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Universal healthcare: One user's experience
By adamg on Fri, 01/18/2008 - 9:12am
ChezNiki describes what it's like to actually be covered by one of the plans set up for people who don't have work-provided health insurance:
... This so-called Universal Healthcare takes a law degree and three or four agencies to decipher, and will be a nightmare for anyone with a language barrier, a temp job or seasonal work. The State will have a very difficult time collecting the tax penalties from people who couldn’t afford the healthcare in the first place. People whose taxes are ultimately taken may even form a class and sue. And the uninsured, underinsured and folk with misplaced paperwork will wind up where we always do for our health care, in an eight to twelve hour wait in Emergency. ...
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Comments
Does anyone else have a problem with this?
Universal Healthcare enforcement, performed by
the Department of Revenue? As in, you can't
afford the programs offered, so we're going
to whack you for $950 that you don't have.
Thanks for filing your taxes and playing by the rules.
And oh, for those of you working under the table
and not paying taxes at all, you're free to leave
without the $950 surcharge.
Huh?
Yup
It struck me as ridiculous, too.
Aside - If the repeal-the-income-tax question passes, where will the enforcement of this provision go?
Suldog
http://jimsuldog.blogspot.com
I don't like the system, either
But her "I wasn't working. I was temping" excuse is nonsense. It sounds like she still got a raw deal, but I'm less sure given her apparent inability to understand that providing work for money is "working" even if its only on a temporary basis. They aren't paying her in Monopoly money.
Temping while collecting unemployment
You are allowed to do a certain amount of work while collecting unemployment, before the unemployment benefits get reduced. I don't know the exact figures, or how any of this interacts with the new health insurance plans.
Unemployment system is different
Unemployment isn't designed to replace income, after all, so it makes sense that some limited work would be allowed. But she wasn't on unemployment because she quit her last full-time job. It sounds like she got herself into a plan designed for people below the poverty line and she admits that her income puts herself well above the poverty line. I'm not saying that the poverty line isn't too low, but the solution isn't to hide income to seem below it.
Indeed, since she makes a point of saying she makes several hundred percent the poverty line, I'd assume she means that she's over the 300% threshold for Connector Plan. That would suggest she's making nearly $30,000 "not working".
This isn't saying that the system isn't flawed. I agree that the premiums are too high and that the system is needlessly complicated. While I believe in universal health care, I don't believe that mandates will prove an efficient or effective way to provide it. That's all something to complain about. Not that you weren't able to hide income from a state run program.
Problem: People Don't have
Problem: People Don't have health insurance because they can't afford it.
Solution: Make not having health insurance illegal.
What could possibly go wrong?
Well said
n/t
It's the law, you need the insurance, suck it up
Sorry, no sympathy.
Suck it up.
You make money, you need coverage. Who the hell do you think is going to pay for it, if you don't?
We all have bills to pay.
It's not easy for any of us.
The Massachusetts Universal Healthcare Law is fantastic. I'm happy we have it and proud, too.
We are all residents of the Commonwealth. Therefore, we all have to share in its costs.
Sorry, freeloader, no sympathy here.
Yep, it a recipe for sure fire success!
State Bureaucracy. Department of Revenue enforcement.
Those always helpful health insurance companies. And
hospital billing departments.
What could go wrong, when you mix those elements together
with a serious illness or two?
Add English as a second language for a large part of the
population you're attempting to address, just to make sure
that you've covered all the bases. Now that's what I call
progess!
Easy for you to say
Its easy for someone who can afford it to say suck it up. Sure, we all have bills to pay. I've got car payments, student loans, rent, groceries, etc, just like anyone else. I could pay for health insurance on top of it, but that means I wouldn't be able to pay one of my other bills.
Which company can I tell to suck it up and not get payment from me? I suppose my student loans since they can't take my education away from me, like they could with my car, but they could take my good credit away from me and some day I'd like to stop paying rent and start paying a mortgage. that won't happen with bad credit.
