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Health Insurance for the Self-Employed?

Cliff posted more than 7 years ago | from the an-issue-that-deserves-another-look dept.

Businesses 462

SharkJumper writes "Looks like this question has been asked before, but might be due for an update. I'm a self-employed programmer who is about to become a father. Previously, my family's insurance has come through my wife's employer, but she is eagerly looking forward to being a stay-at-home mom. We must look for that elusive low-cost insurance in order to enable her to do this. Losing her insurance is not a huge loss as, due to failed negotiations, the hospital in our city (3rd largest city in the state), along with most of the doctors that refer to it, is dumping the network (largest in the state) that our insurance uses. On the individual coverage plan front, my research shows story after story of deception, fraud, and general run-around or obfuscation by most of the major players and nearly all the minors. With all of the bad experiences out there, I've yet to see a good review of an insurance company. What does the Slashdot crowd use and recommend? Company and plan-type? PPO? HMO? HDHP + HSA (High Deductible Health Plan + Health Savings Account)?"

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462 comments

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For better health coverage? (1, Insightful)

clickety6 (141178) | more than 7 years ago | (#17063312)

Move to Europe... or Cuba ;-)

Re:For better health coverage? (5, Interesting)

D.A. Zollinger (549301) | more than 7 years ago | (#17063938)

While a humorous comment, it highlights what makes the American health care system so unique. We are so fiercely independent, that a good majority of Americans don't like having the government telling us what to do, and this includes how we take care of our body and our health. This system allows for many benefits as well as problems. The most visible problem is the ever-increasing cost of health care, and the number of people like yourselves who are falling through the cracks because good health insurance is only available through employers who can command group rates. On the flip side, because the state is not dictating how health care is conducting itself, American health care is a hot-bed of new procedures and techniques that push the limits of health care because people are willing to pay for an unproven technique even if it has even a small chance of success if the alternative is not acceptable. For example, the second son of a friend of mine was diagnose with Spina Bifida [wikipedia.org] and instead of accepting that his child would be born paralyzed, was able to find a surgeon who was willing to perform surgery on the child while he was still in the womb! [fetal-surgery.com] (notice that of the four hospitals in the world that perform this unique and complicated surgery, all of them are located in the United States)

As a graduate student, I am faced with paying for a cut-rate, we-don't-pay-for-anything-unless-you-get-hit-by-a- bus student plan, or a much more expensive individual plan. There are very few national health care providers, and you would be well suited to search for and find a regional health insurance company. In the mid-west, I have been leaning towards Anthem [anthem.com] as my insurance provider, and hope to have a plan from them to help me start off the new year.

Re:For better health coverage? (2, Informative)

killmenow (184444) | more than 7 years ago | (#17064004)

Americans don't like having the government telling us what to do, and this includes how we take care of our body and our health.
Which is why we have seat belt laws, motorcycle helmet laws, non-smoking laws, anti-sodomy laws (yes, they're still on the books in lots of states), drug laws, and on and on and on...

The government loves telling us what to do and as long as most voters don't disagree vehemently, they will.

On topic, I run my own business, a two-member LLC (my wife and me) doing consulting (mostly Linux stuff) and we are screwed royally as far as insurance goes. We have a child with a disability so: (a) being w/o insurance is not an option, and (b) we get the highest rate they can legally charge us: over $1,000/month. (imagine goatse man here, that's how disgusting it is)

Oh, and good luck with Anthem. They're great! (That's sarcasm...two guesses who my insurance provider is...and the first one doesn't count.)

Re:For better health coverage? (2, Insightful)

maxume (22995) | more than 7 years ago | (#17064284)

Not to be a completely insensitive asshole, but who exactly do you expect to pay for you child's care? I'm not opposed to government(and therefore taxpayer) provided, baseline health care services(which would hopefully cover most of your needs), but you used the 'insurance' word, and large, probable expenses cost a lot to insure, because the insurance amounts to prepayment of the expenses.

I realize that you would get better rates if you were hidden in a large employee pool, which is why I like the idea of socialistic baseline care(the US is filthy rich, we can afford it), it makes the cost sharing pool as large as possible.

Re:For better health coverage? (1)

MindStalker (22827) | more than 7 years ago | (#17064290)

$1000 a month really isn't that disgusting, your health bills without it would be much more.
Hell with my state employee plan if you add what the state pays to what I pay its $800 a month or so.

Re:For better health coverage? (1)

pubjames (468013) | more than 7 years ago | (#17064112)

notice that of the four hospitals in the world that perform this unique and complicated surgery, all of them are located in the United States

Except that isn't true. I know that the Royal Brompton Hospital in London do surgery on babies in the womb, and it wouldn't suprise me if it was done elsewhere.

Re:For better health coverage? (3, Informative)

Ihlosi (895663) | more than 7 years ago | (#17064136)

Except that isn't true.

It's true for the spina bifida surgery (I was tempted to disagree, but I re-checked).

However, this is because the operation is still in a trial phase. It still has to be proven that the intrauterine operation gives a better outcome than a postnatal operation. I guess that all other hospitals around the world are waiting for the outcome - they don't want to be the ones to have performed complex and risky procedures that later turned out to be no better (or worse) than the conventional, tested approach.

Re:For better health coverage? (1)

mc6809e (214243) | more than 7 years ago | (#17064378)

The most visible problem is the ever-increasing cost of health care, and the number of people like yourselves who are falling through the cracks because good health insurance is only available through employers who can command group rates.


About 50% of the money spent on health care in the USA is government money. The other 50% comes from people competing for health care services with those the get government money. This race for services is the number one reason prices keep going up. Rising prices are continually reallocating services from one group to another.

Our hero, the small business owner that's looking for help, had his share of health care reallocated away from him long ago.

I think some retired senior living in Miami got it.

Re:For better health coverage? (1)

WalterSobchak (193686) | more than 7 years ago | (#17064220)

On a similar note, could news like this be marked "Of interest to US Residents only" so I can exclude them from my view?

Alex

Re:For better health coverage? (1)

Ihlosi (895663) | more than 7 years ago | (#17064250)

On a similar note, could news like this be marked "Of interest to US Residents only" so I can exclude them from my view?

You obviously don't appreciate the humorous value of these news, and the nice warm "I'm so glad I don't have to deal with this crap" fuzzy feeling afterwards.

Re:For better health coverage? (0)

Anonymous Coward | more than 7 years ago | (#17064486)

It's called schadenfreude, dude!

Can't help with specifics (2, Interesting)

BadAnalogyGuy (945258) | more than 7 years ago | (#17063356)

But you'll need a plan that has a low co-pay for doctor visits since you will take your kid just about all the time for everything from his/her first sniffles (OMIGOD TB!) to fevers (OMIGOD FLU!) to standard vaccinations (OMIGOD YOU'RE GOING TO STICK HIM WITH A NEEDLE!). The cumulative costs of a high co-pay is going to eclipse the savings you'd see with that sort of plan. The higher-cost low co-pay plan pays off in the long run with kids.

For yourself you probably can get by with catastrophic coverage unless there's an existing medical condition that you haven't mentioned. And if there is, you're just about out of luck anyway since many carriers won't cover existing conditions. So unless you go to the doctor for anything except the most serious ailments, stick with catastrophic.

Instead of great health coverage for you, get LIFE INSURANCE. You can probably get some cheap 30-year term insurance which will cover your family in case something happens to you. You may want to cover your wife as well in case something happens to her and you need to hire extra help to take care of your kids. This is less common, but no less a concern.

