Going without health insurance

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Originally Posted By: eljefino
Go to a doctor and complain of wrist pain, first thing he'll do is try to get you to blame your work, because he can go after workers comp, which pays better than regular insurance. If you get hurt in a car wreck there's a third policy for that and they'll all duke out who's responsible.


A little off topic, but as a husband of someone who is in the permanent disability group due to chronic pain from overwork related neck (pinched nerve, cervical disk bulging)and wrist pain (tendonitis), I am very offended about what you said.

We are not at the moment looking at having a lawyer, but these "workers' comp" insurance is nothing but a shell game so the employers can get out of their responsibilities to take care of the employees who got injured from work over time.

She worked 5 years in the field running assay for a drug companies, the health insurance started questioning why she is using her chiropractor visits so often, and when she finally think it is work related and file for workers comp, she got a total of 24 sessions of visits and then they declare it permanent, declare it 3% disability (while some of our chiropractor friends told us it should be more like 6-12%), then send her a $2000 check and say this is all you are going to get, and no more chiropractor visit, ever in your life from worker's comp, case close.

Now, because she is declared disability from workers comp, she cannot use health insurance for chiropractor visit anymore for the injury. The employer's on site nurse says she should use the health insurance (by lying, or so called fly under the radar), and chiropractor offers recommendation that she should visit with other pain and she'll treat the neck and wrist problem instead (insurance fraud).

She is now in pain almost hourly, I'm trying to learn massage to help her cope with it, and I'll probably have to accept that I need to be the single bread winner in the family in the future, as well as doing all the household chores as she cannot lift anything heavier than 5 lb without feeling pain.

Other than chronic, daily to hourly pain, her career is ruined because everyone tells her that the only way she will get better is to quit and work something that completely doesn't get her neck in one position and lift any weight, that rules out computer / desk job and lab work, her compensation? only $2000.

This is all with employer provided insurance and worker's comp, legally, and supposedly the better one in the market today due to the pharmaceutical industry they are in.

If you see a problem with the way American run the health care system in the best case scenario, then you need to see how it is in the worst case like many of the member here posts. If you think you are lucky enough that this won't happen to you or your family ever, and are unfairly pooled into the unhealthy group, I wish you lucky, because no one will be there for you when you are eventually thrown into the other side, or completely out of the system due to pre existing condition.

Don't come back to ask for sympathy, you may not get any.
 
Sorry about your wife Panda. I'm just pointing out a problem some may not know about. I also have, or had, a carpal tunnel issue, and the doctor was "leading" me into saying work did it.

Just more cost shuffling. Effort going into deciding if work did or didn't do it is effort wasted that could have been spent curing more illness.
 
Thank you for all the input. I'm not surprised where this thread has gone but it has been interesting to see different experiences.

In all honesty, hearing "horror" stories of $10,000 - $30,000 in medical bills really don't convince me, when my premiums run $12,000/year with a $5,000 deductible on top of it. In those situations, it seems like the best course of action would be to go uninsured, settle with the hospital and work out a payment plan. With my current insurance, if I had an emergency I'd be out $17,000 for the year. If insurance keeps going up at its current rate (19% last year), then I shudder to think what my premium would cost in 5 years -- if my math is correct, it will cost close to $30,000/year.

I'm hoping to get a new job, either with the government or a large business, so hopefully this will all be a moot point. If I can't, then I'm not sure what we'll do -- I'll probably rely on the VA and we'll try to find an individual policy for my wife and kids. If we can get them a private policy (my wife was turned down last year), even then I wonder how much of a value they would be when the lifetime caps are so low.

Ultimately, the decision to keep insurance comes down to the probability that somebody in my family will run up a $17,000+ medical bill over the course of a year or about $36,000 over the course of three years (3 years worth of premiums, plus a $5k deductible and assuming no premium increases).
 
It also depends on if you feel you need your credit rating for anything in the future, and if your state lets you keep your homestead through bankruptcy.
 