I don't need coverage - I am young and in perfect health. Sure some accident could befall me, but the likelihood of that happening is extremely remote. Meanwhile, the thousands of dollars I have saved over the years by not having insurance would more than make up for the cost of a couple broken bones, and then some.
No, you NEED coverage
See, stupidity like this is why we're stuck with such a bad law. Because while the law is bad, its trying to achieve something good. And enough idiots try to gamble on not having insurance to justify the notion that the problem is that people who can have it just aren't getting it. That people just needed a financial motive to get insurance.
I wonder if its a problem with parents/schools not teaching enough fiscal responsibility. When I graduated college I was on my parents insurance for a few months. When it lapsed and I didn't have a full-time job, I was incredibly scared. The situation made me horribly uncomfortable and I was very thrilled when I finally got insurance.
Do I "need" it? No. I'm bad, too, so I never go to the doctor. I've made three visits for eye exams in the last 8 years. By your logic, the thousands of dollars I've spent have been "wasted", but I know that's wrong. Because I know that health insurance is INSURANCE not a payment plan. That I haven't used it isn't the point. If I got into an accident, if I got sick, if something horrible and catastrophic happened to me, I'd have been okay. I wouldn't have my life ruined by medical debt while I was still in my 20's. Those are the stakes. Regular medical is just a bonus. It's getting your money's worth. The reason you get insurance is so your life doesn't get completely ruined if you get hurt or sick. You want to try paying of tens or hundreds of thousands of dollars in medical bills? You think that'll do wonders for your credit?
I'm sorry, but if you are working, you have no reason not to have health insurance. We ALL have bills to pay. I made very little throughout my 20's. I now learn that I was spent about 5 years hovering between 2-3 times the poverty line. All while paying rent, paying almost $600 a month in student loans, etc. I made it work. You may not get everything you want. You may need to have roommates longer than you want. You may not be able to have a new car or any car. But you'll get by just fine. You won't go cold. You won't go hungry. I did it myself while paying almost $100 a month for health care. The one good thing this law did was expand access to health care for individuals. The premiums are too high and the assistance thresholds too low, but its still something.
Cautionary Tale
A former coworker of my husband was changing jobs. He thought long and hard about paying for COBRA for the month or two he was taking off in between. He finally decided that he could afford the $300 for the interim time, even though he was young and healthy and would not be seeing another paycheck until he returned to work in a couple of months (he had a new job lined up).
So he payed the bill and went off on a rolicking summer ramble for a couple of months.
At least that was what he intended to do ... he was sleeping in the back seat of a car on the Jersey Turnpike. He never really knew or remembered what happened. What he did remember was waking up in a hospital, partially paralyzed.
Best money he ever spent.
Well said, BStu.
Well said, BStu. The above-mentioned quote from your post speaks volumes about why people need health insurance. Bravo.
No, I don't NEED it
Am I saying that health insurance is a bad thing? Absolutely not. I wish I could afford it; I wish we all could. You are right that I am gambling I won't be hit by a car while sleeping on the side of the Jersey Turnpike - for one thing I'm not stupid enough to do that and for another the chances of that happening are so remotely minute as to make it not worth worrying about.
Guess what? The state knows that, too. They are gambling on me paying month after month and never needing the services. They want me to pay more than $100 a month for insurance they know I almost certainly won't need. There is a small, outside chance, but that is a risk they are willing to take. It's also one I am willing to take. Why should they be allowed to take that bet but I can't?
I don't think you wasted all that money, but I also don't think I am fiscally irresponsible, either. Now that I am making slightly more money than I did in my last job I have just set up my first IRA. They money I am going to put in there will do me far better than it would if I was to simply send it off to line the pockets of an insurance executive.
Fiscal responsibility has nothing whatsoever to do with it.
