The state of healthcare on the working poor

[Texashiker]

<serious thread>

My stepson works for a major reseller of home building supplies. Instead of leaching off the system he pays for health insurance through his job. The family qualifies for medicaid, but they choose not to use it.

A couple of months ago there was a change in the insurance policy. Instead of paying your typical $20 - $30 copay, he has to pay for the whole visit himself until he reaches a certain amount.

My oldest grandson has some bad allergies and has been getting a lot of ear infections lately. After several trips to the family doctor, the doctor referred the child to a ear nose and throat specialist.

The first visit was something like $167 out of pocket.
Next visit to have tubes put in kids ears is going to be something like $300
Then a follow up visit for another $167

My wife and I told my stepson to sign up for medicaid.

My stepson is trying to do the right thing by providing for his family. But it seems the company is working against its employees to force them onto public assistance.

If I understand it right, under the new obamacare people will be forced to buy healthcare. How are the working poor supposed to afford expensive copays, buy the insurance, and pay for everyday living expenses?

 

[shadow9d9]

Look up info on the new healthcare law to educate yourself.

 

[brycejones]

OP I hope this doesn't turn into a rage fest. I think the solution for the problem you have described is really moving to a single payer system. The issue with the ACA is that it doesn't go nearly far enough.

 

[nehalem256]

My wife and I told my stepson to sign up for medicaid.

My stepson is trying to do the right thing by providing for his family. But it seems the company is working against its employees to force them onto public assistance.

OP I hope this doesn't turn into a rage fest. I think the solution for the problem you have described is really moving to a single payer system. The issue with the ACA is that it doesn't go nearly far enough.

So how is your solution any different than what Texashiker suggest for his stepson? Except you want to toss everyone on medicaid...

Why work to provide for your family when the government will do it for you?

 

[shadow9d9]

So how is your solution any different than what Texashiker suggest for his stepson? Except you want to toss everyone on medicaid...

Why work to provide for your family when the government will do it for you?

You pay the government to help you when corporations are so greedy that they won't provide benefits.

 

[nehalem256]

You pay the government to help you when corporations are so greedy that they won't provide benefits.

I don't single mothers(with no job skills) with 3 bastard children are paying the government.

 

[Texashiker]

Why work to provide for your family when the government will do it for you?

I pay into medicare, so why cant I use it?

My stepson pays into medicare, so why cant he use it?

 

[shadow9d9]

I don't single mothers(with no job skills) with 3 bastard children are paying the government.

I don't deal with made up situations that you think exist everywhere.

 

[nehalem256]

I don't deal with made up situations that you think exist everywhere.

I didn't make it up (I didn't even include the part about 2 of the fathers being in prison ):

Take the case of 29-year-old Jennifer Stepp, who lives in Reading, Pa. Like 14 million other people in the U.S. who live in families headed by single mothers, she's poor. And she faces incredible odds.

Stepp has three children by three different fathers. The father of her eldest child, 10-year-old Isaiah, is serving 30 years in federal prison for armed robbery.

"He's met my son one time, when he was a baby. And he decided that he didn't want him," she says.

Stepp's middle child, 8-year-old Shyanne, usually sees her father every other weekend. But the father of her younger son is also in prison. Stepp says he's been behind bars for selling cocaine since she was pregnant. He has never met 1-year-old Makai.

....

Now, Stepp and her kids live in a three-bedroom apartment in the city. She doesn't let her kids play in city parks, because she's worried about crime and broken glass. Her employer, Opportunity House, pays half the rent. It's one of many things her employer does to help her out.

Stepp says her parents also struggled, and they didn't really show her how to apply for a job or to college. She had to figure it out herself. Still, her safety net is pretty broad. Her mother stops by many nights to help put the kids to bed. Stepp also gets food stamps and medical aid for the kids.

After her kids go to sleep, around 10:30 p.m., Stepp has a chance to reflect. She says it bothers her that single mothers sometimes get a bad name, that people think they just have babies and collect welfare. She says she briefly received welfare benefits a few years ago, but not now.

