Over $500 per month for the bare basics coverage…so much for “affordable” health care!

I just now had a look at what I might be paying.

It’s over $500 a month and the only questions: your age, your sex, your state and your county of residence.

Everybody knows New Jersey will always wind up paying more.

I am sorry that I even paid for what I paid for: $365 was steep for me — and when that subsidy ended back in 2009, I should have unelected and disenrolled.

And now I feel worse for more or less throwing my money away each month. I’m in a terrible jam and I sure can use that wad of money that I paid into that system permonth — I sure can use it right now.

Yeah, and add to the damage somebody was a first class bleep about not paying what he was supposed to pay as far as taxes and other shared exprenses goes.

It’s like damned if you do and damned if you don’t — you are supposed to have health insurance as a more or less preventative program — in one way or another, you will wind up paying through the nose.

There is no way I can pay for what I was paying for at $365 a month; how in heck am I supposed to pay for over $500 per month??? How does anybody not working pay for it at all? They tell you to apply for Medicaid? Really?

We are cooked.

Every single last one of us.

They needed to go after the health insurance carriers and get them to lower the premiums! That is what was needed.

5 thoughts on “Over $500 per month for the bare basics coverage…so much for “affordable” health care!”

  1. Some ways to lower the premiums are to cover fewer items or procedures, reduce reimbursement to providers, allow clinics to dispense prescriptions that are given to them as the result of bulk purchases from the government or to increase co-payments because insurers are not allowed to exclude people for pre-existing conditions. We’re at a point where insurance companies are pricing for risk, presuming that the sickest people will sign up first. Health care provider are generally not obligated to participate in any insurance plan, including Medicare or Medicaid. One exception might be doctors who work for the VA or in military clinics for a salary.

    The price quoted on the website is not necessarily the price that you will pay. Have you looked into the subsidies that you qualify to receive? As a someone with no income, you ought to get whatever the maximum is for a single person with no children.

    This may all be moot because New Jersey decided to expand Medicaid. This covers anyone with income 138% or less of the poverty limit. This is $15,856 for a single person in 2013. By the facts that you have presented, that of someone who is long-term unemployed with no income, you qualify for Medicaid coverage. There are some copayments, but it’s a lot cheaper than $500/month. Illinois also expanded Medicaid, so this covers New Wave Princess as well.

  2. Dude raises an interesting question when she contemplates that even the $365 she paid per month was too steep. Let’s do the math…

    The US GDP was $15.68T in 2012, and the US spends about 18% of its GDP on health care. About half of that is paid for by the government. If we divide the other half among the population (15.68T*18%/2/314M) we get a per capita privately-funded health care cost of $4494, or about $375/month. So if all privately-funded health care were paid for via insurance, and the insurance companies were perfectly efficient, the premiums would be about $375/month per person.

    In fact, insurance companies aren’t perfectly efficient, and there are other sources than insurance for privately funding health care. But as a starting point, the figures suggest that, absent subsidies, it isn’t realistic to expect $100/month health insurance any time soon.

    And that’s the Obamacare bargain: if you’re really not doing well, you can get coverage via expanded Medicaid, and if you’re doing a little better, you accept that, under the new regulations, you can’t properly pay for your own health insurance anymore, and your employer doesn’t want to (if he can wriggle out of it), so you have to surrender your dignity and take a subsidy to help pay for it.

    1. The policy cost needs to be increased by about 50% to take into account profit for the insurance provider and the fact that family coverage is somewhat more than twice as expensive as single coverage, regardless of the number of people that are covered by the policy. This probably leads to cost-shifting to single policyholders to keep family coverage affordable. The sum of employer subsidy and what I pay for health insurance is $450/month, so I did not find the price of $500 for single-person coverage unreasonable.

      We’ve spent an huge amount of effort in recent years destigmatizing charity. One could look at the subsidy for health insurance as an offset to income taxes that they pay, because that is how it is administered. It is taking money for income taxes with one hand and refunding a certain amount with the other to pay for premiums for people who are employed. For those who are not currently employed, the subsidy can be paid by direct debit to their checking account.

      The government used to negotiate for the purchase of drugs for use by the military and VA. I worked for the agency that did this in the late 1980s. They may still do so, even though the legislation for Medicare Part D forbids the government to negotiate for a better price and provisions of the PPACA allow the government to pay a higher than market price to assure that certain drugs will be available in a timely way. The government still awards indefinite quantity, indefinite delivery contracts that guarantee a company that a certain number of units will be purchased, but we are not yet sure what the delivery schedule will be, but there is a period of performance during which we will accept delivery of all units. We are allowed to get up to a certain percentage of items at the contract price above the amount that we are guaranteeing that we will buy during the period of performance.

      If we want $100/person monthly premiums, then we need a 70% reduction in what is paid to health care providers. In a business that has fixed costs as high as health care, this would be impossible to do and still maintain the number of doctors that would accept patients. I ran into a doctor back in 2004 who had opted out of all insurance, so I wound up paying $300 for treatment that should have cost me $50 from a participating provider. More and more doctors have followed this path, or are leaving the profession completely.

  3. THey “need” a subsidy to get us to buy?

    Why not just LOWER THE PREMIUM, period???

    There are physicians who’d rather put a patient on a retainer. Less paperwork and no red tape and the paitent still gets his or her services.

    1. Paying a physician monthly for access is a trend that is gaining in popularity. Unfortunately, such plans seldom cover the cost of hospitalization or routine medical tests, leaving patients vulnerable to large medical bills. It winds up being an extra payment that one makes on top of rather than in place of health insurance premiums because they want to use a particular doctor who does not accept their insurance.

      What you are neglecting is the fact that the per capita costs of providing health care run about $365/month under Admin’s assumptions if you factor out the costs that are paid by the government, from either VA benefits, Medicare, or Medicaid. There are also some state-sponsored insurance plans that pay other bills. Unfortunately, cost-shifting in health care is epidemic. The people with health insurance subsidize the people who have Medicare or other government insurance, It is literally not possible to get an all-inclusive quote from a hospital for a medical procedure, if only because the hospitals don’t want to disclose how they bill.

      To reduce premiums for everyone, the cost of providing medical care has to decrease as well, because no one will stay in business long if they are losing money due to low reimbursement rates. This means increasing the number of immigrant laborers who will work more cheaply or who have shady histories, or as in the case of law, opening more medical schools, making medical school admission less selective and restricting the number of doctors who can go into a specialty. Another possibility is to expand what nurse-practicioners and physician’s assistants are allowed to do and expand the number of these health care providers who are allowed to be in a practice. Tort reform is also necessary.

      Another way of decreasing premiums is to charge them as a percentage of income so that lower income people pay less. What the subsidies do is to mask this sliding scale. Yes, you are charged $500/month, but if you are single and making around the minimum wage, you are now eligible for Medicaid. Finding a provider who will take Medicaid is another question. If you make a little more, then you get a subsidy to your health insurance.

      The alternatives are to bypass the insurance system and go to a single-payer system like Medicare/Medicaid or to make a direct, massive transfer payment to the insurance companies, which is what the PPACA effectively does. Other people just touch the money in between. You have to have a bank account to buy health insurance on any of the exchanges so that premiums can be paid via direct debit. In a single-payer system, there is still a market for supplemental insurance, as I learned when I lived in England and Germany.

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