Health Insurance for me and the kids

[rufflesanddots]

Mmmhmm. Amen, ladies.

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[MDPhDWife]

Yep this is not what I had in mind when I said I wanted universal healthcare!

[PrincessFiona]

Health Insurance for me and the kids

Insurance is the devil. Medicare for all. We need national health.


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Oh dear God. 😱
Besides quality issues and waitlists (think about all of the people who come to the U.S. To get care because they can't in their country ... How will you pay for your pretty house when Chad earns 75,000 a year? Student loans?

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[peggyfromwastate]

This makes me so grateful we have the military insurance for hopefully the next 10 years. Even though dh's pay is 1/4 of what he could get on the outside... I'm going to open an HSA for my kids (especially the diabetic) bc I have no idea how he's going to afford his meds one day. We get over $2000 of meds every month, when you count insulin, ADHD and Tourette's meds, another add med, allergies, and asthma. Throw in the epipens and other rescue meds... It's scary out there. Ds14 plans to marry a girl from the military to help offset his medical costs. 😀. He's totally serious about it too. It's his top priority. (But by that time military healthcare will be all gone too, though, as the powers that be want to shift military over to ACA plans.)

Before joining the military dh made a post tax salary of $24000 a year, with $500 taken out monthly for our (employer subsidized) healthcare plan. The monthly cost was over$1000, and we were taxed for the part the employer paid. ... It was a Cadillac plan we were required to use, per dh's job (local government). This was from 1999-2003 or so that we were on that plan. Insurance has been out of control for a long time...

Sorry for the tangent.

This should not be so difficult. But I really don't want the govt in charge of it. I like the Ben Carson "everyone gets an HSA" free market model. Call me a hypocrite because we are on govt paid healthcare--- but since we are on it I know how unsustainable it is. The military healthcare is extremely expensive to the taxpayers, and there's no way this level of benefit could be given to the general population. It's just not sustainable. We have had NICU stays (over 3 weeks total), surgeries (4 and counting), hospital admissions (2), so many broken bones, ER visit, complete infant workups at the ER, specialty care, physical therapy, colonoscopies... A lot of healthcare.

Flip side... I am sad to think that people are not getting the care they really need, which is obvious from this thread alone, because it's too expensive and they can't afford it.

Only the very poor, the very rich, or those in the military...

Sad.

[rufflesanddots]

I'm not sure where the belief that the very poor get the health care they need comes from. I'm not trying to be combative, but can someone explain that to me? From what I've seen in my job and through DHs experience, the very poor either use the ED (so no routine follow up or continuity of care), or have to jocky for treatment at community health clinics where all the other very poor go, too (so, waiting months for care). DH volunteers at his school's free clinic and they routinely have to turn away people (with appointments) if the pharmacy runs out of a certain med or vaccine. Their chronic health issues are not well managed, they are sick, and maybe they're not paying what most of us do for care, but they're certainly not getting what they need. Am I totally off base here?

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[PrincessFiona]

I can give you an example: Medicaid is for low income families. Kids on the autism spectrum who have Medicaid get significantly more assessment and intervention services than children with any private insurance. In fact, out of pocket costs for families with kids on the spectrum are higher than for any other disability.

Flipside? Medicaid pays shit and providers only accept s certain number of Medicaid patients/mo. If every insurance paid such low rates, people couldn't afford to keep the lights on.


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[ides]

I can give another example. Dh is forced to give free care including surgery to people who can not pay all.the.time.

[rufflesanddots]

What else are they supposed to do, then? I can tell this is a hot button issue, but should those people just not have surgery?

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[PrincessFiona]

Health Insurance for me and the kids

They are having surgery. Our hospital writes off bills of people who are low income. DH regularly treats people with no insurance or Medicare (which pays poorly).

There are whole hospitals established to meet the needs of low-income people. During fellowship, DH did outreach once a week at a clinic that served the poor. They got all free care including medications. My medications aren't free.

UF's dental school also provided free dental care for the poor. At that time, we had to delay dental care because we couldn't afford it.

Our state offers excellent insurance for the poor. We know a family with this who goes to urgent care for every sniffle. Literally. They are always posting FB pics of ER trips (for ear wax in the ears) and surgeries etc. they don't have a $3500 per person/$8000 family deductible and they don't pay co-pays. They abuse the system, while I can't afford an actual ER trip when necessary.

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[rufflesanddots]

That sounds totally frustrating. I've actually unfriended people like that because it grinds my gears. The girl from high school who gets a full set of nails every month and complains her benefits are gone by the 15th? Yup, unfriended because I'm not bettered in any way by knowing how she uses her resources. So, I feel you there. Definitely hard to see.

