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

[Laura Corin]

 

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.

 

 

Indeed.  In the UK, everyone is covered by the NHS but there's nothing to stop one from having top-up insurance.  Many do, which is affordable because the NHS covers most costs.  It allows one to get faster treatment than is medically necessary, which can be convenient in some circumstances.  Many companies give private health insurance as a perk - I had it with my old company.

[purplejackmama]

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.

WOW!!! Clearly we work for the wrong people.

[HRAAB]

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.

 

I have very limited experience with Medicaid and Medicare, but the experience I do have has been good.  My children are on CHIP, and I have zero complaints.  No problem finding doctors who accept state insurance, (in fact we kept our same doctor).  When my dd needed to get into a cardiologist, the referral process was simple and we had an appointment within a couple weeks.  The only thing that got denied was some acne medicine the doctor prescribed for my dd which wasn't necessary - so no big deal.  When my dad was on Medicare and had bypass surgery plus numerous hospitalizations, again, no problem with finding doctors and getting bills paid.  My fil had coverage through the VA.  His wait times for visits was pretty crazy, but once he got in, he got decent care. Maybe this is dependent upon what state a person lives in?  The area?

 

Usually when I listen to people who are against universal healthcare, they cite the same issues you mention: the already existing problem with Medicaid/Medicare,VA.  I'm wondering what the main complaints are?  Trouble finding doctors who accept medicaid patients?  Wait times for visits? (I have longer wait times with private insurance than my children do with CHIP).  

 

I'm not saying I'm in favor of expanding the already existing programs.  I honestly don't know about that.  I am in favor of universal healthcare.  I'm just not sure how to go about it.  It seems since we already have a program in place, why not use it?

 

I'm not wishing my life away, but I'm counting the years until I'm eligible for Medicare.

[QueenCat]

WOW!!! Clearly we work for the wrong people.

 

It was cheaper for the company to have a plan with high deductibles. The total plan premiums plus deductibles were cheaper than it would have been with a lower deductible so they were looking at overall costs.

[knoxinsox]

We pay just under $400 a month for health, dental, vision thru a plan with a massive US company.  We cannot afford to go to the doctor unless absolutely necessary.  Supposedly we have free yearly dental checkups and cleanings, vax, well visits, etc.  We have been to urgent care one time since 2011 for xrays on a possible broken arm, and I went a couple of times in 2013 to an integrative health physician who does not take insurance.  Other than that, we have not seen any doctors. 

Then we moved to an area where we couldn't even find a pediatrician accepting new patients.  Pretty scary. It took over a year to get into a dentist that took our insurance.  I was able to get a new prescription for glasses after calling at least 15 eye doctors what were listed on the insurance, but did not take it.

 

What I am running into is that we are supposed to get certain "free" things with this insurance....free dental cleanings, xrays etc.  But I always get a bill afterward for the remainder.  

In my bubble of people I know, a lot are turning to essential oils, and DIY meds. At least, the ones that don't think EO's are demonic.  Ha  What helps in our case, is that I worked as a CNA, so a tiny bit of medical knowledge, and my husband was an EMT--so we have a medical kit and he knows how to do quite a bit of stuff.  

I'm kind of like, peace out, medical...if I die, I die....I can't afford treatment, and I would hate to leave my family with a mountain of debt.  

[Alte Veste Academy]

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".

I am 44, born into the Army in 1972 to a current retiree. I married an Army soldier, about to be a retiree. All told, I have spent all but 4 of my 44 years (between college and marriage) as a military dependent "suffering" with Army healthcare. It has, without a doubt, been the single biggest benefit, not just monetarily (we've never paid a dime for anything) but for peace of mind.

 

We have seen Army providers and civilian providers, had treatment/surgery in both civilian and Army facilities, all fully paid for, with no discernible difference in quality of care. We have been able to switch providers at will, never stuck with a poor fit.

 

I just attended a four hour retirement brief with DH yesterday, and aside from learning to apply the formula to figure out the exact amount of retirement pay, the single biggest topic of interest (and relief) was the discussion of Tricare coverage after retirement. It is a sweet, sweet deal. The same thing that provides me peace of mind about my aging parents now provides me peace of mind for DH and myself as we age, and for our kids who are still relatively young. No matter our employment situation in the future, we will have affordable (aka cheap) healthcare for life. Obviously sacrifices were made for this privilege, but the fact remains that it is a sweet deal.

