John E

For the first time in my life, I am discovering the wild and crazy world of private health insurance. With my employer officially shutting down abruptly, I had a COBRA option for the month of January only and had only a few days to scramble for health insurance coverage. (COBRA goes to 18 months only if your employer is still in business.)

I applied to 3 different companies for policies on 3 people (58-year-old parents and 19-year-old son), and got the following matrix of responses:

self: HN: accept; BS: accept; ABC: decline
wife: HN: decline; BS: accept; ABC: accept + 25%
son: HN: accept; BS: decline; ABC: accept + 25%

Identical medical background information and references were given to all three companies.

Amazing!

rae

What's also amazing are the differences in the lists of exclusions to coverage (the fine print). Be sure you check those carefully when choosing.

I had to self-insure for a couple of years when I chose to work on contingent status, in order to control my schedule (single parenthood). Wading through the choices gave me a headache, even though my choice of companies was quite limited. I opted for just catastophic coverage then--as I was secure in my income & thought I could handle the deductable. Forgot that I would have to pay that deductable every year if something chronic came up--luckily nothing did.

Digital Gee

I"m not following what you mean by HN, BS, and ABC. (I haven't had my coffee yet, either.)

MY insurance company, the folks at Blue Cross, oh, excuse me, now it's "Anthem" Blue Cross, just sent me a notice my insurance rates (for just me) are going up 22% in two months. Or I can pick another plan, with HIGHER deductibles, HIGHER annual out of pocket, blah, blah, blah, and "still continue to enjoy the fine quality of service I've been accustomed to..."

Right.

So I fire up their web site to look at these choices, and they're there, with no explanation of anything. Just click on a plan and they'll move me over. Look at the small print??? WHAT small print???

I HATE insurance companies!!!

DnvrFox

I think HN, BS and ABC are the initials of the 3 insurance companies from whom he got quotes - I.e., ABC - likely equals Anthem Blue Cross.

Rober

I work in a field tangential to the health care "industry" and deal with HMOs all the time. They are heartless, profit-driven parasites with criminal ethics. They are horrible. I hope some day we finally HTFU and insist on universal, single-payer health coverage as a nation. Honestly, do you really have a "choice" of health care providers now? That seems to be most people's objection to a universal system. John, thanks for reminding me to keep up the fight, even in a small way.

Retro Grouch 

Then all of those underwriting people (the ones whose job it is not-to-insure anyone who is going to get sick) would be out of a job. Insurance expense loadings typically run about 40% so it looks to me like we could cut our overall heath costs by 40% if we would adopt a single payer system. That's a huge amount of money! Of course, the insurance companies have a lot of money and they're not going to go down quietly. They will continue to convince many people that the system we have to day makes sense.

Monoborracho

One not so obvious thing....unless health insurance companies gross sufficient premiums to pay the costs of not only you but the underinsured and non-insured, as well as make up the lower cost of physician and doctor fees that are paid by Medicare and Medicaid patients, AND generate a rate of return sufficient to satify their stockholders, they wouldn't even exist.

Unfortunately, working and insured individuals under the age of 65, be they healthy or not-so-healthy, are bearing the burden for a substantial part of the cost of the health system in the U. S.

P. S. I don't work for an insurance company, there are no doctors in my family, I am not on the board of a hospital, and the total cost of insuring myself, wife, and two young adult boys is about $1200 per month.

Retro Grouch 

Excellent point! One of the things I hear all the time is how much more money a single payer system that covers everybody is going to cost us. Hello! We're already paying for everybody. We just won't pay for preventive care. We wait for them to have a catastrophic heart attack so we can pay the much higher ER and CCU costs.

Want to talk about RX costs?

John E

HN = HealthNet
BS = Blue Shield
ABC = Anthem Blue Cross

Three underwriters with three completely different outcomes. My strategy going forward is to keep the Blue Shield individual policies for myself and my wife, even if I am offered group insurance by a future employer. John McCain had the right idea, i.e., that we should separate health insurance from employment by giving health insurance tax credits to workers instead of employers.

Kurt Erlenbach

The waste inthe private health insurance industry is staggering. Insurance companies have legions of people whose job it is to deny claims. Docotr have staffs of people whose sole job it is to get the insurance companies to pay claims (for example, when I was getting chemo, every single one of my twelve sessions was rejected by BC, and sent back for more documentation of "medical necessity." The folks at the doctor's office had to deal with it.) Those people, at the company and the doctor's office, are simple waste and drive up costs tremendously.

I am utterly uninsurable, at any price, due to my illness, which means I cannot change jobs. Universal, single payer is the only answer.

George

On top of being ripped off by them, they get a bonus from uncle sam, with some bail out money to save them. I guess I'm not getting the whole picture.

