprisingly I found that postnatal care & well-child visits outside the States to be superior to what I found    back in VT.  Yes, waiting lists are a part of making sure health care gets to those who need it more urgently first, but I have never had to wait where the wait negatively impacted my health.  Talking to people back "home" I think that I have as much choice in providers here, if not more choice as they say they are limited by their insurance provider to go to only certain doctors, etc.  When I travel overseas, I buy private travel insurance for the time I'm away from NZ.  Even with the deluxe coverage needed for travel to the States, I pay no where what you all are quoting above & I have little to no deductible costs.  What you are saying it costs you for a month's health insurance for a family would take a huge % of our after tax income.  Hopefully something can be done to rein in the outlandish cost of health care in the States real soon.   :confused1:

Edited by Deb in NZ
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Right now dd's husband pays $160/week for coverage for their family of 5. They've just been told it is going up $30 per WEEK. They don't have a huge income, and are pretty much living paycheck to paycheck as most young families (they are a one income family).

 

Are there any options? I don't even know what's out there because we've been insured so long through dh's company I haven't had to think about it.

 

I would definitely recommend they explore healthcare dot gov.  

We would be considered high income (relatively speaking, and all) and we get a small subsidy that brings our policy to $750/mo.  Separate dental.  I would assume a smaller income would qualify for a higher subsidy.

Our deductible is another $7,000, but our coverage is very good.

 

We may have to pay back our subsidy if dh's bonus is awesome, but at least we'll have the money to pay it back!

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Not sure about her, but the company DH works for is self funded.  Basically that means they pay all the claims from their own accounts.  They pay a fee for the insurance company to basically act as the administrator and for the discounts/contracts they negotiate. So I imagine their premiums are a reflection of how much they are paying out for claims.  So this isn't about the insurance company also wanting to make a profit.  No clue if that in fact keeps costs lower, but it seems very likely that it could.

 

This would more or less match what Health Share does.  We pay actual costs for what folks use, divided out among members.  That includes the big users like me (sigh) and the folks that never need to use it (as we were for many years).  Divided out without any profit needed for shareholders, oodles of staff, or outrageously paid CEOs, it doesn't end up that expensive for great coverage and total choice of doctors or hospitals.

 

Within health share we get everything from organ transplants to unexplained pains that get checked out, so I doubt there's a major difference in claims.  Health shares don't pay for abortions or anything occurring when one is drunk, etc, but I doubt those add up to oodles more than insurance needs to cover.  Maybe I'm wrong.

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I wonder if this is part of the reason my dh's previous job started making things very unfavorable for him at work.  He got significant pay cuts and a lot of other things that were unwarranted.  He was at a small company (around 60 employees) and we have two children with ongoing expensive medical needs.  Before the pay cut, my oldest had two VERY expensive surgeries and one minor surgery and we adopted a child with medical needs and she had a surgery.  I always wondered if we were costing their insurance plan too much and they wanted him out.  He is now working for a company with a much larger employee base so the costs can be absorbed a bit better.  

 

 

I would say this had a lot to do with it.

 

I think it's also one of the reasons many companies want to push older employees out, because typically as one gets older one uses more health resources.

 

When my DH worked for a self-insured company, I tried very hard not to use many resources, even though I had RA.  Really, I used only cheap medications and did my two appointments per year.  Then I even stopped going, because I didn't want my health needs to impact his job at all.  But in the end it didn't matter, they got rid of him anyway, and I'm sure age and health needs had a lot to do with it.

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Thanks for all the replies. I think they'll just have to deal with it right now, and see what they can do when the enrollment period begins. He may be able to change his plan a little so that the premium is lower. It definitely isn't a big savings at all to just insure him and dd, and they really don't want the kids on a state plan because around here you are severely limited in your choices of physicians. I know dd is really happy with her pediatrician (her office doesn't accept LACHIP) and probably wouldn't consider the cost savings worth having to change.

 

Since he's recently out of the military, he is still looking for what will become his permanent "career." He's with a good company, and if that's where he decides to stay, I'm sure there will be raises and promotions in his future. If not, he'll likely be with another company and there are many with good insurance coverage options. In the meantime, they'll just have to deal like everyone else does; cut back somewhere to make it all work out.

