You Do Not Have Health Insurance

[vinoveri]

Re: You Do Not Have Health Insurance

as to why you were denied, here are my guesses: if you're the father of teenagers, you are entering your dangerous years [and they just keep getting more dangerous] for getting sick with something or other. and your teenagers might decide they want drivers' licenses.

Is this b/c of increasing age or the stress of having teenagers?

[jk]

Re: You Do Not Have Health Insurance

Is this b/c of increasing age or the stress of having teenagers?

pure guess in the first place, but i just had age in mind. the teenagers are also susceptible to sports injuries. they might need acl repairs of their own. who knows? they ran sunskyfan and his boys through their statistical model and thought "who needs the risk?" there isn't much money for them to make selling individual policies in the first place. my guess is that they only offer them at all to meet some regulatory requirement.

the problem isn't the idea of insurance, per se. insurance is a good thing. any homeowners here decided to skip the fire insurance? any parents of young children who haven't at least thought about life insurance? are there any states which allow for auto registration without auto insurance? [i don't know, just asking.]

health insurance, however, is too easily gamed by the insurers. life insurers underwrite their policies- you need a medical exam, but then they have to let you keep the insurance as you age and - in general - accumulate risk factors. they don't get to play with the definition of the conditions under which they have to pay: dead is dead. what is "medical necessity"? lots of wiggle room there.

[bobola]

Re: You Do Not Have Health Insurance

Sunsky,

Surprising that an insurance company would deny you coverage considering that staying fit is an obvious priority.

Someone please correct me if I am wrong here; by denying coverage to the more healthy, who probably will need less health care during their lives, would it be fair to say the insurance company in question is saying no to what is probably a good investment?

I could see the company in question denying coverage to, say, a smoker who is obese, but why say no to someone who wants to stay healthy, and would probably be a good risk?

I myself work hard at staying fit. I eat a good diet heavy in veggies and fruit, no meat, and I get regular ass busting exercise.

What I would like to see is an insurance company that only takes customers who can prove a certain level of fitness and diet consciousness, and would be a good risk. Costs for them would be lower, and they could advertise premiums that would be lower.

Why should I subsidize the many who care nothing about their personal health, or the lack of it?

How about a fat tax? You buy food at McDonalds or Burger King, you pay a hefty tax and the money goes into a government administered fund that pays your health care.

I say seperate the healthy from the unhealthy. Make 2 different health care systems. The public one is for the folks who care not and is funded by their Happy Meals & Big Macs. Call it the Supersized fund.

Make private insurance available only to those who care and take personal responsibility.

[charliebrown]

Re: You Do Not Have Health Insurance

my experiences with h.c.

Left a fortune 500 company in 2003. Got offered COBRA for family coverage with a good plan, ppo with low deductible and out of pocket, cost $900/mo. Ouch imagine coming up with that when your unemployed.

In 2001 worked for a dot bomb that went chapter 7. They were self insured. On the day they went chap 7. I had 20K in medical bills submitted for payment. None were paid. One doctor (evil man...)
reverted his bill from in-network to full retail price when he found out I did not have insurance after the service were performed. Yes I could have sued, but the doc's bill was 2K then reverted back to 4. You can eat up 4k in legal fees really quick, so I paid the 4 k. Some other very nice providers reduced their fees when they heard about my case.

Filed bankruptcy claim form to recover insurance losses. got back roughly 50%. Took 4 years if I remember all right to settle the claims.

Worked with a young guy, in his 30's in good health, non-smoker, had some wierd seizure where he lost consciousness, and was amulanced out of the office. Nothing was ever discovered, never happened again. Left the company to strike out on his own, but could not get anyone to cover him.

Another friend has a daughter with severe allergies and asthma. Lost his job, must cobra at 1000 a month. No private insurer will insure his daughter. Her symptoms are under control with $1 a day in prescription drugs.

That't the real kicker, trying to find and insurer who will pick you up if you have a pre-existing condition. I agree it would be better for my employer to stroke a check for 10k to me, for me to purchase my own insurance, but then you run the risk of denial.

Is this true, or just internet untruth??

http://www.wnd.com/index.php?fa=PAGE.view&pageId=104161

Posted: ffice:smarttags" />July 16, 2009fficeffice" />
8:00 pm Eastern

By Chelsea Schilling
© 2009 WorldNetDaily

The current House health care bill would make individual private medical insurance illegal and obliterate the market for individual coverage, opponents warn.

Investor's Business Daily reviewed H.R. 3200, a 1,018-page bill, and sought help from the House Ways and Means Committee when it stumbled upon the following segment listed under "Protecting the Choice to Keep Current Coverage," in the "Limitation on Enrollment" section on Page 16:

"Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day" of the year the legislation becomes law.

"So we can all keep our coverage, just as promised – with, of course, exceptions: Those who currently have private individual coverage won't be able to change it. Nor will those who leave a company to work for themselves be free to buy individual plans from private carriers," Investor's Business Daily reported.