Originally Posted By: eljefino
It also depends on if you feel you need your credit rating for anything in the future, and if your state lets you keep your homestead through bankruptcy.


Yeah, it's definitely a gamble. Then again, assuming a medical bill is less than $60,000, I could probably take out a second mortgage to pay it down and it wouldn't impact my credit score (my FICO is 810). I'm not sure if you can lose your house do to bankruptcy in my state -- That's something I should probably look into.

It's all going to come down to how much rates go up next year. It's hard to stomach paying 17% of our family's income towards health insurance but it will be impossible to pay 20% of it if rates go up too high. If we get another 19% increase, then we'll be paying over $14,000/year for coverage.

As bad as paying $12,000 a year is, I am aware that many have it worse. My brother pays $16,000 for coverage worse than mine.

The more I think about it, the more I'm convinced that our country needs to legalize doctor assisted suicide for those who might be stuck with these kind of dilemmas.
 
No! Don't hock your house to pay medical bills.

Medical bills are unsecured and they may have to deal with you paying $25 a month for eternity.

A house is handy to keep around.

Though I guess if you can get the hospital to settle for 20% of their bill for an immediate cash payment, it might be worthwhile and honorable.
 
Due to my wifes previous medical bills and our monthly health insurance payments going up around 10% last fall including co-pay that doubled I have had to cut back on buying fertilizer and seed etc. Hay production goes down and we make less money therefor I pay less taxes, buy less new equiptment/parts etc and thus less stimulating the economy due to medical. I have two neighbors in the same boat with medical bills. Medical costs is killing the farming economy on my road.
 
Originally Posted By: eljefino
No! Don't hock your house to pay medical bills.

Medical bills are unsecured and they may have to deal with you paying $25 a month for eternity.

A house is handy to keep around.

Though I guess if you can get the hospital to settle for 20% of their bill for an immediate cash payment, it might be worthwhile and honorable.


I'm just throwing out hypothetical scenarios -- suicide, second mortgage, divorce, etc.

I really don't know what my options are going to be. There's a lot of stuff up in the air right now. It will all come down to how much rates go up, whether we can get a decent private policy, etc.

We got contacted by HR on Friday about filling out applications for insurance and warnings about rates going up and quality going down, so I'm sure there's something going on in the background with our broker and insurance company. Whatever it is, it wont be good.
 
Originally Posted By: kb01

I'm just throwing out hypothetical scenarios -- suicide, second mortgage, divorce, etc.


You forgot another 2: immigration (to somewhere that pay more attention to general public's health and well being) and medical tourism.

If it is not an emergency, it might be cheaper to fly, say, to Thailand, Cuba, Taiwan, China, Mexico, Costa Rica, Brazil, Korea, etc. You wouldn't get the Cadillac part of health care, but it is a lot cheaper as long as it is not an emergency.

As the health care cost keep going, I think this would be the norm just like how we buy Chinese made stuff.
 
Originally Posted By: PandaBear

You forgot another 2: immigration (to somewhere that pay more attention to general public's health and well being) and medical tourism.


That's something that's been in the back of my head. I have a family member who flies to Poland to take care of his recurring thyroid issues. He actually has excellent health insurance but can't stand the medical system here.

My million dollar business idea is to setup mobile health clinics, where the patient video conference with a doctor in India or Pakistan, who can then send prescriptions to a Canadian pharmacy. If a procedure is needed, the patient then flies to a medical clinic where procedures cost significantly less. It's not an ideal system of providing medical care but it's better than death or living with an easily treated issue that you can't afford to resolve.

Outsourcing has devastated the working and middle class in our country. Until this is fixed, I don't see any reason why the medical industry should be exempt.
 
Quote:
The true cost of doign things is not reflected in the price.


Fully expected when the consumer isn't paying the bill. ~50% of the money spent on health care in the US is spent by the government. Most of the rest is spent by insurance companies paid by an employer.

Areas of medicine that are not covered by insurance tend to get better and cheaper just as one would expect under market conditions.
 
