Finished my family’s taxes and e-filed so I had a chance to consider how much we have paid in healthcare costs the last 3 years since my wife was officially declared disabled and lost her job.
She was able to retain her health care insurance from her company’s self funded health insurance plan (at full cost without any contribution by the company) and receives Long-term disability from her employer’s disability insurance — er I mean her company’s ERISA Benefit Plan Trustee The fact that her pancreatic cancer destroyed her pancreas, made her a Type 1 diabetic overnight and the chemotherapy treatments she received caused documented brain damage (loss of short term memory, confusion, panic attacks, inability to concentrate, etc.) was just too much evidence for them to deny her claim under ERISA”s arbitrary and capricious standard. She was also accepted for full SSDI benefits, one of the lucky 3 out of 10 disabled duckies whose claims for disability are accepted.*
* I was not so lucky when I became disabled. The lack of a definitive diagnosis and a confusing array of auto-immune inflammation of my joints and connective tissues, and my severe gastrointestinal symptoms, allowed my company’s disability insurer/trustee of our ERISA Benefits Plan to send my medical records to another doctor employed by the Insurance company, a doctor I never met (and one who never discussed my case with my doctors or with me) to declare that I was not disabled. We sued and lost in Federal Court, because the Judge said that though it appeared to him I was disabled he could not say that insurance company who was the trustee for my firm’s disability benefit plan acted “arbitrarily and capriciously” since its decision as “Trustee” was based on the review by a doctor they hired who never examined me. But I digress.
So as long as my wife’s company doesn’t go bankrupt we get to pay for their group health insurance at the plan’s full cost. They dropped their dental plan years ago, so we pay full price on all dental work for our family.
So here is what we paid for our (drum roll please)
2010 out of pocket medical expenses:
- Wife’s Medicare premiums** $1,158
- Health Insurance Premiums $4,883
- Prescription costs $5,797
- Medical Profesionals $5,353
- Lab and X-Rays $ 158
- Eyeware (both of blind as bats) $ 296
- Medical Milage expense $ 700
- Other Treatments $ 860
- TOTAL $18,636
In 2009 we actually paid more: $21,253
** We had higher expenses on some items in 2009 and my wife’s switch to Medicare (she became eligible for Medicare Part A after 2 years under SSDI) saved us about a thousand dollars in Medical Insurance premiums.
We have a combined income of around $80,000 give or take. I’m not complaining that we pay roughly 20% to 25% of our income on health care costs, because we have insurance (crappy as it is) that currently covers the pre-existing conditions of all four of us (we have one daughter and one son). However, that insurance for everyone but my wife could vanish if the company’s self-funded disability plan gets whacked in a bankruptcy proceeding or otherwise changes.
Not that we are alone in paying ever increasing amounts for less and less health care benefits. It’s a national issue for all but a few of us:
With each passing year, Americans are paying more for health care coverage. Employer-sponsored health insurance premiums have nearly doubled since 2000, a rate three times faster than wages. In 2008, the average premium for a family plan purchased through an employer was $12,680, nearly the annual earnings of a full-time minimum wage job. Americans pay more than ever for health insurance, but get less coverage. […]
For preferred provider organization (PPO) plans purchased through an employer, the average family deductible increased 30 percent in just two years, from $1,034 to $1,344.3 This effect is more pronounced for small firms, where PPO deductibles increased from $1,439 to $2,367 — a rise of 64 percent.
Families purchasing insurance through the individual market face deductibles that are more than two times greater than families with employer-sponsored PPO plans. The average deductible for a family plan in the individual market was $2,753 in 2007. This is an increase of nearly one-quarter from 2004, when it was $2,220.5
A growing proportion of families purchasing health care directly from insurance companies in the individual market are burdened by rising deductible costs. The percentage of families with a deductible over $2,000 increased from 41 percent to 59 percent in the past four years.6 One in five families covered with employer-based insurance also had a deductible over $2,000 in 2008.
The prevalence of employer-sponsored high-deductible plans (also known as consumer-driven health plans) has increased– from 2005 to 2008, the percentage of firms offering such plans rose from 4 percent to 13 percent. For Americans receiving coverage through an employer, the average deductible under this type of plan was $3,511 in 2008,9 while the average deductible in the individual insurance market in 2007 was $5,329.10 […]
I ought to interject here that we have coverage under a plan that requires a $2,400 deductible and requires us to pay 20% of”in network” expenses after the deductible is met, but 40% of costs if the health care provider is “out of network” (i.e., best not to have medical emergency that requires a specialist who is not “in network, such as anyone outside the medium sized city where we live or in other words its better for us not to get sick while traveling). We also are a to use a specific pharmacy chain to purchase our medications. All of that chain;s pharmacies are farther from our home than our previous pharmacy.
Of course, the Republicans just passed a plan in the House that would do away with the Democrats Health Care Reform Ac and, Medicare and all together and further limit access to SSDI disability coverage. The cost of my Wife’s care is roughly 2/3’s of our out of pocket medical expenses under insurance. Since we would be unable to buy insurance to cover our pre-exiting expenses, we would have to pay the full cost of those charges. My wife’s prescription bill would rise to over $15,000 alone and mine would jump to around 3,000 (using 2010 costs which as well know will only go up). Our total Health Care costs for pre-existing conditions (my daughter also has ADHD and suffered from childhood asthma) exceeds our current income.
