With gas prices on the rise, how is it impacting your spending?

Anecdotes are a poor substitute for a sane public health policy that presumes and expects healthy lifestyles from its citizenry. Moreover, IF the population were not sedentary, substance abusing slugs the rates all of us have to pay would be far lower. Public hospitals are lucky if they collect 1/3rd of their bills -- so bills are 3x higher than if people looked after themselves and saved for rainy days.

You might also keep in mind that your other friend pays $18,000 a year just in premiums, EVERY YEAR. In 2012, unplanned pregnancies happen in rape. Everybody else has choices.

Face it JMD, if people want expensive lifestyles *someone* is going to pay. In the case of poor health from stupid lifestyles the cost is shared by all. For now at least. I personally would like to see the government get out of the business of subsidizing the health costs of obesity, substance abuse, tobacco, and last year of life institutional care. Look up the fraction of GDP spent on healthcare in e.g. Japan vs the USA.

Lifestyle choices

 

JMD, or I could get luck and die.

 

Occasionally, yes. My point is that his high bills are mostly due to his subsidizing the poor lifestyle of his neighbors. We should also keep in mind that he was (and is) paying a low premium before the events and can continue into the future.

I looked up the per capita cost of healthcare in Japan. In 2009 it was 36% of the US.

 

LOL

 

Not necessarily the exception, but maybe. My employer provided HD plan costs $95/mo for family. Family deductible is $2500 plus max out-of-pocket $2100 (This does not include dental or vision costs though). As long as I stay In-Network, the max I pay per year on medical is $95x12 + $4600 = $5740. All medical expenses beyond that are paid 100% by insurance plan. This plan was enabled due to Obamacare. Prior to that my insurance premium was ~$150/month with a 20% co-pay that was never capped, plus a $2000 deductible, and no max out-of-pocket.

In addition to the above, I have an HSA (Healthcare Savings Account) that I contribute the max allowed into (pre-tax $$$). I can pay all medical, dental, and vision expenses out of the HSA...but not premiums. The $$$ in the HSA rolls over from year to year, unlike the FSA which was capped at $2000 less per year than the HSA and was use-it or lose it.

 

Does the employer pay part of the premium ?
As for maximum per year -- it does not exist anymore. Check out the small print re: balance of payment.

I recalculated my ongoing medical insurance/care costs:
I pay about $4000 for premiums, vision and dental a year through an HRA
I also contribute the $7450 max to an HSA
Tax deductions aka subsidy are worth $3674.5 (15.3% payroll, 25% fed and 5% state)

So each year I pay about $325 for an ~ annual $6000 cap on hospital care costs. The last 20 years my family has used the hospital once.

 

Look at any other industrialized nation and you'll see it's lower.

Personally, I'd like to copy the German universal healthcare system, but the main thing this country need to do if wants the private insurance system to work at all is to ban employer-provided health insurance coverage. The McCain plan to remove the employer tax credit didn't go far enough.

To work as a market there needs to be as direct a correlation between lifestyle and cost as possible. Group plans lump employees together so the young and healthy subsidize old and unhealthy. But, because of stiffer competition for group plans and because health insurance is usually a take-it-or-leave-it benefit, private plans are overpriced and healthier people are left with a devil's dilemma.

As an example of what happens under the current system, Maine has only two companies providing private annual health insurance, while more than two companies provide plans through employers. Take away the big group plans and you both remove some of the cross-subsidy and you force health insurance companies either to offer insurance to an entire state's population or lose access to the market.

