charlie brown

How we’re handling healthcare…for now

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About Tsh

Tsh is the founder of this blog and lives in Bend, Oregon with her husband and 3 kids. Her latest book is Notes From a Blue Bike, and believes a passport is one of the world's greatest textbooks.

Iknow… healthcare! The most exciting topic in the world. But ever since the Affordable Care Act website went live here in the U.S., I’ve admittedly been a bit confused. You turn on NPR, and every five minutes I’m hearing something new about the site being a frustrating disappointment to thousands of people, and my natural response is to stick my fingers in my ears and say, “Lalalalalalala.” I just don’t want to deal with it. So mature, I know.

But deal with it we must, so I recently used the website to figure out how this would affect my family (admittedly, I didn’t have a problem navigating the site). It easily spit out the plans we qualified for starting next year—there were 52, to be exact.

And you know what I read? Gobbledygook. Jargon. The stuff pretty much read like Charlie Brown’s teacher in my head. Even though I’ve dealt with health insurance quite a bit this year (thanks to my surprise knee surgery from a ski accident), I’m still left pretty confused when I navigate these waters.

We’re mostly self-employed, so we pay for health insurance out of pocket. And it hurts. Honestly, I’m grateful for the option after the avalanche of medical expenses this spring. But I’ll be honest—health care drives me crazy, the system frustrates me, and we’re often left feeling more alone than covered.

So this is why I’m really glad we have an insurance guy. He’s local to us, and though he’s got a plateful of clients and more work than one person can probably handle, he’s easy enough to reach by phone when we have a question.


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We found him several years ago using Dave Ramsey’s Endorsed Local Provider (ELP) service, and we liked him immediately. He was honest, put us under absolutely no pressure, and answered our questions as though they were the most perfectly logical questions in the world (even though we felt dumb for asking them—aren’t we supposed to be grownups and know this stuff already?).

Honestly, as we look to the future and navigate the murky waters involving our healthcare options, I really am so grateful to have someone on our side, someone to continue translating the confusing healthcare jargon into Normal Words.

Our insurance guy has been worth every penny because I know he’s not trying to sell us something we don’t need. He knows our family, knows our quirky lifestyle, and has bent over backwards to find the right coverage we need. Even if it isn’t perfect.

This is one tool that’s really helped simplify an otherwise confusing part of life: an insurance guy. Through him, we can better understand our healthcare options, pick the best one that best serves our family’s needs, and let him take care of the details while we move on with our life.

Of course, this doesn’t mean I just hit cruise control and drive through this part of life on autopilot—I still want to learn what’s best for our family. We’ll see what happens over the next few months… I’m more than a little curious how all the uncertainty is going to play out.

How are you handling the current healthcare situation? For those of you in other countries, what’s worked for you? Any tips or tools you find useful for simplifying this otherwise confusing part of being a grownup?

This post is sponsored by Dave Ramsey’s Endorsed Local Providers.

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Comments

  1. How timely. I literally just came from an insurance broker’s office. She is a friend and she was extremely helpful in helping me compare plans. We navigated the site (from first sign-on to plan purchase) in 1:45. Having someone who could explain everything in common language was extremely helpful. We are also self-employed and in the past have had an extremely difficult time affording health care insurance. My husband and I have been uninsured for the past three years, but starting on Jan 1, 2014 we will now be covered! What a relief!

  2. I live in Canada, so we simply don’t have to deal with this stuff. If we are sick we go see the doctor, if we are really sick we go to emergency. Then we get treatment. I cannot imagine having to navigate such confusing insurance waters just to get healthcare. I do have extra medical insurance, but it for things not covered by the province like teeth and eye care and drug costs. I’m glad you found some one who can help you, he sounds as if he worth his weight in gold!
    Sharon´s latest post: Advent A to Z: Prayerful & Playful Preparations

    • He really is. He’s sorta like a trail guide in the wilderness. ;)

    • I can’t wait until the US finally moves to single-payer healthcare. I know it’s going to take a long time (probably won’t happen in my lifetime and with the way us ‘Merikans act, there’ll probably be a civil war first) but healthcare should not be a capitalistic venture. No one should be profiting off of sickness and disaster.

