Thursday, May 22, 2014
Middle Income Health Care musings - Flashback Thursday
Here's part of a post I wrote in 2010. I thought that in light of the current VA Hospital Scandal it was relevant. The Veterans Administration for our vets was our government's first foray into controlling health care for a section of Americans. It hasn't exactly worked out great for them. So I still scratch my head and wonder about the enthusiasm for Obamacare and wonder how many of us are going to end up on long waiting lists only to expire before we get the chance to see a doctor.
************ Post from 2010
I did spend a lot of time and attention on the Health Care issue this week and wanted to record some of my thoughts on that.
My first thought is - with the economy in shambles why are the President and the Congress spending so much time with health care. Wouldn't it make more sense to get people back to work first? It sure seems to me that besides supporting our troops in peril over seas, getting the economy roaring back should be enough of a full time job for our elected officials.Nonetheless, Health Care is going to be the topic in Washington for a few more weeks at least.
Mr. Pete and I have had a rocky relationship with Health Insurance and Health Care. When Mr. Pete was a kid he was insured through his father's job with General Motors. I had it through my mom's employment as a public school teacher. The attachment of employment to health benefits came about because of government meddling in the market place.
When we first got married, we had health insurance through Mr. Pete's work. Later I had it too through my job and we were doubly insured. However we eventually figured out that employment related health insurance could be like golden handcuffs, making it more difficult for us to consider any changes in our employment status. I remember really agonizing over it with the birth of my first baby and when Mr. Pete set out to fulfill his lifelong dream of having his own business. When he did start his own business we were without health care for quite a while.
That was one of the reasons we started having our babies at home - the cost was significantly lower! We had three homebirth experiences and the cost for all three didn't come anywhere near the cost of just one of our hospital births. We were lucky that our family doctor at the time was strictly fee-for-service so for under $30 we could have an office visit and pay cash for it. It was great! until he moved to the southern part of the state.
Since then Mr. Pete has had insurance for us at work but the premiums keep getting higher and higher. A few years ago Mr. Pete's company started a medical savings account plan. It has a $5000 deductible per person, per year. The idea was that they would have lower premiums and put the savings into these accounts, but one of their employees developed a chronic condition and employees' children got sick a lot so there was never any money going into those accounts. And since we are the family of the owner and not employees, our chance to use this savings plan was just about nil. Sometimes I tell Mr. Pete I would do better financially if he divorced me and then just hired me as an employee!
It's true what they say- you really do become a better health care consumer when you are paying for it yourself. When we were uninsured we were surprised to find out that our costs were higher because we couldn't get the group discount that insurance companies negotiated for their customers. So it turned out that because we couldn't afford the premiums for health insurance, we were charged the higher artificially inflated billing amounts - i.e. the $3 aspirin tablet or $5 sanitary pad instead of the lower costs our insured peers were billed.
But even with insurance having such a big deductible could really suck. Long time readers might remember I ended up being charged $400 for two kids with strep throat - office visit was $100 each and the lab test and blood work was $100 each. That was kind of unbelievable.
There were some rip offs with the insurance too (besides the premiums). Mr. Pete says that routine health visits and check ups would be free but his free physical cost us about $500. My sister said someone must have coded it wrong. I haven't bothered with mine yet.
Our health experience also once included a stint with our state's Medicaid program but my feelings about it are mixed. It was nice to know that if we needed to use it, it was there, but I had to jump through a LOT of hoops to get it and the paper work for the program had to be completed every six months. It was very time consuming. I also remember going to check out one of the dentists on the program. The waiting room consisted of carpet-covered boxes attached to the wall instead of chairs. There weren't private rooms for each patient with a dentist but instead about a dozen chairs in a circle in one big room. That was a little intimidating as well. I remember laying back in the chair, trying to get comfortable in this public surrounding with the dentist next to me starting his examination when I noticed that the light above me that he was using for guidance caught fire. Literally. I grabbed his hand out of mouth and shouted - LOOK! I never went back. Took my kids somewhere else for dental treatment and never regretted it!
I spent a lot of time reading other people's thoughts on the topic last week. Cecily wrote eloquently about her struggles. While I oppose universal health care I do agree with her that the system needs to be reformed and one of the reforms I would like to see is cutting the tie between insurance and employment with the idea being that if individuals and families were the main market for insurance programs, the premiums would have to come down.
I've also been debating this with some folks on Facebook that reflected some of the Catholic thought on the topic. On the pro-big government side several big guns were drawn as support for universal health care: GAUDIUM ET SPES (although I note the word "taxes" only appears once, "medical" once, "medicine" not at all and "health" only four times), the catechism particularly paragraph 2288 ( although I note that paying taxes is only mentioned once and while it says society out of concern for its citizens has to help attain living-conditions that allow them to grow and reach maturity: food and clothing, housing, health care, basic education, employment, and social assistance, it doesn't say it has to be done through taxation and big government.
In fact the catechism only says once that citizens are obliged to pay their taxes) and a pastoral letter from the USCCB which seemed to take it a step further . Some discussion ensued about the infallibility of pastoral letters. I dunno about that. I remember learning about the Winnipeg Statement and while I guess that wasn't exactly a pastoral letter it, to the lay person, it seemed to have the backup of the Canadian bishops. Nonetheless I don't think Economic Justice for All is the infallible thumbs up for Obamacare. And sadly even amongst Catholic Facebook Friends the discussion got kind of heated.
To me things seem a little simpler than all of that. Households can't spend more money than they take in. If that's how my household has to run, it seems that that is how the government needs to run as well. It that sense it's a good thing the public option is dead for now. More competition amongst insurance companies and eventually tort reform seem to be good steps towards bringing health care costs down. I haven't been able to find and read the nitty gritty of the President's plan yet. , but it sounds as if it's going to be very expensive and that can't be good for the country right now.
My own thinking goes like this:
Health care started to get out of control when government got involved. You know why health care is tied to employment? Because the government prohibited employers from giving higher salaries and to entice the best and the brightest companies started offering health care benefits- and Pandora's box was opened. When did prices start to spiral upward? With the advent of Medicare - and so it goes.
The answer to my mind is in less government and lower taxes and maybe even following the constitution! and with that kind of repression behind us, people will feel even more able to find creative and effective ways to reach out to the less fortunate.
In my opinion, Americans are the most generous people in the world. We are always donating for relief efforts at home and abroad. Let BIG government get out of the way and let us do that in bigger and better ways.
A pipe dream I know. In the meantime though I have crossed one Catholic college of my list as a possible "look see" for my high school junior, and feel reaffirmed in my decision to home school high school rather than paying Catholic high school tuition. I guess Catholic Social Justice teaching as it is currently being presented is way to liberal for me, and in conscience I couldn't support it with tuition dollars. I need every dime I can get for my insurance premium anyway!
Update, since I first blogged about this, the health care premium for Mr. Pete and his business partner has gone from $1000/ month for both families to over $2000. We still have the $5000 deductible per person, $10,000 per family.