Question of the Day

Update: Bumping this thread to the top again. Thanks to everyone for so many thoughtful answers.

Update 2: Metafilter has linked to this discussion and has added some interesting insights and commentary.

Update 3: Posting it at the top for the weekend.

Where do you get your health insurance from? And if your answer is “through work,” where did you get your health insurance if you have ever been laid off or out of work for a significant amount of time?

In 2002 I was laid off and I picked up COBRA (allows you to keep your insurance from your former employer for a limited time, but at your expense and providing your old company still exists) at a cost of about $400 a month. Hell, $400 a month isn’t an extra bill you want when you are drawing a regular paycheck, nevermind when you’re on unemployment benefits which is just a bit more than half of what you were making (and don’t forget taxes). And $400 is cheap according to other stories I’ve heard from recently laid off friends. One relative of mine is paying well over $700 a month for health insurance while her unemployment quickly dries up.

What are your insurance stories Cynics?


  1. I can’t wait for the day I have to go forth and venture for insurance. I graduated from college in May and can’t even land a friggin’ job at McDonald’s here. So I currently have no insurance, no job, and no ticket out of South Carolina.

    I’ll be looking back to this post for the ideas of others.

  2. Ugh. My company laid off all the workers and brought everyone back as contractors (advertising agency). Of course we were doing the same jobs we were before but without insurance and with smaller wages.

    Ive been without insurance for 3 years now. Its no fun. Anytime I do anything around the house I’m always aware of bankruptcy awaiting me if an accident happens. Cleaning the gutters…I could fall, working in the garage…. I could cut myself, driving to work…. what if i get in an accident?

    I’m hoping that by the end of fall i’ll have some bills and loans paid off and gone so I have the extra income every month so I can get insurance.

    ONE DAY, ill have the luxury of the rich, which is health insurance.

  3. I get mine through my wife’s work. Luckily she has very good coverage. I am a co-owner of small company. The only employees are us owners, and my partner gets insurance through our company. Best quote we got for coverage of a family of 4 in an HMO type plan was $1700 a month, which went up from $1000 we were paying. My partner switched to another type of coverage, but with a high deductible. It’s cost is still outrageous.

    I have never lost coverage. It would be very tough if we did.

  4. I moved overseas (2nd world country, seemed to have enough money for universal healthcare, even for non-nationals). Then came back when I found a job.

  5. Right now I’m fortunate enough to have health insurance through work. Honestly, I don’t know if I’d still be at this job if it weren’t for the benefits.

    But for nearly three years I paid for my own insurance, with huge deductible, copay, and out-of-pocket expenses (not to mention the monthly fees). Basically I purchased insurance only in case something really terrible happened. Of course I got sick during these years, but only went to the doctor if I felt on death’s door. One trip to a clinic to treat a sinus infection with some antibiotics cost me over $500.

  6. My insurance plan is to hope I stay well enough to not need medical coverage. It involves a lot of denial and delusion regarding my existing conditions. Part two of my insurance plan is to someday be able to emigrate to somewhere more livable than the US.

  7. The last time I had insurance was 5 years ago when I was a grad student at OSU. After graduating, I couldn’t afford insurance offered through my employers. I’ve been unemployed since November and I can’t get any coverage on my own because of a pre-existing disability.

  8. I have private insurance which doesn’t cover that much but its something. It costs me about 250/mo and covers about 1/3 the cost of office visits, 80/20 major stuff with a high deductible, and drugs are basically full price.

    I got it a few years ago when my wonderful ex-boss cancelled our insurance through work because it was costing him too much and according to him threatened to put his business under and take our jobs with it. A woman at work who was pregnant at the time got her insurance cancelled and that cost her an extra 10K when she had the baby. This after he fired the janitors and made us clean our workplace for free after hours, even after 12 hour shifts back to back, in another cost-cutting measure.

    Funny thing was right after the draconian cost-cutting, job-saving measures were in place, my ex-boss bought himself a 900K house, a million dollar commercial space in another city to expand his business, a new Cadillac for himself and a new Ford Explorer for the wife, and a month long trip to Europe. I have my own business now.

  9. Right now I get ins through my wife’s employer’s plan because it’s cheaper than my current employer’s plan (location MA). When I was laid off in 2002 I bought a catastrophic coverage plan with a $10000 deductible for a short period of time before moving back to Canada where there was a 3 mo waiting period. Since then, I have moved back, and MA has instituted mandatory coverage so if you can’t get it through an employer and you’re not already poor, you’ll be driven poor paying the monthly premium.

  10. Now I have it through work, but from November 08 through March 09 we winged it (wife’s company doesn’t offer insurance any longer and my teaching (union) insurance expired in March – we didn’t sign up for the monthly “emergency” WPS insurance). I’m of the opinion that if you don’t think about not having health insurance, nothing will happen to you … as reckless as it may seem.

    The best insurance I had was as a graduate teaching assistant at a university. Not only is it government (surprise!), but there was a TA union … it was fabulous. My wife and I got some stuff taken care of we wouldn’t normally have done.

  11. Oh, and I have a career plan to get back into government when/if we have kids explicitly to have better/reliable health insurance. Small companies change health care frequently … it’s maddening.

  12. I live in Canada at the moment, so my health insurance costs me $44 a month. Regular doctor visits are completely covered. I have additional insurance through grad school to cover all the extra stuff like dentist visits and eye care.

    After I graduated undergrad, I was still in the US and lost my insurance that I had through my parents. I did have the option to pay to extend my parents’ insurance, but it cost over $700 a month. I didn’t have any income and had a lot of student loans. I was without insurance for a year before I moved to Canada. I got very sick during that year and was stubborn enough to not go to the doctor because I didn’t want to pay some ridiculous amount of money for it. I really should have though since I still have some lingering ear problems from that time.

    So, the solution to my problems – move to a country that has waaaaay better health care…. for everyone.

  13. Canadian. Whatever my doctor thinks I need, I get for free.

    Question for the Americans: If you have to go to emergency for something, do you have to pay upfront? This is a bizarre notion.

    Even stranger is that there’s actually people in your country who are against universal health care.

  14. I’m part of the AdultBasic program in PA….I pay a small amount per month for Highmark Blue Cross/Blue Shield.

    Because I’m a lowly substitute teacher struggling mightily to find a real teaching job, I qualify for the requirements (which is essentially earning next to nothing, pay-wise).

  15. I manage a car dealership, we are unable to provide to provide insurance as it’s cost prohibitive. I make use of the short distance to both Juarez and Palomas Mexico where I have any dental or other health concerns addressed.

    I literally risk my life for affordable medical attention.

  16. I dont understand the Neo-con Jesus freak Republicans. Their teachings in the bible speak of helping those less fortunate and giving to the poor and sick and they completely drop the ball on this matter. Doesnt that go against everything that Jesus teaches? I guess Jesus would be a liberal Socialist since he traveled across the land giving people free health care as he performed his miracles?

  17. I’m Canadian.
    My employer pays the OHIP premium to the government on my behalf (the $44 a month that the previous commenter stated) and my employer picks up the “upgrades” (semi-private room, medication, optical, dental, naturopath, massage therapy etc) on an external plan that is still less than $400 a month per employee.
    I do the payroll, so I know that depending on the age of the employee and how many dependents are on the plan…it costs our employer anywhere between $240 to $320 a month per worker.

    I’m still puzzled as to why all Americans wouldn’t want the same if not better for it’s citizens.
    I understand why Doctors wouldn’t want it because they’d have a cap on their salaries…that’s the gripe that some Canadian Doctors have. But, hell…they still make a great living

  18. The company I worked for was the subject of a hostile takeover (“hostile” in this case making the Hatfields and McCoys seem like a petty disagreement). In the end, I kept my job, but it was very very iffy for a while. Because of that, I got my own health insurance. Folks who did not make the transition did not have Cobra as an option, and the original entity ended up going under, with all the assets being purchased by the takeover company.

    My insurance premiums went from $70/mo to $150/mo (I’m a single male). Since that time (7 years), though, it has doubled again. Oh, and the same year my premiums jumped $100/mo, my insurer (BCBS of NC) spent over $1million for a VIP tent at a gold tournament. Of course, I was not a VIP so I could not take advantage of it…

  19. It doesn’t help those with pre-existing conditions, but affordable insurance is out there. I pay about $165 a month for a major medical plan with Blue Cross/Blue Shield. 80/20 plan with maximum out-of-pocket of $5000 a year. I see a lot of folks bitch about insurance while driving fancy cars and living beyond their means and making absolutely no effort to acquire private insurance. Major medical plans are cheap and they protect against the kinds of health problems that will bankrupt a person. Today, what we call insurance is not really insurance, it’s compensation. True insurance insures against unexpected situations and expenses. The average cost of having a kid is about $8000. Real insurance would insure against costs associated with complications, not the base cost.

