More

Featuring fresh takes and real-time analysis from HuffPost's signature lineup of contributors
Richard Walden

Richard Walden

Posted: November 23, 2009 02:16 PM

Health Insurance For Dummies!

What's Your Reaction?

My employer, a charity, just received a 10% increase in our Blue Shield group health plan -- a standard Preferred Provider Plan with a $500 deductible for outpatient care and for prescription drugs. Care is expensive in Los Angeles and many physicians have dropped health insurance billing altogether -- which means we pay whatever their fee is and submit the bills to Blue Shield -- which regularly rejects them to delay payment of refuses payment or pays a fraction of our actual out of pocket bill.

 

Our family of 3 costs my employer $2900 per month or $34,800 per year with the new increase and we are regularly out of pocket over $10,000/yr for what Blue Shield won't pay for or which they only pay a fraction of.

 

The Republicans and scared Democrats in Congress are whining about the new health care bill potentially raising our taxes and forcing health insurers to raise premiums to cover all those uninsured masses who would now be able to obtain some modest level of health coverage.

 

I would RATHER PAY thousands more in taxes for an outright government health insurance plan (NOT government doctors, just a simple plastic govt issued insurance i.d. card with negotiated, reasonable rates) like they have in France, the UK, Canada and most other industrial nations than to get SCREWED like Americans are now by private for-profit health insurance companies.

 

The fact that half the American public does NOT UNDERSTAND how screwed they have been means they are either totally unsophisticated or easily led like lambs by venal private profiteers and politicians.  The estimated cost of the very inadequate Senate and House blls which just passed is equivalent to just 13% of our annual defense budget. A full-on national health plan might cost as much as our national defense but SAVE us the massive insurance premiums we are now paying. One health insurer off-sets the many others and vastly simplifies the system -- think Medicare For All with negotiated rates for health providers. The cry-babies in insurance will still be able to sell policies filling the inevitable gaps in coverage like they now do to seniors.

If the current legislation fails to curb costs or vastly increase access to care, it should be scrapped and a full on national, or even state by state, health care plan substituted in its place. Give them 3-5 years and do a serious analysis of whether the current bills have worked. They won't.

 

Follow Richard Walden on Twitter: www.twitter.com/Rwalden63

My employer, a charity, just received a 10% increase in our Blue Shield group health plan -- a standard Preferred Provider Plan with a $500 deductible for outpatient care and for prescription drugs. C...
My employer, a charity, just received a 10% increase in our Blue Shield group health plan -- a standard Preferred Provider Plan with a $500 deductible for outpatient care and for prescription drugs. C...
 
 
  • Comments
  • 12
  • Pending Comments
  • 0
  • View FAQ
Comments are closed for this entry
View All
Favorites
Recency  | 
Popularity
10:46 AM on 11/24/2009
Medicare, Medicaid, VA & Tricare already exceed the defense budget, but the reason for the rapid increase in costs for those programs is largely due to cost increases in the Healthcare industry. I f we could contain costs by eliminating the parts of the system that drive insurance up 10 to 20% per year, we could cover everyone with the same outlays we're paying now.
photo
illinoisan
We don't need no stinking badges
10:23 AM on 11/24/2009
The only fair, reasonable way to poll Americans about this is to ask, would you rather have single-payer health insurance or continue to be completely screwed by private health insurers?
This user has chosen to opt out of the Badges program
photo
10:23 AM on 11/24/2009
You fail to mention why the healthcare problems of you and your family are my responsibility. If your insurance company is acting in a fraudulent manner then you need to contact your state Attorney General, not pass the bill on to me.
04:31 AM on 11/25/2009
YOU fail to realize that someone else's health insurance problems will eventually affect YOUR family as well. If an insurance company is acting in a fraudulent manner and gets away with it, that company will continue that practice and expand it into other areas of coverage as well. The bill will be passed on to you through your own inability to recognize that you are also part of the health care system.
09:55 AM on 11/24/2009
The issue is really simple. The U.S. spends over 16% of GDP on health care while other developed countries have universal care with less bureaucracy for about 10%. With single payer rather than our current "system" (Totally Balkanized and not really a "system" in any case) we could do the same. I know that a lot of people disagree with that. They are often the ones who shout that America is the "Greatest Nation in the World" and then go on to essentially say that we can't do as well as other nations.

