Health Care Update IV

The true test of any American health insurance program is not whether or not it accepts you as a customer and takes your premium, but whether it actually does what it's supposed to. After our first doctor's visit and first bill from Regence BlueShield of Idaho, it seems we've found a provider that does what it says it will.

It's a curious thing, having a health insurance plan we actually dare use because it does provide some benefits. With our former insurer (Assurant Health) we got basically nothing and paid for the privilege. Going with the not-for-profit Blue Shield actually gets us some benefits at about the same price.

And the bills are certainly easier to read. Whether or not this comes from Obamacare doesn't matter to me. What matters is that BlueSheild tells us what coverage we've still got left on the wellness program as we use it, and how much of the family deductible we've met. Importantly, out of a bill of roughly $400 for some checkups for Michelle, they're paying all but $65. Yes, at this point, we've paid more in premiums than we would have if we'd paid the bills out of pocket, but I like the idea that we could have to go to the doctor again later this month and have some coverage again for the same premium price.

It's not that we're looking to hit the lottery here -- break an arm and win a prize. But it's just nice to know that if someone does get hurt or needs some medical attention, we don't have to plunge instantly into savings to pay the bills. So take me off the "moderately pissed-off" list and put me on the "cautiously optimistic" list for now. That's an improvement in my book.

And if these advantages are coming from Obamacare, kudos to Obamacare. I'd rather have Obamacare than what we had before, if this is indeed helping.

Hey Fatso!

Regence BlueShield of Idaho, it's okay to say it: I'm fat.

We're getting new health insurance, as I've let you know here. We've decided to go with Regence BlueShield because Michelle's Aunt Joan, who works in insurance, recommended it to us (too bad she's not licensed for Idaho or we'd have a new insurance agent as well).

It's a mixed blessing. It's still not affordable by any definition of the word, but we will be getting a bit more bang for our buck, with actual office visit copays, prescription benefits and a few other perks.

Then there's the fat thing.

Except they don't just come out and say fat. What they say is that for me, there are "height and weight guidelines" that, well, they don't really say what, but it's understood that because I'm a relation of Dr. Eva C. Tubby, then, well, these are the plans that can be offered at the prices indicated.

I'm okay with that. I know I've got some weight to lose. I just wish they could just say in plain English: "Hey, Fatso, lose some weight and you'll get a better deal from us." I'd be cool with that. Of course there are those who would take offense. So they have to dither with the language.

Healthcare Update, or More Potential *&@*#!

With our end-of-the-month deadline looming to find new health insurance approaching, we’re holding our breath. Our hopes are not high. And I still haven’t heard thing one from my congressmen aside from boilerplate email responses.

Here’s what’s going on:

• Sayonara, Assurant Health. Fie to you and your more-than-our-mortgage premiums.
• Private individual market for health insurance sucks, according to my wife’s aunt who is in the business, and ObamaCare has made the situation worse.
• Regence Blue Cross/Shield of Idaho, take pity on we poor, simple folk.

Yeah, we’re going to give Regence a try, though our hopes aren’t high. We sent off our application material yesterday and hope that this company will actually offer us something besides the same old crap. Again, expectations are not high. Oh, we will likely be offered a policy. Whether it offers the care we’re interested in at the price we can afford is a different story.

How ObamaCare is making the situation worse, I’m a little fuzzy on. Though this report (sorry, registration required) from McKinsey & Company paints a pretty appalling picture. (This is only one report, I know. I’m still open to reports that have more rainbows and unicorns in them, but this is the one making the Internet rounds right now.)

Basically, the report says that of 1,300 employers contacted by the company, upwards of 30 percent are likely to drop employee health insurance as the ObamaCare provisions come into play in 2014 – this even despite penalties that will kick in further down the road.

Here’s the report’s key finding:

Starting in 2014, people who are not offered affordable health insurance coverage by their employers will receive income-indexed premium and out-of-pocket cost-sharing subsidies. The highest subsidies will be offered to the lowest-income workers. That reduces the social-equity advantage of employer-sponsored insurance, by enabling these workers to obtain coverage they could not afford on today’s individual market. It also significantly increases the availability of substitutes for employer coverage. As a result, whether to offer ESI after 2014 becomes mostly a business decision. Employers will have to balance the need to remain attractive to talented workers with the net economics of providing benefits—taking into consideration all the penalties and tax advantages of offering or not offering any given level of coverage.