Health insurance for your wife should probably be kept at the same level it is now, if possible. She will need extra care immediately after the birth, but once the first year rolls on she'll get into the swing of things and probably not need any special coverage. I'd argue against catastrophic-only coverage for her since if she gets sick the whole household suffers, so having the ability to go to the doctor for anything questionable will be a good investment, if only for the peace of mind of having that security.

I wonder if there isn't a self-employed plan that covers people just like you already offerred by your local carriers. I'd be surprised if there weren't. But don't kid yourself. It's expensive. You want to go with a carrier who isn't going to drop you the first time you make a claim. That's a local issue that would be well served by some research (like, I suppose, asking us idiots).

Good luck.

Re:Can't help with specifics (2, Interesting)

Ihlosi (895663) | more than 7 years ago | (#17063614)

Instead of great health coverage for you, get LIFE INSURANCE. You can probably get some cheap 30-year term insurance which will cover your family in case something happens to you.

Don't forget some sort of disability/invalidity insurance (don't know if they've got that thing on your side of the pond, it's the big thing over here in Yurrop). If you can't get that (pre-existing medical conditions and certain professional fields are a factor here), go with accident insurance.

For all the things that don't kill you but make you unable to work.

Re:Can't help with specifics (0, Troll)

UbuntuDupe (970646) | more than 7 years ago | (#17064638)

Yurrop

I think the correct spelling is Europe, but then again, I'm not as smart as you ....

Re:Can't help with specifics (1)

Ihlosi (895663) | more than 7 years ago | (#17064714)

I think the correct spelling is Europe, but then again, I'm not as smart as you ....

You once again failed to follow your own signature (plus the part about understanding that I recommended to add). Or your sense of humor is nonexistent. Or you're just pathologically vindictive.

Don't you have better things to do than scanning my posts and then pointing out a funny (and common) misspelling that I put in there deliberately ? You might want to look at some of my other posts to verify that I am indeed able to spell "Europe" correctly.

Can't help with your bills. (0)

Anonymous Coward | more than 7 years ago | (#17064544)

"Instead of great health coverage for you, get LIFE INSURANCE. You can probably get some cheap 30-year term insurance which will cover your family in case something happens to you. You may want to cover your wife as well in case something happens to her and you need to hire extra help to take care of your kids. This is less common, but no less a concern."

Shame that life insurance is now the new health insurance.* I'd recommend a good policy (READ THE FINE PRINT!), coupled with a health savings account (keeping in mind that you have to use all the money in a year or lose it). Also she may have sick/vacation time due that's paid. Exercise all your options. You'll need it.

*You can borrow against the cash value and pay it back as needed.

Small business associations (3, Informative)

oneiros27 (46144) | more than 7 years ago | (#17063364)

A while back, on the radio (WTOP in the Washington, DC area), they played an advertisement for a small business association, or something like that. One of the benefits of joining was that they had offered a group health plan to the member companies.

I don't know for sure if it was specifically a small business association, or that's what I just remember it as, or if it was a local or national thing, but you can try asking around. (or someone else might be able to follow up with some knowledge of these sorts of groups)

A quick look online suggests that the ASBA [asbaonline.org] has some sort of discount on health insurance ... that might've been what I remember. As does NFIB [nfib.com] ... just type 'small business association' into your favorite search engine.

Mod parent up (0)

Anonymous Coward | more than 7 years ago | (#17064428)

Your local small business association or Chamber of Commerce should have plans that you can buy under. It may be more expensive than you expect, because you'll be paying the FULL bill, not just the part that an employer makes an employee pay, but it's worth it to have a "name brand" insurance carrier.

Easy. (1)

AdamKG (1004604) | more than 7 years ago | (#17063370)

"Betcha ten grand I won't get sick this year."

Re:Easy. (1)

Joe Snipe (224958) | more than 7 years ago | (#17064370)

wouldn't you be better off betting you would? At least then you could use the money to pay for the healthcare.

Go public. (0)

ColaMan (37550) | more than 7 years ago | (#17063424)

I use public health services, specifically, medicare in Australia. It costs 1.5% of my taxable income and I don't really have any choice in the matter. Yes, I'm happy to be 'forced' into paying for it. It pays for the poor sods who otherwise could not afford health services. Things are fine for me now , but for all I know, one day I might be one of them, so I'm happy to pay. For that 1.5%, minor stuff - setting bones, stitches, emergency visits, overnight stays,etc, it's pretty much free. For 'serious' visits to the hospital (surgery,etc) , you generally end up having to pay. But it's certainly not "sell the house, and the car, and the kids" kind of pay.

What? Your country doesn't really do public health schemes anymore? Oh, I'm sorry to hear that.

From what I can see of the American system from this side of the pond, it's one giant complex ripoff.

Thought about emigrating to somewhere with decent public health services?

Re:Go public. (1)

BoberFett (127537) | more than 7 years ago | (#17063448)

What does unemployment pay over there? I'm pretty lazy and don't really care for the whole "job" thing. How much would I take in per year in Australia if I just moved in and didn't work?

Re:Go public. (1)

richy freeway (623503) | more than 7 years ago | (#17063760)

You can't just not work. There's some pretty strict rules governing who can move into Australia.

Re:Go public. (2, Funny)

Redrover5545 (795810) | more than 7 years ago | (#17064096)

Yeah, for one thing, you need to have commited a crime.

Re:Go public. (1, Insightful)

Anonymous Coward | more than 7 years ago | (#17063790)

I'm pretty lazy and don't really care for the whole "job" thing. How much would I take in per year in Australia if I just moved in and didn't work?

I imagine they'd probably kick you out again pretty damn promptly.

Incidentally, this idea that decent public services == pandering to lazy people is a pack of lies and bullshit spread by selfish people who object to being made to help those in need. In Britain, for example, we also have public healthcare and reasonably generous unemployment benefits... but the unemployment handout is called "jobseeker's allowance", and there's a very good reason for that: if you can't prove you're looking for work (and willing to take any work that comes your way), you stop getting the money. If you lie about looking for work to make the money keep coming in, you are likely to be caught out when you're called in and asked to provide evidence for your claims, and then you go to prison. (Where you don't get raped, because Britain is a civilised country, but you also don't have a particularly pleasant life.)

And I rather like this system. It's really rather pleasant to be able to go and see a doctor and have the first question you're asked be "how can I help you?", not "how are you going to pay?". And I'm getting all this without even having to be oppressed by an evil communist regime! Isn't real-life socialism wonderful? And how different it is from the propoganda you Americans get fed by your corporate slavemasters!

Re:Go public. (1)

BoberFett (127537) | more than 7 years ago | (#17064016)

Are we talking about "can't pay" or "don't want to pay"? Perhaps if the person I was replying to would check facts instead of speaking through his anus and using this as just another opportunity to bash the US he'd know that we do have Medicare/Medicaid for those who need it. Despite the problems those systems have, they do exist and plenty of people do use them.

The original question posted indicates that this person runs a business, and does make money, and therefore can afford healthcare. Does Australia provide healthcare for anybody that wants it, regardless of income? If not, then his answer is off topic and deserving of nothing more than to be trolled.

Either way you're being a douchebag and jumping on the bash America bandwagon with him.

Re:Go public. (1)

tepples (727027) | more than 7 years ago | (#17064470)

[in the US] we do have Medicare/Medicaid for those who need it.

Medicare kicks in only after age 65. Medicaid is a state-managed program; the version available in Indiana is available only to families that make less than $1,000 per month total. Given what families must spend on rent, food, and utilities, and given the earlier quote of $1,000 per month health insurance alone [slashdot.org] , that leaves no room for those who make just above the cut-off to afford health insurance.

