Sunday, January 6, 2008

This is not a political blog...

This is not a political blog. If politics isn't your bag, you might want to hit "next" or that big X up in the corner or whatever, because I've been polishing up my soapbox, and I'm about to get suds all over the place.

Chances are that this is going to happen more than once or twice before November's election. Sorry. I'll try to restrain myself as much as I can, but for the love of Pete...

I need to vent about health insurance.

We're in a unique position, being self-employed. We probably know more about health insurance than the average consumer, because not only do we buy into our own plan, we had to go out and find the plan and research the options and do the leg work and all that jazz to begin with. Most people, when they are dealing with health insurance, have a binary choice - they either do or do not buy into their employer's plan. On the other hand, with the exception of the fact that very few insurance companies will write a policy for a two person group (for the purposes of our insurance BJ and I are separate families), we were able to shop the entire free market of health insurance... and let me tell you, there is NOTHING "free" about the health insurance market.

Here are my main complaints, which come from watching part of the republican debate:

1) Health savings accounts are NOT a panacea. (Bonus points if you get the pun!)

We have an HMO. Our insurance, for the family, costs roughly $15,000 a year. (It was $300 a month when BJ and I started with this company in December of 2004. Turning thirty and having two kids really screwed us over, cost wise. We caused the biggest yearly increase our agent had seen in 25 years of working for the insurance company we go through...). We priced health insurance again last fall, including HSAs, because we knew we were being hit with another big increase (the increase was from $1000 to $1350 a month, but we increased our deductible to make it more affordable, so that brought it back down to about $1200 a month). It turned out that it would've cost us MORE to get the High Deductible Health Insurance (HDHI) that you must have in order to qualify for an HSA (in other words, you can't just start an HSA because it's Tuesday and you feel like it, and then self-fund your health care, which would probably be cheaper and most cost effective for us if it weren't like playing roulette... you have to have this HDHI as well), and it would cover LESS than our HMO covers. A lot less. We would've been paying out of pocket (or out of the HSA, which works exactly like a bank account with a debit card and everything, except the money goes in pre-tax) for office visits, well baby care, everything except like cancer and stuff, and we would've been paying more for the privilege. Um, sorry, but anyone touting HSAs as an answer either A) hasn't done the math, B) is as stupid as our president, or C) is full of shit.

And kids, HMOs, in general, aren't even "great" insurance. We've been happy with ours, but it's not like we can just go in and get all the elective everything we want for nothing. And it doesn't cover dental or vision, either. It's not Blue Cross/Blue Shield. We don't qualify for BC/BS because they won't do a two person group! We'd have to hire another full time employee in order to qualify, and then we'd have to give them insurance, too.

2) Politicians are COMPLETELY out of touch with how much health care costs.

One guy (and I couldn't tell you which because all old white republican men look alike to me) was giving an example of a scenario and said, "So let's say that you have to go to the hospital and have a $1000 procedure done." I'm paraphrasing. BJ thinks it was Mitt Romney. Anyway, the next guy to speak (BJ says it was Mike Huckabee) very correctly said to him, "You can't even get a Kleenex in a hospital for $1000 these days!" and that is SO true. The fact that the first dude said $1000 and not $10000 just proves that he has no freaking clue what it's really like out here in the real world.

3) The myth that people without health insurance could have it if they wanted it, but they have "opted out."

This is fresh out of the bull. I can't imagine anyone who was making enough money to keep food on the table and a roof over the head saying, "You know, I could take this money and put it toward keeping myself and my family safe in the event of injury or illness, but instead I'm going to 'opt out' and trust that the government will take care of me if something bad happens." Bullshit, bullshit, bullshit. First of all, it's not easy to get the government to take care of you - you have to be really poor, and you have to jump through a lot of hoops. It's not something that is just magically do-able for anyone making $100,000 a year (which is the level that the various old white republicans kept throwing around)

It's really like saying, "Well, we don't need to run power lines to those folks over there, because they've opted out of having electricity..." I only know of one person who has done that, and she's batshiat crazy. And here's the irony - crazy people qualify for Medicaid. Everyone else wants health insurance.

Remember, it costs $15,000 a year for our little family of 4, and we get a break because we're a "group." Private insurance (not through an employer, not a "group") costs a fortune and covers squat. Ask me some time about the $500 a month BJ and I spent on MEGA and what we got for it. The answer rhymes with pack spit.

(See, this is why this is not a political blog. I really can't talk politics without swearing a blue streak...)

