How do you meet your health care needs?

We just switched our health insurance to a high deductible health plan (HDHP) and opened a Health Savings Account (HSA) supplemented by a prescription drug discount plan.

With the HDHP in place, we are saving hundreds of dollars a month on insurance premiums. That savings goes into the HSA, and we can then use that money to pay for health care that our prior health plan did not cover, from contact lenses to acupuncture and beyond.

My intention is that now that my money can go directly to health care, rather than to insurance premiums (without health care), I will now actually USE health care instead of avoiding such services. Cool.

But man, what a chore and headache it has been sorting through HDHP and HSA!!

I was a nurse who started an assisted living facility with a partner. When not at the ALF I was working per diem. I could not find a job with health insurance and couldn't afford a policy. I met my health care needs by not getting sick. When I did get sick I went to the pet store for antibiotics.

My business failed and now i work for the largest hospital chain in the United States. i am going to school in order to become a nurse practtitioner. I will continue working at night to maintain my health insurance and practice either immediately after work or sleep a few hours and work in the afternoon and/or evening before returning to work. I will be a hybrid hourly employee and part-time practice owner.

marty

Dear Barbara:

I hve learned when I am poor that life can be hard. I actually went to the pet store and bought penicillin that was supposed to be used in an acquarium. When I do not ave money I learned to be creative. Do you think the warning labels on pet pharmaceuticals mean that these meds are the ons that fell on the floor when being processed for humans? Theses are the real deal. The meds should be used after a knowlegable personprescribes them. I was not knowledable, I was poor and despirate. I can read a PDR and understand it, sort of. I knew the penicillin was in the right class of drugs to take. I did not do a culture and sensativity test. My mother is allergic to penicillin and my brother is allegic to ampicillin so it was a toss up as to how I would react. The force was with me that day.

I will not go on a rant but will say I believe access to medical treatment is a right. It shold be paid for by taxation, not by employers. Ask GM or Ford, they would agree with me. Look at infant mortality and average life expectancy. The US does not do well inspite to our wonder-ful medical technology. Assess to the medical system is restricted to those who have money and good medical insurance. It does not seem right to me. God bless me, i am a liberal.

Marty

Barbara... With a lot of experience as an employer, I came to learn that it was in my best interest for good employee retention to offer the benefit of health insurance (NOT because I was forced to by the government).

As an employee of my own company, I was also now providing for the health insurance for me and my family. A very good reason to start your own business so you can have better control over your life circumstances.

Now that I do not employee others, the challenge of getting a benefit of the large group policy is gone. So, my wife works for a large company that gives us access to a group plan and a Health Savings Account.

I really like Leila's approach and am going to re-evaluate our percentage of insurance coverage vs. the HSA. Thanks for your informative post, Leila. ...Howard

Hi Barbara! I'm one of the lucky ones - I "married" well. My partner works for a large international law firm that has offered incredible domestic partner benefits for many years. It's a good thing too - with the medical costs associated with my 3.5 year experience with chronic vertigo which came to an end late last year. We are required to pay for me being on the policy - but the cost is MUCH less than what I would pay elsewhere.

Jeff Fisher | Jeff Fisher LogoMotives

I too married insurance. My husband Buddy has been at Safeway in their trucking department for 33 years. He wants to retire but we are afraid of not having insurance. My Buddy drives from Snohomish to Auburn and then works 1 0 days on top of that. We have both worked our entire lives, I saw on my social security statement that I started paying in when I was 10 years old and have never missed a year . We don't know what to do about insurance, I guess keep working until we drop dead. I am thankful for Buddy and love that man more and more everyday for the stability and security he brought to my life.

I am all for single-payer health coverage. I think it is the most efficient and fair way to provide health care to everybody. But let's be honest about costs.

Barbara, you mentioned Denmark. I lived there briefly, and got to use their healthcare system. the amazing thing was waltzing into an emergency room, handing them my health ID card, and being taken care of without ever hearing mention of payment. No co-pay, nothing. I did have to pay for the prescription, at a government-run pharmacy (the only kind they have) and it was quite cheap. If you have chronic disease that requires expensive meds, they cover that.

The downside? 40-60% income tax (no that's not a typo) and 25% VAT (sales tax, also not a typo). For that you get the above mentioned healthcare, schooling through graduate levels, daycare, paid maternity and paternity leave, retirement pension, and on and on. In other words, the government taketh, but the government giveth. Unlike here, where the government taketh less but then spends the money on wars to keep your SUV gassed up.

As for me? I get my insurance through my partner, who works for a state hospital. But he wants to quit to work full-time on our business. Then what? In the meantime he must pay considerable federal taxes on the value of my health insurance because the IRS does not recognize our relationship.

I think that the state of health insurance in this country sucks. I was a teacher for 15 years and Bob and I were covered under my school district health, dental and vision insurance for much of that time.

We now have, dare I admit, no health insurance. Last year, Regence Blue Shield raised our rates again, to such levels that we just couldn't manage the premiums anymore. (That was with a major medical, $1,500 deductible per-person policy.)

The self-employed are not only paying more taxes, but we have nowhere to go for reasonable insurance rates.

I don't know what the answer is, but I know one thing. The middle class is getting screwed.

