Our terrible health insurance

[Guest]

Reductive fallacy.

Epistemic fallacy.

 

The bolded is not the only alternative. It is not an all or nothing proposition. Reducing military spending to assist funding universal health care does not equal dissolving all foreign presence and just maintaining borders. It is possible to re-allocate a small portion of spending on military to support social programs.

I never said it was the only alternative, but it's the one with the best chance of the longest sustainable funding. It would equate to about a 70% spending shift. Also? I'm tired of watching friends and family get deployed and then treated like crap for trying to protect people and maintain peace. All or nothing, but half measures only weakened and demoralized everyone in the previous decade it was attempted. Nopers.

 

Then again I'm for abolishing the insurance industry completely, except for catastrophic, and moving to cash and voucher only systems. So there's that too.

Edited July 28, 2017 by Arctic Mama

[Guest]

But shifting some money from defense would surely not create that many problems?

 

I don't know a lot about the military so bear with me here (by which I mean don't take it quite literal if I don't use the right expressions). Let's say the US buys fewer destroyers/aircraft carriers/planes etc for a couple of years (say 3 to 5). I am not sure that would have much impact on how much European countries have to spend on defense. I mean, just because there are somewhat fewer destroyers/carriers/whatever (I am not talking about none or even a huge reduction) doesn't mean Italy will suddenly attack Germany, would it?

 

And again, I feel the US's only obligation is to provide for their own defense and fulfill NATO obligations. Everything else is extra (not saying it is bad or unnecessary). I do feel a country's first obligation is to its own citizens and that includes at least somewhat decent health care.

 

Germany as far as I know has very little of an army, partly because we aren't really supposed to (or at least weren't). But if we had to pay for a bit more to make up for a cut-back by the US, we would presumably do so. Maybe that would suck for us, but it is not really the problem of the US.

 

Again, I am not talking about a sudden, complete withdrawal of all US military etc. But some money could surely be re-allocated to health care.

That was already tried during Obama with poor outcomes. Arguably that was weak leadership but I don't se that improving right now, either. US military reductions would need to be sweeping strategic changes, the gradual attrition style cuts worked terribly. Or, alternatively, stronger arsenal maintenance and a strong standing force, but changes to healthcare alone. That seems to be the direction we are going and it's an improvement over the gradual reductive strategy we came out of, in terms of outcomes, but it doesn't solve the funding issue.

[kewb]

Really? I don't think I know anyone who works 100 hours a week.

I know plenty of people who do. Before my dh became disabled he was one of them. Always on the clock. Weekends, weeknights, family functions, work all the time.

 

We have become a "gig" society. Everyone freelances. When you are freelance you only get paid when you are working so it is not unusual for people to be doing multiple gig's and racking up those kind of hours.

When I worked full-time I usually worked 50 hour weeks and during the busy season easily 60-80. With no overtime since I was a salaried employee. It is expected that you do the work no matter how long it takes.

[LucyStoner]

Really? I don't think I know anyone who works 100 hours a week.

 

Depends on where you live and the industry.  

 

I have some friends and we all planned to meet "after work".  After work for many of them is 8 or 9, and they didn't go into work at noon either.  Many are on call or "working" the weekend.  That's the norm for mid to senior level people at the big tech companies here. The family I know where he's an executive for a major company?  He works almost all of his waking hours and sleeps maybe 4-5 hours a night.  

Many of the people I know who work a 35-40 hour a week, more modestly paying job also work a second job or freelance.  

Edited July 28, 2017 by LucyStoner

[Scarlett]

I know plenty of people who do. Before my dh became disabled he was one of them. Always on the clock. Weekends, weeknights, family functions, work all the time.

 

We have become a "gig" society. Everyone freelances. When you are freelance you only get paid when you are working so it is not unusual for people to be doing multiple gig's and racking up those kind of hours.

When I worked full-time I usually worked 50 hour weeks and during the busy season easily 60-80. With no overtime since I was a salaried employee. It is expected that you do the work no matter how long it takes.

Well, all I can say is you must travel in very different circles.