 

So, as someone who has a pretty real freaking clue, I say onward and upward toward a single payer system!

Edited May 20, 2016 by Alte Veste Academy

[purplejackmama]

It was cheaper for the company to have a plan with high deductibles. The total plan premiums plus deductibles were cheaper than it would have been with a lower deductible so they were looking at overall costs.

That is very generous of his company. We pay $2200/m with a $7500 deductible.

[EmseB]

I am 44, born into the Army in 1972 to a current retiree. I married an Army soldier, about to be a retiree. All told, I have spent all but 4 of my 44 years (between college and marriage) as a military dependent "suffering" with Army healthcare. It has, without a doubt, been the single biggest benefit, not just monetarily (we've never paid a dime for anything) but for peace of mind.

 

We have seen Army providers and civilian providers, had treatment/surgery in both civilian and Army facilities, all fully paid for, with no discernible difference in quality of care. We have been able to switch providers at will, never stuck with a poor fit.

 

I just attended a four hour retirement brief with DH yesterday, and aside from learning to apply the formula to figure out the exact amount of retirement pay, the single biggest topic of interest (and relief) was the discussion of Tricare coverage after retirement. It is a sweet, sweet deal. The same thing that provides me peace of mind about my aging parents now provides me peace of mind for DH and myself as we age, and for our kids who are still relatively young. No matter our employment situation in the future, we will have affordable (aka cheap) healthcare for life. Obviously sacrifices were made for this privilege, but the fact remains that it is a sweet deal.

 

So, as someone who has a pretty real freaking clue, I say onward and upward toward a single payer system!

Yes, Tricare for all! In order to get into the "sweet deal" system you have to be relatively young, healthy enough to do a physically demanding, dangerous job, and in order to stay in that system you have to do said job for 20 years or be medically retired (so disabled or ill you can no longer do aforementioned job). All the while you must be at the beck and call of the government providing you with such benefits, moving every few years, passing a mandated physical fitness test, random drug testing, and let's not forget the whole fighting in wars part.

 

I'm absolutely positive that's not what people are thinking of when they think single payer. And I wouldn't wish the VA on my worst enemy.

 

We signed up for this, but I'm pretty sure it's not what people want when they advocate for single-payer. How many people would actually think it was a "sweet deal" if they had to meet all those requirements for health care? I mean, random drug testing, and you're kicked out for one (ONE!) use of MJ.

[NCMom]

Wow and here I though dh's employer was bad, lol. His salary is really crap and we barely scrape by but at least he gets good benefits.

 

We pay $280 monthly for a family of 4 for medical. 3K deductible and an HSA that the employer adds $500 to and then also matches (up to a certain amount of HSA contributions) by the employee. They pay nothing until you hit the deductible, then it is a standard 80/20 thing. All of this assumes you are in-network, of course. And the provider is...hard to deal with. He does work for a large multi-national company.

 

 

The healthcare system in the country is seriously broken.

 

Georgia

 

 

 

 

 

[Alte Veste Academy]

Yes, Tricare for all! In order to get into the "sweet deal" system you have to be relatively young, healthy enough to do a physically demanding, dangerous job, and in order to stay in that system you have to do said job for 20 years or be medically retired (so disabled or ill you can no longer do aforementioned job). All the while you must be at the beck and call of the government providing you with such benefits, moving every few years, passing a mandated physical fitness test, random drug testing, and let's not forget the whole fighting in wars part.

 

I'm absolutely positive that's not what people are thinking of when they think single payer. And I wouldn't wish the VA on my worst enemy.

 

We signed up for this, but I'm pretty sure it's not what people want when they advocate for single-payer. How many people would actually think it was a "sweet deal" if they had to meet all those requirements for health care? I mean, random drug testing, and you're kicked out for one (ONE!) use of MJ.

I was not advocating military service and "Tricare for all!" I was responding to a poster who argued that she had suffered through Army healthcare and declared that a single payer system would be a nightmare based on that experience. I was stating my experience, which has been lengthy and remarkably different. I am in favor of a single payer system and have benefitted enormously from our government provided healthcare.

 

And, yeah, if you know you're not supposed to use drugs and use them anyway, you should expect to suffer for it. But then the military isn't for those who aren't into following the rules.

[QueenCat]

That is very generous of his company. We pay $2200/m with a $7500 deductible.

 

Sort of....... pay was on the low-moderate end for the industry so that made up for some of it.