The original question posted indicates that this person runs a business, and does make money, and therefore can afford healthcare.

Makes money != makes enough money to afford health care along with rent, food, and utilities. This would require giving the employees a hefty pay raise, something that would likely put the business clearly into the red.

Re:Go public. (0)

Anonymous Coward | more than 7 years ago | (#17063600)

Sorry to disappoint you but it's not quite like that. Health insurance in Australia is relatively cheap provided you sign up when you have no medical problems. As soon as things start going wrong premiums shoot up and so does your chances of something else going wrong. Any injury can lead to chronic pain. Even small surgeries are horribly expensive (think prostate cancer). The waiting lists on the public system can leave somebody waiting for months to years on conditions that are drastically affecting their life but are non life threating.

There does exist an argument for putting away what you would put into health insurance into a bank account but this only works if you actually save the money.

- Australian Med Student (we see the problems but there's nothing we can do ... yet)

Re:Go public. (1)

NeuralAbyss (12335) | more than 7 years ago | (#17063950)

I'd like to put my 2c worth of counterexamples for this. I was diagnosed with gall stones earlier this year.. ended up having an operation to have my gall bladder removed. Total out-of-pocket cost for specialist visits plus surgery (i.e. everything) was about AUD$200. Only had to wait a month in the public system.

Quit being moral about it (0, Flamebait)

NekoXP (67564) | more than 7 years ago | (#17063460)

You have read some news in some newspaper about some shady goings on at every insurance company?

Oh My God.

Who cares? Just pick the one that gives you the BEST HEALTH INSURANCE PLAN for the LEAST MONEY. Why does that have to be so difficult? Ask your doctor which one he would choose, and just go with it.

Re:Quit being moral about it (2, Insightful)

Detritus (11846) | more than 7 years ago | (#17063508)

It's not such a wonderful plan if the insurance company tries to weasel out of paying valid claims. Some companies will tell you to fuck off, and if you don't like it, file a lawsuit.

Corollaries (1)

Ihlosi (895663) | more than 7 years ago | (#17063584)

Just pick the one that gives you the BEST HEALTH INSURANCE PLAN for the LEAST MONEY.



"If it sounds too good to be true, it isn't."



Ask your doctor which one he would choose, and just go with it.



The answer will probably consist of the plan that makes him the most money.

Re:Quit being moral about it (2, Informative)

ktappe (747125) | more than 7 years ago | (#17063992)

Just pick the one that gives you the BEST HEALTH INSURANCE PLAN for the LEAST MONEY. Why does that have to be so difficult?
Spoken like someone who hasn't tried to choose a healthcare plan lately. Dude, my company gives us 6 plans to choose from and even then it's hours and hours of comparing fine print to see what they do & don't cover and for how much co-pay in each and every case. You have to be a really good number cruncher to be able to figure out the best choice for you AND you have to be a great prognosticator of your future health. And I'm single. I can't imagine how much harder it would be if I had a wife and newborn to worry about.

Oh, and the reason it "has to be so difficult" is because the companies purposely make it difficult. Their beancounters figured out long ago that the harder they make it to decipher the plans, the fewer claims they get because their customers can't figure out if they're covered or not, or how to file claims, or whether they can appeal denials of coverage. It's a serious racket. So let's not act like this is child's play.

Re:Quit being moral about it (1)

neimon (713907) | more than 7 years ago | (#17064388)

It's never that simple, and you've obviously never tried it. Most plans provide little coverage for everyday events and horrible coverage for large events. Hospitals WILL bill you for the difference, and they WILL sue you and take your house if you can't pay. There is no free healthcare, and it's rediculously expensive because of what now? Oh yes, providing a service for the common good by expecting a profit from it. Now shut up and hope you don't get sick, because you'll lose everything you own in the process if that's your idea of an "idea."

Baffled (0, Troll)

joshier (957448) | more than 7 years ago | (#17063486)

I can never understand the way people have to use insurance.

Here's a tip. Save.
That's right.. Setup a savings account, and put your money into the bank account.
Pretty simple really.

Re:Baffled (1)

DougWebb (178910) | more than 7 years ago | (#17063588)

Simple Answer: Over the course of your working career, let's say you save $1,000,000. That's great, if you don't have any major problems until well into your career. But what do you do if you get into an accident, or get ill, and need to spend a few hundred thousand early on, before you've saved it?

You either go into debt, if you have enough credit, or you carry insurance to pay for it. A savings plan with a high-limit credit card used just for healthcare emergencies and a health insurance plan are basically the same thing, financially. You'd have to do some analysis on the CC interest rate - savings interest rate vs the insurance premiums to figure out which one costs less. I predict they're both excessively expensive, though.

Re:Baffled (1)

Ihlosi (895663) | more than 7 years ago | (#17063652)

I can never understand the way people have to use insurance.

I take it you haven't been smacked with a six-figure medical bill yet.

I would also guess that you're not too old, and in fairly good health.

Re:Baffled (-1, Troll)

bumptehjambox (886036) | more than 7 years ago | (#17063716)

I haven't had insurance in over five years, so I am obviously very naive. But, six-figure medical bill, WTF? do you have AIDS?!

If you do, shit, sorry. Get well soon.

Re:Baffled (1)

Ihlosi (895663) | more than 7 years ago | (#17063778)

But, six-figure medical bill, WTF? do you have AIDS?!

No. Pretty much any large surgery can get pretty close to that (especially in the US). If it's anything that requires some sort of specialist (cardiology, neurology, oncology), the price tag will start in the six-figure realm and go up from there.

Re:Baffled (1)

bumptehjambox (886036) | more than 7 years ago | (#17064000)

Damn. Yeah, I guess I am playing my odds. I don't have any dependants, so health insurance hasn't been too pressing an issue. Outside of dental, I did break down and pay cash out a few times for dental visits. I do not play games when it comes to my teeth! Health insurance is so expensive, and I can't face another bill. I recently went nuts and cancelled as many monthly services as I possibly could.

I'm pretty young and I don't want to face the conclusion that my health will fail one day, my naive self tells me that humans are stronger than needing constant doctor supervision. The price of that supervision, even with a good healthplan, damned high. Ugh. People like me die painfully and slowly I guess. I have to think about 'preventative maintenance' in a whole new life-threatening way ;D

Re:Baffled (1, Interesting)

Anonymous Coward | more than 7 years ago | (#17063804)

> do you have AIDS?!

Are you trolling or really just that naive? My wife slipped on some ice, and the doctors took her insurance for over $100k. That would have bankrupted us if it had happened a month earlier before her new insurance started with her job with IBM. Never underestimate the greed of doctors. I work with them all day every day (I write medical billing and scheduling software) so I see just had greedy, lazy, and dishonest they are. You obviously have no experience with their type. It's quite an eye opener the first time you see one of them in action when they sniff money.

Re:Baffled (1)

Ihlosi (895663) | more than 7 years ago | (#17063824)

Are you trolling or really just that naive?

I would guess the latter. It's easy to be naive (and easy to get really good-sounding health insurance) if you're young and healthy. Take one of the two away, and hell breaks loose.

Re:Baffled (1)

giorgiofr (887762) | more than 7 years ago | (#17063900)

1. I'm young and healthy but I can see the PP is an idiot.
2. Never mistake malice for incompetence.

Re:Baffled (0, Troll)

bumptehjambox (886036) | more than 7 years ago | (#17064218)

Dang, you guys are pricks. Heh. I got into a bad car accident, wasn't my fault, and got an out-of-court settlement and they took care of all of the medical bills from day one. Otherwise I wouldn't have been able to think about going to the doctor. I saw the bills their insurance company covered were huge, for basically nothing, but I didn't need any surgery, so I didn't see those six-figure ones. That's my only 'real-world' experience. 'Twas a bit of an eye opener.

