Thursday, April 24, 2014

Grateful for Health Insurance

From List Crunch 10 Best health Insurance Companies

Yesterday the boys had their monthly visit with the psychiatrist. Yes I had to lay out the money for the visit, but I know that I will at least be reimbursed somewhat by our health insurance company. We are lucky. We have a good plan that covers, medical, dental and mental health services. And no, it is not cheap....anything but. In fact we have been paying out of pocket monthly for health insurance for almost two decades now. Where we live had one of the highest premiums in the country until Obamacare. Ironically according to some actuarial maps I saw on line, New York premiums should go down since Obamacare. (NY and one other state is the only places in which that should happen.) Also the requirements of health insurance policies that Obamacare put into play for the nation is nothing new to us. If you live in New York, those requirements have been de rigueur for decades. Ironically, even with health insurance we have accumulated that "autism debt" that will never really go away.

FYI- this isn't a riff on Obamacare. As I have written before, there are many aspects of Obamacare that I really really really like. Allowing my sons to stay on my insurance until they are 26 is great. Not preventing people from getting health insurance due to pre-existing conditions is great (considering I am the parent of children with a myriad of medical, as well as mental health issues, this is a Godsend). Not being able to deny someone coverage because of autism is great (having witnessed on-line friends being denied health coverage because of their children's autism this is a very needed provision).

My problem with Obamacare is that they left out provisions that would have made it cost effective for the average person. It was the Washington DC gambit of not listening to the other side of the aisle, allowing competition and really creating a workable system. Obamacare ends up being unaffordable for most middle class families. The average policy will cost a family of 4 in the neighborhood of  $1200 to $1500 a month. Considering the average family household income in the US is near $50,000, who can afford that? (Granted they may be able to receive a government subsidy, but they also have high deductibles and copays out of pocket.)

Most people (approximately 8 million) who lost their private insurance have decided to just pay the penalty. It's really cheaper. (This is on top of the number of approximately 40 million who had no insurance before Obamacare.) These people decide to hedge their bets that they will not get drastically ill and for everything else (well care) their cost benefit analysis says its cheaper to pay out of pocket. Not certain that is true, but its up to the individual to decide for themselves.  (Most who have signed up are those who had been receiving medicaid to begin with and would receive subsidies by the government. Truth is that we don't really know the true numbers of those who have paid their premiums since the government refuses to release those numbers).

The idea that POTUS told people to give up their cable and cell phones to have healthcare when he and his family have one of the best healthcare plans in the nation all paid for by the American taxpayer was just plain chutzpah. Note: I have done without my entire life in order to have health insurance. So Obama is not necessarily wrong that responsible people do without certain luxuries in order to buy necessities. Its just galling coming from someone who is a millionaire, who doesn't have to pay for his own insurance, and who didn't sign his family up for his own healthcare plan. Remember he only signed himself up.

Truth is that what we need in this country is truly affordable healthcare. There is no reason that we should pay more than Canadians for the same medications. There is not reason that to save your life you have to go bankrupt. MRGS was in the hospital for influenza A and strep the beginning of February. He was there for one day in the emergency room. Happily, the insurance company paid most of the bill, which came to over $3000 dollars. I also just received an additional bill for one of the doctors from that day for another $600 (insurance will pay some of that bill as well). But what if you didn't have the copay? What if this was a really scary illness like cancer or emergency surgery (not that influenza A doesn't kill.)? How would you pay that bill then? Listen, it's not easy to pay those emergency medical bills even when you have insurance.

Obamacare was supposed to do something about these outrageous hospital bills. It did not. From what I can see everything is just getting more and more expensive. From psychiatrists, to meds, to therapists to even general yearly well-visits. Is national healthcare the answer? Actually we already have that. It's called medicaid and medicare. Sadly, Obamacare, destroys the successful medicare advantage program that my mother has been on since she aged into the program. I am truly concerned about what is to come for her.

Additionally, no hospitals in my area will take insurance from any of the Obamacare providers in New York State. There is a dearth of doctors who will honor the insurance as well. The government repayment is so low it doesn't pay for the doctors or hospitals to take patients from those insurance programs. It literally would force them into bankruptcy. What good is insurance if you can't use it to get medical care?

Meanwhile, these are the most efficient healthcare systems in the world HERE. In order to fix our problems we should follow their leads. Granted they are much smaller nations than the USA. But there has to be some ability to extrapolate what they do and apply it here. Even if, as has been the prevailing reality since the inception of our nation, the individual states remain responsible for healthcare within their borders.

Anyway, today I am truly happy that I can afford health insurance for my family. I do not know what we would have done for the boys over all these years without it. 



Elise