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Globe Writer Gets A Little Testy About Insurance

I like Mitt Romney. I respect his achievements. I can even understand why he signed off on Massachusetts' universal health insurance plan -- it was a steamroller, being pushed hard by the 85%-Democratic legislature, and Romney had the choice of getting on board or getting flattened.

But I will never understand why he takes such pride in the matter, when it's turning out to be exactly the kind of disaster so many of us expected it to be.

Today, the Boston Globe has a column by a woman who bemoans the problem of not having insurance, but not having enough insurance. And she's hiding behind her 14-year-old son's testicles to make her point.


She turns the story of him getting kicked in the groin into a full-blown (pardon) screed about how one stray cleat nearly beggared her family. And why did that happen?

She's kind enough to spell out just what put them in such straits.

The bills had begun accumulating shortly after my husband, a social worker, switched jobs and we were forced to change health insurance from a local Blue Cross plan to a for-profit national plan. My husband was not offered a choice of health plans, and when we signed up it was not made clear that our deductible for the year would be $3,000 (for in-network expenses; $4,500 for out-of-network expenses).

Nor did we understand that once we met the deductible (i.e., spent $3,000 to $4,500 of our own money), we would then have to pay co-insurance: 15 percent of every in-network expense we incurred and 45 percent of any out-of-network expenses. Some Massachusetts residents who sign up for health insurance under the state's new plan will face even higher premiums and deductibles. Even some low-income residents who used to get free care will have to pay co-insurance charges that they may not be able to afford, according to Physicians for a National Health Program, which advocates for single-payer national health insurance.

In short: her husband, the family's insurance provider, changed jobs for one that had considerably worse benefits (for them), and they didn't read the details of the new plan when they signed up and started paying their premiums.

Even shorter: we didn't do our homework, so pity us.

This is the future of state-mandated health insurance: whatever the state gives you, it won't be enough. Whatever you want, you will get, and you won't have to worry about the costs. The state will pick up the tab, or make the providers take what they're offered.

I've lost track of how many times it's been said, but it's so, so true:

If you think health care is expensive now, wait until it's free.


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Comments (12)

Jay Tea: "If you think heal... (Below threshold)

Jay Tea: "If you think health care is expensive now, wait until it's free."

Not to be argumentative, but wasn't that a PJ O'Rourke line?

Or did he purloin it as well?

Is it even possible to determine point of origin? Probably not.

JT, I heard a person from B... (Below threshold)

JT, I heard a person from Boston call New Hamshire and Boston suburb. I know that will rile you.

To address your post, grown ups have forgotten how to act like grown ups. ww

Fully understanding the hea... (Below threshold)

Fully understanding the health plan of a company when you're interviewing for a job is easier said than done. There is no way to get into all the specifics especially when multiple plans are offered. You're there so they can look at you; not for you to take a lawyerlike view of their health care plan.

A friend of mine had emerge... (Below threshold)

A friend of mine had emergency gall bladder surgery two years ago and Blue Cross was the provider through his employer. I think the total costs, including emergency room treatment, was over $40,000 and his total out of pocket was $50 for emergency plus $10 prescription co-pay.

I can't imagine any national insurance plan taking the place of this kind of benefit. There are some that are suggesting Medicare expansion, but I still think as a diverse nation, we should have choices and the option to select which type of plan is best for us as individuals and families.

National is usually one step closer to mandatory, meaning no other choice. Such is the case in Canada, where it is illegal to purchase private health insurance. In other countries, so far it seems France has a health system that is closest to ours with slightly better satisfaction rate by the people that live there.

While it's true people don'... (Below threshold)

While it's true people don't always have the time to consider benefits when looking for employment, a close examination would be a given when offered anything "new" and unfamiliar.

"Some Massachusetts residen... (Below threshold)

"Some Massachusetts residents who sign up for health insurance under the state's new plan will face even higher premiums and deductibles."

Um, if "free" care from the benevolent government charges more than the "greedy, for-profit" insurance... what's the point?

Sorry, I'm not letting them... (Below threshold)

Sorry, I'm not letting them off the hook for not reading the fine print. If they're not reading their insurance policy then they are probably not reading their mortgage loan papers, their car loan papers, or pretty much any other obligation they are committing to.

That said, the problem with health care in this country, IMHO, is not that health care is private and for-profit, but that the insurance companies are ultimately making the medical decisions by giving or withholding money, and making obscene profits. They are housed in plush highrises while our local for-profit hospital hasn't seen a fresh coat of paint in decades.

I also think it's time we get the employers out of the equation. They are only involved because of a long-past terrible decision to freeze wages - a situation that no longer exists. What would free us up more to get the health coverage we need and want than to be able to choose from ALL available options, not just those offered by our employers? Especially when you consider that many, like the employer in the article, offer only one. If employers dropped the insurance and bumped up our salaries by the amount they are paying in premiums, their savings in administering those plans would decrease their employment costs. It's win-win.

But even before all that, t... (Below threshold)
Peter F.:

But even before all that, there was this beauty:

On Aug. 17, my 14-year-old son was kicked in the groin during a preseason soccer match. He could barely walk and was in considerable pain,...

I feel for the kid. Getting nailed in the 'nads hurts. But not nearly as much if you're wearing a cup. (Trust me, after the first groundball to The Boys, I wore one religiously.)

So who wants to wager that the oh-so responsible parents, the very ones who apparently didn't read the details of the insurance whatsoever, also didn't make sure the kid was wearing a cup.

"I like Mitt Romney."... (Below threshold)

"I like Mitt Romney."

Of course you do, he's a Republican. I cannot wait for your piece on him regarding his total inconsistencies. I'm sure you don't recall, but you wrote this:

"Why I can't vote for John Kerry

"1) John Kerry lacks consistency."


How does one possibly reconcile these two opinions?

And yes, it is a PJ line, lifted without citation.

When you have a policy chan... (Below threshold)

When you have a policy change three times in one week like John Kerry does, that is telling.

JP2, you need to learn the word context. The grown ups understand it. ww

I've changed companies for ... (Below threshold)

I've changed companies for one reason or another about nine times in my professional career (career meaning related to my skill, not pre-adult fast-food type stuff). There is rarely any fine print to read on healthcare or other benefits when you are interviewing. They will answer any questions you have, but few companies send you away with materials to read.

Having said that, once this person got the new job he should've come up to speed on the benefits package. If I got a new job and found out I had the same heath insurance described in this article, I would immediately opt-out (if possible) and purchase a Health Savings Account for about $74 per month.

Sure my deductibles would still be $3500 to $5000 per year, but almost all HSA's offer 100% coverage after that. Plus, when my son isn't taking shots to his groin, I can make pre-tax contributions to my HSA and earn about %2 interest under rules similar to those of an IRA. The best part of all is that I can someday tell my new boss that he sucks even more than his benefits without fear of losing my health insurance. Heck, my previous contributions to the HSA can even be used to pay my premiums if I am unemployed.

This guy should've done his homework when he got the new job.

People blaming others for t... (Below threshold)

People blaming others for their own decision seems to be the hobby of the new millenia.






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