  20. @damron,

    What happens if i’m 50 years old with a previous heart attack and lose my job as well as my insurance? Do you have any clue what that would run me a month? The chances that my genetics would hurt a companies bottom line is too great of a risk for them to take.

  21. My daughter worked for an office supply store, & had no insurance. She had begun to have severe headaches almost constantly and finally broke down and went to the ER. A CT scan showed that she had a pituitary tumor that was HUGE (7 centimeters…not MILLIMETERS) (she’s 26, married and at the time, working only part time as was her husband) Her health insurance benefits finally kicked in about 15-20 days after she found out about the tumor. She was able to make appointments with the Endo and Neuro Surgeon. She was able to get the surgery, spent 5 days in the ICU and has since recovered…. With a $130,000 bill they’ll never be able to pay. Her health insurance was limited to $3000 per calendar year. I’m thankful that she got the surgery but it’s bullshit that she has to pay $130,000 on top of that.

  22. I had a rough time finding a job after grad school, so my parents gave me individual-policy health insurance for Christmas. It was about $100/month (I’m young and in good shape), and while the coverage wasn’t great and the copays were high it was enough that I could afford to go to the doctor once in a while and keep up my birth control. And I wouldn’t go bankrupt if I ever got hit by a bus.

    Since getting a job my insurance costs will go up, but the coverage is much better and now I can afford to pay it myself and go back to sweaters and DVDs for the holidays.

  23. I’m lucky, I’m a Brit,
    Healthcare comes straight from taxes and the total cost averaged out comes to ~2000 GBP per person per year. At current exchange rates that is ~3400 USD.
    With Healthcare running at around 18% of Government spend I am probably contributing ~1400 GBP out of income tax. Considering taxes on income make up 38% of the tax take I am just about pulling my weight.
    Also, having been a customer of the NHS , I can say that it is a very effective service.

  24. I don’t have any. My kids are on K-Chip. My disabled husband is on Medicare. He was getting Medicaid to pay the part B and D premiums, but since he married me, we lost that because I make so much money blogging.

    I took my three daughters to the eye doctor for glasses, then the dentist for a long-overdue checkup. Both docs asked when I was going to get my eyes and teeth checked. Probably never.

  25. Kelsey, you’re right about the bizarreness of it all. And regarding those Americans who are against universal healthcare, you wouldn’t believe the things they’re saying about those countries that DO have it, in particular Canada and the U.K. From the lies and half-truths they’re spewing, any country with universal healthcare automatically euthanizes any patient above a certain age (read: senior citizens) or anyone whose treatment would be “cost-prohibitive” for the plan. The healthcare situation here is scary as fuck, even WITH insurance. I’m only thirty-five and I constantly worry about how I’ll pay for medical care when I’m older.

  26. I paid $250 out of pocket for a consultation that I’m not even going to for 2 weeks.

    Health insurance what health insurance?

  27. Oh yeah, insurance for my family, if I could buy it, would cost over $1,000 a month. That’s four kids and two adults over 50, one with a pre-existing condition. And it wouldn’t cover much.

  28. Mick and Woj – I am the operations manager of private urgent treatment clinic, so I know a bit about the dynamics of public and private healthcare insurance.

    I certainly wasn’t defending the status quo. It is unfortunate that the debate has become so polarized that the merits of private and public plans can’t really be evaluated with any civility.

    The question addressed our individual situations. I described my own situation and commented on my disdain for many people that can be economically insured yet choose to spend their money elsewhere and bitch about not having any health insurance.

    I have access to a gold-plated plan through my employer. My employer lets me take home $3.24/hour * 40 a week in cash if I don’t opt for their plan. If I had a pre-existing condition or if other options were not available or economical, I would take my employer’s plan.

    As I mentioned, the private sector would be protecting their own interests if they addressed the issues of pre-existing conditions and policy portability. Many group plans are must-issue plans, they have to accept pre-existing conditions. There is no reason that individual plans can’t be more accommodating.

  29. I think it needs to be said that many people that are against universal government healthcare ARE NOT endorsing the status quo. The status quo is horrible. I just want a little more honesty in the debate.

  30. We have Blue Cross Blue Shield through my husband’s business. It is not as super awesome as our previous plan through Medica.

    When he was freelance for 6 months in 07, we had Cobra.
    We have two kids, so it was 1,100 a month. Yuk

  31. Back when I was between jobs, I wanted to find out how much it would cost to get private insurance. I’d had it a few years before, and figured I could afford it. But I kept getting turned down by every insurance company I applied to. So I called a broker. His first question? “What prescriptions have you filled in the last 2 years?” Well, in the 18 to 24 months ago range, I’d filled one single Wellbutrin prescription. About a year before, I’d filled one single pain script. The broker laughed, and told me that no insurer would issue me a policy at any price.

  32. Dear cynics,

    I live in a former Yugoslav republic. We were thrown back in time 25 years because of several wars in region in the last 20 years. After that we became quite poor and corruption is everywhere. Our prime minister just resigned 10 days ago (probably blackmailed by mafia). Punch line is that I was in surgery cause of motorcycle accident, 7 days in hospital and currently on physiotherapy and Im not paying a dime extra besides my regular monthly government health tax. You guys need a bit of Chavez…

  33. We can take the $3.24/hr cash post-tax or apply as much as we want towards an employer plan, pre-tax. The cheapest employer plan is $240 a month, but that is a full coverage with a very small co-pay and no deductable. I use about $0.20/hour to pay for short-term and long-term disability.

  34. I am diabetic and use an insulin pump, which requires a small tube change every 3 days. After a brief insurance scare, where I was denied coverage, I started getting a prescription for just slightly more than I use. I now have about 6 months of spare equipment backed up in my basement and plenty of extra insulin. That way if I am suddenly denied coverage of this very expensive equipment, I have about 6 months to get it straightened out, (rather than risk my life by rationing insulin).
    Thats my insurance story – you have to cheat to live.

  35. @ davetheslave – nice.

    I’m currently on Japan National Health Insurance. It costs about $175 a month (it changes depending on your annual income, I make an average salary), and I pay 30% for all treatment/medication.

    I thought it sucked until I read the horrific rates commented above. Good luck Americans in America!

  36. I was in the US Navy for 5 years ending in 2007. If I felt sick, I showed up with my ID to “sick call” and I would probably get some ibuprofen and get sent home for the day. I even received braces and jaw surgery, elective procedures, for free!

    Fast forward to now. If I feel ill, which I haven’t yet, I can stroll down to the VA and, presumably, receive more ibuprofen FOR FREE. What’s more “socialist” than both of the actual scenarios I just described? HAH!

  37. My husband has the military Tri-care system. It doesn’t cost much a month now, I think it’s like $24 a month, can’t remember. But when he retires in a couple of years that same insurance will cost almost $400 a month. It is a good plan if you don’t have anything wrong with you, but if you do it can take months to get it figured out. Right now my husband has back problems and is waiting for a letter to come down to get permission to have a MRI done. It has taken over a year to get this far. The military won’t hesitate to Motrin and Pys. Therapy you to death but above that they will try to kick you out.

  38. I also don’t get the conservative backlash against national healthcare. I swear I just heard something on the air this morning from some such person that thought there was nothing wrong with the American Health Care system as it is. WHA? Anyway.

    Neo cons use religion (without necessarily being religious) to tap into that part of the American population who is easily motivated by it, such as being against abortions.

  39. There is no easy answer. Blue Cross/Blue Shield could write an 80/20/$5K policy for every single American for about $200 a month with Medicare/Medicaid type fee schedule. If you get enought young and healthy people paying into the pool, affordable private insurance is possible on a national scale. My solution would be a government voucher to citizens to pay for private plans and have the government concentrate on prevention and wellness clinics as well as a solution for catastrophic cases.

  40. I’m not currently covered. I haven’t been to the dentist’s office in about 5 years, I recall being told something about fillings that would have to be done later. I’ve got wisdom teeth coming in now, the first one just got done pushing through my gums, it was pretty lame barely being able to eat for 5 days. Last time I went to the doctor (about 3 years ago, piggybacked on a relative’s visit to the family physician) I got a clean bill of health, so here’s to hoping that doesn’t change anytime soon. As soon as I get coverage of some sort I’m planning to see an optometrist first, I think my vision is going slightly bad.

    I completely agree with the other posters lamenting the controversy surrounding the prospect of universal healthcare in America. Money talks. The people who have something to lose if everyone gets access to free medical care have quite a bit to throw around. The majority of us who would benefit the most don’t.

