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Can we talk about health care reform? This isn't an "I'm right and you're wrong" kind of post. The law is what the law is and at this point, much of what people are talking about is little more than speculation, and arguing speculation is pretty darn silly. This is a "Will someone please be honest and give me the 'bad' along with the 'good' instead of blowing sunshine up my ass?" post.
Just so you know where I am coming from, I do believe there is good in the health care reform. The high points?
(1) No lifetime limit on health care coverage
My current insurance has a $5 MIL lifetime cap per person, which is actually pretty high by today's standards, but one serious, long-term health issue could easily chew that up. I hope to never be anywhere near that lifetime cap, but it is good to now know that I don't have to worry about it should circumstances lead me down that path.
(2) "Children" are able to stay on their parents insurance policies up to age 26
I haven't heard what the requirements are for this however most insurance policies currently allow children up to age 22 to remain on their parent's policies as long as they are enrolled in college. This is a great option for parents - giving them the opportunity to continue to help out their kids as they graduate from college and get started out in "real life."
(3) No denial of coverage due to significant health issues
This actually happens throughout the insurance industry because insurance is a numbers game. Have a significant home owner's claim and you might find your insurance dropped. Have too many tickets or accidents and your automobile insurance will likely be dropped. The problem when dealing with this issue in health care is that your treatment options, and quality of care, change measurably when you are dropped from a policy.
(4) Available coverage for those with pre-existing conditions
This was another significant flaw in the system. Denying coverage to those who have the most need for it may make good business sense, but again, it limits treatment options, and quality of care for a great many Americans.
See? I can be objective even though I tend to lean toward fiscally conservative politics! In fact, I'd argue that most people who are feeling angst over health care reform are very much like me ... but you'd never know it by watching the media and monitoring twitter.
My objections are not to providing the things I mentioned above. My objections are to how we are going to do this, the honesty in regards to the cost to each of us, and whether it is fiscally responsible to do so in the ways the law is written.
I keep hearing how this law won't impact my insurance coverage or my taxes - in fact, I can go to this Washington Post link, enter in my data, and "prove" that it won't impact my insurance coverage or my taxes - but in reality, I (and every other American) am being told half-truths.
No, my family income is not above $250,000, so I won't see the Medicare Part A tax rate increased of 0.9% (to 2.35%) nor will I see the entirely new 3.8% tax on unearned income (dividends, interest, etc.), but I can guarantee that I will pay for those tax hikes as they trickle down hill to the cost of goods and services I use every day.
The so called “Cadillac Tax” might get me though. No, I'm not specifically being taxed if my employer offers a health plan that cost more than $10,200 annually for individual coverage, or $27,500 annually for family coverage, but with the tax being 40% of the cost of the plan that exceeds those dollar thresholds, it's a safe bet that I'll see a premium increases should I want to stay with the best coverage my employer has to offer.
Have I mentioned the changes to health care flex spending accounts? Currently, employers set the limit on how much an employee can contribute (pre-tax) to flex spending accounts. The new law caps that contribution to $2500 and excludes reimbursement through flex spending accounts for OTC medicines and (most) medical devices.
If I were a young, single person, this probably wouldn't matter much, but as a "middle income" family of 5, three of whom wear glasses and or contacts, two of whom have chronic health conditions that require frequent (multiple times per month) specialist visits and maintenance medications, and two of whom are actively involved in contact sports that often result in injuries, we easily go through the $5000/year we set aside for flex spending. The $2500 cap costs my family about $700 in tax savings per year.
Some of the other taxes include $16 billion between 2011 and 2019 paid by drug manufacturers (likely resulting in higher prescription drug costs), $47 billion paid by health insurers over the same period (likely resulting in higher premium costs), and a 2.9% excise tax imposed on medical devise manufacturers on the sale of any of their wares beginning Jan. 1, 2013 (likely resulting in higher equipment costs). Oh, and let's not forget the 10% tax on indoor tanning services. Fortunately health care reform didn't tax outdoor tanning services or I'd have to move to Seattle to reduce my costs!
So, the White House really isn't lying when they tell me they aren't going to raise my taxes or change my insurance coverage, but by leading me to believe there will be no financial impact on my family, they aren't being completely honest either.
No, my taxes won't be raised. My insurance coverage won't change. But you damn well better believe I will still pay for health care reform. I'll get less tax savings, I'll pay higher co-pays and deductibles and my insurance rates will likely increase (there is some debate on this one - only time will tell).
In my case I know the cost to my family will be at least $700/year. My educated guess is, when higher costs are figured in, it will be at least twice that amount or at least $100/month. That's a week's worth of groceries for a family of five, and that concerns me.
Does it mean I want to keep children from receiving medical care or that I don't care if poor people die because they can't afford medical insurance? Not in the least. It means that I am doing something as an individual that our government needs to do a lot more of - accept fiscal responsibility for my situation.