[SweetandSimple]

Wow... I had no idea we were so lucky with our employer-sponsored health plan. I've been unhappy lately because they won't cover neuropych testing for my son. But I should really be grateful for the coverage because other than that one thing, it has been great. Definitely a day to count my blessings!

 

(Premiums are $1825 per month, but we only have to pay $300 of that. This is a no-deductible plan with $20 co-pays.)

[EmseB]

I was not advocating military service and "Tricare for all!" I was responding to a poster who argued that she had suffered through Army healthcare and declared that a single payer system would be a nightmare based on that experience. I was stating my experience, which has been lengthy and remarkably different. I am in favor of a single payer system and have benefitted enormously from our government provided healthcare.

 

And, yeah, if you know you're not supposed to use drugs and use them anyway, you should expect to suffer for it. But then the military isn't for those who aren't into following the rules.

Right. All I'm saying is that your government health care comes with a lot of strings attached. And the practices I've encountered with Tricare (frequent referrals to private practice, prescriptions for OTC meds, ER use, etc) are things that are not sustainable or cost efficient for this small group of beneficiaries, much less a larger, less healthy population.

 

Not to mention, there have been many Tricare clinics that I've seen that make soviet-era/style care look good. I've been in one recently in a major metropolitan area. The idea that the scandals at the VA and places like Walter Reed are outliers is not necessarily my experience. They make the news, but aren't ever really fixed.

Edited May 20, 2016 by JodiSue

[EMS83]

OP, perhaps your DD and her DH could figure out how much their family would spend as self-pay on healthcare in a year (including the fine), and comparing it to the cost of insurance (including the deductible, non-covered items, out-of-network providers, and coinsurance); it might shed some light on things.  Good luck; regardless.  It is all several migraines rolled into one.  I hope they find a workable solution.

[AmandaVT]

We pay just under $400 a month for health, dental, vision thru a plan with a massive US company.  We cannot afford to go to the doctor unless absolutely necessary.  Supposedly we have free yearly dental checkups and cleanings, vax, well visits, etc.  We have been to urgent care one time since 2011 for xrays on a possible broken arm, and I went a couple of times in 2013 to an integrative health physician who does not take insurance.  Other than that, we have not seen any doctors. 

Then we moved to an area where we couldn't even find a pediatrician accepting new patients.  Pretty scary. It took over a year to get into a dentist that took our insurance.  I was able to get a new prescription for glasses after calling at least 15 eye doctors what were listed on the insurance, but did not take it.

 

What I am running into is that we are supposed to get certain "free" things with this insurance....free dental cleanings, xrays etc.  But I always get a bill afterward for the remainder.  

In my bubble of people I know, a lot are turning to essential oils, and DIY meds. At least, the ones that don't think EO's are demonic.  Ha  What helps in our case, is that I worked as a CNA, so a tiny bit of medical knowledge, and my husband was an EMT--so we have a medical kit and he knows how to do quite a bit of stuff.  

I'm kind of like, peace out, medical...if I die, I die....I can't afford treatment, and I would hate to leave my family with a mountain of debt.  

 

If you have an appointment for something that is supposed to be covered in full and you get a bill after the fact, call your Dr's office. I received a bill from my Dr last year for $215 for a flu shot. I called, and the receptionist told me that they bill everyone that comes in the door for an office visit. I argued with her (nicely), and read the fine print in my policy that stated that vaccines are covered at 100%. I finally had to get my Dr on the phone to get the charges reversed, but they are not contractually allowed by insurance companies to bill for more than the allowed amount. If you have Cigna, for example, and your Dr. is an in-network provider, they have a set amount they are allowed to accept for different visits/procedures. If they bill $100 and Cigna's allowed amount is $71, they are not allowed to bill you the remaining $29. 

[December]

Our family is on Medicaid and I have nothing but good things to say about it.  I've never had a doctor not take it, it even covered having a home birth with a midwife.  We can get same day appointments at our doctor's if we call first thing in the morning, so wait times aren't an issue.  So when people say that Medicaid where they live is horrible and they can't find a doctor to take it...I just wonder what their state is doing so differently...

[MeghansMom]

We have Cigna through my DH's work. We pay $276 every other week for health and vision. We have a 4000 deductible and the company puts 750 towards that. Once the deductible is met, they pay 90/10. Once we reach the next amount-I think 8,000? We are covered 100%. My medicine is mostly free. Certain things such as physicals and mammograms are covered 100 percent. We do not have dental. It is 150 a month and does not seem to cover much.