However, if I am being totally honest, I do the same shit. I've been paying off a $2000 ED visit with labs and a CT scan since January, but it's only taking this long because I'm also going out to dinner, getting my hair colored, going to visit my mom, etc. I know it's different in that tax money is not going to fund my bill + my lifestyle, but the reality is that I CAN afford the medical treatment I need, I'm just willfully not being as financially savvy as I should be.

Not really sure where I'm going with this, except I'd rather be me (technically middle class and feeling the squeeze) than poor and on government assistance, even if I use it however the hell I want. I'll use government assistance if I ever need it, but knowing how its users are viewed and how it can screw over providers, I'd like to avoid it if at all possible.

ETA: I was thinking of primary care and mental health services in my original question, especially management of stuff like diabetes and HTN, geriatric care, etc. I think it also depends on how people categorize "very poor". For instance, there are people in my state who have too much to qualify for Medicaid, but cannot afford ACA. However, even though Medicaid didn't expand to cover them, I'd still consider them "very poor."

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[Vanquisher]

Oh dear God. 😱
Besides quality issues and waitlists (think about all of the people who come to the U.S. To get care because they can't in their country ... How will you pay for your pretty house when Chad earns 75,000 a year? Student loans?

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That's such a defeatist attitude and not what I believe it would look like at all. I just cannot buy into the idea that private insurance is the solution. Medicaid and Medicare are not the same. Not at all. Medicaid is state run and come with a whole other layer of crap that is state dependent. I'll tell you that people on Medicaid here have a very hard time getting treatment.

Medicare has a 3% administrative overhead. They pay out in 14 days. They don't require prior approval for necessary healthcare.

End of life care needs to be examined. We spend most of our health care dollars in the last six months of a person's life.

If they cut Chad's salary to 75K, the US would not have a single physician to take care of anyone. There is a way to do this.


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[HouseofWool]

Health Insurance for me and the kids

I firmly believe that for profit healthcare is immoral. Why should someone's illness line the pockets of a hospital CEO or insurance exec.

There has to be a middle ground of Medicare reimbursing $1500 for a total knee and a private insurer paying $15,000.

Additionally, the providers can reduce staffing because they aren't fighting with insurance companies for authorizations. All of the rules will be identical and people would have nation wide coverage.

I'm positive there is a better way than what we have now. Is it possible that physician pay will go down? Sure. But, maybe the cost of school will be lowered as well so the debt load is reduced.

[PrincessFiona]

Health Insurance for me and the kids

I lived in 2 countries with govt healthcare. Physician salaries are in that range. Of course, they have no student loan debt and litigation is almost non-existent. Those two areas would have to change if we were to go to a national system. Hospitals are also understaffed and are staffed by nurses who earn significantly less than here. There are wait lists for everything. Not every hospital can afford to have an mri, ct, or pet scanner etc. less machines = more wait. Also, best kept secret? If you want to see the best doctors and have less wait time, you buy extra private insurance.

We live right below Canada. We get patients all of the time who come here for care that they can't get at home. Also, we get plenty of docs coming down to earn American surgeon salaries.

Medicare pays crap.

And I can't wait for the death panels outcry when someone addresses end of life care spending.


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[rufflesanddots]

Isn't that the secret now, though? Those with more money will always be able to pay for access. That is already happening.

[MAPPLEBUM]

Hey Mapplebum! Life after training is pretty close to how the ladies here described it would be. I joked that we were moving from hell (112 degrees in AZ on moving day) to high water (tropical storm had just blown through our new city in TX). DH's licensing paperwork got severely delayed so although he was supposed to start work on 8/1, he didn't actually start until 9/17. While it was nice having him around while we worked on small projects on the new house we bought, we blew through our entire nest egg plus some. It's incredibly frustrating to have "made it" and feel broker than ever. I keep reminding myself of what the ladies here had always said about the first year out of training being one of the hardest. Really though I'm not gonna complain too much because the hours so far (only 1 week in) are amazing and I know the money will eventually follow. Your DH is a senior this year right? Is he still planning on applying for a fellowship?

Wow I bet it was great to have him around that long! Probably the longest break he'll have until retirement! Money will certainly start coming in. What kind of practice has he joined? Or is he at a medical center?

Yep mine is in his last year, applying to surgical retina fellowships. It's hard to believe he could actually be done with training if he wanted to...I try not to think about that. Congrats and good luck in your new life!! I'm sure it'll great.