    • We are the same in New Zealand. It’s been very frustrating being in the USA and paying a lot for insurance and then still having out of pocket expenses!

  3. I’m sorry but, as someone who lives in a country where healthcare is free at point of care to all residents, the US system regularly dumbfounds me. I get glimpses of it not just through blogs like yours but because my cousin married a US-ian and now has a green card. Just one small example, he wound up in hospital with MRSA ten days before their wedding.

    When I think of the US healthcare system, I think of this:
    https://www.youtube.com/watch?v=qSjGouBmo0M

    and this:
    http://www.upworthy.com/why-people-in-other-countries-wouldnt-get-the-premise-of-breaking-bad-6

  4. So, I just wanted to add a little thought here not entirely related to navigating health care in the US. Having a reliable, trusted insurance agent (as in someone you can visually see) can be super beneficial. I have friends and family members who work for insurance agencies that sell different insurance company’s options for everything between commerical insurace to personal insurance. Does it cost more? Not in my case because they are finding the best options for me. When I had an issue with my insurance company not wanting to cover a claim- I put the insurance agent on them. He took care of getting the claimed paid for and it was not my headache to deal with. I consider that simplifying my life. :)

    • Yes, a good point—using this guy does NOT make our insurance more expensive! Quite the contrary, actually, since he was able to find us such a great deal I don’t think we would have found otherwise.

  5. avatar
    Leslie Stover says:

    Thank you so much for posting this. There are many out there that are confused about how these laws impact them. My husband is an independent insurance agent, and he has spent the last two months walking people through their options. The best advice for these times is to find someone local who represents different providers, and sit down and talk with them about all of your options. Independent agents are there to help you make the best decisions for you and your family. I would also advise looking in a phone book and asking friends and relatives as opposed to relying solely on the website mentioned in this post. I live in a small town in a rural part of my state and the website sent me to an agent well over an hour away. There are agents (besides my husband) right in my town, so don’t give up.

  6. avatar
    Abby Jartos says:

    Mostly with nausea and ear-plugging and “Lalalala” like you. :) As a self-employed person, it’s really frightening, and adds a huge amount of research and decision-making to an already full plate. But the email of your post was literally followed by an email from my insurance agent, so I could not agree more – wise counsel is invaluable. A great accountant and a great insurance agent are two of the best people a business owner can find.

  7. I wonder how much your insurance guy really knows because it seems like NOBODY really knows about Obamacare, most of all Obama.

  8. avatar
    Bonnie Jean says:

    Socialized medicine is the worst option. I have relatives in Canada and for any major issues they came to the US and paid out of their own pockets. My Aunt died waiting on a list for 7 years with Breast Cancer. She had waited for awhile then decided too late to come here. She got treatments, but it was just too late. America had the best system in the world and Obama and his cronies are not only destroying our healthcare system they are destroying our country. We are headed in the direction of Nazi Germany and ancient Rome. Soon we will have more to worry about healthcare. Get the best policy you can. It will cost dearly especially if you buy out of a group. Sometimes you can get in a small group business group. But this is a far more insidious question than just healthcare. There is so much more the government is trying to force us all to pay for under cover of a huge document that no one has really studied cover to cover who voted for it. It is a Trojan Horse.

    • “America has the best system in the world?”
      Are you kidding?

      Salon:
      http://www.salon.com/2013/07/29/8_appalling_ways_america_leads_the_world_partner/
      ” The U.S. devotes more of its economy to health than any other country, 17.6 percent of GDP in 2010, and the trend is slanted upward. We spend more in every category of healthcare, especially in administration costs, due to the existence of thousands of different insurance companies.”
      … “Despite all the money sloshing around, the U.S. has fewer physicians per person than most other OECD countries, fewer hospital beds, and a lower life expectancy at birth, according to a recent PBS report. The same report stated that the U.S. spent $8,233 on health per person in 2010. The next highest spenders, Norway, the Netherlands and Switzerland spent at least $3,000 less per person.”
      Please note that Wikipedia ranks Switzerland (2nd) Norway (joint 17th) and the Netherlands (joint 17th) WAY ahead of USA’s 40th in life expectancy.

