The idea of not being able to afford healthcare...

[btenny]

Sorry guys but COBRA or any other health insurance is too expensive for people that are on unemployment. It costs around $130 or more per month for very young people with no health problems and $5K or so deductables. So basically the insurance covers nothing that a young person might need like a flu shot or flu medicine or other stuff. So anyone drawing unemployment would have to forgo rent or food or declare bankrupcy and stop paying all their other bills to afford health insurance.

Bill

[beardsworth]

Losing a job does not make you lose insurance in the US. You have the right to go on COBRA.

Sorry, but that's an oversimplification.

COBRA extends coverage which the now–unemployed person had under their former employer's existing insurance plan. If the employer did not have a group medical insurance plan for its employees, then there is no COBRA extension available.

Employers of fewer than 20 people may not be covered by COBRA provisions in any case.

And, if an employer goes out of business, there is no COBRA coverage because the employer-sponsored group medical insurance terminated when the business terminated. A friend of mine, employed by a small company, encountered this "catch 22" when the company owner decided last year that he was "just tired" and––with one week's notice to the employees––was closing the business. She was unable to get a COBRA extension because the employer medical plan had ceased to exist when the business closed. Ironically, if the company itself had remained in business but she had been fired, she could have gotten COBRA.

I don't live in New York, but here's one pretty good FAQ summary of the situation from the New York State Insurance Dept. (Bear in mind that specific provisions may vary from state to state.)

http://www.ins.state.ny.us/faqs/faqs_cobra.htm

Marc

[BruDude]

Losing a job does not make you lose insurance in the US. You have the right to go on COBRA.

Sorry, but that's an oversimplification.

COBRA extends coverage which the now–unemployed person had under their former employer's existing insurance plan. If the employer did not have a group medical insurance plan for its employees, then there is no COBRA.

Employers of fewer than 20 people may not be covered by COBRA provisions in any case.

And, if an employer goes out of business, there is no COBRA coverage because the employer-sponsored group medical insurance terminated when the business terminated. A friend of mine, employed by a small company, encountered this "catch 22" when the company owner decided last year––with one week's notice to the employees––that he was "just tired" and was closing the business. She was unable to get a COBRA extension because the employer medical plan had ceased to exist when the business closed. Ironically, if the company itself had remained in business but she had been fired, she could have gotten COBRA.

I don't live in New York, but here's one pretty good FAQ summary of the situation from the New York State Insurance Dept. (Bear in mind that specific provisions may vary from state to state.)

http://www.ins.state.ny.us/faqs/faqs_cobra.htm

Marc

You don't need COBRA to be guaranteed coverage. If the employer has less than 20 employees or the plan is terminated altogether, you can qualify for guaranteed coverage under HIPAA portability rules. Of course, insurance agents are unnecessary administrative expenses and should be eliminated according to PPACA even though they're the only ones that know these things, but eh, who cares about that...

[BruDude]

Sorry guys but COBRA or any other health insurance is too expensive for people that are on unemployment. It costs around $130 or more per month for very young people with no health problems and $5K or so deductables. So basically the insurance covers nothing that a young person might need like a flu shot or flu medicine or other stuff. So anyone drawing unemployment would have to forgo rent or food or declare bankrupcy and stop paying all their other bills to afford health insurance.

Bill

Health insurance is to protect yourself from a catastrophic financial loss just like other types of insurance, not to cover every little thing that might cost $20 or $80 or $100. That type of reasoning is exactly why health insurance is so expensve. I pay less than $100 per month for a policy with a $3k deductible and 100% coverage after that. My preventative care costs me nothing. Is it better to have no coverage at all and foot he entire bill, asking/hoping for assistance, or to figure out how to pay a deductible if something happens to you?

Very well said. I know of someone who was a billionaire who was getting denied health insurance because of the health history of her family. Of course, she could afford to self-insure, but I think she was trying to prove a point.

Family health history isn't even a question on any applications I have ever seen....and I've seen a lot. A billionaire probably owns or is a part of a business that would or could have a group health insurance policy too.

[bluemarlin08]

It won't be long before folks will have to rely on government employees to discuss their health insurance options because most agents will have left the business or have been eliminated due to not being paid any commission.

[staythecourse]

Health care is any easy fix, but the decisions to do it are very hard.

Health care is like a baker making a cake. If you ask a baker to make more cake (health care) for more folks to consume he will say no problem, but he will need either more ingredients to make more cake (increase costs) or make the pieces of the same cake smaller for each person (decreasing costs).

What is NOT possible is to do what health care reform supports, which is:
1. Increase coverage (more people to eat the cake)
2. Improve care (higher quality ingredients) AND
3. Decrease costs (make the cake cost less)

Those 3 CAN NOT happen together. You have to pick 2 out of 3.

The hard part is deciding what is ethical as a culture AND ecnomically feasible. Until that decision is made (no attempt yet) all these laws will not change anything.

Good luck.

[specabecca]

1. Interesting that you are looking for something related to "investing" in the forum with "(Not Investing)" in the title.

2. How planning for healthcare spending & healthcare increases not related to "Personal Finance"? What country do you live in?

In Europe health care is paid from taxes and have universal coverage. Loosing a job or being poor does not leave you without health care. Of course, long-term illness will have a detrimental effect on income.

Losing a job does not make you lose insurance in the US. You have the right to go on COBRA.

Yes it does.

1.) COBRA is VERY expensive. Few people without jobs could afford it for long.
2.) COBRA is not permanent. You are forced off eventually.

An unworkable alternative is the same as having no alternative.

COBRA lasts 18 months. That is plenty of time to find another job. I doubt many people end COBRA because they exceeded the time limitations, which in some cases can be extended to 36 months.

