Public Healthcare plan would encourage employers to abandon plans

[Robert Maxwell]

That's the typical debt level of people who go bankrupt because of doctor bills they get creamed by co-pays, 20% doesn't sound like much until you have to pay 20% of a couple hundred thousand dollars.

That's the reason for the maximum out-of-pocket portion of the insurance plan. Every plan I've been on or looked at has a maximum out-of-pocket of something like $2000-$10,000 per year. In other words, once you pay that amount in a year, the insurance pays 100%. The only way to get a $100,000 bill is to go over the maximum lifetime benefit, which is usually $1 million to $5 million.

That's a pretty shitty insurance then. Lifetime benefit?

Lifetime caps are very typical in the US. Other than the plan I'm on now, every plan I've ever had had a lifetime cap of $1 million. However, there are usually weasel words in their contracts so they can drop you long before that point if they consider you financially burdensome.

 

[ST-One]

That's the reason for the maximum out-of-pocket portion of the insurance plan. Every plan I've been on or looked at has a maximum out-of-pocket of something like $2000-$10,000 per year. In other words, once you pay that amount in a year, the insurance pays 100%. The only way to get a $100,000 bill is to go over the maximum lifetime benefit, which is usually $1 million to $5 million.

That's a pretty shitty insurance then. Lifetime benefit?

Lifetime caps are very typical in the US. Other than the plan I'm on now, every plan I've ever had had a lifetime cap of $1 million. However, there are usually weasel words in their contracts so they can drop you long before that point if they consider you financially burdensome.

Wow. Another item to add to the list of 'why the US health insurance system sucks'.

 

[SeerSGB]

Apparently the USA is #1 in everything, except anything having to do with governing.

Which makes you wonder: If our govt. is so shitacular, then why are we so adverse to trading it in for a better version?

"It has been said that democracy is the worst form of government except all the others that have been tried."
-Winston Churchill

Someone also once said that the best case against democracy was 5 minutes with the average voter.

The UHC debate is sort of bearing that point out; what with the uneducated fringe on BOTH sides baring their fangs and shouting like they have a clue as to what it's all about beyond a chance for them to make a public spectacle of the other guy.

 

[farmkid]

Farmkid, do you have $10k a year you could afford to pay if shit hit the fan for you? Bear in mind, you very likely CANNOT work extra hard to make up the money, because if you are racking up these bills, you're probably out of work, or severely limited?

No, I don't. But, the previous posters were talking about bills up to $100,000, not $10,000. And, the plans that have a maximum OOP of $10,000 are typically the inexpensive, high-deductible plans that are only useful in catastrophic situations. Also, an amount as high as $10,000 is usually per family, not per individual. The individual maximum OOP is typically 1/2 the family amount. Most plans are in the $2000 (individual)/$4000 (family) to $4000 (individual)/$8000 (family) range. That amount isn't going to bankrupt anyone unless they were already close to bankruptcy. Even $10,000 won't bankrupt anyone unless they were already in bad financial shape, in which case they most likely qualify for Medicaid.

Now, before you come back with instances where what I said is not true, or does not apply, notice that I'm talking about general rules. I'm certain you can find exceptions if you look for them, but what I said is true for the vast majority of those with health insurance. Also, here I'm specifically addressing the contention that even with insurance, it's easy to be bankrupted by a medical emergency; I'm not addressing the larger issues being discussed here.

 

[ST-One]

Farmkid, do you have $10k a year you could afford to pay if shit hit the fan for you? Bear in mind, you very likely CANNOT work extra hard to make up the money, because if you are racking up these bills, you're probably out of work, or severely limited?

No, I don't. But, the previous posters were talking about bills up to $100,000, not $10,000. And, the plans that have a maximum OOP of $10,000 are typically the inexpensive, high-deductible plans that are only useful in catastrophic situations. Also, an amount as high as $10,000 is usually per family, not per individual. The individual maximum OOP is typically 1/2 the family amount. Most plans are in the $2000 (individual)/$4000 (family) to $4000 (individual)/$8000 (family) range. That amount isn't going to bankrupt anyone unless they were already close to bankruptcy. Even $10,000 won't bankrupt anyone unless they were already in bad financial shape, in which case they most likely qualify for Medicaid.

Now, before you come back with instances where what I said is not true, or does not apply, notice that I'm talking about general rules. I'm certain you can find exceptions if you look for them, but what I said is true for the vast majority of those with health insurance. Also, here I'm specifically addressing the contention that even with insurance, it's easy to be bankrupted by a medical emergency; I'm not addressing the larger issues being discussed here.

I think every chronically ill person will now sleep easy with the knowledge that they would have to come up with only 10.000,00 $ year after year after year while also still having to pay for their horrendously expensive health insurance.

 

[farmkid]

Farmkid, do you have $10k a year you could afford to pay if shit hit the fan for you? Bear in mind, you very likely CANNOT work extra hard to make up the money, because if you are racking up these bills, you're probably out of work, or severely limited?

