<p>My reaction to your story was similar to that of Mspearl’s. My DH’s company switched insurance coverage and all sorts of other benefit packages extolling the change as one that was going to save immense amounts of money. I’m sure it did save the company money because, in short, what they did was cut the benefits, pure and simple. Of course if you switch to a health plan that has such low caps that you would have to find a quack to perform the procedure, you can save money. I am getting rid of my dental coverage because I ended up paying more for it than than I got last year and the maximum benefit I can get out of it is $1500 a person. Why even bother? So it can be with health coverage as well. Comparable does not equal make, nor does equivalent. Maybe the insurance will pay a lot more for some rare condition but will refuse to cover even close to the cost of things that are essential.</p>
<p>If my mother did not live with us, she would not be able to afford her health care needs. Just not doable on the small pension she gets and the Federal survivors health insurance she has instead of Medicare. Her necessary prescriptions are over $100 a month. When she went to the emergency room, though the hospital and some of the doctors were covered under her plan, some of them were not, nor were all of the tests. She got a bill in the thousands. It’s really outrageous the way it works. </p>
<p>So, yes, I am sure that Wisconsin is saving a lot of money on the new health plans for its teachers, but those new health plans are probably a shadow of what the old ones were. </p>
<p>It is a terrible problem with unions and with government as to what to do when locked into prior promises and the money is gone. What is happening is that there is a lot of reneging on health care and other benefits especially for those who have retired. Even the military has done this, forcing retired personnel to pay for Tricare, the health provider, when it was promised that this would be a lifetime free benefit. Through a technicality, the government is able to worm out of this promise. </p>
<p>I think the salaries and benefits of new employees should be restricted by the terms that have to be kept for the ones that have already been given their promises. It appears in the case of Wisconsin, that all of this legitimately can be renegotiated and the state has heavily reduced the ability for these unions to negotiate anything. It all comes down to the fact that they are out of money, doesn’t it?</p>
<p>economy went to the tank because of increase in oil price and the housing problems.
the only reason economy was good under clinton is because of the tech boom. lets not get political but here are some facts:
total US debt so far: about $14 trillion
debt increase since 2008: about $4 trillion
yea…
in about 25 or 30 years (dont remember exact) if US doesnt fix debt problem, total amount of taxes collected wont be even enough to pay the interest on the debt, making the dollar really weak.
the bigger problem is the value of the dollar. as dollar value decreases, inflation increases (US pay more for imports). this means everything is more expensive and because US economy is based on 70% consumption, companies either have to cut jobs or increase prices. this will be very very bad. as economy gets worse, more and more people will lose jobs and lose their health insurance.</p>
<p>a quick way to improve economy is by drilling for oil to lower oil prices. this will lower the expenses for companies when they create and distributes their products, and that eases their bottom line, giving them more $ to expand & hire, which will give people jobs and health insurance</p>
Exactly. And tough choices. If we give this to Jane, we can’t give that to Joe and who decides what is more important?</p>
<p>My husband has excellent dental coverage, but the dentist on his plan gives me panic attacks. I refuse to go to him. I am in the middle of a monstrous process of having much of my mouth reconstructed. I waited in pain for 18 months after getting a different dentist to come up with a treatment and payment plan to save the money that I needed to pay him and have sacrificed, scrimped and given up things because I choose to go a dentist with whom I am comfortable and believe I will have a greater likelihood of a successful outcome. Sometimes people, as well as government, have hard choices and sacrifices to be made. I hate the area in which we live and my commute is 1 1/2 hours each way, every single day, but my husband has a residency requirement, so we stay. We don’t all get what we want all the time. Sometimes we have to make the best of things. I agree with polarscribe about removing restrictions on pre-existing conditions, but I’m not sure how much further than that I would go.</p>
<p>The problem with healthcare is that when things get to an extreme, we have to provide it to a needy person. Whether the person is an illegal alien, has no insurance, no money, is a deadbeat, is a drug addict, a felon, anything… there is a point when we have to provide the healthcare without regard to ability to pay. Preemie born at 26 weeks and the parents have minimal if any coverage and the state has no provisions for children in that situation—still gotta support them. So basically what we do is treat those we have to treat on an urgent basis with no plan in place as to how we pay for it. </p>