Ah, Cobra. If only it were so easy. I have only good things to say about Cobra, despite its ridiculous price tage. Cobra at least gives my family options.

My husband is uninsurable through no fault of his - or his parents - doing. He has his own company. He'd have to give that us for us to grow our family (2nd child) and get a full time gig somewhere with insurance benefits, or I'd have to go back to work before I was ready to do so.

Even though we've saved for the luxury of me being able to be home with a new baby for the first 2-3 years, we cannot do it. I'll have to resume work - at least part time - to receive health insurance for the family.

Our options make me pretty cranky. They are 1) move to another country and hope the business makes it abroad. 2) I go back to work part-time after 18 months of maternity leave, up to a year and a half before we are ready. 3) forgo my husbands successful business and acquire health insurance through his employer. I suppose their is 4) go without health insurance, but as a parent I am unwilling to put my childs health and safety at risk, or my child's father's health and safety at risk.

We made it through babe #1 by trying option 3), and have decided it is not a good option in future. His personal health took a toll, but I won't go into details. Let's just say he is passionate about what he does.

Going forward, either we: put the kibosh on having another babe, move away from friends and family, or outsource babe-to-be's rearing (yr 1.5-3).

I don't like any of these options.

This scenario is not exactly the sort of thing the OP intended, but it does highlight another shortfall of the existing employer-based healthcare scheme WRT small business implications.

[bluemarlin08]

[quote]Health care is any easy fix, but the decisions to do it are very hard.--Political and Economic policy comments deleted--

[BruDude]

COBRA lasts 18 months. That is plenty of time to find another job. I doubt many people end COBRA because they exceeded the time limitations, which in some cases can be extended to 36 months.

Ah, Cobra. If only it were so easy. I have only good things to say about Cobra, despite its ridiculous price tage. Cobra at least gives my family options.

My husband is uninsurable through no fault of his - or his parents - doing. He has his own company. He'd have to give that us for us to grow our family (2nd child) and get a full time gig somewhere with insurance benefits, or I'd have to go back to work before I was ready to do so.

Even though we've saved for the luxury of me being able to be home with a new baby for the first 2-3 years, we cannot do it. I'll have to resume work - at least part time - to receive health insurance for the family.

Our options make me pretty cranky. They are 1) move to another country and hope the business makes it abroad. 2) I go back to work part-time after 18 months of maternity leave, up to a year and a half before we are ready. 3) forgo my husbands successful business and acquire health insurance through his employer. I suppose their is 4) go without health insurance, but as a parent I am unwilling to put my childs health and safety at risk, or my child's father's health and safety at risk.

We made it through babe #1 by trying option 3), and have decided it is not a good option in future. His personal health took a toll, but I won't go into details. Let's just say he is passionate about what he does.

Going forward, either we: put the kibosh on having another babe, move away from friends and family, or outsource babe-to-be's rearing (yr 1.5-3).

I don't like any of these options.

This scenario is not exactly the sort of thing the OP intended, but it does highlight another shortfall of the existing employer-based healthcare scheme WRT small business implications.

Have you explored the option of a group health insurance policy for your husband's business? If he really wants to continue being self-employed instead of going to work for someone else, that might be a good option. After COBRA expires he can also likely qualify for a guaranteed-issue plan under HIPAA rules.

[Shawn]

What I'm curious about is those who don't have insurance but need life saving care of a non-urgent nature (like chemo).

I have a friend who has overstayed her visiting status in this country. She does not have insurance. She is able to get standard preventative and investigative care at no cost (pap smear, MRI, etc). This is not to say it is easy. Routine work requires several months of advance notice and there are a number of bureaucratic hurdles to go through, but it doesn't appear to be too difficult once the steps and processes are understood. Dental care is also available, although it covers only cleaning/exam, fillings, and extractions. I believe she pays a small fee for the dental care. I don't know about more advanced treatment (e.g., chemo). My impression is that this wouldn't be covered since my friend talks about the need for catastrophic health coverage. She has looked into a high deductible policy but so far has elected to forgo it.

[richard]

What is NOT possible is to do what health care reform supports, which is:
1. Increase coverage (more people to eat the cake)
2. Improve care (higher quality ingredients) AND
3. Decrease costs (make the cake cost less)

Those 3 CAN NOT happen together. You have to pick 2 out of 3.

Perhaps you can explain why every other wealthy country has been able to do all three? Just about every major developed country has universal coverage, care at least as good if not better than the US by normal statistical measures and costs that are half of ours?

[BruDude]

What is NOT possible is to do what health care reform supports, which is:
1. Increase coverage (more people to eat the cake)
2. Improve care (higher quality ingredients) AND
3. Decrease costs (make the cake cost less)

Those 3 CAN NOT happen together. You have to pick 2 out of 3.

Perhaps you can explain why every other wealthy country has been able to do all three? Just about every major developed country has universal coverage, care at least as good if not better than the US by normal statistical measures and costs that are half of ours?

The US is not other countries.

[richard]

I pay less than $100 per month for a policy with a $3k deductible and 100% coverage after that. My preventative care costs me nothing.

This is an individual policy? Which state and insurance company? I can't find a policy on those terms at a significant multiple of what you're paying.

[richard]

What is NOT possible is to do what health care reform supports, which is:
1. Increase coverage (more people to eat the cake)
2. Improve care (higher quality ingredients) AND
3. Decrease costs (make the cake cost less)

Those 3 CAN NOT happen together. You have to pick 2 out of 3.

Perhaps you can explain why every other wealthy country has been able to do all three? Just about every major developed country has universal coverage, care at least as good if not better than the US by normal statistical measures and costs that are half of ours?

The US is not other countries.

That's true, but doesn't answer the question.