Whatever, you guys are assholes though. Or you're totally cool, like 'too cool for school' style. Pathetic. I may have no experience with doctors on my own dime, but atleast I am not an asshole, there ain't no cure for that and if there was medicare wouldn't cover it! :D

I hope you all go through long malpractice suits that don't end up working in your favor. Blam!

Re:Baffled (0)

Anonymous Coward | more than 7 years ago | (#17063768)

That's right.. Setup a savings account, and put your money into the bank account.

So the first year you start this your daughter is diagnosed with leukemia. Millions of dollars in treatment ensue.

How much did you put away in a year?

Re:Baffled (1)

oliverthered (187439) | more than 7 years ago | (#17063864)

What happens if you need to draw 10 years worth of money from your fund when you only been saving a week?

Re:Baffled (4, Interesting)

sadr (88903) | more than 7 years ago | (#17063906)

Here's a good reason why you can't:

The insurance companies negotiate with all of your providers, including some you're not even aware exist, for lower rates. And while you can do some negotiation yourself, that is a very difficult thing if you're lying on a stretcher unconcious.

At my most recent physical, the lab billed $900 for all of the tests. The insurance company paid $300 and the rest was the "negotiated discount".

The medical system in the US is fundamentally flawed, and facing it WITHOUT insurance could easily bancrupt you.

Re:Baffled (2, Interesting)

Ihlosi (895663) | more than 7 years ago | (#17063942)

The medical system in the US is fundamentally flawed, and facing it WITHOUT insurance could easily bancrupt you.

Actually, the nasty thing is that it can also bankrupt you WITH insurance. At a certain point, even 20% of the medical bill will be too much. Especially considering that you're not likely to start working immediately after a procedure that expensive.

Re:Baffled (0, Troll)

UbuntuDupe (970646) | more than 7 years ago | (#17064012)

You negotiate insurance discounts while on a stretcher?

I thought most people negotiated insurance policies while not in critical condition.

Re:Baffled (1)

Ihlosi (895663) | more than 7 years ago | (#17064068)

You negotiate insurance discounts while on a stretcher?

Yep. "I want 50% off everything, or I'm going to die right here."

Re:Baffled (0)

Anonymous Coward | more than 7 years ago | (#17064082)

Congratulations, you're the first embarrassingly naive person to respond to this thread. Google health insurance horror stories.

Re:Baffled (0, Troll)

UbuntuDupe (970646) | more than 7 years ago | (#17064126)

Congratulations, you're the first embarrassingly naive person to respond to this thread. Google health insurance horror stories.

I didn't find any horror stories of people bleeding to death while shopping for a good health insurance policy.

You shop for health insurance before you're in an accident.

Why is this so hard to understand?

Re:Baffled (1)

Ihlosi (895663) | more than 7 years ago | (#17064152)

I didn't find any horror stories of people bleeding to death while shopping for a good health insurance policy.

Note that the original post was not about negotiating with the insurance company, but with the service provider (doctor, hospital, etc).

Re:Baffled (0, Troll)

UbuntuDupe (970646) | more than 7 years ago | (#17064192)

He was talking about the advance negations that insurance companies make with providers that cover payments for a broad range of procedures. Insurance companies (like the hypothetical individual he was talking about) don't negotaite those while in critical condition. Of course, what is more likely is that the individual (again, who is NOT currently in critical condition) would negotiate with an insurance company that already has negotiated discounts.

The little barb about difficulty of negotiating while in critical condition was irrelevant.

Moron.

Re:Baffled (1)

Ihlosi (895663) | more than 7 years ago | (#17064232)

Moron.

Read your own signature and apply it to other people's posts (oh, and add "and try to understand" after the "read" part). It would save you from some embarassment.

Re:Baffled (1)

UbuntuDupe (970646) | more than 7 years ago | (#17064278)

No, it won't. [slashdot.org]

Re:Baffled (1)

sadr (88903) | more than 7 years ago | (#17064190)

The original poster was suggesting just saving money and paying cash for services instead of getting insurance.

And you can negotiate with providers before you receive services to lower their prices if you're paying for it out of pocket. i.e. if you don't have insurance.

My point wasn't about negotiating insurance policies, but negotiating the actual price of specific services, which, as I pointed out, can be problematic in some circumstances.

Re:Baffled (2, Insightful)

UbuntuDupe (970646) | more than 7 years ago | (#17064240)

You're still missing the point.

Insurance companies, in advance, negotiate discounts.

The comparable action for an individual (which is of course impractical) is to negotiate, in advance, discounts, while not in critical condition.

So if you were to go without insurance, then you would instead be calling all these hospital to arrange advance discounts -- not in critical condition.

There's a reason why that wouldn't work -- it's impractical and hospitals couldn't justify the expense of negotiations for just one person. The reason it wouldn't work has NOTHING to do with difficulties in negotiating while in critical condition.

The reason I belabor this point is because on another health insurance thread, a moron kept switching between talking about paying the hospital, and talking about shopping for insurance, when you'd be in critical condition in one but not the other, which made it impossible to rationally discuss the issue with him. So, I have to be careful that people don't continue that error.

Re:Baffled (2, Informative)

twotommylong (794494) | more than 7 years ago | (#17064182)

Agreed. I have worked in health insurance for 4 years, and I've posted on other threads that I am now a major 'consumer' of health care.

A couple things to consider. - Shop for insurance looking for these items: Are my favorite doctors in net? Pharmacy? Are my drugs covered, must I buy a generic? Is Chiropractic covered? Mental Health?
- 'In Network' is golden. if you prefer to leave the network, you will pay that doctor's standard rate, often even after your 'Out of Network Max' has been exceeded, because Insurance company's set a 'Usual and Customary' (U&C) value for every procedure, and only pay that amount... MDs, since they are discounting services paid for by insurance companies, up their normal rates to cover the difference (if 20% are paying cash, and 80% are paying via insurance 80% of the 'real costs, the 20% are paying for their costs plus paying for the discount given to the 'network' patient)
- If you are young, healthy, good cash flow (real paying jobs) and have good investing habits... do a High deductible PLUS an HSA... and be disciplined to invest the difference in premiums between the low deductible/HMO and the HDHP in the HSA. Your HSA becomes both your rainy day health fund, but if you maintain good health, eventually it kicks into a retirement fund vehicle.
- Look for these perks
-- 100% coverage on annual exams
-- 100% coverage on immunizations for children
-- Nurse Line (avoid unnecessary trips to the doctor)
-- A good web site, that allows you to track your claim history, medical record, has a real procedure cost estimator and a good network physician lookup

Finally,
- Insurance buys you 'insurability', ie, your current insurance must provide you a certificate of coverage which is the chit that gets you into most group plans even if you have a chronic condition. So being continuously insured when you are diagnosed usually gaurantees you if you ever want to switch plans that you can get insurance (albeit maybe at a higher rate, but at that point coverage is important, not price).

Re:Baffled (3, Informative)

Dunbal (464142) | more than 7 years ago | (#17064090)

Here's a tip. Save.

      I hope you have a lot of money saved up. Heart attack: over $10k including drugs, a few days in ICU or the coronary care unit, and an angiography. Oh, and if you need bypass surgery, the going rate was around $35k last time I checked. So we're up to about $45k. We're still not talking about the $200 in medication you'll be spending every month, plus the semi annual visits to your cardiologist at around $300 each, and the yearly stress test, etc.