NOTE: Her employer, Opportunity House, is a charity.

The article is written to be sympathetic to the plight of poor single mothers, so apparently NPR thought she was a good representative case.

 

[Sonikku]

Considering how much the big corporations want less government and an end to the nanny state, they sure don't seem to mind making a business model off of allowing the government to subsidize the other half of their employees survival, or pigeon holing them into having no other choice.

 

[Incorruptible]

We need a healthcare system that reduces costs and serves the patient which can be accomplished with a free market system. Shame on the people for suggesting single payer.

 

[Vdubchaos]

There is no solution to healthcare problems.

EVERY single sector is an issue. Insurance, providers, pharma and of course the public as well.

NOTHING is changing and eventually it will collapse.

American's can't handle these 10-30% hikes each and every year.

Employers are giving up on covering and simply put the burden on the employees.

My job basically forced me to go onto state. My monthly payment went from $400 to $800 a month.

And now of course the state is cutting budgets and healthcare is one of them.....

fun

 

[nehalem256]

http://www.nytimes.com/2013/06/02/h...ds-the-world-in-health-expenditures.html?_r=0

This article does a good job of describing the actual problem. Simply put the US charges more for operations etc.

This has nothing to do with insurance companies, the typical liberal whipping boy. They are not making a 100%+ margin on operations.

I also think it has little to do directly with pharm companies. While lipitor is given as an example, what it comes down to is the marginal production cost of production is low, so a pharm company will be willing to sell at anything beyond that price. But the costs of development have to be born by someone, and the world tends to stick the US with the bill for that. In a sense US patients are subsidizing drugs for the rest of the 1st World.

 

[Londo_Jowo]

<serious thread>

My stepson works for a major reseller of home building supplies. Instead of leaching off the system he pays for health insurance through his job. The family qualifies for medicaid, but they choose not to use it.

A couple of months ago there was a change in the insurance policy. Instead of paying your typical $20 - $30 copay, he has to pay for the whole visit himself until he reaches a certain amount.

My oldest grandson has some bad allergies and has been getting a lot of ear infections lately. After several trips to the family doctor, the doctor referred the child to a ear nose and throat specialist.

The first visit was something like $167 out of pocket.
Next visit to have tubes put in kids ears is going to be something like $300
Then a follow up visit for another $167

My wife and I told my stepson to sign up for medicaid.

My stepson is trying to do the right thing by providing for his family. But it seems the company is working against its employees to force them onto public assistance.

If I understand it right, under the new obamacare people will be forced to buy healthcare. How are the working poor supposed to afford expensive copays, buy the insurance, and pay for everyday living expenses?

Do us all a favor and post what the annual deductible your stepson's insurance plan is and what the copay is after the deductible is met.

I have an annual deductible of $300 and then I pay 20% until I reach a max out of pocket of $2000.

 

[Attic]

The solution is don't be poor.

/s... though only slight

For all the talk we have about the 47% who don't pay a fair share... as a country we still really put the screws to the poor and lower middle class. Increasingly the middle class as a whole.

 

[fskimospy]

If I understand it right, under the new obamacare people will be forced to buy healthcare. How are the working poor supposed to afford expensive copays, buy the insurance, and pay for everyday living expenses?

The working poor qualify for medicaid and subsidized insurance premiums. If he qualifies for Medicaid, he should go get it.

 

[IronWing]

We need a healthcare system that reduces costs and serves the patient which can be accomplished with a free market system.

Been there, done that. Free market healthcare failed on both counts.

 

[glenn1]

You pay the government to help you when corporations are so greedy that they won't provide benefits.

Yes, they're so greedy that they won't systematically provide benefits at premiums that don't cover their costs. And thus putting themselves out of business and unable to provide any benefits whatsoever in the future.

