What do you think of Bush's healthcare proposal?

[zetta]

My first thought was, "Hmmmm. A $7,500 deduction does nothing for the folks that don't itemize on their tax returns. And I'll bet most of the working poor who can't afford health insurance aren't able to itemize, either."

Sounds like it will help people who buy private insurance, but as inflation rises I bet more and more people will get taxed on employer-provided insurance.

I'm crossing my fingers that the efforts in Massachusetts and California actually work!

[meaghanchan]

I know that it would help me a lot. There are a lot of people who are self-employed, or work for a company that doesn't offer health insurance, who make a decent living... Just not enough to afford insurance. I can't afford insurance right now, and I make a pretty decent wage... but health insurance for me (a healthy single mid 20s woman) would cost nearly as much as my rent does- just for me, no spouse or dependents.

I do think that the amount ($7500 for singles/ $15,000 for families) should be indexed to inflation, and hopefully indexed not just to the CPI, but to some measure of actual health care costs, which are rising way faster than the CPI.

I'm more in favor of plans like those in Massachussets and California- and I'm hoping that New York passes a similar one- but I think this could be a step in the right direction for those who aren't in those states.

[tabbycat31]

There's also many companies who make their employees part time (give them 35 hour work weeks to avoid benefits).

Most big box stores come to mind (I used to work for one whre 80% of the store was PT to avoid benefits)

[PRICEPLUS]

When and if it gets through Congress I'll give it thought. Otherwise it is just rhetoric!

[disneysteve]

Originally Posted by PRICEPLUS

When and if it gets through Congress I'll give it thought. Otherwise it is just rhetoric!

My thoughts exactly. I'm a physician and honestly paid no attention at all to what Bush said (though physicians generally pay no attention to Bush ).

[MonkeyMama]

I think it does nothing, as usual, to fix the root of the problem. Why is healthcare so expensive? I think a big part is the legal industry - lawyers and lawsuits are taking a lot of that money. How much was your malpractice insurance doctors? IT's crazy! (We have a mostly doctor client base - they are getting paid tons and they are paying six figures at the least for malpractice insurance - these are good doctors who have never had a serious lawsuit. I imagine 1 lawsuit would make it prohibitively expensive to practice mediciane - what do your rates go up to then?).

Anyway, I think the plan sucks.

Right now I get a $7k deduction for our healthcare because we pay about 18% of our income to it. Only the part over 7.5% of our income is deductible, but we still get a big deduction because the premiums are insane.

With the new law we would save $220/month (income and social security tax) on the $875 premiums we can not afford now. When you factor the tax savings and that we would pay $655/month which is closer to the lesser coverage (but still more than it) that we just took. So we could still save a little more but it would still be insanity.

It's better than nothing, might keep us out of a HDHP for a couple of more years. But really does nothing for those who can not truly afford it. For the long-term, lessens the blow, but saving $220month when my insurance just went up $245/month in one year (yes a 40% increase), eh, not sure how it fixes the root of the problem. Nothing else not much more than a temp fix. As usual, seems to be all the government can pull together - temporary fixes.

[Ima saver]

I missed it, what was his health care proposal??

[shelbylovesmelby]

What Tabbycat & Price+ said......

I agree about the big box stores & even some of the unionized stores avoid giving people medical insurance by not giving them the hours the union says they have to work to give benefits... my half sister had that problem @ the grocery store she worked @. I also think that's why most folks who like KOHLS DEPT store aren't seeing. I worked there like 3 days before I had to quit because I wasn't getting any hours or benefits & I left a full time job for 5 hrs a week! Complete BS! & then when you looked in the employee area there were atleast 100 time cards!! WOA! I worked in a store half the size & I think we had maybe 20 people full & pt! They paid you a holiday if you worked the day before it & a share of their stock here & there but beyond that it was a JOKE! Makes you wonder where all their mark up is going????

Anywho.... I'm not going to worry about it either til it passes. But I agree I don't think it'll help citizens who can't afford or have the benefit of medical insurance, just people who can afford to buy their own.