 

As part of my on-going, Prius studies:

• Oversized front tires - I've fitted the largest diameter (fewest revs/mile) tires on the commuting, NHW11 which puts it in permanent 'over-drive.' Roughly a 6% reduction in transaxle drag, recent cold-weather, roll-down tests suggests it has had a measurable effect.
• Replacing Type T-IV with Type WS - the lower viscosity oil reduces the cold-weather, rolling drag.
• Using 12V tire pump - every two months, I top off the tires to full pressure, 51 psi.
• Study E85 vs Prius - with a (0.20/3.15 = 6.3% cost reduction per gallon), lower cost per gallon. Test in progress.
• Replacing failing 12V battery - appears to have a 500W overhead load on the car with a new one.
• Testing solar trickle charger - in theory, may eliminate the 30-38ma overhead cost and significantly increase 12V battery life (results will be known in 2020.)
• Radical aerodynamic mod - fully encloses all front air inlets and may either exhaust out the rear of the hood or via the wheel well (each has advantages and disadvantages.)

As far as I'm concerned, higher gas prices are exactly what Virginia and other states planning additional Prius taxes need!

Bob Wilson

 

There is no magic bullet of a system; a sick population is costly.

While I am (obviously!) in favor of people footing their own bills for poor lifestyle choices, your desire to individualize insurance just leads to widespread abuse by the insurance companies through cherry picking. The truth is, it is *very* hard to to spread risk while not encouraging stupid behavior.

 

No, I pay all of the deductible and max out-of-pocket.

I would beg to differ on max. From the 2013 plan workbook:

And also:

So if I stay in-network, my max out-of-pocket (for medical) is $4600 plus my premium of course. This means that after max out-of-pocket, my medical care (in-network) is free. As I said before, Dental and Vision are separate items, but can be paid with HSA dollars.
[edit]Company HSA contribution is $480/year IF you fill out a health survey.[/edit]

 

I agree. A couple years ago I had a run of bad health and ended up getting rushed to the local hospital and then onto the nearby specialist city hospital for an emergency MRI scan at early am on a Sunday morning (or was it Saturday night?). Then spent a week in hospital before being released. A about half a dozen visits to the Doctors afterwards for a checkup and the only direct cost to me was a dozen prescription charges at about £9/$14 each.

The American system to me seems great if you're on above average income, otherwise you're stuck. A few years ago I was earning good money but now I'm not and struggle with minimal bills each month. If I was in the US having to find $1,000 health insurance each month, I'd be in big trouble. I'd rather have the 20% vat/sales tax where I pay £4,000 on the cost of a Prius and a Range Rover driver pays £12,000, and know I have access to free point of contact health care, than end up **** creek without a paddle in hard times.

Sure the free health service has its down sides too but you have a variety of private options available depending on what you require. I have paid for faster private procedures in the past when I could afford it. I guess it's what you know, but I do find that insurance companies have a nasty habit of finding reasons not to pay out at times when you really need them.

 

If you ask, you will find that 'expenses' is shorthand for 'covered expenses.' I'll venture to say that almost every hospitalization has uncovered balance of payment additions.

 

Very well, under Hospitalizations...footnote:

So, assuming I had to go to the hospital and one or more of the OR personnel were non-network physicians, then I would be liable for out-of-network charges. Which could be up to $2500 for me or up to $5000 for my wife.

Realistically, what are the chances of that occurring? Yes, it could happen...therefore, your contention that it COULD happen is correct, but is low-probability. In 'real life' the chances of me or my wife being hospitalized in any single year and having out of network physician services are minimal...and that includes scheduled outpatient tests.

 

Not OR personnel (yet anyway.)
Think pathology, radiology, physical therapy ... anything that is a private group providing services not under contract to your carrier to accept in-network charge limits. It affects outpatient care too. It is not a matter of a different deductible applying, but a matter of your responsibility to pay uncapped balance of payments.

I'm not trying to sensationalize a rare cost, and I do know what I am talking about. I have worked in hospitals most of my adult life as a physician, and I am an informed consumer of healthcare. Caveat Emptor. None of this, by the way, is meant to suggest that HD health plans are anything but smart for people who are 'healthy' and make good lifestyle choices. Get informed or not, as your see fit. This off-topic tangent was really only a PSA. If you have a questions, I can try to answer them through PM.

 

Agreed, we've gone way too far OT.