Just so you know where I am coming from, I do believe there is good in the health care reform. The high points?
(1) No lifetime limit on health care coverage
My current insurance has a $5 MIL lifetime cap per person, which is actually pretty high by today's standards, but one serious, long-term health issue could easily chew that up. I hope to never be anywhere near that lifetime cap, but it is good to now know that I don't have to worry about it should circumstances lead me down that path.
(2) "Children" are able to stay on their parents insurance policies up to age 26
I haven't heard what the requirements are for this however most insurance policies currently allow children up to age 22 to remain on their parent's policies as long as they are enrolled in college. This is a great option for parents - giving them the opportunity to continue to help out their kids as they graduate from college and get started out in "real life."
(3) No denial of coverage due to significant health issues
This actually happens throughout the insurance industry because insurance is a numbers game. Have a significant home owner's claim and you might find your insurance dropped. Have too many tickets or accidents and your automobile insurance will likely be dropped. The problem when dealing with this issue in health care is that your treatment options, and quality of care, change measurably when you are dropped from a policy.
(4) Available coverage for those with pre-existing conditions
This was another significant flaw in the system. Denying coverage to those who have the most need for it may make good business sense, but again, it limits treatment options, and quality of care for a great many Americans.
See? I can be objective even though I tend to lean toward fiscally conservative politics! In fact, I'd argue that most people who are feeling angst over health care reform are very much like me ... but you'd never know it by watching the media and monitoring twitter.
My objections are not to providing the things I mentioned above. My objections are to how we are going to do this, the honesty in regards to the cost to each of us, and whether it is fiscally responsible to do so in the ways the law is written.
I keep hearing how this law won't impact my insurance coverage or my taxes - in fact, I can go to this Washington Post link, enter in my data, and "prove" that it won't impact my insurance coverage or my taxes - but in reality, I (and every other American) am being told half-truths.
No, my family income is not above $250,000, so I won't see the Medicare Part A tax rate increased of 0.9% (to 2.35%) nor will I see the entirely new 3.8% tax on unearned income (dividends, interest, etc.), but I can guarantee that I will pay for those tax hikes as they trickle down hill to the cost of goods and services I use every day.
The so called “Cadillac Tax” might get me though. No, I'm not specifically being taxed if my employer offers a health plan that cost more than $10,200 annually for individual coverage, or $27,500 annually for family coverage, but with the tax being 40% of the cost of the plan that exceeds those dollar thresholds, it's a safe bet that I'll see a premium increases should I want to stay with the best coverage my employer has to offer.
Have I mentioned the changes to health care flex spending accounts? Currently, employers set the limit on how much an employee can contribute (pre-tax) to flex spending accounts. The new law caps that contribution to $2500 and excludes reimbursement through flex spending accounts for OTC medicines and (most) medical devices.
If I were a young, single person, this probably wouldn't matter much, but as a "middle income" family of 5, three of whom wear glasses and or contacts, two of whom have chronic health conditions that require frequent (multiple times per month) specialist visits and maintenance medications, and two of whom are actively involved in contact sports that often result in injuries, we easily go through the $5000/year we set aside for flex spending. The $2500 cap costs my family about $700 in tax savings per year.
Some of the other taxes include $16 billion between 2011 and 2019 paid by drug manufacturers (likely resulting in higher prescription drug costs), $47 billion paid by health insurers over the same period (likely resulting in higher premium costs), and a 2.9% excise tax imposed on medical devise manufacturers on the sale of any of their wares beginning Jan. 1, 2013 (likely resulting in higher equipment costs). Oh, and let's not forget the 10% tax on indoor tanning services. Fortunately health care reform didn't tax outdoor tanning services or I'd have to move to Seattle to reduce my costs!
So, the White House really isn't lying when they tell me they aren't going to raise my taxes or change my insurance coverage, but by leading me to believe there will be no financial impact on my family, they aren't being completely honest either.
No, my taxes won't be raised. My insurance coverage won't change. But you damn well better believe I will still pay for health care reform. I'll get less tax savings, I'll pay higher co-pays and deductibles and my insurance rates will likely increase (there is some debate on this one - only time will tell).
In my case I know the cost to my family will be at least $700/year. My educated guess is, when higher costs are figured in, it will be at least twice that amount or at least $100/month. That's a week's worth of groceries for a family of five, and that concerns me.
Does it mean I want to keep children from receiving medical care or that I don't care if poor people die because they can't afford medical insurance? Not in the least. It means that I am doing something as an individual that our government needs to do a lot more of - accept fiscal responsibility for my situation.