      How much did you say you have saved up? Make sure you don't have a heart attack at 40 years old or you are screwed.

Baffled and Healthy. (0)

Anonymous Coward | more than 7 years ago | (#17064308)

"How much did you say you have saved up? Make sure you don't have a heart attack at 40 years old or you are screwed."

Sounds like an incentive to stay healthy, don't you think?

Not paying is suicide (1)

tepples (727027) | more than 7 years ago | (#17064524)

Some people become no longer healthy despite their best efforts. Are you telling them to just kill themselves by not seeking medical help?

What about a trade organisation? (1)

bLanark (123342) | more than 7 years ago | (#17063490)

In the UK, our Professional Contractors Group [pcg.org.uk] has just negotiated deals [pcg.org.uk] with a leading health insurer or two. I haven't seen the details yet, but it seems relevant to this discussion.

Are there no similar organizations in your country doing this kind of thing?

First things first (2)

OeLeWaPpErKe (412765) | more than 7 years ago | (#17063612)

Congratulations on becoming a father !

Poor Americans, .. again (4, Insightful)

Stigu (919228) | more than 7 years ago | (#17063658)

Seriously, how dare you call yourself the "best country in the world" if you don't even have nationally implemented healthcare?

Europe, glorious old lady that she is has long ago implemented the National healthcare to make sure that
A; Everyone has access to proper healthcare.
B; Everyone automatically pays into the healthcare fund so it can be maintained
C; Good quality in healthcare is guaranteed by state checkups.


In those days there were no "private" health insurance companies, but look what trusting in those has brought you? Deception, Fraud, and general run-around or obfuscation from most if not all of the private insurance companies.

IMHO, healthcare is not, and has never been something companies should be in charge of. A companies purpose is to make money. The state however, if it's run by others then the idiots running the American state, should be more interested in keeping it's taxpayers ALIVE and healthy so they can work and pay taxes next year.

Re:Poor Americans, .. again (1)

CowboyBob500 (580695) | more than 7 years ago | (#17063862)

How is this a troll? Is see it more as a wake up call type of post. Surely there's not anyone who can actually argue that the American system is the best in the world? It's quite clear that there are third world countries with better systems, never mind the rest of the industrialised world.

Bob

Re:Poor Europeans, .. again (-1, Troll)

Anonymous Coward | more than 7 years ago | (#17064540)

Tired Old Europe also has double-digit unemployment, etc.

Re:Poor Americans, .. again (5, Interesting)

Anonymous Coward | more than 7 years ago | (#17064620)

I agree with what you say, but the big difference here is that there are no waiting lists. I moved from UK to US, my family health issues are addressed immediately here. My friends and family in the UK get stuck on waiting lists with can be for months.

Another difference is doctors here make a fortune, just like lawyers. Whereas those in the UK can work 80 hours a week for a middle income. Medical professional are also broken down into an infinite number of specialists here, there's little need to muck around with general practitioners, if you do, you'll get referred to a specialist pretty quick.

There is also free medical for low income and freeloader types. Most places will not turn you away either. If you call up front, you'll be asked about insurance. Even when you receive huge bills, you can make small monthly payments to pay it off. Children without medical cover may be covered by the state, so if you have a young kid and a big bill, yet have no insurance, and if your income is low enough (which is less than something like $50-60k I've been told) the state will pick up the tab.

It's not all doom and gloom like you think it is. Yes, there's a huge amount of profiteering, a bill will be for different values depending on payment, and insurance companies waste a huge resource avoiding payment, you really have to be on the ball even with cover. The real issues are for the long term sick, rather than fixing up a damaged body part.

Re:Poor Americans, .. again (1)

Average_Joe_Sixpack (534373) | more than 7 years ago | (#17064734)

The state however, if it's run by others then the idiots running the American state, should be more interested in keeping it's taxpayers ALIVE and healthy so they can work and pay taxes next year.

Let's not kid ourselves here. The bulk of healthcare costs are consumed by the elderly who are no longer participating in the workforce. The social model only works if you have enough younger workers to support the system, which will no longer be the case for the Western economies in the next decade.

Change is needed now (5, Insightful)

Anonymous Coward | more than 7 years ago | (#17063710)

First, you are about to find out just incredibly broken our health care system is. I doubt if you will get private insurance, as they are denying older applicants out of hand, and if you have ANY problem forget about it.

Many states have an expensive health insurance pool that has high deductible insurance that will only take care of you in catastrophic conditions. If you go for the low deductible, expect to find very high premiums and equally high copays.

With the high deductible plan you can start a health savings account (who has money to save these days?), but that may be your best option.

Most important, keep your coverage with your wife current as long as you can as you may get your prexisting conditions covered without a waiting period.

In my circumstance at least, I have found that health insurance companies have no reason to want to insure anyone that may be a liability down the road. I do not see a political solution to this, as congress is corrupt. The best they could do was pass a bill that made it hard for sick people who got burried by medical bills more difficult to declare bankruptcy. And another program that was essentially a handout to drug companies that foisted a compkicated hard to use drug plan onto seniors. That's all they have done. This last congress was the most do-nothing congress ever. It seems the only thing they had time for was to take bribes from abramoff and hit up underage pages for sex and try to cover up the trail later. The health care industry is not much better with their costs outpacing inflation 3 to 1 at least.

I know neocons are not going to like what I'm about to say, and how important that it is fighting alquaida over in Iraq blah blah blah, but the fact is with what we have spent on this war to knock over a tin horn dictator I bet we could have paid for everybody's current medical expenses in the US, let alone making it affordable.

If you're healthy and have job, you probably will not won't give what I have to say a second thought. But if your sick as I am and can't find coverage or a doctor, you know how bad it is. If your self employed doubly so. Even if you do have coverage, you have got to be noticing how your insurance premiums are getting more expensive and its covering less, your deductible is more, and prescriptions are through the roof.

But the greatest crime of the Iraq war is that it has taken attention completely away from the health care crisis. I have talked to my politicians to no avail. Gratefully though, a challenger for state office DID talk about it and it got him elected.

We had no business screwing around in Iraq (esp. with the WMD big lie) without taking care of our own at home first. It's that simple. If things aren't working for you, it's important to let your politicians and everyone around you know how you feel. Only this way will there be hope for change.

BTW, make sure that the high deductible health savings account pays for 100% above a certain point. 80%, and you still could (likely)lose your shirt if you get sick.

Re:Change is needed now (1)

maxume (22995) | more than 7 years ago | (#17064480)

You do understand that insurance involves risk pooling and cost sharing and not 'magic' right? Most big insurance companies operate as not for profit entities(they have to compete with each other...) and lose money as often as they make money. They make most of their money by investing the float that they have between receiving premiums and making payments. They often spend a big chunk of the investment profit making payments. It's a big hair brained scheme that doesn't work very well, but medical care costs a lot, so insurance does to.

There isn't some bloated fancy pants smoking a cigar every time somebody gets sick.

HDHP + HSA (1, Informative)

Anonymous Coward | more than 7 years ago | (#17063774)

The company I work for currently has a fairly rich plan (low copay, low out-of-pocket max) but we're facing a 25% increase in premiums next year so I've been tasked with finding alternatives that don't break my coworkers' banks. My company foots a good portion of the bill, so I can't say for sure that this works best for the self-employed, but FWIW..

First off, be sure to crunch the numbers. It's pretty easy to work up a spreadsheet or little program to compare plans. Just input expected Rx costs, clinic visits, hospital visits, etc., and have it calculate how much you'd wind up paying under different plans given different scenarios.