 

Pretty thankful for our insurance.

[creekland]

OP, perhaps your DD and her DH could figure out how much their family would spend as self-pay on healthcare in a year (including the fine), and comparing it to the cost of insurance (including the deductible, non-covered items, out-of-network providers, and coinsurance); it might shed some light on things.  

 

If what you are suggesting is to go without if it is less expensive, I just have to point out that there are numerous (relatively young) board members (myself included) who prove that this would be a very risky venture.  Yes, for years we paid into Health Share with no claims at all.  I suppose we "lost" money.  But these last 2, going on 3, years have more than made up for it - 100% out of the blue with something statistically small having happened - something we can't blame on any sort of non-healthy living or anything else.  It's purely unknown as to why it happened.  No genetics suggesting it.  No known cause.

 

Had we not had health share or some other insurance, there's no way we could have paid for the treatment I had, and no, places don't just "give it to you for free if you can't afford it."  There are some places that will do that for kids, and places have to treat basic things if someone who can't pay comes in, but a specific type of radiation to try to kill a tumor with as little damage to the rest of the brain as possible?  No.  Carpal tunnel surgeries?  No.  And while the ER treated my son when he had an epileptic seizure so frightening that folks called an ambulance, they still sent us a bill - multiple bills - they expected paid (ambulance too).

 

I always recommend health share for those who fit the picture.  It saves a ton of money for what seems to be the most coverage (not counting basics, but savings in premiums pay for those) with the least hassle.  But if one doesn't fit health share, then they really should have some sort of health insurance.  Having to pay a 2, 4, or 10K deductible would sure be easier than trying to pay for the whole thing if someone in your family happens to draw the short straw.

 

Quite honestly, I'd rather be one of those still paying in and not getting any "return," but dealing with frustrating issues is much easier than dealing with frustrating issues and bills or bankruptcy, or knowing they could have tried something if only we could have afforded it.

 

To those who opt to "get on insurance only when I know we're going to need it," I wish that were illegal.  It's certainly unethical - saving money, true, but only because you're making others pay for you without reciprocating.  It's not just a company you're scamming.  It's everyone choosing to use that company.  I'm not fond of those who feel it's their right to take, take, take from others.

[TranquilMind]

Well then that could be a reflection of how cheap the company is.  LOL

 

Yeah, this! Every cost that could be shuffled over to the employee  has been shuffled over.  If there weren't the rule that the head guy had to have the same insurance plan as the inferiors, it would be awful. 

 

[PinkyandtheBrains.]

I have very limited experience with Medicaid and Medicare, but the experience I do have has been good. My children are on CHIP, and I have zero complaints. No problem finding doctors who accept state insurance, (in fact we kept our same doctor). When my dd needed to get into a cardiologist, the referral process was simple and we had an appointment within a couple weeks. The only thing that got denied was some acne medicine the doctor prescribed for my dd which wasn't necessary - so no big deal. When my dad was on Medicare and had bypass surgery plus numerous hospitalizations, again, no problem with finding doctors and getting bills paid. My fil had coverage through the VA. His wait times for visits was pretty crazy, but once he got in, he got decent care. Maybe this is dependent upon what state a person lives in? The area?

 

Usually when I listen to people who are against universal healthcare, they cite the same issues you mention: the already existing problem with Medicaid/Medicare,VA. I'm wondering what the main complaints are? Trouble finding doctors who accept medicaid patients? Wait times for visits? (I have longer wait times with private insurance than my children do with CHIP).

 

I'm not saying I'm in favor of expanding the already existing programs. I honestly don't know about that. I am in favor of universal healthcare. I'm just not sure how to go about it. It seems since we already have a program in place, why not use it?

 

I'm not wishing my life away, but I'm counting the years until I'm eligible for Medicare.

 

We are on Medicaid currently. My only complaint is lack of dental coverage for adults. I'd expect there to be more adequate dental care for universal coverage. The kids coverage has been excellent.

[eternalsummer]

Yeah, this! Every cost that could be shuffled over to the employee  has been shuffled over.  If there weren't the rule that the head guy had to have the same insurance plan as the inferiors, it would be awful. 

 

 

When we hire employees, we don't provide health coverage.  We do pay well above a living wage for a job that doesn't require a college degree (or high school degree, for that matter) or any particular technical training.  We could easily pay half of what we pay and still have employees.