      Bloomberg:
      http://www.bloomberg.com/visual-data/best-and-worst/most-efficient-health-care-countries
      USA scores 46th out of 48 for healthcare efficiency. UK? 14th. They ranked Hong Kong number 1 – I grew up there, the healthcare is amazing.

      New York Times:
      http://www.nytimes.com/2013/10/13/us/the-soaring-cost-of-a-simple-breath.html
      “Pulmicort, a steroid inhaler, generally retails for over $175 in the United States, while pharmacists in Britain buy the identical product for about $20 and dispense it free of charge to asthma patients.”
      … ““The one that really blew my mind was the nasal spray,” said Robin Levi, Hannah and Abby’s mother, referring to her $80 co-payment for Rhinocort Aqua, a prescription drug that was selling for more than $250 a month in Oakland pharmacies last year but costs under $7 in Europe, where it is available over the counter.”

      Also the NY Times:
      http://www.nytimes.com/2013/07/01/health/american-way-of-birth-costliest-in-the-world.html
      “And though maternity care costs far less in other developed countries than it does in the United States, studies show that their citizens do not have less access to care or to high-tech care during pregnancy than Americans.”

      I had a stressful pregnancy, with ultrasounds every 3-4 weeks and repeated consultant appointments, because they were worried about my baby’s growth rates. Then I had to be induced and after hours of induction there was the emergency caesarean after they lost the foetal heartbeat. Then there were extra days in hospital while they tried to work out whether the baby had a heart problem or not. Then there were home visits from my GP and prescription antiobiotics (three separate courses, plus lab tests to check for antibiotic resistance) for the infection I got along the incision. Then months of community midwifery support (including weekly home visits, at one point) and referral for cognitive behavioural therapy, due to my postnatal depression. The cost to me, personally, for all of that? Nil. As a new mother I didn’t even have to pay the usual £7.20 prescription charge for the antibiotics (also, that’s a flat rate – you pay it regardless of what drug you’re getting or how much of it you get. And central London is so expensive these days basicaly I can get 6 months of pills prescribed by my doctor for what’s basically the cost of a lunch). I also got free eye checks and free dental care from the 16th week of my pregnancy and for the first 12 months afterwards. This meant that when my tooth broke (hormone changes during pregnancy can affect how gum tissues react to plaque), I got it crowned for free.

      Yes, I pay for my free-at-the-point-of-care healthcare through my taxes. The first £9,500 you earn per annum is tax-free, after that I’m paying the 20% tax rate. This covers everything – military, transport, social welfare, education, etc, etc. I pay an additional 9% for National Insurance, again after a ‘tax-free’ threshold which I can’t remember right now where it is (NI entitles me to benefits such as child benefit and/or jobseeker’s allowance if my income fell below the threshold, and entitles me to the state pension when I turn 68). Apart from that the only other tax I pay is £120 a month for council tax (bin collections, local policing, etc.), and that amount is dependent on the size of my house.

      I’m going to re-post this video, because I think it’s so important:
      https://www.youtube.com/watch?v=qSjGouBmo0M

      “You’ve probably heard that the reason people enjoy “free healthcare” in Australia and the UK and Canada is that they pay higher taxes. That money goes into a big pot and is used to pay for people’s healthcare. But in fact in the United States we spend more tax money per capita on healthcare than Germany, Australia, the United Kingdom or Canada. That’s right Hank, you pay more in taxes for healthcare than you would if you were British and in exchange for those taxes you get… no healthcare.

      “Now, we are also, not to brag, richer than all of these countries, so it makes sense that we should spend a little more on healthcare. But we don’t spend a little more. We spend a TON more. And vitally, we don’t get anything for that money. … Like we don’t live longer, in fact we’re 33rd in life expectancy, and in everything from asthma to cancer according to one recent non-partisan study, American healthcare outcomes are “not noticeably superior”.