<p>Any plan anyone tries to put together for such situations and other healthcare needs gets a crowd of lobbyists wanting to continue the status quo. Too many special interest groups making too much money out of all of this to let go easily. So I have no doubt the union had more than the quality of the health plans it advocated going for it, but at the same time I doubt the state has replaced that union plan with as good or better plan. In the mean time, we still have many un and underinsured folks out there.</p>
<p>We recently were able to put my son on our health care under Obama care. He would have been better off on Medicaid when he injured his hand. With the deductible and copays, he can’t afford the charge. If he just had no coverage, he’d have paid nothing. Kinda crazy the way this all works.</p>
True, but the who and why is interesting. In my state, the access and financial threshholds are so generous that anyone who has the slightest interest in being covered will be. But there are some people who just aren’t going to do it.</p>
<p>You’re right, it is crazy. For me, I think your example illustrates why the whole reform, apart from a few hard-and-fast rules, should NOT be federal. In the attempt to cover every eventuality, a behemoth so huge would have to be created that it wouldn’t work for anyone. That encourages waste, redundancy, fraud. It’s also created so much uncertainty that it’s crippling the economy, which helps no one.</p>
<p>Zooser, I am all for saving, planning and making choices but when you have an emergency health situation that can cost astronomical amounts, very few people can do that. When your child’s or your life is on the line, it a whole different level that whether you are comfortable with the dentist. And I’m one who’d rather have a baby than go get a tooth filled. When I was faced with a 50/50 situation with my kid’s life, it’s damned the costs, and just default on the payments if I can’t make them. Which is what an appalling number of people do when health care costs are just unsurmountable. My brother some years ago blew off a huge amount of costs when he was taken in for an emergency situation. What he owed was more than he earned in the next more than several years. </p>
<p>I also think it’s ridiculous that are elderly are robbed of their eyeteeth if they can’t afford to pay for them. Kind of necessary, one would think? Not according to medicare and any insurance plan I know for the elderly. Both old ladies that I care for need teeth and eye care that have to be paid for out of pocket. It’s inhumane, in my opinion. I’m broke from paying for grandmas’ teeth, and it’s no joke.</p>
I actually agree with you. If you had the option, would you pay a surcharge on your insurance premium to cover those things? As I said earlier, I don’t think people should pay out of pocket for everything, but (again, I was specifically referring to my husband’s union) I do think people should pay premiums and co-payments. My husband, as is the case with most NYC employees, pays zero for a family of five. Think about that for a minute. There’s also the issue of choice with regard to a young person who might find that major medical works for him, and that is a valid choice as well. Opposing Obamacare is not the same as wanting to push granny down the stairs, you know.</p>
<p>The who and why are very clear to me. My son’s insurance covers just enough so that he’s stuck with paying a huge bill that he can’t afford, but since he can either get Medicaid or apply for a hospital’s uninsured fund, he can get most things covered if he has no insurance. The minute you put down “yes” for having insurance, that 's the end of that benefit since there are too many who are uninsured out there to even let anyone in who at least has some insurance. </p>
<p>My mother’s hospital bill is outrageous. When you are admitted through emergency due to dangerous symptoms, you don’t question whether each doctor or part of the hospital is part of the preferred provider of the insurance. They simply are not getting paid anything other than what the insurance will cover. If they want to take someone pushing 90 to court on this, they can. And if they refuse to treat in the future, which I have been told is not going to be the case, I’ll sue. I’m fed up with this system. I’ve paid, paid and paid all of my life, and yes, gotten the benefits of the insurance as well with a child who had some significant issues, but the was like getting a half million dollars of benefits shoved up my backside a nickel at a time with the trouble I had to go through to do things the way they are set up. And I am mentally and academically capable of going through this muck. Those not able are probably better off as they will just throw up there hands and walk away and stick the hospital for the bill. I was shocked at how many people told me they do this. They don’t care after a point because they cannot deal with it. And I don’t blame them one bit. It took me years to straighten out the medical bills from my son’s cancer treatment. And today, I pay thousands in premium because my health insurance refuses to consider Memorial Sloan Kettering as preferred provider and pays a pittance of the cost for him to go to long term survivor check ups. His oncologist is there, the protocol he was on was written there, the continuity is there, but he is supposed to find somewhere else on the preferred list. And for what they pay for such an exam, there is no way anyone will do due diligence even if he could. We can afford it, so we pay for it, but,yes, I am resentful. Many of the young adults do not go for the followups in this sort of thing because they can’t afford to do so in a meaningful way. I haven’t even come to the point of his getting his own health insurance once he is no longer eligible to be on ours. With that pre-existing condition, we’ll see what happens.</p>