 

I can't speak for other employers, but for us, it makes sense to give people as much $ as possible to do with what they think is best.  If we bought health insurance for them we'd have to pay less, so we would have decided how to spend some of their $ for them.

[TranquilMind]

When we hire employees, we don't provide health coverage.  We do pay well above a living wage for a job that doesn't require a college degree (or high school degree, for that matter) or any particular technical training.  We could easily pay half of what we pay and still have employees.

 

I can't speak for other employers, but for us, it makes sense to give people as much $ as possible to do with what they think is best.  If we bought health insurance for them we'd have to pay less, so we would have decided how to spend some of their $ for them.

 

That is great if you are paying them enough to make up for not having health insurance.  Maybe they can find a cheaper plan on their own, but I'd like to see it.

[HRAAB]

We are on Medicaid currently. My only complaint is lack of dental coverage for adults. I'd expect there to be more adequate dental care for universal coverage. The kids coverage has been excellent.

 

To be fair, the dental coverage is pretty much worthless.  I keep an eye on our current dentist's website and am able to use coupons for regular cleanings and x-rays.  My dd that needed braces - that is completely out of pocket.  The medical care has been great, though.

[gardenmom5]

it varies by state.  what state are they in?

(one thing I would GREATLY like to see is being able to do health insurance across state borders, as is done with many other things - THAT will be down rates!)

 

if they're in WA  - you can PM me.  

[EmseB]

That is great if you are paying them enough to make up for not having health insurance. Maybe they can find a cheaper plan on their own, but I'd like to see it.

The point is that the money has to come from somewhere. Footing the bill for premiums is part of a total compensation package. Telling a business owner to just pay people more or just provide more benefits ignores the fact that the business owner doesn't magically just come up with money to pay people or buy health insurance. It's based on what their customers will pay for any given good or service.

 

I actually think having health insurance tied to employment is one of the big things that has led us to the disastrous system we have now.

[4kidlets4me]

Full disclosure I work for a company with a union. I pay $9 a WEEK for me and the kids and that is for medical, dental and vision. The medical deductible is $1000/year and it's not per person. The company puts $600 in an HSA. Our dental coverage is the best I've ever had. $10 deductible per person and the annual max per person is $2500. The billing lady at my dentist office once commented that I had the best coverage she's ever seen. My husband works for a small company and pays $65/ every other week for medical, dental and vision. His medical deductible is $2500/year. 

[TranquilMind]

The point is that the money has to come from somewhere. Footing the bill for premiums is part of a total compensation package. Telling a business owner to just pay people more or just provide more benefits ignores the fact that the business owner doesn't magically just come up with money to pay people or buy health insurance. It's based on what their customers will pay for any given good or service.

 

I actually think having health insurance tied to employment is one of the big things that has led us to the disastrous system we have now.

No disagreement, but what has happened as coverage got worse and premiums skyrocketed is a pay cut. 

[eternalsummer]

Yes, because labor got more available (more people looking for work/lower workforce participation rate) and health insurance got more expensive, but businesses didn't make more $ (except for health insurance companies, hah!) so there was both less $ to go around and also less incentive/necessity to pay more for the same labor (because more people are available and willing to work for less).

 

We pay definitely enough to afford health insurance (should someone want to buy it).  If health insurance costs significantly more in 2 years, though, and we're not making more in 2 years, we can't pay more, because the money allocated for labor in our business model is already spent.

 

I also think it's really weird to have health insurance tied to employment.  My car insurance isn't tied to employment, nor is my housing costs or my grocery bill.  It just seems so inconvenient and complicated.

[Laura Corin]

 

I also think it's really weird to have health insurance tied to employment.  My car insurance isn't tied to employment, nor is my housing costs or my grocery bill.  It just seems so inconvenient and complicated.

 

For comparison: in the UK, everyone has NHS access (because that is seen as a basic need).  Companies often offer private insurance on top as an extra: there is a benefit to the company as well as the employee because you can often schedule private operations at a more convenient time than NHS ones.  It's not a necessity however; when I last moved job, I lost my private health insurance but gained other benefits (stability, training, short commute, interesting industry) that were more important to me, and as the NHS is still there, the private insurance is not crucial.

 

The NHS is paid for through general taxation.  Private insurance is seen as part of the overall compensation package and is taxed as such.  The same is true of a company car (if used for private purposes).