      You may have many reasons for being happy with the way things are now in your country, but please. Your healthcare system is a LONG way from “the best”. Anyone who actually looks at the statistics finds many European and Far East countries to have vastly superior healthcare provision than the United States. The exact placements vary with countries moving up or down a little depending on what particular yardsticks are being used. But USA is consistently only mediocre to poor. And frankly for the amount you all have to pay for it and how advanced your country is in so many other ways, I find that appalling.

    • I just want to chime in here. My husband’s family is in Canada and when there is a serious medical issue they come to the US for treatment and surgery. People like to point to Canada as an example of what the US should do, but no system is perfect as evidenced by the people who seek care here from other countries.

    • Wow I have never heard of anyone having to wait that long for treatment. I know a lot of women who have had breast cancer and they were all treated really quickly.
      Sharon´s latest post: Advent A to Z: Prayerful & Playful Preparations

  9. avatar
    Bonnie Jean says:

    Small P.S. In countries with socialized medicine… they pay half or more of their salaries to get it. And most seem unaware.

    • Actually, believe it or not, America spends more tax money per capita on healthcare than Germany, Canada, Australia etc…..this is a fascinating look at healthcare costs – I totally recommend watching this…..http://www.youtube.com/watch?v=qSjGouBmo0M

    • I live in the UK. Let me assure you, I do NOT pay half of my salary or more on my National Insurance. It’s worth every penny and I would not be without the NHS for anything. In the UK people think the system in the US is unthinkable.

      • When my brother had a brain tumor I read a lot of patient stories online. I read an article by a UK journalist who wrote that his wait time for a brain MRI with the NHS was six months. He said he was glad he had the money to pay privately for an MRI and his tumor was caught very early; six months of an undetected, untreated brain tumor could have meant death.

        This account left quite an impression on me and my perception of the UK NHS. Can anyone who has it speak to their experience with wait times and freedom to choose providers & treatments?

        • I had an MRI for a much less serious reason, to confirm the orthopaedic consultant’s suspicions that I’d torn my ACL (ligament behind the knee). My referral took 3 weeks. Mind you, my appointment was 10.30am on a Sunday morning. My local hospital apparently schedules as many non-urgent scans for weekend as possible (7am – 7pm) so that they’ve spare capacity during the week for emergencies. To be honest I

          • ACK thumb hit send instead of space. To be honest I was just as glad it was on the weekend, the hospital’s in the opposite direction from my work and I was really getting to a good place in one of my projects so part of me would have begrudged the time out of the office.

  10. I know this won’t be much use to some of your readers, but we use Christian sharing plan, called Medi-Share. It has been a lifesafer for us for about three years, when we first signed up. Our kids are enrolled in Washington State medicaid (we pay $40/mo for their complete coverage, it’s such a blessing), and myself and my husband are covered under Medi-Share.
    It is an exempt form of health insurance (under the Affordable Care Act–nothing changes for us) and it’s not TECHNICALLY insurance (but it acts and looks the exact same). The awesome thing is, since I’m a Christian, I trust giving my money ‘into a pot’ every month and letting others use it when they need it, and vice versa when we’re in need. It’s based on the Acts church sharing method, but the monthly premiums, deductibles, and co-pays look the same as average insurance, it’s just a lot cheaper. I trust my money to Christians more than a big, huge insurance company that is mostly looking our for their share-holders, and trying to make a profit. This is a non-profit. I have Big Opinions on insurance here in the US (my husband is dual–grew up in Canada, and currently works in Canada), but I’ll leave it at that! :)
    Sarah M
    PS-We also used an insurance broker for our housing and car insurance and loved him. He WAS worth every penny!
    Sarah M´s latest post: Dignify

  11. We are members of Christian Healthcare Ministries, which is like a cost-sharing co-op for those agreeing to bear one another’s burdens in Christ. It is a limited option but has worked well for us and there is support going through the maze.

    In practice, what happens is our check goes into an escrow that pays out for submitted qualifying bills. I am responsible to negotiate with healthcare providers (a nightmare, for sure, but CHM helps) and also responsible for the bill since this is NOT an insurance.