Bob Nichols

I pay $1,300.00 per month for Blue Cross/Blue Shield. In a little over a year I can get Medicad if they still have it.

Retro Grouch 

The first round of TARP bailouts, Bush's swan song, was unbelievably poorly administered. It's another Katrina only bigger and more expensive. AIG sent their key people on a California spa junket. Wall Street paid their key folks huge bounses. Nobody knows what the banks did with their money because they don't have to tell. Jeeze!

As I understand it the argument for bonuses is that they are necessary, even in the face of poor results, to retain "talent". So where's all this "talent" going to go? Who's going to hire them? "My last company did so poorly that it needed government bail outs, partially due to unfortunate decisions that I made, and cut my bonus. I thought you might be interested in hiring, and paying a big bonus, to a person with my talent."

Digital Gee

Bingo... I agree 1,000%

tulip

I got decent individual coverage with a company called ehealthinsurance dot com. My insurance is with a regular big company, and the deductible is not horribly high. The premiums are quite affordable (I didn't make the best level cut, but just above it). I pay over $800 LESS than COBRA per month. I'm healthy and not yet fifty, FWIW.

DnvrFox

Medicaid is for poor folks, and younger folks with disabilities. MediCARE is for retirees. Medicaid is a state/fedeal program Medicare is a federal progeam.

bikinfool

While am no fan of the current insurance system, and currently carry no health insurance myself, I think part of the problem is our general expectation to have anything possible repaired, or life extended indefinitely, without regard to cost; financially that's a mess right there. If my dad is any example, having been HIV positive for 15 years, having had colon cancer 10 years ago, having had brain surgery 2 years ago and a hip replacement a few months ago (plus a variety of other general medical care expenses). All paid by the taxpayer for the most part via medicare, in an amount far exceeding his lifetime tax contributions; facing an aging and medically spoiled population is indeed challenging whether we're doing it privately or with government intervention.

Retro Grouch 

I totally agree.

Another issue is that people want insurance to cover routine expenses like office visits. That's like expecting your auto coverage to pay for oil changes.

I'll gladly pay for my office visits on the Bohemian EZ pay plan. That's 100% down, no payments. Just give me a discount for the insurance coders and billers time that I'm not using. I still need insurance for the big hits in the event I need surgery or something like that.

bikinfool

When I ask for an appointment with doctors (which I use only as needed, fortunately am generally healthy) the first thing is do you have insurance? When I answer no it's like I'm from Mars or something, similar reaction when I ask for a cash discount which is usually denied except maybe for paying by check instead of credit card. Pisses me off. I never just visited doctors even when I had insurance "just in case" when I caught a cold or the flu or something basic, but know many that do because they have insurance that will pay for it. Doctors and their practices are a big part of the problem as well as the insurance companies; and none of my doctors even offer any kind of ongoing maintenance/preventative type planning. At least I'm quite a bit ahead on my decision not to seek insurance when I was refused continuing coverage at a reasonable rate when my Cobra expired almost 7 years ago.

I don't expect the same level of coverage down the line as the previous generation in any case, and feel sorry for the one behind me...

JohnDThompson 

While that might make sense for someone who is generally healthy, it breaks down with people who have chronic health conditions (e.g. diabetes, COPD, IBS, etc) for whom regular office visits constitute the bulk of their care and help prevent them from needing more expensive acute care.

BluesDawg

So, are we now saying there is no validity to the concept of reducing overall medical expenses through preventative measures like regular checkups?

bikinfool

While I think there's a lot to be said for preventative measures I think most Americans, in particular, are too fat, lazy and stupid to make that mean much. Plus like Chris Rock says there's much more for the medical/pharmaceutical community in the treatment than the cure. Maybe I'm just a pessimist.

austropithicus

Wow, at those prices it's not worth it. I don't have health insurance and instead spend on my health dollars on a gym membership and lots of high quality, organic foods.

I don't think health insurance premiums or healthcare expenses should be tax deductible. There is no reason I should be subsidizing anyone's poor decisions.

BluesDawg

Get really sick once and then tell me having health insurance is a poor decision. People who live very healthy lifestyles get sick sometimes.

cranky old dude

The wife has M.S & Diabetes, both hereditary issues one being an auto-immune disease. What exactly was her poor decision other than residing in this country?

As she's unable to work and not yet dead enough to qualify for dis-ability she's chosen to stop treatments for both conditions as she considers the co-pays for her medicines are too expensive for us to afford on my income. Now I can watch a wonderful person slowly fade away while the rich party on.

There seems to be quite a few cold hearted people responding to this thread who apparently have not had to deal with chronic disease in this selfish money hungry health care system we have.