Perhaps if they'd require all buisness that were say making X amt of profit or X # of employees would be *required* to provide so much insurance coverage per average yearly hours worked or something to that fact. Something so you atleast could have bare minimum coverage instead of none @ all.

I love my dh's insurance they pay out alot & we pay next to nothing in co-pays. If it wasn't for that & having a family he probably would of left the job along time ago. Heck when I had my kids I only paid the co-pays for the office visits ($6 each visit!!! Can't beat that!) & I paid ZERO in hospital bills! But that's changed so I think I have a $200 co-pay tward deliveries but that's still not shabby @ all.

Though I wonder if you ever look @ a hospital bill from a preferred provider & the discounts are huge, cut in half or more! How do they afford to give such discounts? Is that for the people who have to do into some serious debt because of not having insurance who have to foot the whole bill???

[disneysteve]

Originally Posted by shelbylovesmelby

Though I wonder if you ever look @ a hospital bill from a preferred provider & the discounts are huge, cut in half or more! How do they afford to give such discounts? Is that for the people who have to do into some serious debt because of not having insurance who have to foot the whole bill???

I'm not quite sure what you are asking here, but hospitals will often give you a discount just for asking. My wife had surgery in September. Our share of the bill after insurance was about $3,300. When I spoke to the billing department to ask about payment options they said that payment in full up front would get me a 35% discount, so our final bill was only $2,100. I didn't even ask for the discount. They told me about it on their own.

[Ima saver]

I generally get a discount because I pay right away and don't have any medical insurance.

[zetta]

There's a very interesting book called Money-Driven Medicine that lays out where all the money goes and some interesting theories on why costs have gotten so out of control. I just reserved it from our library for a second reading, and plan to summarize some of the main points in my blog sometime soon.

[ilr58]

The reason that health insurance is getting so expensive is because it directly mimics the rising cost of health care.

Universal health care is not the answer as many would hope in CA and Mass as the real problem is the lack of transparency in health care pricing. Who really knows what is reasonable or what is necessary?

What is the one industry that the consumer never comparison shops on price? - Health care. Prices will continue to rise because just like any profit seeking company medical service providers will charge whatever a consumer will pay - and with a large corporate health insurance plan to pay for most of the bills then most shoppers do not even think of what their insurance is really paying for.

[ilr58]

I generally get a discount because I pay right away and don't have any medical insurance.

What is your plan in the unfortunate event of a large medical bill? Your IRA and other qualified plans will be free from creditors but is it really worth the risk for your other assets to be left unprotected?

[Ima saver]

Since I have never been sick in my life, I hope I can make it until I get medicade! Otherwise, I will just make payments if I encur medical bills.

[ilr58]

Since I have never been sick in my life, I hope I can make it until I get medicade! Otherwise, I will just make payments if I encur medical bills.

If God forbid, you have a large medical bill because of cancer or something else unforeseen (assuming that you will be able to even get adequate non-emergency treatment and care without insurance) you do realize that the total medical bill can approach 6 and 7 figures very quickly, correct?

It is not practical to assume that you will be able to afford making monthly payments on that large of a bill. On top of that, there is the separate issue that you will never be able to get the best care (and maybe even any care) if the medical provider knows that you do not have insurance.

Some types of prescriptions cost in excess of $5,000 monthly not even considering the cost of chemo, surgery, and other types of expensive but common procedures. You can't even obtain those type of necessary treatments without insurance or some kind of help - simply offering to make monthly payments will probably not be a viable solution because either A) The provider will not be able to accept so little compensation and you wont get the treatment/care needed or B) You will not be able to receive the best care/treatment or C) You will get the treatment/care needed but will put yourself and those that care about you in such a financial bind with lifelong monthly payments that you will decimate any chance of saving for retirement or any other savings goal.

It is irresponsible in every single situation to not have at least some form of major medical catastrophic coverage health insurance.