    Their website is http://www.chministries.org/ and they are grandfathered into the Affordable Care Act for now.

  12. This is exactly what we are doing and we’re saving a lot of money because our ELP is brilliant!
    Amy´s latest post: The Wart Zapper 20,000

    • I’m so glad! Yes, the ELP program really has been a goldmine of resources for us. I think we’ve used it for three different services so far. :)

  13. Ok, this may sound sarcastic, but it’s not meant to be: you pay Dave Ramsey to find you a guy, then you pay that guy to find you insurance? I’d appreciate DR’s advice so much more if it didn’t come with an additional pricetag for families already stretched and frustrated. And I would really love helpful, reliable information on a topic as complex and important as healthcare unrelated to a sales pitch (and not influenced by a sponsored post). That’s one of the reasons I love AoS… you are trustworthy, helpful and available to all. :)

    We work for american non-profit but live overseas in a nation with socialized health care; we HAVE to maintain private insurance so we will be covered when we are stateside. Our premiums are well over $1,000/month and we raise support to cover that cost. When we’re overseas, we can choose to go private under our global health insurance, pay out of pocket and eventually reimbursed. Even then, the private fees here are so much less than if we get medical care in the States with the same insurance with extremely high deductibles and the remaining only partially covered. Our org encourages all employees to be treated in our host-countries (with our private insurance in lieu of going public – though we can choose to do that, as well), as the more of us who get our care in the States, the higher our premiums go. Sadly, it’s far from simple.

    (for what it’s worth, I’m a fan of ACA, while recognizing it’s not a perfect system… I think it’s absolutely necessary for there to be options, availability and affordability in health care. I am thankful that where we are, if there’s an emergency requiring hospitalization, our fee is minimal and the care is excellent)

    • There is no cost to use Dave Ramsey’s preferred providers list. It is just a place to reference when looking for a reliable provider.

    • You don’t pay for either. You can find an ELP on Dave Ramsey’s website for free. When we bought our own health insurance, I don’t remember ever paying the individual broker. I’m sure she got some sort of commission from whatever company we bought our plan from, but essentially, all she did was present us with plan options that fit our needs, and we bought one.

      I also don’t understand what costs you are talking about with Dave Ramsey. My husband and I got his book from our library, and we listen to his podcast/radio show for free. We are doing very well paying off our debt following his plan. Maybe you have heard him teach something I didn’t?

    • A good question. No, I don’t pay this insurance guy at all, nor does it cost money to use the ELP program. The ELP people pay to be officially endorsed by The Lampo Group (who owns the service). I think it’s considered quite the “seal of approval” to be in the database, because requirements are pretty strict.

      And I don’t agree with Dave 100% on everything. But so far, the ELP program has been really, really good for our family. :)

      Thanks for reading!

  14. For years we were self-insured and relied on an agent for guidance. I worked for physicians for a long time so my husband hands the paperwork to me. Even with a bit of knowledge, it is still overwhelming. Agents are a huge help. Interview them, find one that works well for your family. Also, there are people posted at many public libraries and Sr./Community centers to answer questions about the Affordable Care Act. It is complicated but people do want to help.

    • Yes! Interviewing is key. Don’t settle for just anyone, and make sure they’re actually teaching you things, and not saying, “just trust me.” Ask them hard questions, and make sure they’re using a language you can understand. :)

  15. I’ve been uninsured since becoming a stay at home mom almost 2 years ago and private insurance was completely denied and to add me to my husband’s insurance would have been $900 a month. My 2 year old son’s insurance was about $100 a monh. Thanks to the ACA both my son and I will be covered for $350ish a month. We didn’t find it difficult to navigate the federal exchange at all nor to understand what was available. Thanks to the ACA our family will not be homeless or bankrupt should anything medically serious happen to me.