  41. Luckily my family all are in Canada. Health care is really not a problem. I admit people complain about wait times, but having to wait for 10 stitches while more urgent cases are rushed ahead seems reasonable to me. I think people just like to complain about health care.

    I had surgery on my sinus cavity and the time line was short – from seeing the specialist (4 months) to surgery (3 weeks) and follow ups at 1, 3 and 6 months respectively. My cost was approx $30, for 2 prescriptions and a lot of gauze.

    The biggest problem we are having up here is all the new Med. School grads head south, for the money and “Melrose place” hospital scenes…

    I have nothing against the US, but you couldn’t pay me to live there now (Though I did for a couple of years in the 90’s)

    I really hope the citizens realize the opposition comes from the health insurance companies. They are making the politicians rich. I think things would change in a hurry if the senators and congressmen paid a proportional amount of their salary as the average Yankee…

  42. I am disabled because i have bipolar very bad and I can not work because If i work at all i would get to much income to qualify for Medicaid and then i would lose the benefits of Medicare that is even if I where to work only one hour a day i would make 200 and lose over 20000 dollars in healthcare coverage

  43. Through work. My boss just graciously bumped up his contribution and put in a small accidental death and long term disability insurance policy free to us.

    If I lost my job I’d get it through my husband’s or start charging enough for freelance to pay for cobra.

    Fun fact: My husband and I “shacked up” for 6 years before marriage. I was able to be covered by his policy at work through the domestic partner laws put in place for gay couples.

    Another fun fact: My husband’s mom thinks Obama is ruining this country because if we get socialized healthcare they won’t treat her for anything because she’s too old… Which is different from our current system where your insurance company can decide not to cover you for no reason whatsoever.

  44. I’m a Canadian. One thing for certain, you can’t believe the horror stories being thrown around by the right wing in the US about Canada’s health care system. As an example the woman in the ad claiming she would have waited months for treatment in Canada for a brain tumor has been completely discredited here. Basically if she’d gotten a second opinion or referral to a specialist she would have been treated in the same time or less than she did by going Stateside. Plus she probably got her entire treatment paid for by the good people of Ontario where she lived. In the Provinces that charge for medical coverage it’s usually less than $100 Cdn a month for a family. You can get extended care coverage for a little more & most company plans allow for extras like ambulance coverage & private rooms if you want to pay a bit more. For all my “benefits” I pay about $125 a month & that includes 90% prescription coverage, 90% dental for the basics, 50% for specialties, $250 a year for optical, life insurance, AD & D insurance etc. etc.
    Make the change & enjoy the difference. No one anywhere, least of all in one of the “richest” countries in the world should have to endure what you’re enduring in terms of health care.

  45. This thread scares the crap out of me. Right now I’m very lucky: government contractor, my company pays most of my fantastic insurance leaving me to cover about $25/month. I pay about 20% of medication for the few times I have to go to the doctor, and the rest is “free.” Maximum per year cost to me is $500.

    While I was in college I had to cover my own, and even at 25 in great shape I was paying $120/month for, basically, not to have to declare bankruptcy should I require an emergency room visit. Which was fortunate the time my throat closed up during an illness. I think i ended up shelling some $5,000 out of pocket for the two hours I was there (10 minutes of actual doctor time, 1hr 50 minutes of sitting in a room waiting to see if the treatment would work.)

    Speaking of, anyone bitching that we’ll get silly wait times if we go national health care clearly have not been to an ER in the last 20 years. My brother cut his fucking finger of and had to wait 9 hours for someone to have a look. He even has great coverage. Our system is broke as hell and everyone seems to be worried about the things that ‘could be’ without noticing that they already are (except, of course, we’re paying through the nose for this shitty service).

    Also, I know for a fact it takes 6-8 months to get knee surgery from the time you are told you need it to the time your insurance company lets your doctor know it’s covered plus scheduling the thing etc, etc.

  46. I’m German, and part of the majority who have mandatory insurance through being employed and earning under a certain sum.
    I currently pay 7.5% of my gross income for insurance while my employer pays another 7%. All insurances charge the same base rate but they can levy an extra fee from me (not from the employer) if they don’t get along with the money – but if they do that I can switch to another insurance.

    You read that right, insurance premium here is dependent on your income, not your health status.

    If I lose my job, at first the (also mandatory) unemployment insurance pays my premium for a year, and the government after that.

    While you can go without insurace here, it requires an active effort on the insured person’s part.

    Coverage I get for the money:

    -Free pick of any MD I want. I have to pay 10 Euros every annual quarter to a practise I visit unless I have a referral from another MD.
    So basically when I go to my practitioner, I pay 10 Euros. When I then go to, say, a cardiologist I pay 10 Euros again unless my practioner hands me a referral. Both will not charge again until the next annual quarter no matter how often I come back.

    -When I get a prescription, there is a flat co-pay of 5 Euros for any one drug.
    If the practise and drug copay rise over 1% of your annual income or if it is to treat a chronic disease, you can have it waived.

    -Free pick of a hospital, just tell the doc which one you want if you have a certain preference.

    -Spouses and children are insured along, with no extra pay. However if the spouse or kids take up work they automatically pay the insurance premium too.

    -Waiting times, the Big Issue Of The Health Care Debate:
    To see a particular, very popular specialist you may have to wait two or three months to get an appointment. If a less popular specialist will do, a week to a month.
    Hospital stays / Surgery: Depending on severity and type of treatment, between zero waiting time and two weeks. Random example: An eldery woman I know was diagnosed with age-related hydrocephalus and needed a shunt installed – she waited 8 days from diagnosis to surgery.
    ER: Depending on severity, other patients and mood of MD’s, zero to three hours.
    -Dental: Basic coverage, no copay for tooth fillings but replacements are only covered about 20%. Cheap additional insurance for the remaining sum is available too, though.

    -Preexisting conditions:
    Not an issue because it is mandatory as long as you are dependently emloyed. So Twain, come over here and get job that pays you less than roughly 42000 Euros a year and there you are.
    If you earn more or are self-employed, you can still get to be a ‘voluntary’ member and they can’t chuck you out. But you pay more.
    Or you choose not to and basically do it American-style with private insurance, which is often cheaper… until you get sick of course. By then you can’t easily return to the womb of employe insurance so many don’t do provate.

    -Treatment by an MD:
    Because most are insured anyway, and there’s cheap insurance for MDs to be had for the few people who are uninsured and won’t pay themselves, treatment anywhere is a relaxed matter concerning money. The doctor knows that he’s going to get his money one way or the other so there is no hassle with people badgering you for insurance details.

    I can’t say its perfect, and it certainly has its sucky moments. Of course it sucks to drag along the smokers, drinkers, idiots an other self-endangering folk. But compared to the U.S. system it is practically paradisical. I paricularly adore the fact that no matter how sick you get, no matter how long, they cannot drop you, and they can’t charge you more.

    Also, this isn’t socialized healthcare as in UK or Canada. The insurance companies are non-profit organizations but they are all independent and not run by the government, although the health care sector is heavily legislated.

    BTW: New legislation this year means that people who need treatment after getting a tattoo or another unnecessary body modificatiion have to pay that themselves.

  47. Used to bartend, which I loved, but gave it up for health care. I hadn’t had it in ten years.

    For those against national health care, I see your point of view. “When do we stop?” you ask yourselves, “federally mandated pedicures?” It can seem extreme to you, paying for others’ misfortunes, or bad habits. Some “sick” people just drain from the system, gorge themselves on McDonald’s, cigarettes and vodka, and you are not paying to stitch them up and send them out on the streets.

    But (you knew a “but” was coming), look at it from a libertarian businessman’s point of view. If it’s an insurance company’s job to bet that you won’t get sick, it’s a terrible bet to make. If there’s one thing that is going to happen to each and every one of us, it’s a visit to the doctor. Whether it’s for an appendectomy, the birth of a child, a car accident or cancer, we’re all going one direction and that’s into a hospital.

    What I’m saying is that you can’t run a business betting that people are not going to get sick. The overhead is insane, the liability insurance usurious, the drugs worth their weight in moon dust.

    The only way to do it is to charge gold-plated premiums, or, that old standby, deny, deny, deny.

    If you believe, as many do, that the federal government should only pay for what the private sector cannot handle, you can see for yourself that health insurance cannot be handled by the private sector.

    One other thing: At the turn of the last century, people used to pay for fire insurance. If a fire fighter showed up at a house that didn’t have its company plaque on the door, they’d watch it burn. Fine, fine, until people realized that it’s inhumane, and much more importantly (that’s tongue in cheek there, folks) oh yeah, other people’s houses caught fire. If you let the sick stay sick, you live in a cesspool of your own creation.