I can't speak to which specific provider is best since from my experience that's pretty localized, but I can tell you that my analysis indicates that for the vast majority of people, HDCPs with HSAs are the best choice. Find a plan that provides preventive exams on the house (this includes well baby care, by the way) and unless you expect to have over a couple grand or so in prescription costs per year, get a plan that doesn't include Rx.

This advice is based on the rates in my area with a $2000/$4000 HDCP plan. Most families at my company will save thousands and at worst will be no worse off than if they had chosen to take the 25% hit and stick with our old plan.

Be sure to build up your HSA account. Remember, you can always move a portion into an HSA investment account (as opposed to the HSA transactional account) and basically treat that money like it's in a 401(k).

Good luck!

Blues (2, Informative)

tverbeek (457094) | more than 7 years ago | (#17063846)

I use an HMO program offered by my state's BlueCross BlueShield company. It's the same plan they sell to employers, but with me paying the full premium. It's not cheap (and for someone with a family it'd be even less so), but it's... affordable, and in the few years I've been using it, it's been a lot easier to budget the monthly premiums than it would have been to pay the medical bills I've had, and definitely made my recent visit to the ER less stressful, knowing I wouldn't have to pay for it.

Re:Blues (4, Insightful)

baptiste (256004) | more than 7 years ago | (#17064140)

Except many people have varying concepts of affordable. I have kids so the BCBS plans for a family run in the range of $600 (barely covers anything) to a typical co-pay 100% plan you'd find at most corporations which runs almost $1100. That's over $13,000 a YEAR for health coverage. It's pretty scary when you're paying as much for health insurance as you are for your mortgage. Healthcare in this country is broken. We spend insane amounts on all the bean counters whose job is specifically to figure out how NOT to cover something and then blow hundreds of BILLIONS of dollars on a war fought over a lie and yet universal healthcare is some sort of evil that we can't afford. I know catastrophic illnesses can cost a lot of money. But over the course of, say, 20 years while your kids grow up, how many people are going to even come spent more than 25% of the $260,000 they pay in premiums. I also think it should be illegal for hospitals and doctors to 'negotiate' rates with insurance companies. Why does being self employed, poor, or a small business owner mean you have to pay 2-3 times more for services than someone who works for IBM? Everytime I see those EOBs where 50-75% of the cost is 'negotiated away' - we're all human - if they can survive charging $300 for a procedure, it should cost $300 for EVERYbody, not just people stuck in cubicles. And for those of you who will scream 'I don't want to pay for other people's healthcare in a universal system' you're naive. You already do. Besides that - you're supposed to be all 'support the small businesses' well, healthcare costs are a HUGE expense for small businesses. Imagine how many more would thrive if they didn't have such a disadvantage compared to medium or large size businesses? Good luck finding coverage you can afford. You're going to need it. Like the previous poster said - you almost HAVE to have the co-pay plan with young kids - the doctor visits are frequent. You're pretty much stuck.

Re:Blues (2, Insightful)

Ihlosi (895663) | more than 7 years ago | (#17064176)

But over the course of, say, 20 years while your kids grow up, how many people are going to even come spent more than 25% of the $260,000 they pay in premiums.

Quite a few of them. All it takes is cancer, or a heart attack. Two of the top killers in industrialized nations.

Re:Blues (2, Insightful)

hal2814 (725639) | more than 7 years ago | (#17064304)

"I also think it should be illegal for hospitals and doctors to 'negotiate' rates with insurance companies."

Why not? They'll negotiate with you. In fact if you can pay them promptly, they'll cut you a better deal than they'll cut any insurance company. Insurance companies have a nasty habit of holding onto payment well after it's due. If you can get cash in hand or even set up a payment plan with the hospital, they'll take it at a great loss (compared to their asking price). They won't advertise that because then the insurance companies wouldn't think they are getting a deal.

This would be like making it illegal to negotiate on new car prices. Sure the car dealer has a high MSRP, but you're a fool to pay it. Our insurance system has it's problems, but hospitals and doctors being free to negotiate prices isn't one of them.

Chamber of Commerce (1)

njb42 (556147) | more than 7 years ago | (#17063918)

Your local Chamber of Commerce may offer a group health plan to its members. It'll probably be a better rate than you could get on your own.

Just look around... (1)

Ritchie70 (860516) | more than 7 years ago | (#17063968)

Slashdot is international. Health insurance (in the US, at least) is regulated state-by-state, and priced at that level or smaller.

You really just need to look around, make sure you find a company that isn't fly-by-night, preferably with an agent who wants to help you.

Also, look at any organizations you belong to - IEEE, ACM, etc - some or all of them may have health insurance programs. Since you don't have an employer but don't have an income, around here that means you're probably a consultant. Is there a consultant's organization (national or local) that you can join? They probably have some discount program.

Or think outside the box. The lady who cuts my wife's hair also works part time at the local grocery store, because part-time people at the grocery store can get benefits, and that's the primary reason she works there. I've heard that's true at Starbuck's and Home Depot, too, but you'd need to check.

Re:Just look around... (1)

Ritchie70 (860516) | more than 7 years ago | (#17063972)

OK, first sentence, he says he's a self-employed programmer... Not sure how you do that unless you're working as a consultant to another company, but maybe he's got a product that he sells enough of to meet expenses.

Couple of suggestions (3, Insightful)

real gumby (11516) | more than 7 years ago | (#17063998)

Buying insurance just on your own is expensive. There are various parameters you can fiddle to help (e.g. register kid and parents separately, though this means you don't share a deductible; set your deductible as high as possible -- here the highest I could get was $5000/yr, which really ends up being more like $10K), but it's really expensive -- we were paying about $300 a month and were in perfect health -- that was almost 4K + deductible per annum.

(it's even worse for a small company under 25 employees!)

If you're a member of the IEEE or any other "entrepreur" association you qualify for a group policy via them. That's usually a good deal. For example a quick search of "self-employed association" just showed as its first hit an association that offers health insurance. I have no connection and won't shill for them by including the URL.

If you live in CA I hear Kaiser is quite good though I've never used 'em myself.

Good luck. You'll find a lot of "well baby" visits will be needed in the first year or so. Well, at more than you need as an adult anyway. The insurance companies usually subsidise them because it's cheaper to catch something in the bud.

And finally, in all seriousness, consider moving to my home country, Australia. There's a preference for computer programmers under 40, and it's a great place to be or raise a kid. (though I live in California right now myself...)

Oh and have fun. One thing to be careful of / manage: I basically didn't work for the first couple of years after my kid was born and again when he was perhaps 4-6. That was really great. Try to find a way to balance the time with the family with making sure there's some regular income!

IMPORTANT (5, Insightful)

SpartacusJones (848951) | more than 7 years ago | (#17064094)

Before you drop your wife's insurance let me tell you what I am currently finding out the hard way. You will be hard pressed to find an insurance policy on a pregnant woman. Group policies can be more forgiving, but so far everyone I've talked to says it is a 'pre-existing condition' and they won't cover my 7-weeks pregnant wife. If you are going to get a policy, your wife can't deliver for 11 months from the date the policy becomes effective or it's not covered.
I just got out of the Air Force and am now working as an independent contractor. Tricare does have a COBRA-type polkicy I can get but it's very expensive. I can't just get the coverage for my wife, I have to be on the policy, so I'm having to pay about $2200/3 months for it. At least it comes in 3 month chunks, so I won't have to carry it longer than I need it.
If there weren't that program available to me, I don't know what I'd do. In Georgia where I live there is a Medicade program for pregnant women, but I make too much money to qualify for that. If you make more than $1600/week with a family of 4 (they count the unborn) you make too much. My wife had to have a c-section last time and I saw the bill Tricare got. For everything throughout the pregnancy they paid out over $60k.
I have heard that if you can't get coverage and you talk to OB docs, they can usually work with you and sometimes you can end up paying less than if you had insurance. I have not looked in to that yet. Good luck!