  16. We have been blessed to have health coverage through various jobs, but it has been amazing how much the costs to us have increased. 10 years ago, our employeers fully covered our health coverage. Last year, our “employer sponsored” plan, cost us $600+/month for our family of 4 plus a $5,000 deductible, so we’d be out of pocket $12,200/year before the insurance takes over (once/year physicals were fully covered). My husband recently got a new job that came with FULLY COVERED healthcare for our whole family… we nearly passed out with joy!

    I keep hearing people that are shocked by the cost of the plans available through the ACA, but we looked in our state and found that they were nearly identical to what we’re paying through our employers… Only now, everyone has the option of participating.

    Our system is a mess, but I think the problem has much more to do with the outrageous COST of everything medical related. Go to the drug store and buy a bottle of asprin for a few dollars. But if you are in the hospital and they give you the SAME asprin, is suddenly costs $20/pill. That’s a broken system. It’s easy to point fingers, but there are sooooo many intricacies of the system, that it’s not just one person or one bill or one event that’s gotten us to this point.

    • I checked the current plan we’re on at the ACA website, and the price was almost exactly the same. So, I think for families like ours, it doesn’t really affect our cost at all. Thank goodness.

  17. Thank God I live in Canada. I hear how ridiculous your health issues are and I’m just so thankful I don’t have to deal with that BS. Healthcare here is not free as some would think, we obviously pay from our taxes but at least I go to the ER when there’s an emergency and not wonder if I need to fork over $$$$$$$ just to see a doctor.

  18. This is an important topic, but one that bogs down so quickly into political fingerpointing (too bad some of that’s made its way here). Right now, we have good insurance thanks to my husband’s job. I work part-time, so I’m not eligible, but his covers me and our son as well.

    I think the current system is messed up. It’s something we faced when my husband lost his job due to a bad boss and a bad contract. Our son was born with a congenital defect and suddenly, we had nothing. Him not having surgery wasn’t an option (he would have starved). Thankfully, there was a new law that was signed that enabled people strongly effected by the economic downturn to afford COBRA coverage for a fraction of the price. So we got part-time jobs and paid! That law, no matter who signed it and who fought against it), saved us. I think about that situation a lot. I just desperately wanted treatment for my son! I don’t think there’s an easy solution, but I think, as a country, we will have to try different solutions. It’s a complex issue in a highly polarized place and the over-simplified talking points are hurting us.

    • “It’s a complex issue in a highly polarized place and the over-simplified talking points are hurting us.”

      YES. So true.

  19. I am planning to be self-employed in 2014, so I visited healthcare.gov to check it out (just doing my research!). The site worked beautifully for me, and I had no trouble understanding the information I was trying to find. Here in Texas, I don’t have that many insurance options, so that may simplify things for me. I also want minimal coverage for myself (no kids), so that also simplifies things.

    I for one am glad that the ACA passed, and that we are trying a new strategy for insuring people, one that can be independent of one’s job. I was hired in August 2013 for what was supposed to be a one-year position, and I found out last month that I’ll be laid off by the end of the year. So yeah: relying on my job for health insurance is not something I want to do because clearly I can’t count on my job’s longevity, no matter what someone tells me.
    Rose-Anne´s latest post: Chocolate and Defiance

    • I’m really sorry to hear you’re being laid off. I hope you find something else soon.

      • Aw, thank you, GM! I’ll be alright :-) It’s just a bumpy ride, going from what felt like some short-term security back onto the job market and that huge looming question: What am I going to do with my life?!? The on-going discussion about intention on this blog has been helpful for me as I think about my next move very deliberately.

        This will be the second job I’ve lost this year. Hurray, academic jobs!
        Rose-Anne´s latest post: This Week in Thoughtful Consumerism, Vol. 2

  20. I was really excited and refreshed to see this post. Most of what I’ve run across that deals with Obamacare has been angry ranting, and let’s face it, that does no good. This is a reality to be dealt with. Great, informative post!
    Andi´s latest post: Requesting Recommendations! Picture Books for Pre-Schoolers!