  48. i must be the grey duck of the group. my employer isn’t too large (300ish), but provides a self insured health plan that’s better than what i’ve read above at least… have the option of 3 plans, only 2 attractive… the more expensive one better if you have dependents, the less expensive one better if you’re single (cheaper and better catastrophic coverage), co-pays for prescriptions ($15 i think) and urgent care ($40 maybe), $4k deductible, in patient you pay 20% till you hit the deductible (out patient you pay something too, can’t remember what it is), $1 million lifetime cap. I pay $23 per month. Family coverage with dependents around $200 iirc.

    Company is in the technology sector, self insured so rates have the risk of volatility… but we’ve had our share of babies and major illnesses, whoever is managing it is doing it right.

  49. I’m lucky. I live in So. Cal and have Kaiser Permanente. I’m on Medicare, and with Part B, I pay about $280 a month. I have excellent coverage, low co-pays for both doctor visits and medication, no cost for tests of any kind. I have easy access to specialists, and can’t be cancelled. In the past I have been without any coverage, paid extremely high percentages of my income for not much insurance, and a whole lot of money with very high deductibles when my husband had his own business. I fear we won’t get a single-payer option for a long time, and think it’s down-right unAmerican that we have so many people uninsured and underinsured. And yeah, I condemn those so-called Christians for denying care that their religion demands they give.

  50. Canadian: I may a monthly sum of $44 (cover emergencies and doctor visits- mostly), my current employer offers full benefit coverage insurance (eyes, teeth, scrips, etc… even some alt. med). New job starts on friday: I’ll pay more for only 80% extra coverage because it’s a smaller and newer co.

    Not bad, but once I left my parent’s coverage I wasn’t able to afford those pesky dentist visits for several years before I had an employer that offered benefits. That’s the most common complaint from people (post school age) around here, if their employer doesn’t offer it, they go without. Not that I’m complaining.

  51. Another Canadian here. Full health coverage through my husband’s municipal employer, so over the past 20 years we’ve been paying 20% of prescriptions and roughly 1/3 the cost of any orthodontic work for the kids, which will only total something like three thousand bucks I think. Over the past 20 years, I’ve had two somewhat complicated pregnancies and deliveries, was diagnosed with Crohn’s disease and my husband had a complete workup for cardiac disease since there is a history of it on his side of the family. (thankfully, he came out looking pretty good) Oh and my son was born with congenital scoliosis, which meant several visits to specialists and x-rays every few years but it looks stable and you’d never really know it unless you realise one shoulder dips a little more than the other. My son was in the ER today for some scheduled minor surgery to his foot, all he needed to have with him was his BC Care Card, not my credit card!

    The only time we’ve even come close to some kind of serious money being owed to a hospital was this past spring, when during a trip to Hawaii, I had a run-in with a sea-urchin and came up second best. For the twenty minutes I sat on a hospital gurney in the Kona ER, was treated with a warm blanket and some vinegar to help dissolve the spines (plus a tetanus shot because I had a couple of open wounds as well from jagged rocks), we were billed something like $550 bucks US. Don’t get me wrong, the service was great but I have to say it was huge relief to know that my husband’s insurance also had a pretty damn good travel component to it, so outside of a couple of stamps and two phone calls, we were completely covered.

    Not sure I’d even want to know what life would be like if we had to make a decision between good health care and paying the bills….

  52. @AJ Is there anything else, besides your heebie-jeebies that you object to? Because I respect your opinion, but because “I hate it” is rejected by many as being totally puff-ball old-manishness. Give us something to work with, please.

  53. I’m Canadian – my health premiums are currently deducted off my paycheques by the government but when I was making less than $16,000/year I didn’t pay anything and I got 10 free appointments/year of chiropractic, massage therapy, or physiotherapy. Even now I get a lot of my deductions back as a tax rebate every year.

    I’ll admit that sometimes I’ve had some pretty long ER waits, but at least I never had to worry about payment or clearing it with my insurance company first. And everyone I know who’s had serious heart problems or cancer has received thorough and speedy treatment.

  54. My school requires us to have health insurance to register for classes. The student plan is $800 per semester, which works out to ~$200 a month. I thought I’d try for some cheaper insurance since I don’t work, so I applied to the state medical assistance program. I qualified and started getting coverage, but there is a transitional period shortly after you are accepted where coverage is “optional” for a month. The state claims they sent a letter to notify me to pay my premium if I wanted coverage for the transitional month. I didn’t get the letter; I don’t know what happened to it. In the interim, excited to finally have some health care, I made a long-overdue psychiatry appointment to be tested for ADHD. At the end of the month I got another letter from the state saying that I was denied coverage for the interim month. This means any bills I incurred during that time were going to be my responsibility. The cost for the psychiatrist appointment turned out to be around $2700. I requested an appeal meeting with a judge, but she affirmed the state’s choice to deny me coverage (not surprising with recent budget cutbacks). The only reason I qualified for the state plan in the first place is because I have no income, so I don’t really see how they expect me to be able to pay the bill. I called the billing department at the hospital and the girl on the phone said, “Well, don’t you have any friends or parents who can help pay it for you?” I realize there are a lot of people whose parents pay all of their expenses while they go through college, but this is not the case for me, and I would never ask my friends to pay my medical bills; it’s just not their responsibility.
    In the five or six years before I started going back to school I worked and carried no insurance. I managed to see a dentist once during that time and he waived the fee because he is an old family friend.

  55. I live in Australia. My wife was diagnosed ten years ago (in her late 20s) with a heart condition which will need surgery probably within the next 12 months.

    Five years ago we went out to get insurance for her. We chose a company, filled in a form and got it. End of story. None of this pre-existing conditions BS you get in the US; the insurance companies are not permitted to do that. Nor are they permitted to charge us any more than anyone else, nor cancel or change the terms of the insurance when we actually have the audacity to make a claim.

    And had we been unable to afford the insurance (which comes out to about US$150/month for our family) we could have had exactly the same care through the national public insurance system for nothing. The only reason we are paying the extra is so that we can choose the doctor who will perform the surgery.

    I can’t understand why Americans like their health insurance system. I lived in CA for several years and it was frankly terrifying. In a civilised country like mine people basically do not go bankrupt due to health care costs; just doesn’t happen.

  56. I’m Canadian. The MRI wait is about 3 months. It’s free. I just had trigger finger surgery from a plastic surgeon. Free again. My brother had an aneurism start to leak and they fixed him right up. Years ago when the doctors here couldn’t figure out what was wrong with him, they sent him to the Mayo Clinic in the US, where they did brain surgery. Free. He gets a new knee in a few months. Free.

    We pay for our pharmaceuticals, dental, and eyeglasses.

    I’m 50. I can go to the doctor when ever I want. My neighborhood is on the wrong side of the tracks and it’s full of walk-in clinics. People here complain about waiting lines and over crowded hospitals, but I gladly put up with the wait. If I get sick, I go to the doctor or the hospital. And it hasn’t cost me a dime my whole life, and I’ve never lost a moments sleep.

    Health care in Canada was brought about by a socialist politician. He convinced the conservatives it was great idea, and in a rare moment of clarity, they agreed. Ain’t democracy grand?

    I love Canada.

  57. I’m Canadian. Currently underemployed part time and taking classes. I haven’t had to pay for anything. It is likely paid through a progressive income tax system. I still appreciate the ability that I was able to get an ACL replacement without declaring bankruptcy.

    To any American legal and political buffs: The Canadian health care system started in the province of Saskatchewan and spread from there. Why hasn’t one of the blue states attempted a socialized health insurance plan and let its popularity grow? Would the Supreme Court rule that a socialized health care plan infringes on interstate commerce and is that the reason why this has to be tackled federally?

  58. Thank God I live in Australia.

    When I travel overseas, I only have to get the top coverage (most expensive) travel insurance if I go to war zones or the United States of America.

  59. No insurances here in Italy Chris.

    I give you a translation from wikipedia about our national health service:

    The Italian National Health Service is a public system of universal character, which guarantees health care to all citizens, financed through general taxation and the direct revenue, collected by local health centers from the ticket to health (ie contribute to the costs of medicines) and performance pay. Through it is given effect to Article 32 of the Italian Constitution, which enshrines the right to health of all individuals.

  60. Okay, I am so ready to move to Canada.

    Yes this is a rant. I am still so angry about this so do forgive me for being harsh…

    I have been without insurance about as much and I have had it and frankly I don’t notice a difference in the horror story of trying to get treatment. I finally gave up working soul-sucking jobs just so I could have it, because even when I had it I could not get treated.

