Self-Employed health insurance

My rates have been going through the roof on a catastrophic policy.

What do I do? I was paying $159 a month three years ago. Now it's $439 and climbing 20 - 30% every six months!

I cannot switch companies because of pre-existing conditions.

When I complain to the State of Illinois, I am told that they have no authority to regulate rates.

I cannot keep up with these increases much longer. This is for a catastrophic policy where I can pay up to $5000 out of pocket for me and another $5000 for my wife - besides the monthly costs.

I think that the health system is definitely broke. We pay much more than other countries, and because individual policies are so expensive, a lot of innovative people do not take the risk of being self employed because they cannot afford the rates and risk restrictions because of pre-existing conditions.

Then on top of that, we Americans have the worst health statistics in the developed world. According to the CIA, our infant mortality rate is worse than Cuba!!! https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html.

Hey, man, it's rough on small businesses, too! I still provide health insurance for my people. At the warehouse., I only have 4 employees, and the rate has been over $490.00 a month for each.


Recently, we formed a buying alliance with several other family businesses (about 240 people) and cut the rate to a little under $375.00 (still with a significant deductible).

From a personal (self employed) or small business owner standpoint, the burden is substantial.

Maby I should consider a Life Of Crime! (LOL)!


Russ

You'd be in good company. I've heard quite a few tunes 'murdered' here on the 'zone .......including some that I posted .

chas

Very funny!

Sorry for venting. I'd be asking for advice for cheaper insurance, but any move to a cheaper policy would require accepting restrictions for pre-existing conditions.

Life is a pre-existing condition.

I just hope that my wife will get a job that has company health insurance. That will help a little bit, but I heard that companies are raising costs and reducing benefits also.

Beakybird

This whoe thing really pisses me off...
Here all the hospitals are building new buildings...There is NOTHING wrong with the old ones...you see they are not-for-profit...so all that $$ they make every year..they just spend it, so the paperwork looks good!

Lee S.

http://www.healthcare.gov/law/provisions/preexisting/index.html

There's a wealth of information available through the website above. I linked you directly to the general pre-existing condition insurance page...

The average health insurance policy for a family of 4 is roughly $13,000.00 So called "cadillac plans" kick in around 18k or higher. $439.00/mo. projects over a year to be roughly $5,268.00

Here's the link to Illinois's specific page for Pre-existing condition insurance plan...
http://www.healthcare.gov/law/provisions/preexisting/states/il.html

There's a phone number and web site to learn more about this issue.

Here's a link to a bridge program, that went into effect on July 1st, 2010.
http://www.healthcare.gov/law/timeline/index.html

"A Pre-Existing Condition Insurance Plan will provide new coverage options to individuals who have been uninsured for at least six months because of a pre-existing condition. States have the option of running this new program in their state. If a state chooses not to do so, a plan will be established by the Department of Health and Human Services in that state. This program serves as a bridge to 2014, when all discrimination against pre-existing conditions will be prohibited. Learn more about the Pre-Existing Condition Insurance Plan."

Its certainly not perfect. I do think there may be some reasonably appealing options that can get you through on a short term basis, until the exchanges and everything kicks in in 2014.

It goes without saying that if the Republicans are successful at repealing the Affordable Care Act, then you have much bigger problems. Even if the individual mandate is ruled un-constitutional, that sticks the Insurance companies with a lousy risk pool, to which they know only one remedy. Raise everyone's rates enough to absorb the people who don't get health insurance until they become ill.

Funny how this individual mandate was just dandy when the GOP used it to scuttle Clinton's attempt at HC reform back in the late 80's. They insisted on it, Clinton rejected it. Likewise, a republican governor, Mitt Romney-MA used it in his universal coverage and I don't remember anyone predicting the fall of the country.

Good Luck, Beak....If I can help with any questions or other info, just let me know...

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Bill in Dayton

[This message has been edited by Bill in Dayton (edited 12-14-2010).]