It has to do with the fact that nobody, whoever s/he may be, is infallible. One can become seriously injured or ill anytime. Maybe you are fiscally responsible, and a responsible driver who doesn't get into accidents of their own making, but, unfortunately, not everybody on the road is responsible, and there's always the possibility of having a car accident that's not of your own making. If you're driving along, and someone rear-ends your car, cuts you off, or if another driver runs a red light or STOP sign and hits your car broadside, particularly in the driver's seat, or if there are any passengers in your car with you, or drives into your lane while going in the opposite direction, colliding head-on into you, or, in the event of a roll-over accident, and you wind up seriously injured and in the hospital as a consequence of any of the above accident(s), you'd be absolutely and totally up the creek without healthcare insurance. You might want to think about that.
You're right. I would
You are absolutely right. If I were to be in a horrific car accident today then I most certainly would be far, far up the creek. No doubt about it.
The odds of that happening are very slim, however, and at this point in my life that is a risk I am willing to take. If it is not one that you are willing to take then I completely understand and respect your decision. Why is it so difficult for you to accept the fact that I am a rational person who has done a cost/ benefit analysis and come to a different conclusion than you did when you were my age? Why can I not be independent minded as well?
Because ...
If you DO get into that accident, then I wind up paying for it, along with everybody else who did buy insurance (because, fortunately, a hospital can't refuse you service even if you aren't insured). Why should I pay for your decision?
Why should I?
If I am forced against my will to get health insurance, and you and I are in the same plan, then I can be forced to subsidize your liposuction (or insert another non-necessary procedure). Why should I be forced to pay for your decision?
Sorry, Anonymous, but
I'm not buying into that at all. Even if you were to be covered by the same insurance company as one of us, your account would be different, and, especially since you're much younger, you'd be paying far less for premiums than an adult who is much older, like in their 40's, 50's or beyond.
It's also true, however, that, everytime one has an automobile accident where s/he is at fault, that person's automobile insurance gets jacked up...by a lot, partcularly if a person's under 25 years of age.
Regarding health insurance, nobody's going to force anybody to subsidize another person's liposuction treatment or whatever. That idea's merely a smokescreen that people who don't want health insurance use as an excuse.
It's no smokescreen
The premiums I pay and the premiums you pay go into the same pot. My premiums would help to pay for your liposuction, no matter how old you were. That's not the point, however. The fundamental point is, I don't have an extra $1,200 in my budget. I can't afford to have insurance, so I don't have insurance. Plain and simple.
I live in a small, attic apartment. I don't go out more than once or twice a month. I eat out once or twice a year, tops. If I eat lunch I bring it with me, but usually skip that meal all together to save on the grocery bill. I run so I don't have to pay a gym membership. I could go on and on. You take a look at my budget and tell me where I can save more than $100 a month. If you can, you deserve the Nobel Prize in economics.
Far, far too many people take this sort of
Far, far too many people, imo, take for granted that catastrophes of some sort or other will never, ever happen to them. That's a naive and dangerously cavalier attitude to take, imo.
If you ever, ever had some sort of catastrophe happen to you, be it serious injury or illness, you'd be out more than just twelve hundred dollars. Also, anonymous, rest assured that you'll never, ever have to pay for my liposuction or plastic surgery if I ever wanted either of them.
I'm not saying never
I'm saying highly unlikely, extremely unlikely, slim to near nil chances. The reason Jon Lester's testicular cancer made the news (aside from his being a Red Sock) is that it was so rare. The millions of cars that make it to their destinations safely every day don't make the 11 o'clock news.
As I pointed out above, the state and the insurance companies know that as well. They want to take my money, and use it to cover the expenses of older people who are more likely to need it. They need my $1,200 a year more than I need their assurances that they will be there in case I do have some tragedy befall me.
All that said, now we are just repeating arguments. You have made you previous point before, and this is the second time I have made mine. Unless you have something new to say, at this point I will simply end by saying I respectfully disagree.
$1200 a year
It doesn't even begin to cover the cost of insuring a young, healthy person even you. You are subsidizing nobody at that rate. One broken bone in a five year period and you are still not subsidizing anybody. It merely defrays the inevitable cost of whatever reason you WILL end up in the emergency room - and encourages you to go to the doctor for that strep throat rather than become a charity case with rheumatic fever and heart valve damage.
