Tag Archives: insurance

How to fix the insurance issue

I have many times complained about the lack of a good insurance and how the republicans chewed up the Affordable Care Act and spit out a lame attempt to shut it down. Here’s my take on how to fix this.

Make insurers cover everything (except cosmetic surgeries) with an 80/20 split and then end the laws that prevent people from being denied medical coverage if they do not have insurance. Fix is simple. No insurance no medical treatment. It sounds cruel but think about this. If someone says I don’t need insurance because I am heathy and it is a financial burden I do not need, they are lying to them selves and anyone who believes them. How many of you have planned an accident that landed you in the ER or worse yet admitted to the hospital? I know I never have. Dislocated shoulder? Nope didn’t plan that one out. Getting hit by a resident at work and sent to hospital for a bite or stitches? Nope that one wasn’t planned either. With incentive like this, who would not get insured? Why would someone risk falling off a ladder and being laid up for months only to never walk again because they decided to forgo getting health insurance hence the leg was never set right. I’m not saying to be mean and cost someone their life because they aren’t covered but make the option of not carrying any more unappealing than it is now. I know people right now who complain and moan about having to carry insurance because they are fit and heathy with no major heath problems and so they don’t need it. It cost too much. Well if everyone carried the insurance premiums instead of only those who really need it the cost would be so much lower. Do the math on this issue. I carry insurance that has a say $300 a month premium. The pay out for my medicine is $450 a month. Add in a doctor visit and the insurance company is losing money. Now picture that you have 10 people paying that $300 dollar premium and only two of us use it on a regular monthly basis. Now the insurance company is bringing in $3000 a month and only paying out $900 Face it, everyone will at some time, for some reason need that insurance. Too much time in the sun? Skin cancer. Playing football with the kids or your bros? Broken leg or messed up knee. Slip on the ice in winter? Back surgery to fix that pesky disc. I had a friend who kept saying he couldn’t afford the insurance his employer offered. He was heathy until he started having problems walking. He wanted to go to the doctor and get checked out but without insurance the $30 copay was now a $100+ bill. By the time he finally could no longer walk or even sit well he bit the bullet and had a CAT scan done and found the worse possible news. He had stage 4 cancer. It had started somewhere and gotten into his bones and worst of all his spine. He lived in agony for many months until God took him home. If he had been able to get insurance he might still be alive. Not getting checked out until it was too late maybe cost him his life. Moral of the story, Just because you feel fine today does not mean it will last until tomorrow.

Another trick in the lawmaker’s bag could be to remove medical bills from being covered by bankruptcy. Go ahead and file. We will still get that $100,000 bill from your heart surgery after the attack. Running did you no good that day. Think of that $100,000 and only paying 20% of it. $20,000. Is anyone from congress reading this post?

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Scapegoat or Scoundrel

Here’s my foray into the world of sensitive politics. I heard it last night at work again and over the last few years many times that people are so mad at Obama for the Affordable Care Act, the so called Obamacare. That name is false though. The bill that was actually pasted by congress and later signed by the president was not the original bill. People forget about all the arguing and political deals that were made to get it passed. Funding was cut and here just last year penalties for not meeting the mandates in it were removed. At least for businesses they were. There was talk that they would also be suspended for the people that couldn’t get insured but I looked on line and found nothing about the penalties being suspended. Hey wait, Why are the businesses being exempted but not the people who may have been banking on the supposed employer insurance? Could it possibly be the business friendly republican congress using the president as a scapegoat to make it seem the plan was flawed from the start? If you haven’t guessed yet I am very much in favor of the plan for health care to be given to everyone. As well as the cost of said plan. You may have been listening to the Supreme Court’s opinion on the tax benefits for states that use the Federal plan. If they had not backed it up and let it be defunded millions of people would have lost coverage. I read the first part of the opinion and I loved the way it was written. They could not believe that congress would have written it to cause a death spiral of insurance premiums intentionally therefore they upheld the ruling to continue funding. There are days I am not so sure anymore. The republicans have said they will do what it takes to get it repealed. There is also a rumor that once it is gone they will seek universal insurance. Last time I looked that one up we are in the very small minority. There are 36 first world countries and we are one of 3 that do not have universal health care. If you are wondering It’s not just Canada that carries this Britain, France, Norway, Sweden, Cuba are just few I know off the top of my head. How long you ask, Norway I believe started just after WW2. That is 70 years of testing get over it. It is also a good side note here that the USA life span is shorter than most of these places. People tend to go see a doctor sooner for problems if the cost is not astronomical. OK back to the Affordable Care Act. I never was able to get a personal policy because of pre-existing condition clauses. I now have a huge medical bill because I had an employer insurance that had a pre-existing condition clause written into it, pre ACA I am sure. That was also a legal way around the ACA and many insurance companies took advantage of it from my understanding and renegotiated the policies before the law hit. Because I lost my insurance from my last employer before getting my current job, I lost the ability to continue coverage for my diabetes. The entire first year the costs were astounding. Each visit to the doctor, every 3 months, was about $250, Lab test were on top of that about $110. The insulin and pump supplies were much worse. The insulin was $220 a bottle with a new bottle every 9 days roughly. The pump supplies were $131 each month. The pump payments were also $131 each month. Let’s see what we are up to now. $220 times 4 weeks (it was just over one week that the bottle would be empty) is $880 plus $131 is now $1,011. Add in the pump payment each month and now we reach $1,142. The doctor visits are only every 3 months so divide that total by 3 and we get another $120 each month for a grand total each month of $1,262. At least I was working overtime then. Without it I would not have been able to afford just he medicine. Scary? I have heard of others who fall into this category even farther where insurance companies are slipping through the cracks created by all the knit picking in congress and leaving Americans uncovered and unprotected from the extreme cost of health care in this country. Here’s more food for thought, ideas that have crossed my mind over the last few months. If they repeal the Affordable Care Act how long before millions of Americans lose coverage for the now covered pre-existing conditions. Did you injure your knee in a high school football game? They could deny it as a pre-existing condition. Are you getting meds for high blood pressure? Don’t change jobs because it is now a pre-existing condition? No way you think. Why would a company miss a chance to save money? I had a foot pain last year and went to see the doctor because it hurt so bad I was having trouble walking. Lis Franc fracture was what he said. It happens in diabetics. That went on his report that was sent to the insurance company. Result was the X-ray, CAT scan, and MRI were denied due to pre-existing condition since it was related to my diabetes. It was not a new injury and I argued with the insurance company that this was not new. I had never had an issue with my foot before. I was told as long as it was shown to be related to my diabetes it was denied  Here’s my thing on this, we need to get rid of all these loop holes and back doors for coverage. You should be covered period. I’m not saying they need to pay for a chin lift or tummy tuck but a possible broken foot? Come on. The Affordable Care Act was supposed to be designed to fix problems like this not create them. It is over 2,400 pages long. I have it saved on a flash drive. I have not read the whole thing yet but I reference it every now and then. Wow 2,400 pages of hitherto and therefore. The last book in the Harry Potter series was only 759 pages. Image reading it 3 times.

Well I’m going to slink off in the corner after upsetting a lot of people with this blog entry. Hey it is my take on things and my opinions. Feel free to disagree with anything or everything I have said. I just hope it makes people think about where our health care is really at today.