Affordable Healthcare: Unaffordable Healthcare Insurance
Copyright 2006 Majella.us
If you think you have healthcare insurance, here are a few
simple questions you might ask yourself: Have you met your
deductible? If so, what were your out of pocket costs for the
year? How much did you and your employer pay for your healthcare
insurance last year and what did you get for it? And where is
your money going? According to the California Health Care
Foundation[1] 45 million Americans are "uninsured." While this
number may seem alarming, consider the fact that 100% of
American's are essentially uninsured on the 1st day of January,
every year, and they remain so until they have met their
deductibles--something that insurance companies are increasingly
making an impossible thing to do. You owe it to yourself to find
out the actual costs of healthcare in order to make intelligent
decisions about what you CAN afford. Here are some more
statistics that you might find alarming:
1. In 2004, the average healthcare premium employers were
charged for a family of four averaged $9,950[2].
2. By 2006, it is predicted that the average annual family
insurance premium will reach $14,500[3].
3. National surveys indicate that the primary reason for being
uninsured is for the simple reason that insurance is not
affordable[4].
4. There are more Americans (50%) who are now worried that they
cannot afford their healthcare insurance than there are (42%)
who report being worried about not being able to afford their
healthcare[5].
How do bills get paid?
Don't be fooled by the difference between billing and
reimbursement. Your insurance company will readily send you a
copy of the amount that was billed for your latest healthcare
encounter. What was actually paid--if anything--however, is
actually another story and it would behoove you to find this out
for yourself. Let me give you an example.
On October 6, 2003, the hospital sent a bill to my insurance
carrier (Blue Cross of California) in the amount of $11,569.20
for "Inpatient Services" related to an uncomplicated c-section
and a 2-day stay. My insurance carrier "discounted" the bill by
$9,869.20 to $1,700.00. This is the "fair and reasonable" amount
they "pay" for this service. But wait, who paid? I did! This
claim put me over my deductible for the year by whopping $7.70.
The amount applied to a member's deductible is always the amount
billed minus the "patient savings" minus any insurance
reimbursement and amounts "not allowed."
Mark my word, essentially, you will require major surgery or you
will have a significant accident that results in enormous bills
before you will meet your deductible--if you are still even able
to meet this amount at all. And until you exceed this amount,
you are a cash paying patient. Make no mistake about it.
See for yourself. In my case, the amount applied to the
deductible for the above transaction was: $11,569.20 - $9,869.20
- $11.00 = $1,689.00.
If you are still a non-believer, I can show you the bill on
April 4, 2003 for $766 where I paid $266 and only $84.26 was
applied to the deductible. I have many more examples and I'm
sure that if you pay attention, you will find plenty of your own.
But can you really afford to pay cash for healthcare?
Absolutely! What you can't afford, is healthcare insurance. If
you have a family, you already know that this is true. If you
are single--maybe, but why throw your money down the toilet when
you can get so much more for your hard earned cash!? I have a
wife and 4 kids. To pay $6,000.00 in premiums and miscellaneous
fees this year is simply unacceptable. I'm joining the ranks of
the uninsured and I have a good job! I just called Hollywood
Presbyterian Hospital to get an update on the cost of a
c-section. Low and behold, the cash price for a c-section is
$3,000.00. You can call yourself.
But what if you get injured and have massive bills? You have too
much to loose.
Of course you do. Hopefully, however, you are not ignorant
enough to believe that your healthcare insurance company is
going to bail you out under these circumstances. If for some God
forsaken reason you are hit by a truck and spend 2 months in the
hospital accumulating millions of dollars in bills, I am afraid
that you will still be in a pickle because your insurance
carrier is sure to sue the trucker's insurance carrier etc. for
the next 10 years while the collectors come after you for unpaid
bills.
You owe it to yourself to get smart and stop giving your hard
earned cash to this scandalous industry. Please feel free to
comment on this story for a lively discussion!
References
1. California Health Care Foundation, Health Care Costs 101 --
2005. Mar 2, 2005.
2. The Henry J. Kaiser Family Foundation, Employee Health
Benefits: 2004 Annual Survey. Sept 9, 2004.
3. Simmons, H.E. and M.A. Goldberg, Charting the Cost of
Inaction. National Coalition on Health Care, May, 2003.
4. The Henry J. Kaiser Family Foundation, Health Care Worries in
Context with Other Worries. Oct 4, 2004.
5. The Henry J. Kaiser Family Foundation, The Uninsured: A
Primer, Key Facts About Americans without Health Insurance. Nov
10, 2004.