No, I don't. But, the previous posters were talking about bills up to $100,000, not $10,000. And, the plans that have a maximum OOP of $10,000 are typically the inexpensive, high-deductible plans that are only useful in catastrophic situations. Also, an amount as high as $10,000 is usually per family, not per individual. The individual maximum OOP is typically 1/2 the family amount. Most plans are in the $2000 (individual)/$4000 (family) to $4000 (individual)/$8000 (family) range. That amount isn't going to bankrupt anyone unless they were already close to bankruptcy. Even $10,000 won't bankrupt anyone unless they were already in bad financial shape, in which case they most likely qualify for Medicaid.

Now, before you come back with instances where what I said is not true, or does not apply, notice that I'm talking about general rules. I'm certain you can find exceptions if you look for them, but what I said is true for the vast majority of those with health insurance. Also, here I'm specifically addressing the contention that even with insurance, it's easy to be bankrupted by a medical emergency; I'm not addressing the larger issues being discussed here.

I think every chronically ill person will now sleep easy with the knowledge that they would have to come up with only 10.000,00 $ year after year after year while also still having to pay for their horrendously expensive health insurance.

If they have a OOP maximum of $10,000 per individual, as you suggest, their insurance isn't horrendously expensive. Such a plan would also have a high deductible and high co-pays and a low premium. The hypothetical chronically ill person would, if they at all intelligent, opt for a higher-premium plan with better coverage.

 

[ST-One]

No, I don't. But, the previous posters were talking about bills up to $100,000, not $10,000. And, the plans that have a maximum OOP of $10,000 are typically the inexpensive, high-deductible plans that are only useful in catastrophic situations. Also, an amount as high as $10,000 is usually per family, not per individual. The individual maximum OOP is typically 1/2 the family amount. Most plans are in the $2000 (individual)/$4000 (family) to $4000 (individual)/$8000 (family) range. That amount isn't going to bankrupt anyone unless they were already close to bankruptcy. Even $10,000 won't bankrupt anyone unless they were already in bad financial shape, in which case they most likely qualify for Medicaid.

Now, before you come back with instances where what I said is not true, or does not apply, notice that I'm talking about general rules. I'm certain you can find exceptions if you look for them, but what I said is true for the vast majority of those with health insurance. Also, here I'm specifically addressing the contention that even with insurance, it's easy to be bankrupted by a medical emergency; I'm not addressing the larger issues being discussed here.

I think every chronically ill person will now sleep easy with the knowledge that they would have to come up with only 10.000,00 $ year after year after year while also still having to pay for their horrendously expensive health insurance.

If they have a OOP maximum of $10,000 per individual, as you suggest, their insurance isn't horrendously expensive. Such a plan would also have a high deductible and high co-pays and a low premium. The hypothetical chronically ill person would, if they at all intelligent, opt for a higher-premium plan with better coverage.

Suppose they became ill long after they got their insurance and now can't change it because of their illness.
They are screwed under your system.

 

[Mallory]

This would be a good point except that you don't say what your monthly salary is. In this country people pay a percentage. You would have to be earning a helluva lot before the equivalent of $900 was coming out for health insurance.

I didn't mention my monthly salary because it's irrelevant to the cost of private insurance. Whether I make 20K/year or 100K/year my insurance costs will be the same. Health insurance is not based on a percentage of income here nor is there anything that I saw in the proposed plans to make it so.

Fortunately it doesn't have anything to do with optimism... it has to do with motivations.

By your logic, you shouldn't have health care to begin with. After all, why in the world did they ever start offering you health care? The best way to have avoided providing you with health care was to not offer it to begin with.

Because back in the 1980's when I joined the company it was an affordable benefit. Now it amounts to 20% of our total payroll expense. In a crap economy we're always looking to shed expenses, through layoffs or other means.

If you believe that they are looking for an excuse to stop providing you with health care... then you seem to be forgetting that they don't need one.

Never said otherwise.

The reason they offered you health care to begin with hasn't changed, and if they can do it while paying less then you have a better chance of keeping it. On the other hand, their out of pocket expense for your health care have been rising at many times the rate of inflation over the last ten years... so if nothing happens, they're most likely going to drop your health care anyways.

My contribution has also increased at many times the rate of inflation as well. I did point out upthread that I pay 1/3 the cost. When insurance costs rise, not only does the company pay more, so do I.

If you think they'll continue providing health care for you as the cost continue to increase, odds are you are the optimistic one here.

Probably not. But then I'm in a different situation from most of the other posters here. My company is winding down. We're all in our fifties and sixties and willing to accept what amounts to pay cuts in order to maintain our coverage. In another 10 years (at most) the company will no longer exist.

Weigh all the factors involved and see what you come up with if you don't believe me. But don't kid yourself on something this important.

I'm not. Mainly I was presenting a rhetorical argument and, as AJ pointed out, trying to get across the idea that the current plans offer a significant incentive for small businesses to drop their private plans.

Personally, I'll be fine. Medicare kicks in for me on November 1st.