For us normal people (read: not politicians) $15,000 falls well over the threshold of "discretionary income." $15,000 is the difference between being able to, oh, I don't know, EAT or not. We don't just throw around $25,000 an hour to go to Jerusalem like some people do. Aside from my car and my house, I don't have a single thing that cost $15,000. I'll bet you don't, either. $15,000 is a damn lot of money. It's not like we (those of us in or around the $100K bracket that they were talking about) sit around and say, "Gee, you know, I was going to buy health insurance this year, but instead I'm going to go out and buy a Segway so I can chase the mailman..." It's 15% of our income. If you put it on the scale they're used to, that's like $2,500,000 for Giuliani (and I really hope he doesn't win, because A) I don't want to learn to spell Giuliani, and 2) I don't want to hear "9/11" every day for the next 4 years). It's like $5,640,000 if you're Mitt Romney (and I do not want a president named Mitt, either, that is not a respectable-guy name. It's a piece of baseball equipment). In other words, $15,000 is Real Money to us, guys. Not discretionary money. Not something that you'd just spend on Cheetoes and Pay Per View in a year, if it were a choice between that and health insurance. Dur.

And remember, that $15,000 a year we pay is a lot LESS than we'd pay if we had "private" insurance (the big "Free Market" answer that Republicans love). It's a steal, really, even though it's a small fortune, even though it's more than we made the first year we were married (and we've only been married 6 and a half years).

4) Self-employed people are hosed.

When they talk about the 43 million people in this country who don't have health insurance, they aren't talking about poor people (they have Medicaid). They aren't talking about retired people (they have Medicare). They aren't talking about working people (they, mostly, have health insurance through their employers). They are talking about self-employed people. You know, all of those innovative, dedicated, brave, determined people upon whose blood, sweat, and tears this great nation of ours was built. They're talking about us, and the people who work for us. Because it's damn near impossible for a lot, and I do mean a LOT of small business owners to obtain and afford health insurance for themselves and their employees. I am convinced that it was actually a minor miracle that we found the coverage we did. I didn't think it could be done, and I was actually bitching to my accountant about it, and she referred me to her friend Deb, who was able to find us that Holy Grail - the Two Person Group.

Oh, and we pay more in taxes than un-self-employed people do, too. And BJ works 80 hour weeks, routinely. Why do we do this again? Oh, yeah, we did it so we could stay close to home. You really should feel guiltier about not coming down here more often, considering all that we go through to stay close to you, and you know who you are!! I digress. The fact is that the American economy really, really needs self-employed people, and it's about time we started feeling the love.

I really like what Mitt Romney did in his state (even though he has a stupid name) with making all the uninsured people into a "group" of their own, and allowing them to reap the benefits of being a "group," which lowered their cost and insured them. I think he said that they insured 300,000 people for $200 per person per month or something. Sign me up. (If you don't start visiting more, we're going to move to Massachusetts or New Hampshire or wherever the hell that happened! So there!!) That's smart. That would work. That may just win him my vote, unless Barack gets the democratic nomination because I'm an Obama girl.

Anyway, dragging this post back on topic, here's a picture of my cute kids.


We're doing it for the chillllldddreeennn... The really really expensive children.

3 comments:

Jen said...

This is funny... I was going to post the solution (or at least the most plausable one) before I read your last few sentences...
Vote for Obama.
Love,
Jen

Anonymous said...

I completely agree with you that self-employeds get hosed. My dad is self-employed and my sister and her husband both work for him. My mom is employed by another company so she carries health insurance for the two of them. But right now, my dad cannot afford to offer health insurance to my sister and her family (two kids ages 6 and 9mos) or the other full time employees that he has.

My dad looked into getting health insurance for him and the business. I don't know if he found anything yet for the business, but the kicker is he cannot get health insurance for himself for 7 years because he was diagnosed with prostate cancer... eventhough he had a complete prostatectomy (prostate completely removed) and found that the cancer was very small and localized in the prostate. The other great thing is that the insurance company did not want to pay for his last day of hospital stay because statistically the hospital stay was not that long. I guess the insurance companies know better than the doctors what kind of care patients need.

I am so for a generalized healthcare plan. There are so many other prosperous, civilized countries in the world that have one that don't seem to be any worse for wear.

Anonymous said...

I just saw Michael Moore's movie Sicko tonight and it has solidified my feelings about our health care situation in the U.S. even more so than ever before. From my studies in health care administration I was already completely aware that the U.S. rates very poorly statistically in regards to life expectancy, morbidity and mortality rates, etc. than countries that have universal health care, yet the U.S. spends more health care than any other country. This movie makes me want to pack up and move to Europe or Canada. If you haven't seen it yet, I highly recommend it.