Section 102(a)1(A)

=====
If it true than the promise that we can keep our existing plans is a is a deception. How many other deceptions are in the 1080 pages? That is why people are afraid. How do we vote for something that is so complex and we are not being told the details. Just trust us, doesn't work, our leaders have lost our trust.

Lets forget about the total cost being 1T or whatever. What is my cost? If I get into the plan and I'm generally healthy, and have a wife and two kids what is my premium? what is my out of pocket? what is my deductable. Is there a cap? Can I see the doctor of my choice, etc. All the questions that one would ask when buying a private policy are not being discussed in the MSM.

Heck if they would say, its just like your private plan. You can buy your employers plan, or buy ours, and if your employer will give you the 10k in salary that they were using for HC, I might just go for it. But that is never discussed. Just a lot of ideology and platitudes from the left and right.

[GRG55]

Re: You Do Not Have Health Insurance

...I hope those in charge of arguing for nationalized health care can do better than this feeble effort.

I would have thought that the onus is on those that are against reforming the current system. The statistics for the USA are abysmal every comparison I've seen. Health care consumes more national income, and the outcomes [including the child mortality rate] are substandard, in the USA compared to other jurisdictions.

Now that the nation's politicians and vaunted financial system can't find another bubble to inflate, the ability to continue with this drain on your economy is unsustainable.

[jiimbergin]

Re: You Do Not Have Health Insurance

They gave no real answer. There was a vague referral to muscular issues. I had knee surgery (ACL because I am physically active staying healthy ) in June 2007 but they did not reference that. I followed up with another letter and asked for clarification but another letter followed with a once sentence decline with no detail.

You should file a complaint with your state insurance commissioner. A complaint must be answered by the company within 10 days of receiving it from the insurance department.

jim

[Munger]

Re: You Do Not Have Health Insurance

"Once you lose your employer-based coverage, for whatever reason, you’re in the individual market, where, you may be surprised to find, you have no right to affordable health insurance. An insurer can refuse to insure you or can charge you a premium you can’t afford because of your medical history. That’s the way a free market works: an insurer would be crazy to charge you less than the expected cost of your medical care (unless they can make it up on their healthy customers, which they can’t in the individual market)."

There are two sides to this point. Put another way, if you live a healthy life style, do not smoke, do not drink to excess, and do not engage in dangerous activities (skydiving for example), you can get much lower insurance rates in the individual market than if you had to subsidize your overweight, smoking, heavy drinking co-workers. "That's the way the free market works."

Yes. Fuck those lazy irresponsible juvenile diabetics, the down syndrome kid and his asshole deadbeat self-employed parents, the blind kid, the cancer patient, the guy hit by a drunk driver who lost his job. Fuck. Them. I got mine.

[thriftyandboringinohio]

Re: You Do Not Have Health Insurance

The average monthly premium for the four similar (although slightly inferior) non-HMO plans we priced were as follows:

single employee = $425
married employee, no kids = $938
married employee with kids = $1,241

That's about what we were paying at our little manufacturing plant last year, $1,200 / mo for a family plan. Company is 180 people. Company pays 2/3, the employee pays 1/3. Business is light manufacturing with a low skill, low wage labor force. Average hourly worker is only making about $9 an hour. So health insurance costs are half that, about $4.50 / hour, just for company portion. And it's a crappy policy with high out-of-pocket requirements. I am still astonished that small business owners aren't screaming to get a public option, the cost of insurance alone makes it difficult to compete globally. For us private health insurance is an immediate 50% additional labor cost.

[Zen$]

Re: You Do Not Have Health Insurance

[i][b]

Yes. Fuck those lazy irresponsible juvenile diabetics, the down syndrome kid and his asshole deadbeat self-employed parents, the blind kid, the cancer patient, the guy hit by a drunk driver who lost his job. Fuck. Them. I got mine.

Welcome to America--it is a dog eat dog country. Nobody really gives a damn about you. Most people are on the make. Behaviorally it is a cruel country in many ways.

Now what would be naive is to deny the fact that the motto of many is "socialism for me, capitalism for you." Example: I pay for your kids education with property taxes but if I get sick--I'm on my own and might even go homeless. Now why should I pay for your kids "right" to education when you tell me to go to h*ll in my time of need? I will probably need that property tax money potentially for my healthcare. In any event you chose to have those kids which are costing me money.

We either need real capitalism (you are on your own) or real social insurance. This socialism for me and capitalism for you is killing this country--oh and the tremendous costs of empire.

Social insurance does not have to be run by bureaucrats in washington--there are other options--but the dummycrats think this is the only way. They are so enamoured with statist thinking that it is stunning.

In the end the "reform" will be unjust, inequitable, and absolutely screw one group. I'm not talking about insurers or doctors but the insured. Young people will probably be the ones.