    You hear about the discrimination against African-Americans – try being a woman who doesn’t want to get pregnant. I suffered with a benign fibroid that was making me bleed almost to death (I had to take iron constantly) for 6 years because I would not say I wanted to get pregnant. The FIRST question you are asked is “Do you plan to get pregnant?” OB-“gyns” will not treat you unless you want to get pregnant. Seven doctors in three states over six years and I had to threaten suicide to get doctor #7 to operate. That was WITH health insurance. I repeat – I HAD HEALTH INSURANCE!!!

    You know what that doctor got paid for the TWO surgeries it took to get that thing out? $600.

    I refuse to pay for insurance anymore. It’s pointless. My husband and I found out that you can bargain with the hospital when you tell them you can pay cash – but MAN do they jack the bill up! They tried to charge us $2500 for a x-ray, 1 hour with the doctor and a cast for his broken arm which they didn’t even set properly. 3 hours on the phone and we got it down to $600 which was still freaking ridiculous.

    We plan to emigrate to Canada eventually. We’re just saving up to do it. I have friends who rave about it constantly. I HATE our health “system” bitterly and unreservedly.

    To all of you who hate the idea of socialized medicine – choke on it. Try living with a painful bleeding tumor that you can’t get out even WITH insurance because the doctors won’t get paid! Try losing 6 years of the BEST years of your life, almost losing your husband because some bastard in our government thought that it was okay for insurance companies not to pay for a woman’s health unless she was PREGNANT! TRY IT!!!

    I’ll take socialized medicine, get our decent doctors who give a shit back into practice where they are protected from frivolous lawsuits and I’ll HAPPILY pay another 10% of my income so that no one would ever have to suffer what I did!!! You think the “horror stories” of socialized medicine are bad? I lost six years of my life FOR NOTHING!!! Oh but if I was a man with a tumor on my friggin prostate, or a polyp in my intestine – immediate response!!!

    1) I was told it was normal for an overweight woman to bleed heavily. I told them it wasn’t for me. Nor was the burning, crippling pain and the sudden change in my ability to go to the bathroom.

    2) Every one of those doctors gave me sonograms and spiral CT’s and found a 10mm shadow on my cervix – and said it was nothing. Turned out it was the stalk to which my grapefruit sized tumor was attached.

    3) When my anemia was so bad that my hair was falling out and my skin developed open sores I was told to see a dermatologist. And to keep taking iron. They could do nothing about my memory loss.

    4) when it finally got to the point where I was bleeding EVERY DAY I was told this was normal for overweight women. I yelled at that particular idiot that it wasn’t normal for ANYONE to bleed every day, even a skinny bitch like her. (Needless to say I had to find doctor #5 after her may she rot in hell)

    5) I pointed out to each doctor that I could feel a big lump in the lower part of my belly. I was told it was a cyst and that overweight people frequently get them – go see a dermatologist. (See a theme here?!?)

    6) The number one treatment I was prescribed? Various forms of the pill. For a tumor.

    Shall I continue?

    All of this humiliation and suffering because they knew they would not get paid because I did not want to get pregnant.

    Tell me again how our system is so much better.

    Thank you for reading my rant.

  61. I have nothing and have had nothing, insurance wise, for far too many years now. When you are already barely getting by with no luxuries in life, the idea of paying hundreds, if not thousands of dollars more for health insurance is laughable (though I feel more like crying).

    I even did the military thing once but when I went to apply for VA benefits years later, I was told that as a Reservist, I had not done enough ‘active duty time’ to qualify for any health benefits. Nice-they sure didn’t point that out when I first signed up.

    I’m originally from Michigan and EVERYONE I know there is struggling due to the economy and going without the even the most basics of health care, due to cost. People I know and care for aren’t going to the doctor when they need to, are treating eye and dental care like luxuries that they have to go without, and dangerously halving or quartering the ridiculously expensive medicines they really need, just to get by.

    The trailer park that I briefly lived at last year to save money, had so many people with the scariest teeth and dangerously ignored health conditions I have ever seen, shy of third world nations’ slums. I saw case after case of obvious substance abuse and/or mental health issues that went untreated until the person just ended up arrested and imprisoned. It was like a huge health care refuge camp right here, in the middle of a major west coast city. The ER (or corrections system) was basically everyone’s default provider, there.

    I just want to STRANGLE anyone who goes on a tirade about ‘socialized medicine’. You are a tool that doesn’t know the facts and are just reciting glib talking points quoted from those making the most money off the current health care chaos. You have your own health insurance, lucky you, so screw everyone else, eh?

    My only contingency plan is to take care of myself as well as possible and hold out that something will change. I have had to use the internet to self-diagnose several (fortunately mild) conditions and purchase medicines overseas (at far cheaper prices, even when the meds are made here!?!) for self treatment. I personally have had to ride out dangerously high fevers, do limited ‘self surgeries’ such as lancing a boil myself, and used over-the-counter stop gap measures instead of going to the doctor when I should have, and I know I am NOT the only one.

    The U.S. is sadly fooling ourselves that this is anywhere near sustainable, for much longer. I had hope with Obama being elected but I fear that there is just too many big-money interests behind defeating any real change, like how single payer was “off the table” from the start.

    My life is literally in jeopardy here in a money buys access system. I unfortunately don’t make much money, never have and probably never will. I am still a good person and a good citizen that doesn’t deserve to suffer and live a shorter life due to lack of health care access. Basically, if things don’t change soon and substantially, I will have no other choice than to move to Canada where the health care system apparently puts people before profits.

  62. American. I have health care through my work — bc/bs of PA. It has a $2500 deductible per year, which makes it cheaper for when I’m not using it and also means that I don’t get care for much unless I want to pay for it or am expecting the total bill to top $2500. I have personal savings for th $2500 part. It works, in practice, like this: for little stuff, I don’t get care. For big stuff, I get care after I front $2500. I don’t have drug coverage or dental or vision, so those are out of pocket.

    I’m posting partly because I had a hysterectomy due to massive fibroid cysts a couple of years ago. I went to my GP and complained of excessive menstrual bleeding. Excessive. Like to-my-knees excessive. It was gross.

    On 11-15-05, GP did a pelvic, said OMG, your uterus is huge. Sent me (same day) to get an ultrasound, the which I did.

    11-16-05 GP called with ultrasound interpreted. Said it appeared benign, made me an ob/gyn appointment for me for 11-29-05.

    11-29-05: Saw ob/gyn, discussed options, inquired about scheduling for surgery. He said he’d get back to me.

    12-6-05: Pre-op appointment.

    12-9-05: Surgery.

    12-11-05, evening: home from surgery.

    I did not “want to get pregnant” and in fact ended up having the baby-making parts totally removed. One does not need to be pregnant to get an appointment with an ob/gyn nor does one need to *want* to get pregnant for same.

    Resolving massive fibroid cysts with significant bleeding issues DOES NOT always take a million years as it did in poster Julia S’s experience. Sometimes it takes about a month.

  63. As an international student in Australia, I pay $297 US dollars a year for private insurance that covers everything except dental, optical, cosmetic surgery, and some prescription medication costs.

    If I wasn’t a student, I would have to pay $606 per year for a reasonable private health insurance plan.

    Alternatively, if I choose not to get private insurance, I would have to pay the 1.5% tax levy and would be covered under the government’s universal healthcare system (which isn’t bad).

    It’s quite a good system, I’m surprised you don’t hear it mentioned more often in the current US health care debate.

  64. free in my place for everybody(taxes), now they are trying to take out those rights to inmigrants, and they are trying hard to privatize social security.

  65. When my first child was born in 1999 my wife quit her job to stay at home with her. My company is small (5 employees) and we got insurance through her work. We got a policy for $400 a month and the deductible was $2,500.00. SO we were already out about $7,000.00 before any of their charges kicked in. So I had to pay an entire $2,000.00 emergency room visit bill because it didn’t cover that under the deductible (which was a moot point because the hospital in question was not in their “provider network”, so I would have had to pay anyway).

    The wife went back to work (for a subsidiary of Blue Cross) and we’ve had a second child in the interim. We pay close to $600.00 a month for insurance and her company kicks in $400.00.

    The wife wants to quit work again to stay home with the 2 year old full time. We looked for a private policy and for $750.00 a month we can all get covered with a $2,500.00 deductible. So we would be out $11,000.00 before health coverage will cover anything.

    My idiot conservative friends (many who got through college on government student loan programs) who scream FREEDOM! Mel Gibson style to the rooftops say I should get a job at a larger company to get benefits. Yet I like my job and don’t want to work for a large company. Is that Freedom?