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Since he's recently out of the military, he is still looking for what will become his permanent "career." He's with a good company, and if that's where he decides to stay, I'm sure there will be raises and promotions in his future. If not, he'll likely be with another company and there are many with good insurance coverage options. In the meantime, they'll just have to deal like everyone else does; cut back somewhere to make it all work out.

DH started out as a DoD contractor (now works in a different govt related job). 5 out of 6 companies had fantastic insurance, and even the temporary recruiting firms had decent benefits. One company, for some reason, had crummy benefits, and he turned one job down because the $6,000+/yr pay increase wasn't enough to cover the higher premium. I think the lower insurance premiums have something to do with the high number of retired military employees, who have their military medical/VA benefits to cushion their health expenses. If he has a clearance and can handle some of the insecurity of contracting, I'd recommend sticking with DoD.

 

(Unless he's already doing this, then ignore me!)

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For us it is cheaper to buy catastrophic and just pay to go to the doctor for everything except catastrophes, as we would get no subsidies from the ACA and monthly premiums + deductibles are not worth it vs. catastrophic.

 

The only thing that doesn't make it worth it is the tax on not carrying "acceptable" health insurance according to the ACA.  The government costs us a lot of $, unfortunately.

 

We are, luckily, relatively healthy people.  I think the last time any of the 7 of us needed a doctor's visit (except pregnancy and etc.) was maybe 3 years ago when DD had stitches at the ER.  Oh, and DH was bitten by a bat, so we paid $4000 or so for the immunoglobulin stuff, that *sucked*.  Still much much cheaper than premiums, and we wouldn't have hit the deductible at any rate.

 

eta: we're self-employed, so there's no employer to cover part of the cost.

 

First.......... this is a genuine question and not meant to be snarky......... does catastrophic include ongoing cancer treatments and things like that? I ask because I often here people say the reason they don't need insurance is that their family is healthy and doesn't take risks....... but even healthy people get cancer and get in bad accidents.

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Am I reading this correctly, your DH employer gives you half of the deductible?

 

Not Joker but dh's last employer gave us ALL of the deductible because it was cheaper for them than a policy with a lower deductible.

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In MY social circle, conversations about health insurance almost immediately coalesce around "ugh, it's so stupid, why don't we have universal health care and join the mid-20th century already!?" I'm fairly confident that if I brought up healthcare ministries, I'd get a completely baffled response until I provided an explanatory link. I've certainly never once heard it anywhere outside of news articles and this thread.

 

Oh, I hear a lot of those types of comments as well. To which I respond, "If you'd ever suffered through the Army healthcare, you would not wish government-run healthcare on ANYONE!!!!!"

 

People have no freaking clue. They imagine single-payer would be like what we have now only with the insurance companies replaced by Uncle Sam. What we'd actually get would be the equivalent of replacing all the grocery stores from Whole Foods on down with a crappy school cafeteria and telling people they could "eat for free".

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First.......... this is a genuine question and not meant to be snarky......... does catastrophic include ongoing cancer treatments and things like that? I ask because I often here people say the reason they don't need insurance is that their family is healthy and doesn't take risks....... but even healthy people get cancer and get in bad accidents.

 

 

Catastrophic insurance is what we called Major Medical back in the day.  It is supposed to be designed to cover catastrophic illness, such as cancer. 

 

Where I live you can't buy catastrophic insurance. The closest thing is a very high deductible plan. But the cost for that is ridiculous for us because dh has a chronic illness and we spend a lot on medical stuff.

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Not Joker but dh's last employer gave us ALL of the deductible because it was cheaper for them than a policy with a lower deductible.

Here, too. They chose a high deductible plan for the cost savings, and pre-fund the HSA every year with the deductible amount. It's called "making the policy whole" or something like that.

 

We are a high medical needs family, and I believe our policy is in the $2000s monthly, with a $4K deductible (made whole by the company). They pay the monthly premiums as part of the benefits package. We know we are lucky.

 

DH works for a European company. They strive to provide the same level of care to their US employees that their European employees receive, because they feel that it's the right thing to do. (Yes, DH is in a position to know the personal thoughts on this.). They are appalled at healthcare costs here. And have been since long before the ACA. Thanks to the ACA, the costs have finally stopped skyrocketing each year.

