I hate insurance. It's a lose-lose proposition at best. If you don't use it, you're out all the premiums you paid. If you do use it, that means that something bad is happening to you. If you have a car, house or body, you have to insure them every year, and insurance companies are allowed to look you over and decide how big a risk you are.
I understand car and home insurance. I don't have to have a car or house, and my premiums should reflect my choices, both bad and good. If I chose to drive poorly, my premiums go up. If I live in a flood or earthquake zone, it makes sense to charge more. Having a body is not a choice, and sooner or later it will need some help. Without insurance you're at the mercy of others and your health will suffer. Without health insurance, even the slightest problem, left untreated, can mushroom into a debilitating catastrophe.
So here is my rant. Today I signed up today for health insurance in 2020. Like most people my age, I have pre-existing conditions but am generally healthy. The choices this year for my plan included one company, Cigna that is rated 2 of 5 stars, and two companies, Ambetter and Wellfirst, that I've never heard of. Ambetter, which is managed by Centene, has less than stellar reviews online from customers according to a Google search (some of them are very disturbing and should be looked at by someone) Wellfirst is brand new and managed by SSM Health, so I rolled the dice and went with them.
Here is the kind of thing that showed up for me when I tried to sign up.
Because I'm over age 60, I am deemed a high risk and charged more than most people that apply for insurance. Even worse, because I am offered health insurance through my wife's plan, that fact locks me out of any subsidies for my own insurance. It doesn't matter that the plan my wife's employer is unaffordable, the "family glitch" (affecting nearly six million applicants a year) says that I still can't get subsidies. So I have no choice but to pay the full amount that the companies on Healthcare.gov offer me, with most plans averaging $700-$900 per month.
I'm employed, responsible, and trying to do the right thing, but I still have to pay $10,000 plus per year for insurance that won't cover most expenses until I reach a $6,000 deductible. The deductible on my car and house are a small fraction of that and so are my premiums. My health insurance premiums are not deductible on my taxes because itemizing deductions is practically impossible, so I have to pay tax on that $10,000 while folks getting insurance through work pay nothing. I will definitely have to change doctors next year, and have heard that a big problem with plans is that many doctors in the networks aren't taking new patients or have gone out of business. I'll find out in January.
How did we get here? The story began when employers were forbidden to raise wages during World War II, so they raised benefits instead, initiating the employer-based system that America alone relies on. While we were setting up government healthcare systems in Japan, Germany and Israel after the war, we decided against it for Americans and came up with the mess that you see today. The employer-based system gives your boss way too much control over your life and hampers businesses that have to compete internationally with businesses that don't have to worry about insuring their people. If your employer doesn't offer insurance, it used to be you had to go out on the open market and deal with private companies that won't cover pre-existing conditions. So if you have any kind of chronic medical condition, forget it.
I had great hopes for the Affordable Care Act (please don't call it Obamacare- Obama didn't invent it nor pass it through congress) This was supposed to be a compromise that left the private insurance system in place and helped the unfortunate 20% that had been left behind. How this idea, that at times had been supported by both parties, became the political hot potato it did is beyond me. To score political points, the Republican party has repeatedly tried to torpedo this act, always promising something better that never materializes. Shame on them for playing politics with people's lives.
At this point I don't particularly care if we change to Medicare for all or a public option, but we need to do something about our bloated, expensive and inefficient health insurance system. We pay the most per person of any country in the world and get mediocre results. I'd even go for tweaking the system we have now to make it more fair and better functioning, but the last eight years have shown that getting anything done to improve the ACA is politically impossible.
I encourage everyone currently not covered to sign up on Healthcare.gov before the deadline on December 15th. If you are single and have income below $50,000, ($100,000 for a family of four), you probably qualify for subsidized health insurance. Please don't fall for the junk insurance that is not ACA qualified- you're just throwing your money away. Junk policies and short-term policies may have lower premiums, but they aren't eligible for subsidies and provide very little coverage when you truly need it, (especially with pre-existing conditions).
Health insurance is no longer mandated, but it still is essential. Without it, one hospital stay can send you into bankruptcy. People are turning to Go Fund Me pages and trivia nights to pay hospital bills, which is nuts. With good insurance, you can get preventative care from medical professionals that will hopefully keep you out of the hospital so you never pass those lofty deductibles. I will be voting in 2020 for the people that can best improve this broken system. We created it, and we can sure do better.
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