If my wife has a recurrence of her cancer or my auto-immune disorder worsens we likely would be bankrupted if we had to rely on health care that excluded pre-existing conditions. And we are in a much more favorable position than millions of Americans who are uninsured or who have pre-existing conditions or who have to pay premiums right now on single health insurance plans rather than employer provided group plans. We’re much more fortunate than many people in this country, including many who post here.
Yet, the Republicans insist that their tax subsidies for the wealthiest people in America cannot be repealed. Indeed, thy insist that those tax subsidies must be increased! They want anyone in the middle class or lower class to simply go bankrupt or die from lack of health care in order to fund those tax breaks.
As President Obama implied in his speech regarding the Republican plan to gut our social safety net, this is an immoral act to place the burden of more tax subsidies for large corporations and the wealthy on the backs of the sickest, neediest people. His plan wouldn’t even save us any money on our health care costs or cut the deficit!
Indeed, as the bipartisan Congressional Budget Office found in its analysis of the plan (done at Ryan’s request), until the Medicare and Medicaid cuts kick in starting in 2022, the red ink of its tax cuts overwhelms the savings from other program reductions. Ryan’s plan actually increases federal public debt compared with what it would be under current law: to 70% of gross domestic product under the Ryan plan compared with 67% under current law. Nevertheless, it passed by a party-line vote Friday, just before the nation’s lawmakers high-tailed it out of Washington for a two-week vacation.
As for the health programs, the House passed Ryan’s proposal to extinguish Medicare as a guaranteed coverage program and substitute healthcare vouchers, allowing seniors to buy private health insurance with a government subsidy.
The vouchers would rise in value with the consumer price index, but as medical expenses have been rising much faster than general inflation, the value of the government subsidy would erode over time. The CBO calculated that the share of standardized medical expenses paid out-of-pocket by the typical 65-year-old in 2030 would be 68% under Ryan’s plan, compared with 25% under current law.
The delivery of health benefits would be much less cost-effective under this giveaway to the private insurance industry than it is under Medicare, as seniors would be paying for the private insurers’ much higher administrative costs, including profits. And don’t forget that the elderly are sicker than the general population, so the premiums charged for this standard plan may well rise faster than overall medical inflation, putting the seniors further behind the curve. […]
The Republican plan would rob not only people in my situation, but our children too, as they would lose the benefits their grandparents enjoy and be burdened with the additional cost (financial and emotional) of caring for us, their sick parent. It’s either that or watch us all die an early death.
How Ryan’s and the Republican Party’s proposed theft of our future and our children’s future, and the guarantee that millions of people will suffer and die because of lack of affordable health care merely so companies can make more profits and outsource more jobs overseas, and so wealthy people can make even more billions of dollars while we suffer, is a reprehensible, nasty business. More than that it a crime against humanity.
Our family pays 20-to 25% of our income for health care costs now under the present system. Others no doubt pay an even greater share of their income for health care today. Under the Republicans, they would have us paying amounts for health care that are simply not feasible for ordinary Americans to afford. In many cases, amounts that exceed both our income and whatever few assets we own.
Perhaps our older parents and grandparents, insulated from the worst effects of the Republican plan, and misinformed of its true costs for our society don;t car what happens to their children and grandchildren. I’d like to think that is not so, but with so many elderly people forming the base of the Tea/Republican Party, I have to ask myself that question?
They benefited from government programs that helped many of them get out of poverty, attend college, buy affordable homes, provide stability to our markets and make America the richest nation on earth. Somewhere along the way many of them got the notion imbedded in their brains that they did this all by themselves. That government played no role in their success. That government, the same government that provides them medical care and social security payments is the Bad Guy, and the Wall Street Thieves and Big Oil, Big Pharma, Big Utilities, Big Insurance Companies, etc. can do a better job running this country.
After seeing the effect that diminishing the role in government in our free enterprise system over the last 30 years has had and the precipitous decline of wealth among most Americans (except among the rich of course), the massive increases in deficits and the failure to provide the same economic and financial opportunities to their children and grandchildren that they were provided, you would think they might consider that Government is much better at solving our nation’s problems than letting the Free Market (i.e., the greed is good mantra of mega-corporations and the criminal manner in which many of them have acted when the regulatory “cats” have gone away) have its way.
Yet, sadly many of them do not. They think their American dream was earned solely by their “hard work” when in reality it was a by-product of government assistance to them and government intervention in the economy, and our foreign policies that favored American business interests. They thing we and their grandchildren our lazy, yet I know more people who work 32 or 3 jobs and put in many more hours working now just to tread water than the fathers (and a few mothers) I remember ever did back in the day.
I just wish that someday soon those who feel that government is the problem and Republicans have the solutions with their crackpot ideas that have never been proven to work whenever they have been implemented will wake up and smell the rot in our Republic. Sadly, for many of them, and for many of their children and grandchildren I don’t believe that those of them who get their information from Fox News and Conservative Radio ever will.
