Insurance Woes for the Middle Class and Self-employed

This is an issue that effects all of us.

www.nytimes.com...

Ms. Readling, a 50-year-old real estate agent, is one of nearly 47 million people in America with no health insurance.

Increasingly, the problem affects middle-class people like Ms. Readling, who said she made about $60,000 last year. As an independent contractor, like many real estate agents, Ms. Readling does not receive health benefits from an employer. She tried to buy a policy in the individual insurance market, but — having had cancer — could not obtain coverage, except at a price exceeding $27,000 a year, which was more than she could pay.

My mom and stepfather pay $1800 for their insurance premiums with a deductible of approximately $20,000. My mom went into the hospital a month ago for a hip replacement. They were already over their deductible, and it seemed theere would be no problem with the insurance company paying (they have the health savings plan that the President advocated back in 2002 plus major medical). In order to perform the surgery, the hospital (a Health First hospital) required them to sign a document saying they would pay if their insurance company would not.

Now, the insurance company won't pay. apparently hip replacement for a 58 year old is "elective surgery". They now owe the hospital over $50,000. They put their house up for sale, and are hoping they can sell their house before the hospital puts a lein on it.

“I don’t know which was worse, being told that I had cancer or finding that I could not get insurance,” Ms. Readling (pronounced RED-ling) said in an interview in her office, near the tree-lined streets and stately old homes of this city in the Piedmont region of North Carolina.

It is well known that the ranks of the uninsured have been swelling; federal figures show an increase of 6.8 million since 2000.

An increase of 6.8 million uninsured since 2000!!!

Today, more than one-third of the uninsured — 17 million of the nearly 47 million — have family incomes of $40,000 or more, according to the Employee Benefit Research Institute, a nonpartisan organization. More than two-thirds of the uninsured are in households with at least one full-time worker.

Katherine Swartz, a professor of health policy and economics at Harvard, said the soaring cost of health care was a major reason for the increase in the number of uninsured. She said it also reflected long-term changes in the economy, like the decline in manufacturing jobs and the growth in the share of workers in service industries and small businesses, which are less likely to provide health benefits.

As an independent contractor with a Century 21 real estate brokerage, Ms. Readling had bought insurance on her own, a temporary extension of coverage from a prior job. But she was unable to renew it after she had surgery for breast cancer in 2005. Most insurers would not offer her coverage, she said, and one carrier quoted a price of $2,300 a month for coverage with a deductible of $5,000 a year.

How many people do you know who could afford that?

Even those with insurance have reason to be concerned, economists say, because they end up paying for the uninsured in various ways. Some of the costs are also passed on to taxpayers and employers. To help cover the cost of treating the uninsured, hospitals often increase charges to other patients. Insurers then increase premiums for companies that provide health benefits, and they in turn shift some costs to employees.

When this woman was shopping for insurance, she was told to remarry her ex-husband so she could get insurance.
We've got to do something about this!!!

I'm not advocating socialized medicine, but I'm of the opinion that we need to do something to hold insurance companies accountable. We already have tax breaks for insurance, but the premiums are going up so fast for the self-employed that the tax cuts don't even make it worth buying insurance.

reply to post by pjsconcrete


PJ's Concrete, that is absolutely horrible. The insurance companies can deny payment for any reason they want at any time they want and never have any kind of penalty. They've been given free rein and are destroying health care. Who gets a hip replacement as "elective surgery"???? That's just stupid. Nobody wakes up and thinks, hm, think I'll get my hip replaced just for the helluva it. With this kind of treatment, is it worth it to pay huge sums for health insurance, only to be turned down when you need it?
I could rant for days about this, but I won't bore anyone with it. It's just disgusting and inhumane.

IMO it comes down to the fact that the essentials of life (i.e. somewhere to live, food, heating, water, health) should never be handed over to the free market. I read in a recent poll 75% of Americans are willing to pay higher taxes to have a nationalized health-care system, but the candidates never discuss it. They discuss irrelevant hyped-up non-subjects like religion. There's too much money being made by private companies in health, that's the problem. Hilary might do something. Edwards would be better, but hopefully she'll try to do something.

[edit on 30-12-2007 by rizla]

reply to post by pjsconcrete
look... it's quite simple...if the government thought this was of extreme importance....they would have called congress into session and hammered out a health policy for all americans. if you don't think that ever can be accomplished...remember how fast congress acted on the brain dead terry schivo case, or look how fast the validation of bush for president in the 2000 election. i believe they just want more people to die off and not cost the wealthy any more of their money. this isn't rocket science on their part, lack of motivation is

reply to post by pjsconcrete

one critical thing you have to remember...health insurance companies increase profit by DENYING their product to their customers...that's why these companies will never improve the general health care in this nation. do you honestly think any ceo of one of these companies will say to his wokers..." we need to to provide greater coverage to our customers, so make sure you pay out more in benefits". what wacky weed have you been smokin'?

No "wacky weed" for me!! I guess the thing to do would be take health care out of the free market system. My parents could have gone over to Europe where the artificial hip was created and spend $20,000 cash for the hip, 2 weeks of rehab in a bed and breakfast, a limo ride from the airport to the bed and breakfast, ect.... They almost did that, but their insurance said they would cover it, but when it came down to it, they didn't.