The U.S. has to get universal coverage for both fairness and national security, which requires that a country have a well-educated and healthy population. In addition, we have to cut the cost to international levels to improve international competitiveness. The trade deficit has to go and U.S. manufacturing and tech have to be rejuvenated. Getting out from under the health care costs is essential to doing this.
photo
HUFFPOST SUPER USER
minerva117
This space for rent. Cheap!
10:09 AM on 11/24/2009
I really can't stand the whole 'we're #1' screed coming from the righties. Actually we're #37, places like Malta and Costa Rica having superior health care delivery systems. Our ranking for infant mortality is a dismal #19 out of 25. How anyone can claim to be number one is just plain silly!
10:28 PM on 11/23/2009
Congratulations! Your are one of the few that knows the actual cost of their health care and that is precisely the problem. Although, I feel in the next five years, employees will became intimately aware of the cost as their employers will be handing them a much larger percentage of the bill, if not all of it. The luxury of "not understanding" or being "totally unsophisticated" is about to completely disappear. Will your organization be able to sustain 10% to 15% premium increases for the next five years? Few will and many are already at their breaking point.

An increasing number of doctors no longer submit to insurance companies. My primary care physicians do not submit, leaving me being what I jokingly call "health insured without health care." For many self-employed people such as myself and others who pay the full cost of their premium this is a reality. After paying the high premiums, it can be a challenge to find the funds to meet the deductible. The situation leaves people without primary care and its sole purpose becomes catastrophic.

The last thing the American people need from our hapless representatives is another heads we win, tails you lose piece of legislation. A boon to the health insurance industry is a bust for the American people. I agree with your conclusion, this legislation must curb costs and vastly increase access to care or be scrapped. We don't need a mandate to make a bad situation even worse.
photo
HUFFPOST SUPER USER
EbonBear
opinionated hairy man
07:25 PM on 11/23/2009
I live under single payer (the NHS). It works, for the most part. One can always cherry-pick some tragic case but overall, it works pretty well.
06:22 PM on 11/23/2009
Yep just wait till the bill mandates everybody must buy insurance from the insurance companies. The rates will be high especially for people who have alleged "pre existing conditions" and for older people. As for the public option "compromise" (what a joke), it will be a State Opt in with a trigger in 2013. It will be just like Medicare Part D was for PhMRA , a gold plated gift to the insurance companies. As for the Opt in, the insurance companies will have 4 years to pad the state officials' wallets to avoid opting in. The Bill will also allow , like Congress did for credit card companies, a nationwide preference, where they can go to the state with the least regulations and call that "home base" so the alleged "trigger" will never happen anywhere. I can see it coming
photo
HUFFPOST SUPER USER
RichardWalden
President & CEO, Operation USA,a Los Angeles-based
06:20 PM on 11/23/2009
Agreed. Giving them millions of new customers is terrible but the bills have passed and nothing in the legislation protects us from that. If the Congress fails altogether at passing a bill which the Presdient can sign, then we can start over with "Medicare for All", which would have made more sense to begin with and would have been a much easier sell to the public.
photo
JohnFromCensornati
The End is near
03:10 PM on 11/23/2009
"If the current legislation fails to curb costs or vastly increase access to care, it should be scrapped and a full on national, or even state by state, health care plan substituted in its place. Give them 3-5 years and do a serious analysis of whether the current bills have worked. They won't."

In the mean time, we'll be offering up millions of new *mandatory* customers to the for-profit HC industry. Don't you think it's a bad idea to make them stronger before the next fight? I do.
photo
HUFFPOST SUPER USER
RichardWalden
President & CEO, Operation USA,a Los Angeles-based
02:46 PM on 11/23/2009
Couldn't have said it better!