[disneysteve]

Originally Posted by ilr58

Prices will continue to rise because just like any profit seeking company medical service providers will charge whatever a consumer will pay

This couldn't be farther from the truth. As a physician, I have virtually no control over how much I charge for my services. My fees are all determined by the government and the insurance companies. If my expenses increase (salaries, rent, supplies, insurance, etc.) I can not raise my fees to compensate. I just need to swallow the difference. That's why doctors have seen a steady slide in income over the past 10-15 years. TIME magazine has an article this week about how many doctors are moving into alternative/quack medicine, cosmetic procedures and other side businesses to boost income. It also discusses how many doctors have left the medical field entirely because they just can't afford it anymore.

So health care costs are steadily rising, but that money is not going to providers. It's going to insurance companies and drug companies primarily.

[boefixepa]

This is one of the those problems that has no easy answer. Single I don't incure enough medical expenses to take a deduction on my taxes. However, eveyone I know who is on the family plan does, just on their insurance premiums, and that's with the company paying 1/2 of the cost!

I don't know Bush's plan, but what I think I've heard is that a person will be able to write off any insurance costs like homeowner's insurance...no need to meet a minimum. Is that correct? That will give most people a little bit of a brake, but doesn't solve the problem nor make health care more attainable for most.

[ilr58]

So health care costs are steadily rising, but that money is not going to providers. It's going to insurance companies and drug companies primarily.

Good point. That is true and what I said should have been reworded to reflect the pricing power that the insurance companies and drug companies have rather than individual physicians just as you described.

[cornflakesdisease]

All I can say, is that some of the best cost cutting medical procedures and so forth come from countries with national health care because they are always looking to find new ways to save money.

In the USA 40 cents of every health care dollar goes to administration. while in the UK or Canada it is 11 cents.

"Well you might have to wait . . ."

Yeh, four or five days to have a kidney stone blasted with sound waves on a lithotripter machine before it passes out harmlessly from your body. Yeh, well I'll take the morphene for four or five days, instead of having it done in 2 days here in the USA.

oh yea, cost here in the USA: $60,000 for one treatment.

Why do you wait in Canda, because they only have 15 machines in the whole country. they're a small country with limited resources.

Lets see, go bankrupt and lose everything, wait four or five days on painkilling drugs . . .

hmm, seems and easy choice to me.

Many business move opperations to countries with national health care because they save money (like Toyota opening in Ontario rather then USA).
So the USA keeps loosing high tech manufacturing jobs to other countries.

Canda and the Uk spend about $2,800 per person on health care and USA spend about $9,000. If Canada (with 26,000,00 people) had our resources, they'd be jumping for joy.

Big drug companies and corperations that profit, keep our health care system schizophrinc because they directly profit.

With nationalized health care, a DOCTOR will be the gate keeper, not the insurance company or the drug company for that matter.

You know how you turn a conservative into a liberal? Give him cancer and no access to insurance. they change real quick, like my now deceased boss.
When the shoe was on the other foot, he certainly had a big change of heart. remember folks, 1 in 3 of us will eventually have cancer.

Don't like nationalized health care, oh I see, all those minorities will go down and "get on the welfare". Sorry Mr. Bigot, but once again, Doctors are the gatekeepers. Also, Most doctors become doctors because they care about people and that field fascinates them. not to make big bucks $$$$.

truth is, if my doctors only motivation was money, i don't want to see him.

Americans need to realize that they are all just cattle to big business; something to be used and then expended. Wake up people.

Your gonna pay for health care one way or the other, you mine as well spread the risk to everyone, so it's the least exspensive.

hey, if the US army can buy medicine and bulk and get a discount, why cant medicare? oh that right, the politician who wrote the bill, retired and went to the Phramacy lobby group the next year. there is your reason for the crsis in health care.

Something is better then nothing, and right now, we have nothing.

But hey, what would jesus do?

[ilr58]

Something is better then nothing, and right now, we have nothing.

I'm not really sure what you are saying here when you say "nothing"... unless maybe your definition of nothing is no free government handout for those who are not responsible enough to get health insurance before they actually need it.

Once someone obtains health insurance then there are laws in place to make sure that no matter what happens they can always keep coverage (COBRA and HIPAA) - all they have to do is simply pay their premiums.