Originally Posted By: Tempest


Fully expected when the consumer isn't paying the bill. ~50% of the money spent on health care in the US is spent by the government. Most of the rest is spent by insurance companies paid by an employer.

Areas of medicine that are not covered by insurance tend to get better and cheaper just as one would expect under market conditions.


Do you have a proposal on how to tackle a $700k operation under market condition for the typical Joe?
 
Originally Posted By: PandaBear
Originally Posted By: Tempest


Fully expected when the consumer isn't paying the bill. ~50% of the money spent on health care in the US is spent by the government. Most of the rest is spent by insurance companies paid by an employer.

Areas of medicine that are not covered by insurance tend to get better and cheaper just as one would expect under market conditions.


Do you have a proposal on how to tackle a $700k operation under market condition for the typical Joe?


I think his postion is the 700K operation would have to become a lot cheaper under market conditions. But it's never going to become cheap enough for the average Joe. My position would be the operation probably shouldn't be 700k under any conditions. It's just unrealistic and no system can support that kind of pricing.
 
Originally Posted By: PandaBear

Do you have a proposal on how to tackle a $700k operation under market condition for the typical Joe?


Quote:
# Medicare spending grew 7.9% to $502.3 billion in 2009, or 20 percent of total NHE.
# Medicaid spending grew 9.0% to $373.9 billion in 2009, or 15 percent of total NHE.
# Private health insurance spending grew 1.3% to $801.2 billion in 2009, or 32 percent of total NHE.
# Out of pocket spending grew 0.4% to $299.3 billion in 2009, or 12 percent of total NHE.

https://www.cms.gov/NationalHealthExpendData/25_NHE_Fact_Sheet.asp

Guess who is driving prices up? Kinda' obvious. Just print more money and all is good according to some.

If there were no government distortion (and it is massive) and people could purchase their own insurance (without tax laws distorting the market), it would send pricing signals to the health care sector. It would also send pricing signals to consumers because insurance would cost them and looking for the best deal on a provider would matter.

Now, there are no such signals getting to end user. If someone else is paying the bill, resources will always be over utilized.
 
Again with the figures that are pro-private. You can make figures look like anything you want. What's not being explained is how the private insurers had lower spending. Maybe they cut coverage and and raised deductables etc. The real problem is healthcare costs and as long as there is insurance the cost keeps increasing. Medicare and Medicaid have a lower administrative cost than when private insurers provide the same coverage.
 
Originally Posted By: kb01
The more I think about it, the more I'm convinced that our country needs to legalize doctor assisted suicide for those who might be stuck with these kind of dilemmas.


A lot of people don't realize it, but we already have that. Except it's done in a way that is not out in the open and the patient doesn't really know and it's basically involuntary. It's hospice and living wills. The insurer and Dr may come to an agreement that they are not going to treat the patient maybe due to cost more than medical reasons. The patient is proclaimed terminal and pawned off on hospice. For hospice to make a fast profit, it is most expedient to put the patient on 24 hour drug dosing. The patient usually dies with 2 weeks. Slow enough that it appears they just took a sudden turn for the worse. That's how the system can work in a nutshell.
 
Private companies administering Medicare/Medicaid benefits pull from the same funding that pays Medicare/Medicaid, just the private ones have higher administrative costs. Well I'd agree that healthcare industry's pricing enabled by insurance is the real problem. But I don't believe more privitization of healthcare is the solution. All that will result in is more of the same except some private individual will make a profit. A privatized monopoly that isn't under real market conditions is if anything worse than a public one. This is the hypocrisy of the privitize everything crowd.
 
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I went to school for four years to learn about healthcare. Instead, I should have looked at a couple of out of context statistics to prescribe solutions. Could have saved a fortune.
 
Originally Posted By: CivicFan
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I went to school for four years to learn about healthcare. Instead, I should have looked at a couple of out of context statistics to prescribe solutions. Could have saved a fortune.

Then please enlighten us with your knowledge.
 
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