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13 comments:
Mine and most of my friends are allowed to keep our children on our policy until the age of 25, that my vary state to state, I don't know. I am interested to know what your view is on abortions being covered or not, just curious what your take is on that. I guess you are counting yourself as still married with stepkids to be a family of 5 you've referred to. If that is the case then you should not have to go to the food pantry's; you should still be benefitting from the community property shouldn't you? I'm not sure if that is coming out how it is intended, I am not dissing you for feeding you and Cam, I am saying that I hope you have at least some sort of temporary support from him, and if not I hope you get it court ordered.
Being punished for having Cadillac Coverage is ridiculous. It is another tax on the successful, responsible people. Why does the government consistently make it advantageous to contribute less to society and to earn less money? It honestly is insulting. If I am going to be required to pay an extra 5% in taxes to supplement this insurance reform, how about the American's insured under this new law contribute 5% of their income to my student loans? I think that is only fair.
snugs, the abortion issue is a sticky one. The Hyde Amendment (1976) excludes abortion from the comprehensive health care services provided by the federal government (with some exceptions). It will be interesting to see how this "conflict" is handled when the government is subsidizing all health care coverage.
Karen, I too, am quite frustrated that by doing the "right" thing (carrying comprehensive health insurance and putting aside money to cover out-of-pocket health care expenses) I will now be "punished" with higher premiums and less tax savings.
i don't generally speak out about politics in my blogging life....
but i have to at least say this -
these posts - are just one of the reasons i love reading you.
Great post!
It's nice to hear someone realizing that this IS going to cost us. Somehow. Someday. Probably sooner rather than later.
And if you hit the health insurance companies too hard, they'll have to do something to offset higher costs, won't they? Perhaps they'll start doing what some of the auto/casualty insurers have done in the past...remove themselves from states that have very high payout to premium ratios. The Pharma companies? They will likely slow down or stop new research. Why would they continue if there would be severe penalties for developing new drugs and actually...gasp...earning a profit.
There are so many flaws in this plan it's scary.
The only real way to lower the total cost of health care in this country is for everyone to take better care of themselves. Thirty percent of the population smokes, seventy percent of the population does not exercise regularly, we eat too much food and eat the wrong things...and we wonder why health care costs are out of control. And then we use the unfortunate few that legitimately got sick not of their own accord as an example of everyone, when in fact they are a small fraction of the people that are over stressing our health care system.
Please. I go to the gym regularly and work my ass off. I try to eat right most of the time. Please don't ask me to pay for someone that is chomping on a big mac between puffs on a cigarette while I'm working out. Ask THEM to self correct. There's plenty of money in the present system to deal with the unfortunate outliers if people didn't self inflict poor health onto themselves!
well I for one watched the debates all day and was fascinated. I am glad this is passed but it will be changed long before much kicks in so people need to take a deep breath and relax. in my state my son cannot be on coverage unless he is a full time student, once he turns 19 so I am thrilled about that change.
the bigger issue that congress cannot put on their big boy pants and play in the sand box together.
One of the big sticking points about this reform policy for me is that the Government is forcing everyone to have health insurance. If you don't your taxes will be raised or you will pay a penalty on your taxes.
I believe this to be unconstitutional. That would be like forcing everyone to get a driver's license. If you don't have one, then we are going monetarily penalize you in some way.
Excellent post Dana. I understand this might cost us more, but the alternatives are just to horrible to imagine.
The disinformation being put out there by the opponents of this bill is a terrible thing.
Your words would explain this to so many.
To follow up on yesterday's post, do you see what happens when you write an intelligent post that can not be commented on with a funny quip? Your comments go down...Don't allow that to stop you from writing these.
k bare, generally, female bloggers do tend to stay away from politics which I think is unfortunate. I believe there is a lot to say and we should use our voice more frequently!
Real Live Lesbian, I know there are people who feel change needed to occur at any cost. Call me selfish, but I'm not one of them. I believe change needed to occur when we could be honest with everyone about the cost.
Justa, I think preventive care is HUGE. I also think the reason the government is becoming so intrusive in day-to-day life (i.e. tanning tax, requirement for fast food restaurants to include calorie counts on menus, etc.) is that they now have a vested interest in the cost of health care. Too bad it isn't really about the people!
dlk24, I finally saw the requirements for covering adult children, one of which is that they cannot be eligible for insurance through their employer.
Joker_SATX, I'm not a fan of the mandate either, but it looks like it will actually cost less to NOT have insurance than it will to carry it in many cases. I am wondering just how they'll enforce this as well.
Bond, I will never attempt to discount the benefits of providing insurance for all who desire to carry it, I'm just not sure this was even close to being the best we could do though!
I'm probably in the minority here on healthcare reform in general (not what was passed though), what with being one of those liberal northeastern, public-health-degreed bleeding hearts. But I will say that this bill came as a result of compromise that turned out to please and benefit very few people. By trying to placate the people who weren't going to vote for it anyway, they just ended up pissing off the people who were trying for real reform.
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