April 3rd, 2010

planet

the health care bill and me

I have no idea what's in the health care bill, you do searches on it and all you read is fear-mongering from both sides. It's pretty sad.

On one hand I'm glad someone has finally brought up some reforms, and I'm ashamed that republicans just wanted to bury their heads and pretend like health care was no big deal and didn't need any changes. I've got too many friends who are uninsured for that. And I am SO SICK of my very conservative coworkers rambling on about how we're all "socialists"... people if you went to public schools, drive on roads the government built for you, enjoy having the security of a fire department and the ability to call 911, you're a socialist. You're sharing the wealth. It benefits society and you're just fine so quit your bitching.

On the other hand, I'm one of the few Americans who really likes my health care. The only thing I don't like about it is that it's always threatened... if I lose my job, it goes away.

My deal: I have a high deductible HSA plan. I pay almost nothing in premiums. Instead, I put some money out of every paycheck into a savings account that's ready in case something crazy happens to me, like I have a baby. So my annual deductible is something like $4000, but I put $100 a check or so towards that and it didn't take long until it was all saved up.

It's made me think about what I spend on health care. I'm not skipping anything I need... things like annual physicals are covered and don't come out of my HSA. But it makes me notice things, like how my doctor's office charges over $100 for an office visit just to get a sinus infection treated, but there's an immediate care place that's always just $60 a pop no matter what you need. I don't think I'd notice things like that if it was just "oh well insurance pays whatever" and I never actually saw the bills.

Anyway, callingthemoon posted a link to this washington post tool that helps you understand what the health care bill will do to you, and it said my deductible would be capped at 30% of costs from now on instead of 100%. I'm not really all that happy about that, because my insurance company will just increase my premium in order to help them foot the cost of the deductibles I'm paying now. I'm young, healthy, most years I don't get pregnant, so I'd rather not be paying premiums.

As I said, I support the bill and know it's about more than just "me", it's about a lot of other people who've been left behind with the current system. But when it comes to the deductible thing, I just flat out don't see the logic in the cap. It's preventing consumer involvement, which is the one thing that could help reduce health care costs in this country.

This American Life did some good stories about health care and why it's so expensive. In one very good episode they talked about drug company coupons. A brand-name drug will be hundreds of dollars more than the generic version, and in order to keep costs down insurance companies started charging expensive copays for the brand-name drugs so people would want to switch. Then the drug companies started publishing coupons for people, saying "we'll pay your copay" because they knew the copay was still only a fraction of the cost of the drug. $400 drug, $100 copay, you use the coupon to pay nothing, the insurance company pays $300 which they have to spread out to premiums. Meanwhile there was a $50 generic. But hiding the costs from consumers means we all pay more.

I believe government can fix some things, but I also believe in the free market, and I'm not thrilled that they're capping my deductible. That's all.