  66. It’s appalling that the Richest Country in the Worldâ„¢ cannot and will not care for it’s citizens. These stories are heartbreaking. It seems to be accepted as normal that sickness will bankrupt you.
    Canada has had publicly funded health insurance for over 40 years, and we haven’t spiralled into an evil vortex of Communism and revolution.

  67. I’m a Canadian girl living in Ontario, in my early 20s with a common law husband who is a student. I pay a grand total of $7 a month for 80% coverage of prescription drugs/dental/chiro/massage/etc. I can buy a new pair of glasses up to $200 every two years. There are a few other benefits sprinkled around there, things like coverage for therapy, etc.

    The rest of the cost of health care, things like hospital visits, getting bones fixed, cancer treatment, heart transplants, etc, are paid for via taxes, which at my age and with my current salary amounts to about 25%, and I often end up with a refund come tax time.

    The comparison to fire fighter insurance is very appropriate here. Yes, I hate losing a full quarter of my paycheck to taxes, but honestly I wouldn’t ever want to live in a place where someone could be bankrupted for something that’s not their fault at all – such as if the person was mowed down by a drunk driver. Or the person gets cancer.

    I mean, you guys have to PAY to have babies? WTF?! How does that in any way benefit your society as a whole? You would think that having to pay for babies means there would be less unwanted babies and more babies birthed by affluent or rich people, but that’s certainly not the case at all. One may also think that not paying for babies means people would pop them out like it’s going out of style, but that is ALSO not the case, in fact our birth rate here in Canada has been dropping for years now.

    The for-profit system in the States is shameful and not at all in accordance with the concept of “life, liberty, and the pursuit of happiness”. Please tell me how someone with tens of thousands of dollars in medical bills can have a happy and free life.

  68. Insured through my work: My premium is $100/month for my wife, our child, and me. We pay $30 on top for each doctor visit.

    My last job cost me over $400/month for about the same service.

    Someone asked about emergency hospital care in the US. Unfortunately, I’ve experienced that twice in the last decade. The waiting rooms are typically full of uninsured patients who are there for non-emergency treatment that they know they can get for free at the expense of the hospital.
    What I did upon entry was make it very clear to the staff that I have insurance so it may help me (or my child, in one case) get in for faster treatment– money talks. Then, after treatment begins and things are stable, a hospital staffer comes and asks for payment of any copay (I had to pay $250 on my plan).
    However, if I had no insurance or no means to pay any of it, it would have been free, just like the uninsured people. My insurance subsidizes the care of the uninsured.

  69. Oh, let me throw in how much is costs to have a baby in the US:
    We planned on a ‘standard’ birth that ended up in a c-section. This led to a three night stay for my wife to recover. Bottom line (wife’s expenses only– none of baby’s expenses in here: over $14,000. No kidding. Our insurance covered the vast majority of it, but c’mon…

  70. I currently have very basic care from my employer for ~$80 a mo but I am in favor of universal care b/c of this situation:

    3 yrs. ago I was a recent college grad, working full time as a temp at my current employer plus part time at a hospital laboratory. I was also an Army reservist. None of the jobs OR the military offered health care at that time. I was assaulted and the guy broke my arm, it required surgery. I waited almost 24 hours to go to the ER, praying that it would just “go away” because I had no health care. It cost about $20grand AND I lost my job at the hospital because of the injury.
    And my stupid gun-toting supervisor has the nerve to call me a “liberal hippie”. ?!?!?!

  71. I’m a healthy male in his early twenties. I get health insurance through my job. It’s a minimal plan which I have “just in case”. I pay ~$20 a month. Each time I visit a doctor, I pay a $20 co-pay. I had blood work done, which would have ended up costing me $230. Insurance took care of all of it.

    I live in the US. I guess I lucked out?

  72. @Milo,

    I guess I lucked out?

    Just don’t lose your job…. Or get an injury or problem where your great insurance starts denying claims. And you might want to stop aging.

  73. Great post Chris. I was thinking about writing about this topic, but it emotionally upsets and exhausts me when I think about it. Maybe that’s why I really need to write it…

    Anyway, long story short. I pay for my own health insurance and my monthly premium just went up to a little over $400.00 a month. *sigh*

  74. Okram, uninsured people do not get emergency care “free” by any means. The hospital will try to get you on Medicaid if possible. If not, they will work out a payment schedule. If you have property or wages, they will attach it. They will sue you. Medical debts are the most common reason for personal bankruptcies in the US. If you are completely indigent, you might get written off, but only after all other possibilities of making you pay are exhausted.

  75. Just got back from the hospital to see my dad. He was admitted to hospital because of a complication with a trachea. Exactly 1 year and 1 month ago he suffered from a catastrophic heart attach. He was resuscitated and had a quadruple bypass performed. During resus, his trachea was damaged. Since then he has been to visit the doctors atleast twice a week and on average spend a week in hospital for every three months (1 quad bypass, 6 Throat surgeries to clear his trachea). His monthly medical bills are about 300-400 AUD a month.
    Medicare (Australia) picks up 90% of the medical bills, and anything above $1500 AUD per year for medications (Medicare safety net). Only major expense we have incurred was for a throat reconstruction surgery @ Brisbane, as the specialist was not available in Melbourne. This was done privately and it cost him approximately 16,000 AUD. Because of the Medicare safety net he will be able to claim at a later date.

  76. I get mine via my job, which happens to be with a Jesuit university. They offer three types of coverage and I opted for Kaiser Permanente which I’ve been reasonably satisfied with. If I were to lose my job, I’d have to sign up on my husband’s dreadful Blue Cross plan, which is scary to ponder. Once I finish school we’d like to relocate to Canada. Not just for the healthcare, but that is a very powerful incentive. The US still not having single payer is a great disincentive for us to remain here.

  77. I am an “undecided” about this healthcare reform issue, but I would like to just ask people to stop picking on the Christians and Jesus. If you read the Bible, Jesus teaches us to “love our neighbors.” To me, this means that families and communities should help each other, not that we should depend on Big Brother Government to help our neighbors. Therein lies the distinction. Many Christians you will find give money and their time to charities, often through the churches they belong to. It is more common to find food pantries and clothing offerings than medical assistance, because naturally you need some expertise to treat medical conditions. But the problem here is not the Christians who try to follow Jesus and minister in their communities and around the world.

    I have a friend who grew up in a small town with no running water or electricity. They had a doctor in the community who treated people for what they could afford. And families would help other families in a crisis. Believe me, I appreciate the convenience and the life-saving technology available now, but I think there must be some kind of middle ground between communities pooling together to have a school and a doctor, etc., compared to government controlled everything. Do you even know who your neighbors are? Do you really care about them? Jesus’ point is for ME to make a difference in other people’s lives, not for me to depend on the government to make a difference in people’s lives. Seems to me that Jesus is more of a grassroots kind of guy than Democrat or Republican.

    FYI, I get insurance through my employer (small non-profit in NY state). It costs the company about $400/month to insure me through a small business association. That would more than double (?!) to add my husband, and I would have to pay the difference. My husband is a student (and job hunting) and has a minimal policy through the university.

  78. Rachel, I really don’t think health care for the 40 million uninsured is possible through charity. And if it is, it sure won’t be equitably dived on either contributions or distributions. Maybe you can think of the taxes as forced charity.

  79. I don’t have a burning desire to share my story, but what the heck. Here’s another data point from a well-insured individual:

    I have always worked for very large companies and selected the plan with the highest benefit levels. Over the years, benefits have significantly decreased, and costs have significantly increased. With the latest company I joined, it has made a good rebound.

    $600/year for medical. I put aside $2,500/year in a flexible spending account for out-of-pocket medical/dental costs. All of this is in pre-tax dollars.

    The medical plan tells medical providers, “We’re a huge insurance company. We send tons of customers your way. But there is a cost for this. When you send us a bill, we’re going to pay you incredibly low rates for your services. Thanks for letting our company only pay for $500 for two MRIs that you were trying to soak us for $3,000.” They negotiate all bills down by such an incredible factor, I sometimes feel guilty that the poorly insured or the uninsured are charged so much, and that providers are paid so little to work on me.

    The medical plan (similar to a PPO) tells the insured (with large amounts of complexity removed for your reading benefit), “No deductible. Pay your copay for whatever visit ($15, usually). Most everything is 100% covered. Some cases (surgery, hospitalization) are 90% covered. Maximum you would ever pay out of pocket in a year is $1200. But the catch is, you can only go to our in-network doctors, hospitals, specialists, etc. But you can see whoever you want in the network at any time, no authorization required. Go out of network, and you’re screwed – no benefit at all.” #1 tip: be careful with who gets to work on you, or you can pay the nice non-negotiated rates for services.