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I don't know why there is not open revolt in the US - I have lived in many different countries with 'socialised medical care' as some Americans call it and can.not.imagine. paying the costs you guys do. I mean - having to pay to have a baby??? Having to pay for it if my kid breaks his arm, or needs stitches, let alone needs treatment for cancer? Having to stay at a job I hate because if I leave I might not get adequate medical cover for my family? Sorry, that's insane. 

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Oh, I hear a lot of those types of comments as well. To which I respond, "If you'd ever suffered through the Army healthcare, you would not wish government-run healthcare on ANYONE!!!!!"

 

People have no freaking clue. They imagine single-payer would be like what we have now only with the insurance companies replaced by Uncle Sam. What we'd actually get would be the equivalent of replacing all the grocery stores from Whole Foods on down with a crappy school cafeteria and telling people they could "eat for free".

 

Honestly... if my choice were to eat in a crappy school cafeteria or eat nothing at all and waste away because I couldn't afford food, it wouldn't be a tough decision.

 

It also wouldn't replace all the grocery stores.  Those with means could still shop at Whole Foods.  That already happens in places where they ensure all can eat.

 

Health care should be a basic right IMO, not a luxury reserved for those who can afford it.

 

And I'm not even in the group who can't afford what we have...

 

And our school cafeteria, while not necessarily a 5 star dining establishment, isn't that bad.

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Am I reading this correctly, your DH employer gives you half of the deductible?

 

 

My employer used to do this.  Then in one year the OOP max went from 5k to 10k and the $2,500 they added to the HSA went away.  For my family that usually hits the OOP max my cost went up $7,500 in a year.  

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People have no freaking clue. They imagine single-payer would be like what we have now only with the insurance companies replaced by Uncle Sam. What we'd actually get would be the equivalent of replacing all the grocery stores from Whole Foods on down with a crappy school cafeteria and telling people they could "eat for free".

 

Funny, everybody else seems to manage universal health care just fine. If we can't make it work, when the entire rest of the developed world does, that's not because it's a bad idea, it's because some people don't want it to work.

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I would have them look into Medicaid/CHIP for their state.  I'm sure it varies, but many places take them around here, including the best hospitals (even Hershey).  They can apply, and they can find out for sure.

 

Also, are they eligible for the Exchange, which might get them a subsidy?  Oh, wait, if I read that it's through an employer, they might not qualify for a subsidy, depending on whether or not the employee's portion is "affordable."  But they can apply and see.  

 

Otherwise, the health share thing might work well for them.

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We pay $270 a month (yes, a month) for a family of four, employer pays the rest. We have a $4k family deductible and everything but well person visits comes out of that first. The employer puts $3k of that in our HSA and if my dh does certain things for his health during the year, they put in another $500. Once the deductible is met, we have 100% coverage except for <$50 co pays. He works for local government.

 

So yes, there are good, affordable plans, but they are rare. Our health care system is utterly broken. I can't believe what people pay. Why we stand for it is beyond me, but the more we can see how unfair it is that one family pays so little and another pays so much, maybe we'll be motivated enough to change it.

 

BTW, our insurance is considered a Cadillac plan and will have to be changed once the Cadillac tax goes into effect. Luckily for us, they are kicking that time down the road some.

Edited by livetoread
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Dh works FOR the hospital and our coverage is more than $1500/month. When dh and I got married it was about $50/month and one of the perks of working in healthcare. Now not so much. If dd (24) bought her works offered insurance (she's a teacher) the premium would be a whole paycheck. Not feasible. Ds makes approx $15,000/ year as an EMT. He makes too much to qualify for HIP so I continue to cover him too. At 36 when they age off our insurance I'm guessing they will have to do some sort of HSA.

Edited by joyofsix
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Oh, I hear a lot of those types of comments as well. To which I respond, "If you'd ever suffered through the Army healthcare, you would not wish government-run healthcare on ANYONE!!!!!"

 

People have no freaking clue. They imagine single-payer would be like what we have now only with the insurance companies replaced by Uncle Sam. What we'd actually get would be the equivalent of replacing all the grocery stores from Whole Foods on down with a crappy school cafeteria and telling people they could "eat for free".