 

I dont see how anyone would have time for a relationship of any kind working 100 hours a week. That would be over 14 hours every day of the week.

 

My Dh has an hour commute and he is away from home 10 -11 hours a day depending on if he takes a lunch.

[Scarlett]

Depends on where you live and the industry.

 

I have some friends and we all planned to meet "after work". After work for many of them is 8 or 9, and they didn't go into work at noon either. Many are on call or "working" the weekend. That's the norm for mid to senior level people at the big tech companies here. The family I know where he's an executive for a major company? He works almost all of his waking hours and sleeps maybe 4-5 hours a night.

Many of the people I know who work a 35-40 hour a week, more modestly paying job also work a second job or freelance.

Of course I imagine in ever industry there are work aholics......I still wouldn't think it was normal.

[LucyStoner]

Of course I imagine in ever industry there are work aholics......I still wouldn't think it was normal.

 

Most of my friends are not workaholics.  They are doing what it takes to keep their salaries and benefits packages in a place that is very expensive to live.  Because they have families to take care of.  And for the most part, these people aren't living extravagant lives.  They are largely paying for housing, medical care, and their kid's educations.  Chalking it up to workaholism shifts the responsibility of these incredibly draining expectations and economic realities onto the workers and off of the actual causes.  

Edited July 28, 2017 by LucyStoner

[Katy]

What types of insurance companies were required to increase their cash reserves?  Property and Casualty or health insurance?  Was there a particular act that led to this?  Can you provide any additional info--I am trying to find out more about this and having trouble locating sources.

 

All of the above.  Keep in mind most (larger) companies don't sell just one type, and this was after the law was changed that forbid insurance and investment companies from being combined.  Yes, congress changed the laws in the weeks or months shortly thereafter, no I don't remember the bills, it's been more than 15 years since I needed to recall it.  It was in the same group of insurance reforms that declared the missing would be considered dead for the sake of the attack without the typical waiting period of years, and that restrictions on terrorism in life insurance would be ignored, as for legal purposes it would not be considered terrorism.   I worked for one of the companies that had floors in the trade center at the time (my office was out of state, though someone who worked in my office was killed that day), I don't care to publish the name of the company on the internet but if you PM me I'll tell you.

 

 

ETA:  I'm not finding much about this online as I'm googling for it either.  I'm guessing the easiest way to find it would be to go to a large library and read the NYT or WSJ's issues in the 3 months after 9/11.  It was a very big deal at the time.

Edited July 28, 2017 by Katy

[Guest]

Really? I don't think I know anyone who works 100 hours a week.

Including hours worked from home in the evening, my DH does. We're currently on vacation and he spent several hours on the phone. It is frustrating but I'm used to it.

Edited July 28, 2017 by Moxie

[Laura Corin]

You realize there is far more to funding a functional military than NATO, right? The UK has decent military spending for the region, no doubt. But again, pretty much the only projected way to cover the healthcare expenses without a higher tax burden is shifting from defense or other entitlements like social security or medicare/medicaid. I don't have time right now but there are some great studies with analyses of spending by governments and where the priorities are. A shocking number of European countries spend almost nothing on defense and have no effective standing military other than ceremonial, but spend a great deal on their social safety nets. If they were required to maintain the bulk of their own defense and couldn't call in another country's bigger and more stable force they could not afford both. Heck, a handful can't maintain the safety net anyway - not enough revenue coming in.

 

I can't remember for the life of me which thinktank had the best breakdown on this but it was a fascinating look - essentially, what happens to spending in other countries if the US military dissolved all foreign presence and just maintained borders.

 

I don't think that it's the time to be patronising about the UK's support for US military interventions ('decent military spending').  It has been considerable since 9/11, and at least one UK prime minister has broken his reputation over it.  Compare the US armed forces deaths in Afghanistan to the British ones; the UK suffered equal casualties by head of population.

 

I only dispute the idea that spending has to be one thing or the other, because some other countries manage both.  I'd be happy to read the article you mention, however I don't necessarily think that increased taxes are a problem, if they are coupled with reduced payments to insurance companies.

