Affordable Healthcare: Unaffordable Healthcare Insurance

Copyright 2006 Majella.usIf you think you have healthcare insurance, here are a fewsimple questions you might ask yourself: Have you met yourdeductible? If so, what were your out of pocket costs for theyear? How much did you and your employer pay for your healthcareinsurance last year and what did you get for it? And where isyour money going? According to the California Health CareFoundation[1] 45 million Americans are "uninsured." While thisnumber may seem alarming, consider the fact that 100% ofAmerican's are essentially uninsured on the 1st day of January,every year, and they remain so until they have met theirdeductibles--something that insurance companies are increasinglymaking an impossible thing to do. You owe it to yourself to findout the actual costs of healthcare in order to make intelligentdecisions about what you CAN afford. Here are some morestatistics that you might find alarming:1. In 2004, the average healthcare premium employers werecharged for a family of four averaged $9,950[2].2. By 2006, it is predicted that the average annual familyinsurance premium will reach $14,500[3].3. National surveys indicate that the primary reason for beinguninsured is for the simple reason that insurance is notaffordable[4].4. There are more Americans (50%) who are now worried that theycannot afford their healthcare insurance than there are (42%)who report being worried about not being able to afford theirhealthcare[5].How do bills get paid?Don't be fooled by the difference between billing andreimbursement. Your insurance company will readily send you acopy of the amount that was billed for your latest healthcareencounter. What was actually paid--if anything--however, isactually another story and it would behoove you to find this outfor yourself. Let me give you an example.On October 6, 2003, the hospital sent a bill to my insurancecarrier (Blue Cross of California) in the amount of $11,569.20for "Inpatient Services" related to an uncomplicated c-sectionand a 2-day stay. My insurance carrier "discounted" the bill by$9,869.20 to $1,700.00. This is the "fair and reasonable" amountthey "pay" for this service. But wait, who paid? I did! Thisclaim put me over my deductible for the year by whopping $7.70.The amount applied to a member's deductible is always the amountbilled minus the "patient savings" minus any insurancereimbursement and amounts "not allowed."Mark my word, essentially, you will require major surgery or youwill have a significant accident that results in enormous billsbefore you will meet your deductible--if you are still even ableto 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 thedeductible 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 onApril 4, 2003 for $766 where I paid $266 and only $84.26 wasapplied to the deductible. I have many more examples and I'msure 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. Ifyou have a family, you already know that this is true. If youare single--maybe, but why throw your money down the toilet whenyou can get so much more for your hard earned cash!? I have awife and 4 kids. To pay $6,000.00 in premiums and miscellaneousfees this year is simply unacceptable. I'm joining the ranks ofthe uninsured and I have a good job! I just called HollywoodPresbyterian Hospital to get an update on the cost of ac-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 toomuch to loose.Of course you do. Hopefully, however, you are not ignorantenough to believe that your healthcare insurance company isgoing to bail you out under these circumstances. If for some Godforsaken reason you are hit by a truck and spend 2 months in thehospital accumulating millions of dollars in bills, I am afraidthat you will still be in a pickle because your insurancecarrier is sure to sue the trucker's insurance carrier etc. forthe next 10 years while the collectors come after you for unpaidbills.You owe it to yourself to get smart and stop giving your hardearned cash to this scandalous industry. Please feel free tocomment on this story for a lively discussion!References1. California Health Care Foundation, Health Care Costs 101 --2005. Mar 2, 2005.2. The Henry J. Kaiser Family Foundation, Employee HealthBenefits: 2004 Annual Survey. Sept 9, 2004.3. Simmons, H.E. and M.A. Goldberg, Charting the Cost ofInaction. National Coalition on Health Care, May, 2003.4. The Henry J. Kaiser Family Foundation, Health Care Worries inContext with Other Worries. Oct 4, 2004.5. The Henry J. Kaiser Family Foundation, The Uninsured: APrimer, Key Facts About Americans without Health Insurance. Nov10, 2004.