 

It ain't necessarily so.....

 

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Short answer, "No".

 

I will say that the insurance I had when I taught in PS and was on the state employees plan was much better than DH's giant company provided plan, so be aware that sometimes lower paying jobs may even out some due to benefits.

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People have no freaking clue. They imagine single-payer would be like what we have now only with the insurance companies replaced by Uncle Sam. What we'd actually get would be the equivalent of replacing all the grocery stores from Whole Foods on down with a crappy school cafeteria and telling people they could "eat for free".

1. I find your statements odd since you are constantly telling people our DC should join the army to pay for college (my DC medically cannot do this). If my DC were able to do this, you are saying they will sacrifice their health, but that's ok because they are young? Whatever. I think you are viewing the army system through your family's limited experiences. Understand in any system (unless money is no object) any specialty care will be a hurdle. You may have gotten lucky with your current location.

 

2. I've heard from friends who sing praises and damnation of the military health system. I can say the same about what I've had trying to navigate care on an expensive Cadillac plan. There's the full range of good and bad in both.

 

3. Universal coverage does not mean no private coverage. Other countries allow people to seek care through private pay. Those who can afford it have a choice and don't as always seek private pay.

 

The system in the US has got to be the most inefficient in the world. And it is truly inexcusable that people can't access or forgo basic care due to cost.

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Hmmm. Not sure that is true. DH works in an office with mostly 30somethings and a policy through them would be $2k/month.

 

:iagree:  My dh works for an aluminum manufacturer where guys in their forties, fifties, and sixties are cutting red-hot metal with giant, dangerous saws all day long and family coverage is something like $500 a month. So yeah, I don't know that the work environment plays much of a part.

 

Of course, where my dh works the pay is lower middle class, so none of us could possibly afford 2k a month and it would be ridiculous for them to even offer that.

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Funny, everybody else seems to manage universal health care just fine. If we can't make it work, when the entire rest of the developed world does, that's not because it's a bad idea, it's because some people don't want it to work.

If we were basing what our universal healthcare would be to what hey have in some other countries - I would agree.

 

But the reality is when people say universal healthcare in the states - what they are really talking get about is expanding Medicaid/Medicare/VA to everyone. Having been on some of that or have close family on it - that's terrifying to me. Our Medicaid/Medicare/VA is nothing like what most people think the universal healthcare in other countries is like.

 

I'm VERY pro universal healthcare.

I'm also VERY anti- Medicaid/Medicare/VA becoming the universal care. It sucks just for the limited people it's for now. And it isn't as free as people think it is.

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Oh, I hear a lot of those types of comments as well. To which I respond, "If you'd ever suffered through the Army healthcare, you would not wish government-run healthcare on ANYONE!!!!!"

 

People have no freaking clue. They imagine single-payer would be like what we have now only with the insurance companies replaced by Uncle Sam. What we'd actually get would be the equivalent of replacing all the grocery stores from Whole Foods on down with a crappy school cafeteria and telling people they could "eat for free".

 

That hasn't been my experience at all. The VA specifically has some issues that go beyond just healthcare, but government-run healthcare in general seems to work a heck of a lot better than private plans that don't cover anything and no one can afford to begin with. My dd is on our state health insurance (in MN, you have to have a really high income for your kids NOT to qualify) and it's fantastic. She can see any doctor she wants and has plenty of dentists to choose from, and she's treated no differently than the people who have private insurance. It even covered complete genetic testing and trips to a developmental pediatrician when she was a toddler. I'm actually dropping off the paperwork to get on it myself, since with my giant list of medical issues, private insurance isn't cutting it anymore. The premiums for dd are zero, for me they'll be something like $50 a month. 

 

And our state has a budget surplus of almost a billion dollars btw, so it's not like we've bankrupted ourselves paying for this. 

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The system in the US has got to be the most inefficient in the world. And it is truly inexcusable that people can't access or forgo basic care due to cost.

 

Oh, definitely. Per capita we pay a lot more to get a lot less.

But the reality is when people say universal healthcare in the states - what they are really talking get about is expanding Medicaid/Medicare/VA to everyone.

 

 

Not the people I know.

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