[Scarlett]

Most of my friends are not workaholics. They are doing what it takes to keep their salaries and benefits packages in a place that is very expensive to live. Because they have families to take care of. And for the most part, these people aren't living extravagant lives. They are largely paying for housing, medical care, and their kid's educations. Chalking it up to workaholism shifts the responsibility of these incredibly draining expectations and economic realities onto the workers and off of the actual causes.

No attempt to shift responsibility. Like I said, I just know it is not normal where I live.

[Kassia]

I know plenty of people who do. Before my dh became disabled he was one of them. Always on the clock. Weekends, weeknights, family functions, work all the time.

 

We have become a "gig" society. Everyone freelances. When you are freelance you only get paid when you are working so it is not unusual for people to be doing multiple gig's and racking up those kind of hours.

When I worked full-time I usually worked 50 hour weeks and during the busy season easily 60-80. With no overtime since I was a salaried employee. It is expected that you do the work no matter how long it takes.

 

My DH doesn't work 100 hours/week, but he is a salaried employee and is pretty much always on call.  Sometimes he has teleconferences with people in other countries/time zones, which means late night meetings for him.  He has had to work on vacations several times due to work emergencies.  He works from home, which is wonderful, but I can't ever count on him being available.  

[FaithManor]

Of course I imagine in ever industry there are work aholics......I still wouldn't think it was normal.

It isn't workaholism! It is simply what is expected in order to keep one's job and health insurance.

 

Due to campaign contributions and lobbying from the IT industry when NAFTA was drafted, the tech industry was exempted from Fair Labor practices. That's right. Things that can't be done to workers in other industries can absolutely be done to IT workers. Short of locking them in buildings against their will for prolonged periods, employers can pretty much work an employee into the grave, and should they complain or attempt to NOT work the mandatory over time, fired for cause. It is perfectly legal.

 

At 53 with all of his life work experience within IT, and a degree in IT the reality is that he isn't going to find employment in another industry. So he endures.

 

He would work regular hours and be home more IF he had control over that. Of course if I had stayed in the work force and NOT homeschooled, he might have gotten into something else a long time ago since there would have been a second income on which to rely. But we made the choice to be single income for the sake of the kids' educations.

 

It is disturbing that anyone would suggest he works so hard due to a moral failure which is what the term "workaholic" suggests.

[Supertechmom]

The drs at my hosptial make rounds before office hours, so usually 6:00-8:00am and then after hours from 500ish to 800ish. Their normal work day is pretty much 14 hours on average and they do that 5 days a week.  Most are in groups and share call so every over night has someone on call and everyone weekend has somebody on call.    It is very common for the mds work day to start on the floor at 6:00am, office hours until 5p and then back at the hosptial until the NEXT MORNING and then they start the routine over and get off that evening.  They may or may not get sleep.   36 straight at one time and they still have 3 more office days and may have weekend call which runs Fri eve to Mon morning.   So yea I can see them averaging 80-100 hrs a week.  Notice drs talk about reducing hours to 50 or 60 a week as a good life balance so I think it is pretty normal industry standard.

[Catwoman]

Yep, my husband feels like a wimp for having to cut back and feels like he is seen that way by his partners.

With everything your dh has been through, if his partners view him as a wimp, they are terrible people!!! I hope the concern is all in your husband's head because he feels badly that he can't handle the same crazy workload he used to shoulder, and that his partners are actually impressed by how hard he is able to work considering his health issues. :grouphug:

 

Your dh sounds so dedicated that I hate to think he's worried that he's not doing enough. :(

[Scarlett]

It isn't workaholism! It is simply what is expected in order to keep one's job and health insurance.

 

Due to campaign contributions and lobbying from the IT industry when NAFTA was drafted, the tech industry was exempted from Fair Labor practices. That's right. Things that can't be done to workers in other industries can absolutely be done to IT workers. Short of locking them in buildings against their will for prolonged periods, employers can pretty much work an employee into the grave, and should they complain or attempt to NOT work the mandatory over time, fired for cause. It is perfectly legal.

