*shug*
Difference of opinion I suppose. I'm not saying you're wrong, because I know that I'm not right either, but in general, I'm not a fan of most insurance company practices, including my own. The for-profit nature appears to get in the way of legitimate coverage under some circumstances.
Before government got involved and regulated the industry the for-profit plan allowed competition and kept prices down. Insurance used to be a purely catastrophic plan only and you could afford the rest out of pocket and even work out a plan with your doctor personally.
And it isn't as if Medicare, which is what this is being modeled after, is an ideal plan either. Particularly not compared to my insurance. Some stuff requires a referral first on Medicare. I can walk into any doctor I choose and get checked for whatever I want. My wife was having trouble sleeping, felt tired every day, and so we went to a sleep specialist. It wasn't recommended by anyone, we just went.
Similarly, looking at out of pocket costs at Medicare.gov and the forms I have because my insurance gets renewed tomorrow:
Premiums
Medicare Part A (hospital): $244 per month
Medicare Part B (physician): $96.40 per month - if you make under $85,000.
Total Medicare premium: $340.40 per individual.
My plan (BCBS PPO Gold Plan): $236 pre-tax a month, total for physician and hospital coverage.
I pay: $406 a month for my wife and I both.
Deductibles and Coinsurance
Medicare Part A:
For each benefit period you pay:
- A total of $1,068 for a hospital stay of 1-60 days.
- $267 per day for days 61-90 of a hospital stay.
- $534 per day for days 91-150 of a hospital stay (Lifetime Reserve Days).
- All costs for each day beyond 150 days
Skilled Nursing Facility Coinsurance
- $133.50 per day for days 21 through 100 each benefit period.
Medicare Part B:
- $135.00 per year. (Note: You pay 20% of the Medicare-approved amount for services after you meet the $135.00 deductible.)
I pay:
In-patient Hospitalization: $300 one-time copay.
Out-patient Hospitalization: $0
General Practitioner: $25 copay
Specialist: $30 copay.
Now granted, I pay for the most expensive plan I can get because the Bronze Plan is an 80/20 plan, but it is only $164 premium. And the Silver plan is 90/10 and is $190 a month. But they are still cheaper than the Medicare options.
The design of Medicare is purely for people that cannot gain access to anything else. It is obvious in its uncompetitive design.
Now, if we design a nationalized single-payer system designed like Medicare, and I have no other choice, I have to assume that I will pay more out of pocket than I do now and that on top of it I will be getting taxed more too. My main issue with this latest idea is that they are claiming it will just be a competitive option to the private plans, but if they tax my benefits then it is no longer just competing and is working to effectively remove the private option from the market.
I can't afford a national single-payer system, even if I don't use it.
And before someone mentions that not everyone has the options I have: I purposefully pursued a job with good medical benefits. Requesting information regarding their health care plan is a legitimate question during an interview. I didn't get this health plan by luck. I looked for it. My boss is fully aware that of our plan changes I will be looking for a new job.
Personally, I'm a bit worried about my situation with kidney stones and how that will effect my ability to buy coverage in the future, jacking up rates, or eliminating coverage altogether with a "pre-existing condition."
Check your state laws. In Kentucky if you have not been without coverage since before the pre-existing condition was diagnosed they have to cover it. And then I have only heard of kidney stones creating an issue for six months after they have been passed/removed.
If Michigan laws are like Kentucky laws then I suggest getting coverage, no matter how cheap, as soon as possible and do not let it go.