With your grasp of risk, statistics, and costs and benefits, I suppose you are just biding your time in a crappy job until you win the lottery, too? Maybe you should look for a job at one of the local hospitals - pays better, provides benefits, and would give you a first hand concept of how much insuring your fair self REALLY costs compared to $1200. In other words, you would learn how much you are being subsidized, whether you are paying $1200 a year or become a charity case when something preventable blows up on you or when you get into an accident that isn't even your own fault.
Something new to say
The only thing I have to add with this is that you're gambling partially with someone else's money.
Personally, I understand that you're making a cost/benefit analysis, and this is where you think it comes out. My half-brother reaches the same conclusion. I think you probably know more about the facts of your life than I do, so I'm willing to take your word for it. But I think part of the problem other people have with your cost/benefit analysis is that it seems you're only figuring in your costs, not the costs to other people, such as taxpayers and other health care users.
The argument that you shouldn't have to pay for old farts like me having numerous medical procedures seems reasonable to me -- but how about the argument that we shouldn't have to pay your emergency room expenses?
I have to say I don't think that's a good argument. I think you should be able to go to the emergency room if you slip with the chainsaw, whether or not you have insurance. And you can't get blood from a stone, so odds are good you won't have to pay much of that back - the hospital will have to eat it.
So there's a bug in your rational argument -- your gambling has a partial safety net provided by me, other taxpayers, and other hospital users.
Where I might differ from others, however, is in saying "you're welcome" rather than "you're ignorant." And I sincerely hope that you manage to get insured before you get hurt.
Red herring alert
My health plan doesn't pay for "unnecessary" procedures, so don't worry, you won't be paying for my nose job or hair transplant.
LOL!
Seriously, I'm LOL! Adam, you're a comedian!!
What about ...
your nose hair transplant?
BTW anon, you are a complete idiot to go without coverage. If you think you can't afford health insurance, wait until you REALLY need it.
You aren't paying for anybody else - you are just banking for your inevitable demise.
As for this:
The only time I could imagine any insurance plan paying for an unnecessary and entirely cosmetic procedure is when they pay for that sacred cow called infant circumcision. The only possible time anything remotely related to liposuction would be covered is when it is actually necessary - such as for the removal of a lipoma. (liposarcoma would be resectioned en bloc).
By repeating this highly erroneous refrain about cosmetic surgery, you are simply demonstrating how very willfully and intractably ignorant you are.
SwirlyGrrl, you've articulated some good points.
SwirlyGrrl, your post, especially the above-mentioned quote from it, articulates
precisely and succinctly what we've all been trying to drive home here on this particular thread that clearly can't be underscored enough: People can't afford not to have health insurance coverage. It's quite scary to know that millions of people not only here in the Bay State, but in the United States overall, are either without health insurance or are inadequately covered.
Come to think of it, I have a friend who thinks the same way..and it's like fighting an uphill battle to try to convince him otherwise. SwirlyGrrl, it looks like there are quite afew people like that here, too. It's agreed...Anon--by going without healthcare coverage, you're taking your limb and life in your hands..
Oh, and one more thing
Oh, and one more thing Anonignoramus,
My friend was IN A CAR sleeping in THE BACK SEAT while a friend of his drove down the Jersey Turnpike.
He might also have been in a bus.
You are also at rather high risk of injury in traffic. We all are. The statistics are daunting, so maybe your brain can't grasp your personal risk here?
What I wrote is pretty damn clear. After looking up thread and finding that you can't even follow a simple sentence, I think it is pretty damn clear that you need to learn to read, but I'm not holding out much hope. Lent is coming up and maybe you could make a few bucks of a friday afternoon selling some of that red herring you are peddling here, no?
Not needed, nor helpful
I am very sorry for misunderstanding you, and even sorrier for what happened to your friend. I assumed that he pulled over on the side of the road to take a nap. You never mentioned that someone else was in the car. I'll chalk this up to a simple and innocent misunderstanding, rather than hurl an ad hominem attack at you. Such personal attacks don't do anything to advance the conversation, and by insulting me and my intelligence you don't endear yourself or your argument to me.