 

At 53 with all of his life work experience within IT, and a degree in IT the reality is that he isn't going to find employment in another industry. So he endures.

 

He would work regular hours and be home more IF he had control over that. Of course if I had stayed in the work force and NOT homeschooled, he might have gotten into something else a long time ago since there would have been a second income on which to rely. But we made the choice to be single income for the sake of the kids' educations.

 

It is disturbing that anyone would suggest he works so hard due to a moral failure which is what the term "workaholic" suggests.

Sorry workaholic isn't seen as a moral failing to me. And again, it isn't that way in my part of the country. Not saying it isn't like that where you live .

[scholastica]

Doctors around here no longer do their own rounds. They leave it to the hospitalists. In fact, while you're in the hospital here, hospitalists pretty much handle all your care. Your doctor just gets updates.

[Supertechmom]

Doctors around here no longer do their own rounds. They leave it to the hospitalists. In fact, while you're in the hospital here, hospitalists pretty much handle all your care. Your doctor just gets updates.

 

Hospitalists, yes for family docs and basic medical pts.  Surgeons, GI, Nephrology, GYN/OB, Urology, Psych, Ortho, Neuro, Cards still handle their own pts in my area. They usually will consult a hospitalists to manage chronic issues like diabetes or blood pressure but surgeons typically don't have anyone managing their surgery pts.   Most of my pts have a team of docs that round on them every day including the hospitalists. 

[maize]

Really? I don't think I know anyone who works 100 hours a week.

Me.

 

But it isn't paid work...

[unsinkable]

Sorry workaholic isn't seen as a moral failing to me. And again, it isn't that way in my part of the country. Not saying it isn't like that where you live .

I don't think it is a moral failing, either. Alcohlic, shopoholic... compulsive behavior isn't a moral issue.

[Kassia]

Doctors around here no longer do their own rounds. They leave it to the hospitalists. In fact, while you're in the hospital here, hospitalists pretty much handle all your care. Your doctor just gets updates.

 

I didn't know this.  I was recently hospitalized and expected my family doctor to see me or at least follow-up with me and...nothing.  

[kewb]

Doctors around here no longer do their own rounds. They leave it to the hospitalists. In fact, while you're in the hospital here, hospitalists pretty much handle all your care. Your doctor just gets updates.

Interesting. My dh was it the hospital recently and his doctor came around. Most care is done by the nurses but you will see your doctor at some point. My friends who are doctors do their own rounds, too.

[Frances]

When my dad was hospitalized several times for issues related to his cancer treatment, he was assigned a hospitalist and nurse each shift. But the oncology practice still made rounds, as did the surgery practice after his spleen was removed. His primary care physician never visited, and we didn't expect it.

Edited July 29, 2017 by Frances

[foxbridgeacademy]

The end result of this health insurance is..it is just bad. That dollar amount was a deductible to be met before they started to pay. The copays kick in after the deductible is met. I had a doctor appointment last week and had to pay just over $170. I am supposed to have a procedure next week, outpatient, and turns out, it is going to cost me $2500. I told them I thought there was just a copay and was told they checked with my insurance and the copay only kicks in after I meet my deductible. I am paying $900/month for this insurance.

 

Here is the real kicker. IF we had no insurance, we would pay the self-pay rate which is lower than the insurance rate. So it is costing us for not just the insurance, but also for higher visit rates as a result. Last weeks appointment would have been just under $100 if I was self-pay and the procedure next week would have been $2025.

 

 

I need the procedure, but I had to cancel it. I won't be having it. Bottles of Ibuprofen and other painkillers and limiting my physical activity is cheaper than that cost.

This is me.  Our deductible is $4500 and the insurance pays NOTHING until we've met it. Now my monthly premium is significantly lower but not low enough to cover the $4500.  I need to have my heart looked at again because 2 doctors have now told me I shouldn't be in this much pain unless something is wrong.... can't afford it and won't be able to for another couple years.  I had to go to the local clinic for low income because I can't swing the $120 my previous doctor charges.... if I was cash pay he'd have only cost $75.