Okay so we do have this big problem. How can we band together to do someting? Biznik alone has over 6,000 members that is a lot of voting power in an election year. How can we make Dino Rossi and Christine Gregroire hear us? Can we start something together? Can we make demands? How can we be heard? Some one must know someone some where that can organize us and make our voices heard? Suggestions?????

Hi Barbara; I just enrolled in a Health Savings Plan and am excited about that. It's cheaper than a regular plan and, if you're healthy, a great way to go. Yes, it has a very high deductible but also has an attached savings account for expenses such as eyeglasses, prescriptions, etc. Although it's not ideal, I believe for entrepreneurs it's the best thing going! Take care.

The fact that Biznik has 6,000 member sgives me another thought. We could at least provide a group insurance plan with a major insurer that lowers premiums. In addition, what if our membership fees paid for the services of a few medical professionals who are also Biznik members: a medical doctor, a psychotherapist, an acupuncturist, etc. So our fees pay for regular visits for primary care and then for a major medical to cover catastrophic costs. Would that work?

I lived in New Zealand for 12 years where everything was paid for 100% and came back here and it is such a contrast to feel that I can't even go get a blood test to check my cholesterol without paying a lot. My husband is a social worker and his insurance only pays for him. I would have to pay $465 month to be on his group plan. So I am paying $215 month for very high deductible as I am in the age group that no one wants. (60-65) I Plan to go on his group plan in December when its open again but that's a lot to put out every month!! I honestly do not see another solution.

Geez. It shouldn't be this hard. I thought my family was being proactive and smart, setting up the HSA and the HDHP. More than a month later we are still yakking with the insurance company and the savings bank to get our accounts set up correctly. ARGH.

The bank happily took our $5,800 then put a hold on the account (because I don't show up anywhere in credit checks). And the insurance company made a typo and gave us the wrong policy.

Anyway. Yesterday I dropped $212.67 on three prescriptions. Yeah, I know. Some people spend that much a day on prescription drugs ... but I'm used to spending more like $1.00 a day (with the old insurance policy).

I'm sure I'll get used to the HSA, etc. But I'm still a little wobbly with the whole thing. And we even had a great insurance agent who spent hours helping us sort through the options!

Barbara,

You mentioned the group rate thing. After we dropped our individual policies with Regence, we learned of an opportunity to get group insurance through the Chamber of Commerce (of which we belong to three). When we got the quote, we were astounded to see that it was more than $300 a month higher that the individual policies we could no longer afford!

Same insurance company, same coverage, same deductibles. We were told that it's because we don't have employees. Of course, we don't. We're SOLOpreneurs!

Good luck with your book. I don't hear any of the presidential candidates talking about health care yet. And if they do, it probably won't be on the front burner after they take office.

Now there's an idea.

Ooooh. The activist blood in me is bubbling. I'll get my poster paint and sign boards ready.

What a helpful thread Barbara, thanks. I'm in process of making a change as well (from state, to probably going the same route as you Leila), so I would love to read your book when it comes out Barbara.

Now, being 50% Danish, do you think I can get the Danish gov. to lend me a hand? ;)

Judy, you're getting me all wound up!

Short Summary of Candidate Healthcare Positions on Vote Gopher

Barack Obama’s healthcare page

John McCain’s healthcare page

John Goodman, PhD, who helped craft John McCain's health care policy: “I have a solution [to the healthcare crisis]. And it will cost not one thin dime. The next president of the United States should sign an executive order requiring the Census Bureau to cease and desist from describing any American — even illegal aliens — as uninsured. Instead, the bureau should categorize people according to the likely source of payment should they need care. So, there you have it. Voila! Problem solved.” Dr. Goodman’s Complete Blog Post. Be sure to read his first category.

Things I have been wondering about:

1. People against universal healthcare usually say they are against it because it will “cost too much”. Private insurance companies need to make a profit. Government-run programs don’t need to make a profit. If the profit is taken out of the cost, wouldn’t the total cost be less?

2. Employers began offering healthcare coverage, not out of the kindness of their hearts, but only to attract the best employees. As the economy slows, there are fewer reasons to offer benefits. If you currently have insurance through your employer, and also purchase coverage for your spouse/children, have your premiums gone up? Is the reason because the employer "can't afford" to pay a larger percentage?

3. At my stress echo test last year, I told my cardiologist that I thought we needed universal healthcare. His reply: “We already have universal healthcare!” He had placed a stent in an uninsured patient and the patient couldn’t afford the $20,000 hospital bill. Highline Hospital wrote off the bill. Who is actually paying for him and who is paying for all the emergency visits by the uninsured?

4. We always hear that the United States has the “best medical care in the world.” When access to medical care is included, not so much. Global Health Facts lists the infant mortality rate in 204 countries. At 184 deaths per thousand, Angola is rated number one (the worst). At two deaths per thousand, Singapore is rated 204 (the best). The U.S. is rated 170 (six deaths per thousand; 35th below Singapore), ahead of Croatia and Belarus but behind Cuba (172), the United Kingdom (180), Canada (185), Denmark (190), Sweden (203), and other “socialized healthcare” countries.

Global Death Rates