I’m sincerely sorry that you’re family is going through all that. You’ve been such an incredibly generous resource through my time on CC that it breaks my heart to hear of your family’s difficulties. I hope you will accept my best wishes and good thoughts.</p>
<p>A huge percentage of health care costs never go paid by anyone because they’re billed to people who can’t afford to pay them. It ends up written off as charity care, and the costs get built into the bills for everyone else. Emergency room care is the most expensive and least efficient way to treat anyone - but it’s the only way a lot of people can get health care.</p>
<p>I had student health insurance, but I still owed thousands of dollars after the insurance kicked in. Three days in the ICU, CT scans and lots of blood tests add up FAST.</p>
<p>I could easily have defaulted on my hospital bill, told them to shove it and dare them to collect from a (then) unemployed and broke college student. I didn’t want to do that, and I’m lucky enough to have relatively wealthy parents who helped some. I’m still paying those bills on the installment plan, 18 months later.</p>
I am also very sorry for what you had to go through. I hope that your health is fully improved and I would like to say how much I respect and admire your determination to pay those bills.</p>
<p>How do you feel about union members earning six figures paying zero for their healthcare costs while much lower-paid people in the private sector are crushed by poor or no insurance - not to mention staggering tax loads? How do you feel about families making up to $80,000 receiving heavily subsidized care on the public dime? You and cpt obviously have a skin in the game and are among the most educated healthcare consumers. Don’t you think most people should make some contribution, and don’t you think the public healthcare dollars are better used for the truly needy than the truly connected?</p>
<p>Kajon. I don’t “hate much.”
Zoosermom: I don’t get emailed talking points.</p>
<p>No one will change my mind. Personal responsibility…don’t get me started. Sensationalism? You bet! What is happening is sickening. And the “abstract rich guy” does exist. Have you heard of tax cuts?</p>
<p>I don’t advocate a complete abandonment of capitalism but it must be tempered with compassion. And certain things shouldn’t be left to the whims of the market: schools, healthcare and security. I want to see my tax money support these things. </p>
<p>And kajon, I will happily accept being called a hater if it means standing up for the people. If it means standing up for everyone’s right to get treatment. </p>
<p>Honestly, how do people want to live in such a self centered society? And my friend who couldn’t get her son to the Dr.? She isn’t wasteful and doesn’t live a lavish lifestyle. She buys her clothes at goodwill. She demonstrates personal responsibility every day. She takes care of sick, dying, suffering people. She wipes their excrement, cleans up their vomit, feeds them and holds their hand. And when a hospice patient dies she cleans their body and gives them dignity to give the family a little relief. All this for about $10.85 per hour. I would say that is a pretty d#$n important contribution to society. And you see, she didn’t grow up privileged with a family that valued education, or showed her much care. She has had to go about this world alone and I think she is doing the best she can. So don’t talk to me about personal responsibility and choices.</p>
<p>And I am acquainted with many many people in similar situations. I am not isolated from poverty and it is not an abstract. </p>
<p>But back to healthcare. Everyone deserves it and it shouldn’t be wholly at the whims of the free market. That is dangerous. I don’t want to live in that kind of society.</p>
<p>Oh and more about the talking points. I grew up and live in one of the most conservative counties in America. I have always thought differently than my peers and have experienced taunts and bullying because of it. But I have never succumbed to this bullying and I never will. I have always been a fervent supporter of the underdog. It is how I live. And if I had more money I would probably give it away. I am not a saint at all and I mess up all the time. But this is my morality and how I try to demonstrate compassion. It is a hard way to live in American society but I will not ever change.</p>
<p>zoosermom, yes I think everyone should pay - into a national non-profit system. The current system of private profit is disgusting. The whole point of insurance is to minimize the amount of money they pay out for care because that is how they make a profit. Insurance corporations have a completely perverse incentive when it comes to health care, and this has been proven over and over again.</p>
<p>So yes, I think the system needs fixing. The first fix is to take all the profit-grubbing insurance bureaucrats out of the system.</p>
<p>The number-one, most efficient insurance system in America? Medicare. Lowest administrative costs of any insurance plan in the nation. Look it up.</p>
<p>Of course, if the surcharge were worthwhile, yes. My dental plan sucks. Plain and simple. The only way to suck money out of it, which I have done, is to plan it out very carefully. Otherwise it isn’ t worth it. I’ve gotten my $3K benefit out of them for two years and I’ll sit dormant with no dental insurance next year. It’s ridiculous the lengths one has to go to work this stuff to one’s advantage. </p>