    Pharmacy benefits aren’t that great, though. 50%-80% coverage based on a complex series of rules. There are different tiers for different types of medications and how long you’re on them, etc etc. Co-pay is capped at $40-$80 for a 30 day supply, again, based on complex rules. Not so hot if you have expensive medications, but otherwise, good.

    This really is a good plan on the medical side (not as hot on the pharmacy side). Little things are covered. Big things are covered with a cap on the out-of-pocket costs. Maximum per-person benefit of $1M, I believe.

    What is the unexpected downside that I discovered reading other people’s stories? From now on, if I don’t work for a major company, I am screwed. I have taken advantage of the medical benefits and I have a nice trailing history of pre-existing conditions and medications over the years. There is no way I can get a personal policy or a small group policy. If I don’t work at a large company, I simply don’t have health insurance.

    So even though I have great benefits, I have to say, I’m all for any kind of health care reform. The system is just screwed up, and I’m just a layoff away from disaster.

  80. I am a 43 yr married female. Having just left my job to start a business, I am on COBRA ($400/mth, $200 deductible), but have been preparing to pay my own insurance. The most cost effective plan I have available to me is $600 month with a $5000 deductible. And I have to structure my business differently to get this. Otherwise I might qualify for 2 plans (and they might deny me that coverage).

    My husband’s plan will not cover any dependents. This is only legal because they have made their own insurance company and can make their own rules.

    I had my own insurance 10 years ago as well when I was freelance $260/month and they covered very little. They would not give me maternity coverage, because I was not married (therefore would not need it in their judgmental, conservative eyes) I can olny imagine what the cost would be then.

    I would welcome a universal plan. Medicare is a great example of it a working system. I had a disabled partner on it. The only time his coverage got messy was when they gov’t privatized the RX. Talks about red tape. the plans would constantly change and you had to switch each time to find one to fit your needs.

    And if you think the insurance companies have no red tape? I have had to call mine monthly for the last 7 years to fight for my coverage (United Healthcare). They deny claims for no reason constantly. In comparison, my dealings with the IRS has been nothing short of pleasant, intellegent conversation with results.

    My husband and I have had serious discussions of emigrating to a country with better health care.

  81. I’m 29, male with graduate degree and self-employed. I’ve been uninsured for four years. Since then, I’ve had four grand mal seizures requiring ER visits. I owe like $30K. The medicines which keep me seizure-free cost $180/month from a regular pharmacy, but I signed up for state-subsidized health care when I was unemployed for a spat.

    I’m still getting cheap meds from the county hospital, and I go there when I need care. Unfortunately, I am due to update my file with them, and since registering, I’ve been managing OK work-wise (despite all the medical debt that I’ve been ignoring). I expect that I’ll lose my subsidized prescription and have to pay out of pocket, which I think I can manage.

  82. I have health insurance through the Veterans Administration because I served in an Army MASH unit some years back.

    And if I didn’t have V.A. health care then I’d be well on my way to dead by now because when I served in that medical unit I apparently contracted hepatitis C by being stuck with a needle in the O.R. Guess what? Regular insurance now refuses to cover me and I am flagged in the system so I can never get temporary disability insurance or life insurance any more – because I am no longer a potential profit center any more.

    But the V.A. covered me because it was free for all Vets. And they cured me completely (after 60 thousand dollars of chemo for a year). That’s right – I have no virus in my system any more and I am healthier than ever quite frankly.

    But other people who got this are not so lucky because Blue Cross or Kaiser or Aetna will turn them down and they will eventually die of liver cancer and waste away before that.

    This isn’t the America I signed up for and fought for.

  83. I moved to England, Pay load more taxes but don’t worry bout being stuck without insurance. Ive only used it for a tetnes jab in 6 years, but not terrified about being without it now.

  84. @ which_chick

    Yes I see your point – but you had opted for the hysterectomy. If I had opted for that I would have gotten “cured” faster. However I also did not want my health ruined early in my life by removing something that did not need to be removed.

    The three options I was given to stop the bleeding (which I did not mention in my previous post) were 1) hysterectomy 2) shooting boiling water into my uterus, thus “cooking” it and ruining the lining and 3) the pill to control my hormones.

    Because I would not opt for the hysterectomy I was shuffled off. They get paid for those. They do NOT get paid for leaving your plumbing where it belongs.

    I may not have wanted to get pregnant then – I didn’t say I NEVER wanted to get pregnant. I also did not want to go through instant menopause at 30.

    Hysterectomy is NOT health care! In some case it is, but in the case of fibroids, even one coated in them can be saved by a surgeon – IF THEY GOT PAID FOR IT!!!!

    The point is – we should be able to get the treatment we NEED not what an insurance agent thinks is a good monetary risk. Doctors have NO freedom to do what is best for the patient – only what is best for the insurance company.

    Hysterectomy may have been the best thing for you – and I am sure you are incredibly relieved by the procedure. You were lucky you did not have to wait. But approx 75-85% of non-cancer related hysterectomies are unnecessary.

    I am not the only one who went through this:

    The point is – the guy next to me in my office had a polyp in his intestine. He had it removed without having to have colostomy.

    Why am I told I have to have my reproductive organs removed for a fibroid?


  85. Another Canadian here. Same story as above Canadians. Our dog was sick recently and having to make medical choices for her based on what we could afford to pay was awful. I cannot imagine making those choices for a child.

    And yes, there’s waits for some doctors and procedures. But I have personally witnessed a number of incidents where, if it’s a serious problem, you get immediate care. For example when my Mom was diagnosed with cancer, a radiologist and a nurse were brought in specifically for her on a holiday (Good Friday) so that she could start radiation in the hopes of shrinking the tumor and regaining her mobility. When it’s most needed, it’s definitely available. When it’s not as urgent, you will probably wait. Overall it works well.

  86. Oh, I read the Times article, before you posted it, even. Hysterectomy=bad. Hysterectomy rates in the US are criminally high. Blah, blah, blah. I did rather a lot of reading during the approximately two-week period between ultrasound and ob-gyn visit.

    Going in to the ob-gyn visit, I was aware that there was a groundswell of “Woodsman-spare-that-uterus” sentiment taking hold in this country. And, in point of fact, despite my pro-hysterectomy views, my doc pitched me the myomectomy (cut the lumps out, keep the uterus) option on the grounds that my thirty-five year old self would want babies “later”. (No, it would not. It does not. It will not ever.)

    I’m not sure why your ob-gyn didn’t offer you that option, but mine did. I didn’t mention the myomectomy option because I was not particularly interested in it as a treatment. However, since you’ve raised the question — yes. My doc offered that to me as an option.

  87. My absolutely deplorable New Zealand socialized medicine works like this:

    Doctor’s/specialist/office room visits: charge
    Pharmaceuticals: charge
    Dentistry: charge
    Glasses: charge

    Emergency/Acute health care at hospital: Free
    Ambulance: Free
    Surgery: Free
    Accidents: Free
    Birth: Free (but do pay for doctors, medication, extraneous outside of the actual birth procedure)

    We have insurance in NZ, but it’s all optional – you use it if you want a) choice of health care provider b) private care c) bumped to the front of the line.

    The problems with our system are waiting times and underpaid/underappreciated doctors/nursing staff. HOWEVER, when it comes to red tape and medical mishap, I’d say our system is way less faulty. With no insurance, I can walk in off the street and be seen immediatly, even if it means a little waiting time.

    Personally, I am in good health, I only have to pay for optometry, occasional dentistry, and non-life saving pharmeceutical (eg: birth control and anti-histamines). I have never required acute care, but in the times my partner has (emergency appendectomy, surgery to remove cyst), it has all been free.

    In times of broken bones, sprains, sports/work injuries etc it has been covered by “Accident Compensation Corporation” – our countries state run entity which covers just what its name suggests.

    I’ll take wait times over threat of complete financial ruination any day thanks.

  88. Oh, forgot to mention another draw back of our system is that sometimes you can get bumped from state facilities before you’re fully recovered (eg: a day after giving birth, too early after having surgery) because of a lack of beds/staff. However, there is always the ability to return if acutely affected, and we have good in-home visiting facilities for mid-wives (Plunkett) and travelling nurses (Nurse Maude).

  89. canuck reminded me that although the system here is Canada is flawed, it does work. I’ve had many instances in which doctors (who are only paid to work until 5 pm or who just received test results late on a Sunday night, for example) personally make the effort to call their patient or meet with them if their situation is urgent.