[Scarlett]

Me.

 

But it isn't paid work...

Ha, I was thinking that earlier.....moms certainly work almost 24/7....especially moms of many.

[Scarlett]

This is me. Our deductible is $4500 and the insurance pays NOTHING until we've met it. Now my monthly premium is significantly lower but not low enough to cover the $4500. I need to have my heart looked at again because 2 doctors have now told me I shouldn't be in this much pain unless something is wrong.... can't afford it and won't be able to for another couple years. I had to go to the local clinic for low income because I can't swing the $120 my previous doctor charges.... if I was cash pay he'd have only cost $75.

I just don't understand this and it isn't my experience at all. We had a $6000 deductible policy that paid nothing before it was met...but we still got the discounts that the doctor had negotiated with the insurance company.

[justasque]

I just don't understand this and it isn't my experience at all. We had a $6000 deductible policy that paid nothing before it was met...but we still got the discounts that the doctor had negotiated with the insurance company.

 

Yes, that is how ours works as well.  The bill says "office visit, $150, insurance adjustment -70, payment due 80" or something like that.  Make sure they're quoting the rate after the insurance adjustment, not the base rate.

[QueenCat]

Hospitalists, yes for family docs and basic medical pts.  Surgeons, GI, Nephrology, GYN/OB, Urology, Psych, Ortho, Neuro, Cards still handle their own pts in my area. They usually will consult a hospitalists to manage chronic issues like diabetes or blood pressure but surgeons typically don't have anyone managing their surgery pts.   Most of my pts have a team of docs that round on them every day including the hospitalists. 

 

Here it is the same except that there are also hospitalists type doctors for neurology at the two main hospitals. They only see patients at the hospital, they do not have their own patients.

[QueenCat]

I just don't understand this and it isn't my experience at all. We had a $6000 deductible policy that paid nothing before it was met...but we still got the discounts that the doctor had negotiated with the insurance company.

 

 

Yes, that is how ours works as well.  The bill says "office visit, $150, insurance adjustment -70, payment due 80" or something like that.  Make sure they're quoting the rate after the insurance adjustment, not the base rate.

 

That has always been my experience too, with many different plans and companies over the years. You still get the insurance negotiated rate, but you pay all that negotiated rate until the deductible is met.

[Zinnia]

The drs at my hosptial make rounds before office hours, so usually 6:00-8:00am and then after hours from 500ish to 800ish. Their normal work day is pretty much 14 hours on average and they do that 5 days a week. Most are in groups and share call so every over night has someone on call and everyone weekend has somebody on call. It is very common for the mds work day to start on the floor at 6:00am, office hours until 5p and then back at the hosptial until the NEXT MORNING and then they start the routine over and get off that evening. They may or may not get sleep. 36 straight at one time and they still have 3 more office days and may have weekend call which runs Fri eve to Mon morning. So yea I can see them averaging 80-100 hrs a week. Notice drs talk about reducing hours to 50 or 60 a week as a good life balance so I think it is pretty normal industry standard.

This was my life as a hospital based CNM, too. I also see it as industry standard.

[Frances]

Yes, Texas does make it intentionally difficult. I was born there, have family there. It's frustrating by design.

An interesting editorial in The NY Times today related to this. A pregnant woman in Texas is 10x more likely to die than one in Sweden or Spain.

 

https://www.nytimes.com/2017/07/29/opinion/sunday/texas-childbirth-maternal-mortality.html

[LucyStoner]

An interesting editorial in The NY Times today related to this. A pregnant woman in Texas is 10x more likely to die than one in Sweden or Spain.

 

https://www.nytimes.com/2017/07/29/opinion/sunday/texas-childbirth-maternal-mortality.html

I don't doubt it. One of the main reasons my parents left Texas was because of social services needs were too hard to meet there (having a child with CP and being very poor meant a lot of decisions were made that way). I guess, yanno, kids just shouldn't be born with disabilities. Edited July 30, 2017 by LucyStoner