Not pretty. The subsidies will be nice – as far as I can tell, we’ll qualify for some amount – but if we’re looking to the individual insurance market to keep prices down even with this potential influx of new insurees, well, I guess we’re also likely to buy swampland in Florida. (Yes, there are bright spots. The study also points this out):

This development should not suggest, however, that employers considering the elimination of ESI are focused exclusively on the bottom line, at the expense of their employees. In fact, because of the subsidies, many low-income employees will be able to obtain better health coverage, for less out of pocket, on an exchange than from their employer.

So we’ll see what happens. Feeling pessimistic, however.

*&#*$&@*# Follow-Up

Used under the fair use doctrine for commentary purposes. Wish my health care was this clear-cut.

I’m doing this, yet it feels as effective as yelling into an empty room:

Congressman Simpson,

What's a guy to do when he gets a letter from his health insurance provider saying that come the end of June he's going to have to pay more for health insurance than he's currently paying for his home mortgage?

The individual health insurance market is murder. And yet all I hear from the GOP is that we need to turn to the private market for health care solutions. The private market sucks rocks, congressman.

What's worse is that I don't feel that writing to my congressional delegation will do anything to fix the problem, or that it's even fixable by anyone outside of those guys who write those utopian novels.

Feeling slightly depressed,

Brian Davidson

Sheesh. That depressed me even more, just writing it out. I sent that to Mike Simpson, and a similarly-worded missive to Sen. Mike Crapo as well. Expecting back the traditional form letters, the glass of water and the pat on the head, because this kind of rhetoric just isn’t heard over the partisan noise in Washington except at election time, when such drivel can be used a fodder for campaign stops when all sorts of wild promises are made with 99.9 percent of those in the audience cheering them on while at least fifty percent of us know such promises won’t be kept. At all.

Used under the fair use doctrine for commentary purposes.

Health Care, or #*&*#**@*!

Image used for commentary purposes under the fair use doctrine.

We're looking for new health insurance.

Why?

We got a letter from our health insurance company this week informing us that because of rising medical costs, our premiums are going to go up nearly $200 a month. This is after two years in which we submitted the following claims:

• $200-some-odd for a visit to a community care facility to get an enormous sliver removed from under the fingernail of our youngest son. Claim denied because we hadn't paid any of our deductible.

I'm sorry if you were waiting for a longer list. That's it. Two years, one denied claim, and because costs are going up, up, up, we're now being asked, starting at the end of June, to pay more for health insurance than we are currently paying for our home mortgage. Am I the only one who sees something wrong with that situation?

It's malarkey, this so-called private market for health insurance. And though our letter made grandiose promises about what Obamacare regulations is doing to the health care industry, all I'm seeing is that our premiums are going up on a product we can't use because our deductibles are so high we'd only hit them in a given year if we were all involved in a horrible traffic accident. And then our rates would go up.

A few weeks ago Michelle jokingly said she'd like to see the church offer members a health insurance plan, and I joked back, "You know, I'd pay an extra 10 percent in tithing to see that happen." Now though it's still a farfetched idea, it sure sounds a lot more attractive. Maybe I'll send that on down the line to Salt Lake City . . .

NPR Explains. Sort of.

Argh. Just when you think maybe you've got a handle on things, something comes in to change the game.

I wrote earlier about my efforts to understand the current proposed health care bills. Generally, my understanding is growing and, generally, my desire to see a version of these bills passed into law is growing.

Now NPR had to go and remind me of something: The sweetheart deals. So maybe these deals -- like the Cornhusker Kickback -- are still in the bills being considered. Mr. Cornhusker himself, Ben Nelson. D-Nebraska, says he wanted to kickback in the bill -- effectively exempting Nebraskans from paying into portions of the bill while everyone else in the country had to obey the lay -- in order to vote for it, but now favors getting it the hell out. Good thing, because even liberal-way-beyond-leaning MSNBC realizes such deals are deal-brakers.

It's heartening to see, per NPR, that another deal is in the works to kill these deals. That's good news. If we're fixing health care, let the same fix apply for everyone.

Health Care Reform for Everybody -- Including Our Fearless Leaders

Where I come from, what’s good for one is good for another. If, perchance, one of my kids gets in trouble for using a bad word – my nine-year-old called me a dumbass (during scripture reading, no less) this weekend – I should get in trouble too, because I’ve used the word too, probably in front of said nine-year-old. (One of my most enduring memories of parenting will always be hearing this same kid, as a two-year-old, following me around the back yard saying “Shit! Shit! Shit!” because he heard his Dad say it.)