    My mom was diagnosed with breast cancer and within THREE WEEKS she had had a mastectomy. She would probably be dead now if it weren’t for the fact that the system works. And considering her terrible cancer genes (66% of the girls in every generation of her family get cancer), either my sister or myself will get it someday. If it weren’t for the regular screenings, mammograms and even ultrasound I wouldn’t be able to sleep at night (particularly since I have a benign lump in my breast the size of an egg. I had to wait a couple of weeks for the diagnosis… I can only imagine what it would be like to be waiting, knowing you could be about to die because of that wait).

    Socialized medicine may be scary in some ways, but there is nothing scarier than the thought of someone being refused life-saving/improving treatment because of MONEY. That’s simply barbaric.

    And if you’re worried it will make you lose control over your own health care… don’t worry. You don’t have any choice now anyway, so what is there to lose?

  90. I was talking to an American neurosurgeon last week, and he was explaining whe he didn’t ever want to work in Europe. The main issue was money, of course, though he seemed shy of purtting it quite like that. Some of his points about how doctors are regarded were interesting, though – he claimed that doctors in nationalized healthcare systems tend to feel like civil servants instead of professionals, for example (possibly highlighting failures of management).

    But then he took my breath away by complaining that a big part of the problem is that in countries with socialized med ‘people feel they have a right to health care’. The clearly unquestioned assumption that health care is not and should not be a basic right left me staggered.

  91. I’m a Canadian and won’t speak of my coverage because it would feel like I was rubbing it in your faces. I’m sitting here at work, shocked and close to tears for all of you.

    I can’t imagine living in such abject fear on a daily basis.

  92. @ which_chick

    You were so lucky – you had a rare and good doctor who gave you those choices and treated you with respect. You made the choice your were happy with and works for you – you GOT that choice which many women do not.

    And it is NOT “Woodsman-spare-that-uterus” sentiment – It is medically SOUND to leave a uterus in a woman’s body – it regulates much of our health especially when we are younger! Not to mention the muscular attachments blah blah blah. (Remember I was only 29 or 30) It’s like telling someone “you have a polyp in your colon we’re going to hack the whole thing out” So PLEASE do not perpetuate the idea that crazy hippies are out to save the uterus and that it is an unnecessary accessory! (snarky and I apologize, but I am sensitive about it – the humiliation of how I was treated still stings)

    Okay that was WAY off topic, but the point again is, even with “insurance” I could not get the treatment I desperately needed, and was not even informed of the option of myomectomy because the doctors would not get paid, and DID NOT get paid when I finally got the surgery I needed. The doctor charged a total of $3000 including general anesthesia for both surgeries and only got paid $600. I thought $3000 was cheap! (Especially in New Jersey!) and I had paid far more than that into my insurance policy – so where did all my money go? It did not go toward my treatment I’ll tell you that much!

    The thing that is the horror that we live with in the U.S. is that unless you have a stable corporate or Union job with a company that pays for the good stuff, or you are completely poor and get Medicare and Medicaid which is a horror story all in it’s own, you are screwed. That leaves a very large number of people out in the cold. My husband and I make a better living income-wise than my father did, but we can’t afford to buy our own insurance. We live in fear of accidents and illnesses like people did back in the 1800’s. I am terrified of getting pregnant now – because we don’t have insurance OR the $10,000 to $15,000 that it costs to have a baby!!! Is this a great country where a woman has to live in FEAR of getting pregnant!?!

    That is KILLING me!

  93. P.S.

    There is no PERFECT system – but any system where everyone can get the medical care they need, that is not dictated by anyone but the doctor and is not financially ruinous to the patient or doctor is a far better system than we have here whether it carries the label “Socialized” or not.

  94. Update to my post at #62….

    My husband took a nasty tumble off his bike today when he hit a piece of wood (has logged something like 2700 kms so far this summer riding back and forth to work) and hit the pavement shoulder first. I got a call at home, picked him up and took him to the nearest hospital, where he was seen immediately after the paperwork (5 mins) was done. Was examined by a doc, x-rayed, diagnosed with a really nasty clavicle fracture (bad enough that with any other bone his body, he’d be having orthopedic surgery but collarbones just get rest unless they are compound apparently), got outfitted with a sling,etc and we were out of there within 1.5 hours. All of which was covered by provincial insurance. Where was the long wait for service that naysayers claim socialised medicine results in?

  95. I get my health care insurance from the government. It doesn’t cost me anything. There’s no deductible, there’s no upper limit to the coverage, and I’ll never be dropped for a ‘pre-existing condition’ or because of where I live. I see a doctor whenever I need to, and I can go to a walk-in clinic if it’s more convenient. I live in Canada.

  96. I don’t have health insurance. I have a Master’s degree and am working a part time job until I go back to school for my PhD in the fall, when I will be required to buy the school insurance (and I will probably not be able to afford it without bailouts from loved ones). I get free birth control and annual “lady” exams from Planned Parenthood because I qualify as “low-income.” I just have to make sure I don’t get hit by a bus. I have a few medical issues I need to see a doctor about as soon as I have coverage again, and I could also use a pair of glasses that doesn’t fall apart once a week. But hey, at least I’m not pregnant!

  97. i don’t have it for last 3 years .i just got it from current employee i know a lot of people the don t have it at all.because if you work in fast food making 300/400$ how you will got it .if you are sure about your health than you can got cellphone instead of a lot of countiries the got from the government and its good ;like europe middle east ….here we have it detailed dent vision health .and lot of plans .companies they take advantage of poor citezens .the reach peoples the don’t care because the are in Washington the stand against national health care .if they don’t need it they can keep their s . but let the rest who need help to have it other ways the selfishness in the health and politics will not America

  98. My husband is self-employed in the auto industry and I’m not working currently. We have private insurance and pay $800/mos + 30% copay. We are expecting a 15% increase soon. BCBS is our only option, here in Michigan, due to pre-existing conditions.
    Our 19 son died last year due to complications following surgery. Our portion of the bill was $30K for the surgery and 2 days of hospitalization. That’s WITH insurance! An amazing social worker at the hospital found out that he was eligible for assistance from a government fund which picked up whatever our insurance wouldn’t cover. I don’t know how we could have paid the bills otherwise.
    If I could find a job in Canada, I’d move there in a heartbeat!

  99. 1. Get insurance through my job (with some fanagaling to get around a pre-existing)!
    2. Got insurance through my school.
    3. In the in between times lived in fear that I would become ill or get hurt, which probably decreased my immune function because of the stress.
    @darmon: yes, many young healthy people can get insurance at an affordable price because that is who insurance co. want to insure!! However, what percentage of the population does that really make up??

  100. Fortunately, I am a veteran, so I got free health care from the VA when I was laid off. No insurance company would give me health insurance due to my past medical history. BTW, I am healthy.

  101. Fed employee so I get it through Blue Cross/Blue Shield. Not expensive but not cheap either for myself+spouse. I pay the same rate/deductible as someone with kids.
    When I got out of the military I had nothing, always had VA to fall back on for myself but my spouse had nothing either. Started a job where we had to wait 3 months for coverage, she got acute colitis 3 weeks before my insurance kicked in. ER and 2 nights in the hospital later we were an extra $9k in debt. Just about had my car paid off and had to refinance it to pay the bills.
    Also had to go on a TB prophylaxis prior to being hired at that job due to a misread TB test and crappy walk-in clinic X-ray that couldn’t tell the emphysema on my lung from TB. $100 a month in prescriptions for 6 months.
    I do not take my health insurance for granted now.

  102. I moved to korea 10 years ago. This is one of the most capitalist societies in the world. since then, I pay about 70 dollars a month, and my employer 70. Anytime I go to the doctor, be it for a common cold, an eye infection, or a broken ankle, I pay about 4 dollars.

    Government run, single-payer insurance.

    yeah, socialism is a bitch, right?

  103. I lost my job two years ago,I picked up cobra at around a thousand a month for my family.[cobra coverage can be up to 103% of cost so that was the cost]I had to pay this for eight months until I finally got a job that covered us again.I average 50k per year and this cost strained our budget to the limit.My daughter broke her wrist the deductables and copays came to 3 thousand dollars.That was 11k for eight months of coverage.Add to this our prescriptions andother copays and my medical coverage was nearly 13k for eight months.Thank God that I stayed healthy and was able to return to work with medical.Here is the scary part,If I had cancer or some other long term choices would have been get treatment and bankrupt my family or just die.That is the reality of the situation.every senator or congressman that wants to stick with the status quo is jeapordizing your families future.Think about that when elections come up

  104. I’m australian, if i want to go to the doctor i go and its free or a small fee, maybe $40, but whatever is needed is done, i’ve never been without a job and dont struggle to find one when i need one. I hear people from USA saying how great their country is, well i for one would never go there, for a place that is the richest in the world and cant even give its citizens decent health, dosnt seem like such a great place to me

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