About that liposuction ...
Did you get the part about how plastic surgery isn't covered now too? How about the bit where your risk of injury and illness is higher than you are making it out to be?
Calling someone ignorant isn't an ad hominem attack when there is prima facia evidence of stubborn ignorance of reality of both insurance plans and personal risks.
Just an aside
Different anon here. Calling someone ignorant actually *is* an ad hominem attack, regardless of the evidence. It's purely name calling. If there's evidence of something like one person being ignorant or obstinant and you debunk their debate points, that should make it obvious to all whose argument is stronger and doesn't require any comments on the person's lack of intelligence, etc. It only distracts from the logic of the discussion and acts to characterize the person and not their poor argumentation, thus the ad hominem logical fallacy (i.e. "you are stupid" implies everything they say should be ignored and doesn't address what they said). If you address what they said, then anything else is extraneous and just gives them ways to attempt to play off your valid responses by arguing the arguing rather than the actual debate points.
Yes, "temping" is working
Hmmm, yes, that's why they call it temp WORK.
It stinks being short of money, but would you rather have medical insurance or not? And who else should pay for your insurance if not you? I have a pretty good BC/BS plan through my company, and I've had to wait 4-5 weeks for my PCP to see me too. Plenty of people wait in ERs for 8 hours, that's not uncommon. ChezNiki's experiences are what health care is like for most people, not just people under the state's universal health care system.
And for the healthy, young person who thinks the thousands of dollars he saved over a few years will take care of him if he breaks a bone, think again. If you badly twist your knee and need arthroscopic surgery to repair torn ligaments, you'll be out 20K in no time. Get the insurance! Or get a job that offers insurance. Pronto.
It's agreed, Kelly.
All too often, one reads or hears about people without any kind of health insurance who're young, healthy, etc, and ending up either sick or injured, and they end up totally depleting whatever savings they may have had, all because of no health insurance.
I still remember many years ago, I saw something on "60 Minutes", where a woman was shot in the back while walking through downtown Detroit with a friend of hers. Before that horrific incident, as a divorced mother with a 7-year-old daughter, she'd had a good job, working to support herself and her young daughter. Unfortunately, this woman had no health insurance--her place of employment didn't offer it. By the time the woman got out of the hospital....you guessed it...she was flat broke and a welfare case.
Things like this, and the scenarios that you mentioned in your post, Kelly underscore
one thing: People can't afford not to have health insurance.
We Should All Be Covered
I agree that we all need health coverage. Where I disagree with most people, is who should pay for it.
I was covered by my parents when I was a child, by my school (through the health clinic) in undergrad, by my job when I was working, and (up until this summer) by the State/Fed when I was out of work. We (taxpayers) can get ahead of the ball and provide some minimal coverage for everyone. Or, we can just pay for it on the backside when the uninsured wind up in Emergency... or when the State has to create a whole new agency to collect the premiums and tax penalties.
This is a mess and I cant wait for the lawsuits to begin. And they will. People whose taxes are garnisheed; People who work seasonal jobs; People who have a lapse in coverage and need maintenance drugs ie diabetes, hypertension, psych meds; Cabdrivers (LOL!)
But on a serious note, I paid into the system for years, so did my mother, her mother and her mother. If one of us needs temporary managed care while we are out of work, we should be covered. This whole idea of pulling yourself up by your boot straps was invented by the people who own the boot factory.
In countries where Universal Healthcare exists,
people pay into the system through their taxes, but the government subsidizes their healthcare, nonetheless, and, not only do people in countries such as Canada, France, and many, if not most countries in the Western Hemisphere get free healthcare, but it's better than here in the United States, in many instances. If anybody here hasn't seen Michael Moore's documentary film, Sicko, I recommend that they either rent it, or go see it in a movie theatre, if it comes back. This well-done film gives a good insight as to what's happened to our healthcare system during the past 30 some odd years, and gives examples of how the healthcare systems in other countries work. Britain is also included here.