<p>The problem is that medical care has gotten to be so expensive that people literally cannot afford it. Plus with all of those who are getting care and simply not paying for it, has upped the cost for those of us who do to the point that people don’t want to pay a dime for anyone else. They are fed up. So am I. We have some of the leading edge, best health care in the world available here but we have to play games to get it, not to mention pay horrible amounts. </p>
<p>The only way to address this issue is to meet it straight on. What does it cost to have an excellent healthcare system and make it available to everyone? What is that bottom line cost figure? Then we have to come up with a realistic way of charging the cost to everyone. Yes, it’s socialist. I’m Republican in most ways, but the day we started taking social security and medicaid monies out of everyone’s paycheck, that line was crossed. Healthcare is even more all encompassing. Gotta give to those who need it whether they can pay or not. Can’t boot them out of the ER and let them die, so that is a real, given cost that is there . So we all gotta pay for it. It’s gotta come out of the pay check. Get rid of all of these for profit plans–of course, they are making money off of them, why do you think the health care lobby is one of the biggest there is? Shut it all down, make it single payer and let the privates compete for boutique coverage from those who can afford it and want more. In NYC, Harley St has existed for a long time now, so it’s no news there. But hospitals and essential procedures go strictly on a need process. Pay the doctors well, pay for research and get a nice chunk out of some of those drug companies profits . It’ll take a juggernaut to do all of this because there are too many pockets being filled by the system as it is now because it is so cumbersome and complicated that there are too many little niches where one can leech on and suck out a fortune.</p>
<p>Zoosermom, I am not worthy of sympathy. I am very, very lucky in that my DH has worked for major companies, made a lot of money and had what are considered above average benefits. My son is a 21 year old college athlete now, on no medications and doing well. My other guys are in good health, knock on wood. Just the usual knucklehead ER issues. My MIL and mother are in their mid and late 80s and still have a lot of mileage in them. Their health issues are not serious by a long stretch. I don’t want to overstate. But the danged paperwork and process of going though the health care labyrinth has just worn me thin. </p>
<p>I am finishing up on $6K of dental work as my 40 year fillings are all coming apart. It’s taking tow years of dental benefits to squeeze the max out of the plan to do this. My MIL and mother both have eye and teeth issues that are not covered by Medicare and federal health insurance, not to mention the hearing aids one of them needs. If it isn’t kicking grandmas down the stairs to make their eye/teeth/ears too expensive for them to have, what is? Get a load of what dentures and hearing aids cost. The glasses, we can deal with but I’ve been fighting with insurance on some eye issues with macular degeneration and glaucoma. I’m just tired of it all, and I am,yes, capable supposedly to do this. And being a SAHM, I supposedly have the time to do this, and am still overwhelmed. On top of it all, I’ve been one of the lucky ones who has managed to get through all of this with everyone still standing. </p>
<p>What’s even more of a disgrace is how our veterans are treated. I had to take on Tri-Care 5 years ago when my brother was stricken and they are terrible. Don’t want to pay for what it costs to get things done properly. Tried to get my brother to go to a general surgeon for pancreatic surgery. We just went ahead and did what we wanted and challenged them to sue us for the costs and took it through the system to get everything paid after the fact . He would have died waiting for approval, going through their prescribed administrative route. </p>
<p>So, please don’t get the idea that I am in a medical quagmire. I’m just sick of dealing with the system (successfully, so far, I might add) to the point that I really don’t blame people for just not paying. We just have to much to lose to do that. But I have no compunction telling anyone that if I couldn’t afford it, I would have taken every bit of health care and just been a dead beat about it. Serves the system right.</p>
It is exactly that, but it is not what I am advocating.</p>
<p>In the narrow lens of my own city, where the unions hold everyone else hostage, I believe very strongly that union members need to pay into the system. Everyone needs to participate in some fashion. Things may be different where you live, but the benefits here and in places like California are too expensive to be afforded. That’s part of the problem, not the whole problem, but it’s a biggie in my area, and is certainly a contributing factor to the concern that our largest state may become bankrupt. We aren’t arguing at cross purposes here, we may just have different circumstances and different suggestions as to the best way to fix things. I think eyeglasses and dentures should be covered, absolutely, and it amazes me that it’s even a question. Viagara is covered in many places, but not teeth? Really? I’m not advocating for that status quo. I’m just saying that Obamacare is very problematic – probably more problematic than we now realize.</p>