I'll look for the website that offers the program overseas for US citizens and post it.

reply to post by jimmyx


Thats the core of the problem. You cannot place a true price on health and to place the responsibility of the costs on insurance companies whose sole purpose is to make a profit is crazy. Thats like trusting a pedophile to babysit your children. There is just too great a conflict in interests.

The government should create or dissolve health care corporations into non-profits so that the goal becomes service oriented instead of profit oriented.

Here are some.
www.europeanmedicaltourist.com...

www.europeanmedicaltourist.com...

Here are some cost comparisons.
medicaltourism.com...

I couldn't find the one they checked out with the all-inclusive stay for 2 for 2 weeks at $20,000 including the operation, butI'll look for it.

Check out maybe going to Poland or India.

reply to post by rizla


Already considering perminantly moving to Slovakia. Went there last year, and it's not like they say it is here in the US. It wasn't like the movie "Hostel" at all!!!
I can get citizenship there and get free health care since my grandfather expatriated from there back in the 30's. The people are all really nice, and they have the BEST pilsner in the world right next door in the Czeck Replublic (Pilsner Urquell)!! One of the rules there is in order to be considered a town, you must have a brewery. My kind of people!

Yeah its nuts whats going on...I pay over a grand a month for my insurance. Then you have companies like Signa turning down people and letting them die like that girl...I hope the sue the park out of them and when alot of money. I dont pay you people to be my doctor...I pay you to pay my doctor when he makes a recommendation. It is so deep and complex and wont get fixed because of the big fat lobby that is sitting in DC as we speak.

Originally posted by jimmyx
reply to post by pjsconcrete

 

one critical thing you have to remember...health insurance companies increase profit by DENYING their product to their customers...that's why these companies will never improve the general health care in this nation. do you honestly think any ceo of one of these companies will say to his wokers..." we need to to provide greater coverage to our customers, so make sure you pay out more in benefits". what wacky weed have you been smokin'?

I think socialized medicine is becoming more inevitable because insurance companies are continuing to decrease the quality of care by cutting corners. Back in the early 90's when Hilary Clinton first kicked around the idea of socialized medicine, the idea got shot down because a large portion of the 80% of people who had health insurance did not want their high quality of care compromised in order for the other 20% of society.

Fifteen years later, the quality of care most insured people have is not that great and seems to be declining. Most people with private insurance have to deal with red tape, long lines, poor service and all the other negative qualities that people feared would exist in a socialized medical system.

When the idea of socialized medicine is kicked up again, people are less likely to buy into arguments that their "high standard of care" would be compromised because their standard of care is not so high anymore. Furthermore the argument that the government would waste billions of dollars becomes less appealing considering that the upper management of HMO's and other companies in the health care industry have exorbitant salaries.

before i started getting free health care i had a private insurance company that never denied any of my claims. they paid 80% of all medical dental and perscriptions. i had it through work and my cost was less than $20 a month. atena although it is hard in the south to find a doc that will take it was a very good company. i never had to argue with them about anything..

What a great country!!! I live in Massachusetts and wonderful Mitt Romney signed into law and passed a bill that would require EVERYONE to have some form of insurance in this state or pay a stiff penalty as of January 1!

After having done much research, i have no other option than to put my husband on the list for Commonweath Aide, since its too late to sign him up under my insurance and his through work would take away every penney he makes and with the 575$ in heating oil per month, there is no way we can possibly make it- SO i am resorting to dumping the problem on the State of Ma. and from what i can see, we qualify.

This is great- A law that is making everyone resort to government help
How does the state have any advantage if everyone ends up applying for public assistance???
This is unbeleivable! Its retarded and stupid.
Sooo, i am now more than happy to make the state pay for his insurance, after all, old Mitt made the law, now they can deal with it.

reply to post by dgtempe


thats kinda crazy that that can even be a law. i would might look into finding somewhere else to live. but hey thats just me..

reply to post by dgtempe


'Ole Jeb Bush tried to push that one down here too, but it didn't pass. All of the corportists are trying to help their "buddies" in the insurance business. After seeing Sicko, I think that socialized medicine may be the way to go. Otherwise it's just going to be handouts to big business again.

Update from my parents' insurance dilemma: they will pay for the operation, but not for the hospital stay. Apparently they think hip replacement surgery should be an outpatient surgery. But, their premium will be going up 20% this year. They came to the decision that it's cheaper not to have insurance and go to Europe. That's 2 more people not going to be consuming goods here in the US. 2 more people who should be on the verge of retirement losing everything to our failed medical system.

And guess what. They can still receive their social security over there when they get of age. They just have to have a small piece of vacant property in there name here.

reply to post by dgtempe


How can this has not been challenge by the people in the state!!!!!!!!!!!!

This nothing more than giving insurance free reign over citizens and to fatten their pockets.!!!!!!!!!!!!!

Incredible, my husband and I have insurance, medical, dental and eye care, but now that my two children are adults still living at home they can not afford to get sick.

It's just sickening.