And prices are only going up because Obamacare basically disallows two of the main ways companies could do ensure costs < premiums paid:

1. "shall issue" basically outlaws use of medical underwriting to set prices sufficient to cover actual expected costs
2. Minimum standards for covered benefits means they can't offer a less comprehensive policy for less money
3. Raise prices, letting Uncle Sam subsidize the costs.

 

[fskimospy]

Yes, they're so greedy that they won't systematically provide benefits at premiums that don't cover their costs. And thus putting themselves out of business and unable to provide any benefits whatsoever in the future.

And prices are only going up because Obamacare basically disallows two of the main ways companies could do ensure costs < premiums paid:

1. "shall issue" basically outlaws use of medical underwriting to set prices sufficient to cover actual expected costs
2. Minimum standards for covered benefits means they can't offer a less comprehensive policy for less money
3. Raise prices, letting Uncle Sam subsidize the costs.

You realize that since the ACA was passed that the rate of medical cost inflation has been much lower than normal, right? Correlation does not equal causation, but what you're saying here isn't supported by the evidence.

 

[Texashiker]

Do us all a favor and post what the annual deductible your stepson's insurance plan is and what the copay is after the deductible is met.

I have an annual deductible of $300 and then I pay 20% until I reach a max out of pocket of $2000.

I'll try to get that information.

 

[shadow9d9]

We need a healthcare system that reduces costs and serves the patient which can be accomplished with a free market system. Shame on the people for suggesting single payer.

No other first world country uses "free market" because the idea that a free market could be used for a necessity and monopoly is absurd.

 

[shadow9d9]

Yes, they're so greedy that they won't systematically provide benefits at premiums that don't cover their costs. And thus putting themselves out of business and unable to provide any benefits whatsoever in the future.

And prices are only going up because Obamacare basically disallows two of the main ways companies could do ensure costs < premiums paid:

1. "shall issue" basically outlaws use of medical underwriting to set prices sufficient to cover actual expected costs
2. Minimum standards for covered benefits means they can't offer a less comprehensive policy for less money
3. Raise prices, letting Uncle Sam subsidize the costs.

Prices went up an INSANE amount for healthcare/insurance over the last 20 years...trying to blame it on "obamacare" is laughable.

 

[glenn1]

You realize that since the ACA was passed that the rate of medical cost inflation has been much lower than normal, right? Correlation does not equal causation, but what you're saying here isn't supported by the evidence.

Saying that companies can't survive as going concerns if their costs exceed revenues is fairly self-evident IMHO.

As for cost deflation, that's 3-ish years of data points inside a rising trendline going on decades if not centuries. Also, correlation =! causation is just as much applicable to ascribing this drop to Obamacare. Since most of the currently operating provisions of Obamacare are pushing on the demand side (guaranteed issue, coverage on parents insurance until 26, etc) without bringing any additional supply online (new company providers or new enrollees whose policies are generally economically profitable) it seems somewhat implausible that Obamacare is the cause of the cost inflation drop. I'm willing to consider whatever evidence you have to the contrary however.

 

[fskimospy]

Saying that companies can't survive as going concerns if their costs exceed revenues is fairly self-evident IMHO.

As for cost deflation, that's 3-ish years of data points inside a rising trendline going on decades if not centuries. Also, correlation =! causation is just as much applicable to ascribing this drop to Obamacare. Since most of the currently operating provisions of Obamacare are pushing on the demand side (guaranteed issue, coverage on parents insurance until 26, etc) without bringing any additional supply online (new company providers or new enrollees) it seems somewhat implausible that Obamacare is the cause of the cost inflation drop. I'm willing to consider whatever evidence you have to the contrary however.

My point was that you were claiming cost increases were due to the ACA, which is implausible considering that cost increases have slowed since implementation. While there is already evidence that the ACA is helping to lower insurance premium costs through increased competition, I was just pointing out that your statement lacked factual support.

 

[Incorruptible]

No other first world country uses "free market" because the idea that a free market could be used for a necessity and monopoly is absurd.

No it's not. The free market system would reduce costs and provide better healthcare.