Re:IMPORTANT (1)

jschrod (172610) | more than 7 years ago | (#17064336)

That's unbelievable.

I knew that the US medical insurance system sucks, but I didn't know that it sucks so much. Good luck for your wife, that she delivers without any problems for her or the baby.

Re:IMPORTANT (1)

clare-ents (153285) | more than 7 years ago | (#17064520)

Can you explain how this situation would work out.

A colleague of mine started work for us, got pregnant very early on and left after ten months to go on maternity leave. Difficult labour and eventually gave birth via C-section.

This is in the UK so it's all on the NHS and paid for by the taxpayer, the company don't provide private health insurance.

What would happen in the US - presumably the company would have some form of health insurance, but she wouldn't be covered so they'd just let her die? I'd really like to know how it would work. She's young in and wouldn't be able to afford to pay for the operation herself.

Re:IMPORTANT (1)

Ihlosi (895663) | more than 7 years ago | (#17064548)

but she wouldn't be covered so they'd just let her die?

Oh no, that's not going to happen. Ending up neck-deep in debt is the likely outcome, with all its nasty side effects (sleeping under bridges and such).

Re:IMPORTANT (1)

SpartacusJones (848951) | more than 7 years ago | (#17064696)

In the US, maternity leave means you are technically still an employee and are not dropped from the policy.

This is how I understand things to work:
If you quit a job while pregnant, you can rely on something like Medicade because presumably you won't have an income. It's great if you qualify, and the closest thing to socalized medicing the US has- everything is 100% covered, including the first few weeks after the delivery.
If you are dropped from a policy by no fault of your own, like the company defaulted on payments or something, it's illegal for another insurance company to refuse to insure you.
The only time it gets weird is in a situation like mine. I am more than capabale to pay for insurance, and I'd really like to, but no one will insure us.
So in the US, your co-worker would have still been covered by the company policy (assuming there was one), or she'd have public assistance.
I should note that no doctor or hospital in the US will ever deny care due to inabililty to pay. A large portion of hospital revenue is eaten up every year for indigent care, though the state helps pay for some of the cost with tax money.

Go for the high deductible (3, Interesting)

bhmit1 (2270) | more than 7 years ago | (#17064116)

I'd recommend a high deductible plan if you're self employed. You should already have money saved up to weather the rough times, so just add some more to cover the deductible. The amount you save is significant. The baby will most certainly have you going to the doctor a lot. I've used eHealthInsurance [ehealthinsurance.com] myself, and my only complaint is that the fine print is hard to find or not available until after you purchase a policy. But the policies they offer are from the major carriers.

For the record, the place I got in trouble was picking the cheaper plan and then getting a physical. Burried back in the fine print was a clause that they don't cover anything preventative, but that wasn't obvious when I was ordering the plan or looking through the main section of the booklet. Had I clicked a link to the provider's comparison of all their plans, it would have jumped out like a sore thumb. Personally I think it borders on criminal when a company doesn't make it obvious where you risk owing a lot of money and what coverage is missing that many others would frequently include.

And a final note, always get the price an uninsured person will be responsible for up front for everything! This is what you'll be stuck paying when the insurance company says they aren't responsible, and you should be able to afford it. My family's neighbor (a doctor), myself, and many others agree, the medical system in the US is broken. Insurance is complicated, costs are going up, and lawsuits are giving insane sums of money for just about anything. My biggest peeve is that you aren't told how much you owe until a month after the procedure is done. Admittedly this is a service and things may fluctuate when you find a problem, but every doctor uses charge codes and their office knows their fee for that code, and the insurance companies know what they have agreed for those codes. But no one will tell you those numbers until after you've had the service. Congress would do a lot for people by requiring every insurance provider to publish how much they cover and what the patent is responsible for on a standard list of charge codes, and make it available before signing up for that coverage.

IEEE (3, Informative)

shaka999 (335100) | more than 7 years ago | (#17064170)

Join the IEEE.

They have some good group deals for insurance setup just for cases like yours. They also have group life and a few other things that might be of interest.

Oh, and its a good organization to boot :).

How about.. (3, Insightful)

Eivind (15695) | more than 7 years ago | (#17064180)

How about moving to a civilized country ?

You know, one of those where it's recognized that decent healthcare for everyone is a good thing.

It's quite silly, the way you do it in USA. It prevents people from acting rationally, to the detriment of all. (it's the same in *parts* of Europe, you guys aren't alone about it.)

For example, a friend of mine (living in the USA) is currently at home (watching his baby) while the mother works. He works a little evenings and earns a little extra for the family, but little enough that he was still health-insured trough his wife.

Then he got offered a larger position. He had to turn it down. It'd have put him above the limit where he'd need his own health-insurance, so in the end he'd have ended up working *more* and getting *less*, which is nonsense.

Everyone is a loser in this scenario:

  • The family doesn't get the extra income.
  • The employer doesn't get the extra work done. (atleast not by the person that was his first choice)
  • The insurance-industry covers both today, paid for by his wifes employer, the two of them wouldn't actually be *more* sick if he worked more.
  • The state (and thus indirectly all projects that benefit from tax-money) don't get the extra tax-money thay he'd have paid if he worked and earned more.

Stupid. Very stupid.

It should pay to work. Putting someone in a situation where they get *less* for working *more* just serves as an insurance that these people won't, infact, work more.

There's similar mechanisms in welfare-programs too, where you earn $100 more and get $150 less from welfare. The effects are similar. (it'd have been different if you'd earned $100 more and as a consequence gotten $50 less from welfare, that'd have been fine)

Re:How about.. (1)

Reality Master 101 (179095) | more than 7 years ago | (#17064728)

You know, one of those where it's recognized that decent healthcare for everyone is a good thing.

I know why you think that, but it's not a "good thing", for a simple reason: What if you don't like you're health care? I can go to another insurer. I can go to another doctor. I can do pretty much any damn thing I want. I never have to wait for anything. You're at the mercy of what your government provides, including the infamous "waiting list".

No thanks. I'd like my complex-and-expensive knee surgery scheduled in a few hours, thank you. I'll take freedom over the nanny state any day.

Look into using an 'umbrella' company (2, Informative)

Jah-Wren Ryel (80510) | more than 7 years ago | (#17064212)

Also known as "employer of record" - they exist for independents who need "big corp" sorts of benefits like access to health insurance. Here is one that I haved used in the past - MyBizOffice. [mybizoffice.com] Despite the stupid, formerly-trendy name, they are one of the largest out there and do a pretty good job of things.

If you're planning on having more children after.. (1)

Assmasher (456699) | more than 7 years ago | (#17064238)

..this one (congratulations by the way :) being a daddy is awesome), your choices will be limited because maternity coverage is sparse and expensive. I recommend that you contact *several* health insurance agents (the ones who shop around for insurance for you like they would for a company) and ask them all to look for the plan you need. This at least will save you from having to figure out which plans are out there, which ones cost what amounts, which ones cover these features, yadda ^ 3. I was doing this myself until very recently. It was expensive, but manageable.

Good luck with the little one :). Some advice there too ;), (1)Prince Lionheart Bear (yes, stupid STUPID name, but it makes a womb-like/white noise sound and if the baby wakes up it starts again), (2)Aquarium rocker (trust me), and the greatest of all time (3)Motorized swing. I still open the toy closet once in a while to blow that bad boy a kiss.