BTW you need to qualify for medicare through work; its not automatic based on age!

[Jim Nickerson]

Re: You Do Not Have Health Insurance

Welcome to America--it is a dog eat dog country. Nobody really gives a damn about you. Most people are on the make. Behaviorally it is a cruel country in many ways.

Now what would be naive is to deny the fact that the motto of many is "socialism for me, capitalism for you." Example: I pay for your kids education with property taxes but if I get sick--I'm on my own and might even go homeless. Now why should I pay for your kids "right" to education when you tell me to go to h*ll in my time of need? I will probably need that property tax money potentially for my healthcare. In any event you chose to have those kids which are costing me money.

We either need real capitalism (you are on your own) or real social insurance. This socialism for me and capitalism for you is killing this country--oh and the tremendous costs of empire.

Social insurance does not have to be run by bureaucrats in washington--there are other options--but the dummycrats think this is the only way. They are so enamoured with statist thinking that it is stunning.

In the end the "reform" will be unjust, inequitable, and absolutely screw one group. I'm not talking about insurers or doctors but the insured. Young people will probably be the ones.

BTW you need to qualify for medicare through work; its not automatic based on age!

Decent points about property taxes to run the schools whether or not one has children.

I have Medicare insurance which became effective on the first day of the month I turned 65. I think you are incorrect that working and earning has anything to do with eligibility for Medicare. It is likely the qualifications are citizenship and being 65, and that is it.

Social security benefits are work related with regard to quarters worked and the amount paid into the system by you and employers.

Medicare is not free to me or to anyone I don't think, as opposed to Medicaid through which one may be covered before age 65 because of poverty. There may be some provision for those in poverty who qualify for Medicare. My Medicare premium is 96.40/mo, and my drug plan is 30.50/mo. There are gaps in what Medicare covers, and because of that there are "supplemental plans" available through private insurers. I have a supplemental plan through BC/BS of TX for which I pay 177$/mo presently.

The big savings to someone is the amount that Medicare does not deem covered from charges by doctors, hospitals and I'm sure other providers of various supplies. My most recent visit to hypertension doctor primarily for annual refill on my two medicines was 297$ for office visit, a urine creatinine 39$, and a urinalysis $28 which were covered at 90.68$, 7.56$, and 3.28$ respectively. For the total of $364, Medicare approved $101.52, and Medicare paid $10.84, and BC/BS supplemental paid $90.68.

[santafe2]

Re: You Do Not Have Health Insurance

I am still astonished that small business owners aren't screaming to get a public option, the cost of insurance alone makes it difficult to compete globally.

We're too busy working to scream about anything. A public option would help us compete and keep our overhead down.

[monyPro]

Re: You Do Not Have Health Insurance

For those who are interested, the monthly premium for the HMO is as follows:

single employee = $327
married employee, no kids = $653
married employee with kids = $979

The average monthly premium for the four similar (although slightly inferior) non-HMO plans we priced were as follows:

single employee = $425
married employee, no kids = $938
married employee with kids = $1,241

The premiums for your specific company are based upon the employees ages and then averaged to arrive at the monthly cost. If your company had more younger or unhealthy employees the cost could be substantially different.

The young single Male employee is overpaying and the older employees are not paying their fair share of the real cost.

[Jim Nickerson]

Re: You Do Not Have Health Insurance

http://www.nakedcapitalism.com/2009/...ready-won.html

Here's further discussion by Yves Smith "The Health Insurers Have Already Won."

[Rajiv]

Re: You Do Not Have Health Insurance

Jim,

His comment was to "rjwr"

You should shift to viewing the forum threads in "Hybrid" mode. That way you will have and idea as to who is replying to which post. Viewing in a linear mode will get you the post by time, and not threaded -- as the forum is designed.

Rajiv

[thriftyandboringinohio]

Re: You Do Not Have Health Insurance

The premiums for your specific company are based upon the employees ages and then averaged to arrive at the monthly cost. If your company had more younger or unhealthy employees the cost could be substantially different.

The young single Male employee is overpaying and the older employees are not paying their fair share of the real cost.

It's been my experience buying group health and dental insurance plans for a company that they are all pretty closely priced when you adjust for different details, and all too expensive.

Your use of "fair share" is off-base. All young people get old, and it's fair for us to pay something in our youth to get something when we're old. Taking your point to its logical extreme, no healthy person pays a penny more than they use, so it's just a cash-on-the-barrel-head retail purchase system.

If you're unlucky enough to be injured, get really sick, or have a very sick child your life is just ruined, tough luck for you. We need to admit there is an element of luck in one's health, and we'd like to insure against that.

Plus it's inevitable each of us will get old and sick at some point, and wish to have some amount of affordable care without turning over our life savings to the health care industry -not every person, every time. In your proposed "fair" system, only those "lucky" enough to drop dead on the sidewalk would escape the 100% wealth tax at end-of-life.