So why is the concept that senators, the president, and all associated staff should have to sign up for the public healthcare option if it becomes law a bad idea, or, at best, a “political feel-good stunt” motivated by Republicans. Read more about it here.

One of the amendment’s sponsors makes a good point:

Coburn, a medical doctor, said that his amendment isn't a gimmick, but rather a serious attempt to mitigate the harms he believes would come about through the existence of a public option. If the president and other political heavyweights are enrolled in it, his thinking goes, they'll make sure it runs well.

I just know that those in government have it pretty sweet when it comes to health care, pensions and such. They’re not lacking, I know that. If they think a government-sponsored public health care option is great for the average uninsured or underinsured or fully insured American, then surely it ought to be good enough for them?

I’d like to see health care reform. I’d like to see the public option become part of our choice. I’d also like to see those in government who are getting great health care at the moment take the same kind of medicine they’re offering us proles. But of course what we’re getting isn’t real health care reform. We need price controls and equal access, not competition in the currently broken field of health insurance. We’re getting a band-aid when what we need is a transfusion. But that’s just my little idea.

Economies of Scare

I'm tired of having health insurance.

Not that I think we should be without it. But I'm tired of the concept. Here's why:

Two years ago we signed up for some basic health insurance that would pretty much take care of us if one of us lost a limb or got blowed up or something. Obviously, we have not used it. At all. I was lucky enough to get a physical for free at work that didn't identify any terrible problems aside from my weight, which I knew about already. We've had our daughter into the dentist, and our oldest son to see, well, the witch doctor.

So explain to me why I had to get a letter from our insurance company this weekend saying that due to rising medical costs, our premium is going to jump $150 a month. Madness. We have not had a claim. We haven't had a claim on our auto insurance, and it's actually gone down in price since a few years ago. Why doesn't health insurance work this way?

It's all a racket, of course. Costs are going up for somebody because somebody at the health insurance provider wants an ivory-handled back scratcher. And pharmaceuticals in this country are ludicrously expensive. And doctors struggling with malpractice insurance, and, they can't deny it, boat payments and payments on their huge houses and whatnot. I know a few doctors, and have seen where they live. They're not living in hovels bereft of toys.

And then there's my employer. A few months ago, they said they were looking into health insurance for their employees so they could remain competitive. Right now, I get an extra $3.01 an hour so I can pay for my own health insurance. I was excited that perhaps with our employer now going to bat for us insurance-wise, we might get a better deal someplace else, using our combined buying power to get insurance that we could actually use. (As much as I hated working for the Post Register, I have to confess that their insurance was pretty good.) And back when I worked for Qwest -- as much as I hated that place -- the insurance was by far the best. $300 a year -- $300 a year, folks -- and we could see a doctor any time we wanted. For free. Economies of scale are possible. It's too bad right now that we operate on economies of scare.

Then the employer sent out a memo with two very naughty words in it: Supplemental and Aflac. Great. So, meeting attended where the two goons from Aflac explained their wares and I find that all the employer has done is figure out a way to help us spend the money we're already getting for health care without actually offering us any health care at all.

I'm ready for something akin to Britain's National Health Service. Yes, we hear the nightmare stories about long waiting lists and such. But can we honestly say that's any worse than the system we have, which is pretty much a roulette wheel that says "We might take care of you but it'll cost you plenty. You didn't need that house any more, did you?" I'm ready to pay higher taxes for something that would actually let me go to a doctor or a hospital without worrying myself even sicker over how to pay for it all. This is one of the primary reasons I voted Democrat this last time round. I do not, however, have high hopes that anything will come of my invidiual vote. Clinton had a majority in congress back in the early 1990s, and squandered it without doing a blasted thing on health care. I have little faith that one party can do anything to fix things. Truth be told, I believe it's going to take some kind of national catastrophe -- aside from the millions of people who go uninsured and are unhealthy, a catastrophe which we already have -- to fix things. Which means it's going to take something awful, because no one seems willing to fix what's going on now.

I'm done with my rant. Except that the employer's going to hear it from me, and our insurance agent is going to hear it from my wife. It's Network News time -- We're as mad as hell, and we're not going to take it any more.