Larry,

There are lots of options, all of which are somewhat complex when you look into them carefully. The best you can hope for is to reach the ripe old age of 65 when Medicare kicks in. This is by no means a panacea--Medicare only covers about 60-percent of your expenses, while the other 40 percent must be either paid out of pocket, or you purchase supplemental coverage, which varies dramatically depending upon which options you select. Most of us old codgers go with Option "F" with a high deductible. This keeps the premiums relatively low, averaging about $100 per month. Of course, as you get older those premiums increase, mainly because you will likely be spending more time at the hospitals and doctors offices and less time chasing members of the opposite sex and drinking Margarettas.

Good Luck,

Gary

Thanks Bill! The Illinois program sounds pretty reasonable. Well, on the other hand, those prices are for one person and not for two.

The only preexisting condition I have is benign enlarged prostate - even though when I last applied to change insurance they said that anything that had to do with my prostate would not be covered - forever.

The thing with the pre-existing condition is that if you ever complained to the doctor about anything - snoring loud, indigestion, feeling depressed - all this stuff can come back to haunt you when you change policies.

I told my wife, who's slept longer than normal since she was 15 and has started to have a few other ailments that might be all related - I told her not to tell her doctor the truth. I said, "Tell the doctor you have been sleeping longer than normal for the last 2 1/2 years while you were covered under insurance - otherwise, they can say it's a pre-existing condition." I'm sure this goes on a lot.

I think the price of health care is a big disadvantage for the US in areas like manufacturing where we compete with other countries for price.

I'm worried about the day that they start shipping Chinese musicians to perform at American nursing homes, playing Frank Sinatra for $50 a gig. That will be a sad day, indeed.

One of the major features of the ACA is that pre-existing conditions won't be a reason any more to be denied coverage.

See how far you get with the info I gave you...maybe there's more good news than you expect...

Maybe not...

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Bill in Dayton

Hi Beaky and others:

Bill is correct. There are changes happening to overturn many of the insurance companies' Pre-existing definitions and stances. Insurance is totally "out of control" and if things don't change, we will all be "wards of the state" in no time.

There are entirely too many people getting preferential and free treatment at our expense. No, I don't condone refusal to treat but I do oppose having the cost passed on to those who pay premiums... and pay and pay and pay. Certainly, Hospitals and Medical institutions have overhead... just like any business... but their treatment of the indigient (and those who claim to be) must be paid through other channels and not passed on to the insurance pool. As taxpayers and policyholders we must get our lawmakers to address this issue. Otherwise, socialized medicine and all it's negativity will prevail... and we will be waiting for years to get critical treatment, just like the folks in Canada.

I feel you pain. As a retiree, insurance has become my largest expense when all forms are lumped together. My wife and I are considering just pulling the plug on all policies we can legaly shuck. While we are healthy, we can begin a medical expense savings account. (Whether or not it qualifies for the government program designed to do just that... or not!)

At least, with the retained income (instead of paying premiums) we can eat healty meals, pay our damn taxes and possibly save a little for a rainy day.

What a sad state of affairs. And our Senators and Congressmen don't have a clue about our problems 'cause they have their own retirement program, medical coverage and insurance. Yep, American Royalty!

If I sound bitter, it's only because I am.
Sorry for the rant. Good luck on alterntives, Beaky.

Dave Rice

If health care is so horrible in Canada, then why are they #11 in life expectancy and we're #36, tied with Cuba!! http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy.

We're paying more per capita than any other country, for what? To live no longer than those in a slovenly, backwards communist dictatorship. It's sad.

Just be happy you're not in NY. I'm perfectly healthy but am paying $1100 a month for myself, my wife and my newborn, and it's a crap plan. I managed to convince a friend of mine who I do studio work for to put me as part of his company so that I could get the company rate because doing it as a solo would have been much more expensive. And my plan does not include dental which itself runs me thousands each year...

Highway robbery. My brother in law in California pays $350 a month for better insurance.

I don't get it one bit...

[This message has been edited by chony (edited 12-14-2010).]

Dave-

Canada does not have Socialized medicine. They employ a national single payer system. They do not own all the hospitals or clinics, they don't employ all the doctors, nurses, etc. Britain has that system, which is similar to our VA System. Think of Canadian health care system as a national Medicare for all program. Medicare in the US certainly has major issues to address, but I've never heard of a Senior citizen who refused it. One reasonable argument I've heard is that if Medicare is great for those 65 or older, why not for 64 year olds? If we lowered the qualifying age, the risk pool would be healthier, more people would have access to better health care and the financial effect on the overall Medicare system would improve.