One option: MEGA through NASE (1)

Jaiden (64072) | more than 7 years ago | (#17064292)

I joined NASE (National Association of the Self Employed) and had a plan through MEGA which was basically just a major-medical plan. It didn't cover basic stuff, but would cover a big accident or something. I'm not saying this is your best option, it's just one I happen to know about.

It wasn't that expensive, but then I was single. I think you're in for a rude awakening, either way.

The European side of this is... (0)

Anonymous Coward | more than 7 years ago | (#17064316)

... that your government bullies you into a health insurance that doesn't pay when it really matters. I see so many people posting how good they feel that the state provides insurance for them. You obviously haven't been chronically ill. My wife suffers from CFS (or by whichever name you want to call it), and since it's not a well-defined illness with known causes, the insurance doesn't cover shit. Yet I can't even get out of paying the monthly rates, because the law demands that I'm insured. I'd actually have saved a lot of money if I'd just paid doctors directly these past few years, because as it stands I have to pay insurance that I don't use and doctors.

It's a great system in so many cases, except for the unusual ones that need the most attention.

Re:The European side of this is... (1)

Ihlosi (895663) | more than 7 years ago | (#17064496)

... that your government bullies you into a health insurance that doesn't pay when it really matters.



Depends on what country you're actually in.


Here (Germany), your only "bullied" into health insurance if you are a) an employee and b) make less than X Euros a month. If you don't fulfill both conditions, you're free to go uninsured, pick up private health insurance, or stay in the public plan. And even if you're bullied into the public plan, there's different carriers to chose from.

What about COBRA? (5, Informative)

Bored George (979482) | more than 7 years ago | (#17064346)

Even if your wife leaves her job, she (and the family, if you have a family policy) can stay on her former employer's health insurance for 18 months under COBRA [dol.gov] . But they can charge you the actual cost of the policy plus two percent. (Meaning if she currently plays 80% of the cost of the policy through deductions and the company pays the other 20% percent, after you go on COBRA you'll pay the 80% + 20% + up to 2%. The HR department of her company can tell you the COBRA rates.)

After the 18 months of COBRA runs out, the insurance company is required to offer you a non-group policy that is not medically underwritten. I think they usually call this a HIPAA policy. This will probably be more expensive than the policy you get through COBRA, but you can't be denied for pre-existing conditions.

It's been a while since I've read the DOL publication on COBRA, so follow the link above to verify that none of the details have changed.

HDHP + HSA (and don't spend the HSA money) (3, Informative)

G4from128k (686170) | more than 7 years ago | (#17064436)

HDHP + HSA is the way to go if you are at all heathy and fiscally prudent. Low deductible insurance is a money loser. With a low deductible, you are all but guaranteed to pay more in premiums each year than you would by saving the money and paying from savings. The tax-deferred/tax-free nature of the HSA makes this even more true.

Also, the HSA regs give you tax advantaged savings based on the money you put into the HSA (not the money you take out of it). Check with your accountant, but I believe that nothing in the IRS regs says you must pay for all healthcare expenses with HSA money. Yes, you can't use HSA money for anything but healthcare (unless you are over 65 or disabled), but that doesn't imply that you can't use non-HSA money for healthcare costs. An HSA is a great way to build more tax-deferred savings if you've hit the limits on other tax-deferred savings programs.

US Health Care Costs (2, Interesting)

rlp (11898) | more than 7 years ago | (#17064510)

A while back the WSJ published an article on where US health care costs go. Around a third of the costs went to two places - lawyers and terminal care. Medical procedures don't always have a happy ending. All too often - when they don't have a good outcome, Americans tend to sue. The last stages of life in America are very expensive. Most Americans die in a hospital attached to tubes and instruments. And this doesn't count costs like defensive medicine (too many tests to avoid potential litigation). So more use of hospice services and real tort reform would go a long way to lowering costs of health care. Of course this would negatively impact profits at commercial hospitals and income of trial lawyers. Don't expect action from either political party any time soon.

Government (1)

kevin_conaway (585204) | more than 7 years ago | (#17064582)

Have your wife get a part time job with the post office or some other government job where she would get government benefits which usually come out ahead of what the private sector offers.

Speaking From (Too Much) Personal Experience... (5, Informative)

stan_freedom (454935) | more than 7 years ago | (#17064594)

Unfortunately, I have way too much experience with health insurance, so here's my suggestions.

1. Extend your wife's plan with COBRA even after she quits at least until your baby is born. Do this, even if that means traveling further because your closest hospital is no longer in network. My first child required an emergency C-section and a few days in the neonatal ICU. He was almost 11 pounds at birth and there was no way he was coming out through the in door, so to speak. The bill was pretty amazing, but I didn't have to pay much out-of-pocket. So, if there are additional expenses related to your child's birth, at least you won't be completely screwed. On a side note, my son ended up with cerebral palsy, possibly due to decisions made by our doctor and his team. Learn up front about what can go wrong, and don't assume the experts are paying close attention to your wife/child.

2. Never go without health insurance and life insurance. I was 33 years old and my wife was pregnant with our third child when I found out I had testicular cancer. I caught it before the cancer had spread, but I still required one minor and one major operation, all kinds of diagnostics, and years of follow-up. My bills, way back in 1994, were well over $100K. My insurance at the time covered almost all expenses. Because I had life insurance, I had one less thing to worry about. Without life insurance, I probably would have died simply from stress.

3. If you have pre-existing conditions, you really need some type of group plan. Individual insurance plans are out of the question if you have any kind of serious pre-existing condition (cerebral palsy, testicular cancer, etc.). I know, because I tried this route. I pay around $10K per year for medical/dental at my current company. I thought that was a ripoff until I tried to get insurance on my own. Your only reasonable way to get health insurance is to be in some kind of group plan where your risks can be spread across a large pool of individuals. Even then you may have problems if you have any coverage gaps or you aren't going into a large enough group plan. If you have no pre-existing conditions and are healthy, the medical savings plan along with a high deductable plan is a cost-effective approach.

4. Without health insurance, you pay much higher rates for the same procedures/care. I recently had a 4-day stay in the hospital (as a result of the cancer surgery 10 years earlier). The unadjusted bill was 3 times the amount of the adjusted bill. Without insurance, you get the unadjusted bill and no expert on your side to help negotiate the bill down.

Hopefully your luck will be better than mine when it comes to health. However, I can say that insurance has saved me from financial ruin on more than one occasion. More important, insurance allowed me to make career and life decisions (like having more than one child) that I may not have made if I was paying out the ass for the rest of my life due to one bad medical experience.

I wish I had an answer for our country's current medical insurance problem. I don't think a government-based single-provider solution is best, but I think government may need to help fund large group plans that are affordable for the tens of millions of americans that want insurance but can't afford it. The uninsured are driving up costs for the rest of us by waiting too long to get care, and then entering the system directly through hospital emergency rooms. I'm encouraged by the pay-as-you-go clinics that are popping up at Wal-Marts and elsewhere for non-emergency care. It costs a lot less to pay $25 at a clinic to have your kid checked out than to wait until your kid is seriously ill and then take him/her to the emergency room.

Best of luck with your new family.

Re:Speaking From (Too Much) Personal Experience... (1)

Ihlosi (895663) | more than 7 years ago | (#17064662)

Your only reasonable way to get health insurance is to be in some kind of group plan where your risks can be spread across a large pool of individuals.

Actually, isn't this the point of _any_ type of insurance ? The cherry-picking in individual plans leads the whole principle ad absurdum, but I guess it's the best for the people that an insurance company really cares for (its shareholders).

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