My Dad is reporting much higher supplemental costs this renewal season as well. Of course, I want my Dad to have everything he could ever want, but I do see a fundamental problem. His rates for supplemental coverage are distressing him, yet there are millions in the US who simply have no coverage whatsoever. None...Going to the ER because the cold has now turned into a major infection isn't health care. Its a $15 thousand dollar way to take care of a $30 buck problem. He can't afford the extra insurance he wants. Too may Americans can't afford ANY insurance.

Your comments on finding another way to keep from passing the costs of the indigent are very common as well and I think are well reasoned. The most successful way I've learned of exists in several European countries like Germany and France where the Government oversees a non profit insurance system. Basic coverage can not be part of a profit pool. However, supplemental plans can be sold to earn profits. They are quite lucrative and that system, I think could be a possible answer in the US someday. The sky would fall and people would lose their minds, but in the end..I think it would be better than what we have now.

Regarding Canada. Its a myth that people are waiting years for critical care in Canada. There are significant waits for elective procedures. Just as its a myth that Canadians are flocking into the US for health care or that Canadian docs are moving to the US. Studies have been done that disprove it. Canada has some big problems that have to be improved. No question about it, but they pay less for HC than we do, their results are no worse than ours are and everybody gets it. Everybody...
http://voices.washingtonpost.com/ezra-klein/2009/08/we_ration_we_ration_we_ration.html

Did anyone notice Arizona's new rules regarding medicaid funded transplants? They have stopped paying for several different procedures based on cost issues. Literally, a panel of "experts" have determined that various different transplants are too costly to continue to provide. (If this isn't a death panel, I don't know what is.) This was voted into law last March...before the ACA was voted into law. Where's the uproar? I thought Obama wanted to pull the plug on Granny, remember? (He didn't...) But you hardly
hear a peep about this. Where's Fox News on this? They went wall to wall last year when Palin said there were death panels, but now nothing. Great double standard and yet another example of politicians playing around with people's lives. Fair and Balanced my butt...

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Chony- So the "free market system" isn't providing the cost points that work for you? Hmmm. I thought the free market fixed everything. (Not based on anything you said but I've heard it somewhere, lol...)

Once the exchanges kick in in 2014, there will be more competition, which should lower prices. There will also be subsidies to help people and small business pay for coverage.

Unless the Republicans repeal the ACA, in which case you'll likely pay more...


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Bill in Dayton


[This message has been edited by Bill in Dayton (edited 12-15-2010).]

I want to stress, I think Canada has some significant issues that need addressed. I wouldn't desire the US to copy their system. There are better in Erupoe or Japan.

Here's a recent study form Health Affairs:

Very interesting...
http://theincidentaleconomist.com/wordpress/access-experiences-in-health-care/

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Bill in Dayton

Thanks for all the information, Bill! I think that for now, $439 is the best I'm going to get to insure myself and my spouse.

It looks like all the American full-time musicians here who do not have spouses with insurance benefits are in the same boat here.

My take on the new health care act is that it will insure millions of new people but it won't reduce rates for those already insured. Too many compromises were made to lobbyists from the insurance industry, hospitals, and pharmaceutical industry, all who made millions of dollars in campaign contributions to senators to water down the law and protect their interests.

In the last election cycle, these lobbies spent millions of dollars on anonymous ads to elect politicians who will gut the law altogether. They'll probably get their way.

Here's a link to a fascinating documentary from PBS, done by TR Reid.
http://www.pbs.org/wgbh/pages/frontline/...utm_source=grid

A terrific look at how several other countries handle their health care system.

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Bill in Dayton

Hi Guys:

I'm not here to argue healthcare and insurance. Just wanted to let you know that I realize it's a problem. I suppose one can read just about anything regarding any viewpoint on this complex issue. If I knew how to solve it, I'd be in Washington DC right now... being misunderstood, just like here... LOL! I sincerely hope that we can get this mess resolved... and quickly. When I'm at the poor-farm, I hope you guys will come by every month or so... and bring your arrangers to console me. (Another attempt at humor!)

Merry Christmas,

Dave (no relation to the famous U.D.)