  21. This was another article that horrified me: that the insurance industry was so poorly regulated pre-ACA that people could be sold insurance that didn’t even cover them, and didn’t even realise it:
    http://touch.latimes.com/#section/-1/article/p2p-77982565/

    I tore the ACL in my left knee a few years ago and it’s this year it’s started actually giving me trouble. My GP referred me to Orthopaedics. As I wasn’t urgent (sufficiently mobile and usually no pain), I waited about 3 months to see the consultant. In the mean time the x – rays were taken and I continued all my usual daily activities. The consultant then referred me for an MRI. I saw the consultant again for the results and have been referred for 6 months of physio (I’ll do anything to avoid a urgent and apparently only about 30-40% of ACL tears actually require surgery). I have another consultant appointment in January to check my progress.

    The cost to me? My national insurance and tax that I would have been paying anyway.

    My mother was diagnosed with a 10cm tumour in her bowel a few years ago. She had emergency surgery, stayed in hospital nearly 3 weeks, and had months of chemo after. She has annual check-ups with the oncology team, is still seeing a psychotherapist who specialises in processing the experiences of having cancer. She’s had two further hospital stays for weeks at a time due to ongoing complications from the surgery. My mother has been unemployed for many years for various health reasons, but she got exactly the same level of care, for the same cost (free). She didn’t have to worry about losing her home or declaring bankruptcy. She even has has special card so she doesn’t have to pay prescriptions. Which reminds me, prescription costs are fixed at £7.20 (central London is so expensive now that’s about the cost of a lunch) regardless of what drug you’re getting or how much of it you’re getting.

    Three years ago I had an unexpected pregnancy with complications and ultrasounds nearly every 3 or 4 weeks, then an induced labour followed by an emergency cesarean after they lost the foetal heartbeat. Followed by antibiotics for the infection, and months of counselling and community midwifery support for postnatal depression. All for “free”.

    The NHS is far from perfect, but I will defend passionately the idea that health coverage should be universal and free at the point of care.

  22. We are apart of Christian Healthcare Ministries and love it. I have full maternity (currently pregnant) and my deductible is only $500- and we only pay less than $290 per month for our whole family.

  23. We have been on my husband’s employer-sponsored (GREAT) insurance for 22 years. After 2014, thanks to Obamacare, it will disappear. I have two friends who are self-employed. They were each paying under $400 a month, with a $3,000 deductible. Now, because their plans don’t meet the new federal guidelines, they are being discontinued. New, similar plans will cost $1,100 a month (without the required pediatric dental) with a $12,700 deductible. Not affordable by any stretch of the imagination. If someone didn’t have insurance before the ACA, they just didn’t care about insurance enough to get a job that offered it as a benefit. The ACA won’t change that. BUT, it WILL change how much you pay for the same OR LESS coverage. So, thanks Obamacare. I will go from $4,000 a year out of pocket to $25,000 a year out of pocket. Yeah for socialized medicine. PS. Our employer-sponsored plan will disappear because Obamacare makes it lucrative for companies to pay the penalty rather than provide the insurance. And can someone please explain to me why a person without a uterus and who cannot convert food into people is required to have maternity coverage?

    • Yeah, even though it’s helping some people out, ACA still has so many wrinkles to iron out. That one you mentioned makes absolutely no sense.

      Sorry to hear about the loss of your coverage. That’s really rough.

    • “If someone didn’t have insurance before the ACA, they just didn’t care about insurance enough to get a job that offered it as a benefit.”

      This is laughable, offensive and simply untrue. I’m sorry Obama has made your life so miserable and your corporation is taking advantage of it by simply eliminating the benefits they once offered.

    • It does seem narrow-minded to suggest that everyone is able to pick their job based on the quality of the health insurance. What if I suggested your husband quit his job so he could find a position that offered your family better health insurance?
      Rose-Anne´s latest post: This Week in Thoughtful Consumerism, Vol. 2

  24. Forgot to mentioned we will go on Samaritan Ministries in 2015. Medical cost sharing that satisfied the mandate while not participating in the crummy government plans or the insurance companies who are bloating plans (because they have to. When you have to pay for everything, you have no choice).

  25. Dr. Ben Carson has it right. We should all independently save (imagine that!) money in a medical account that follows us for life and can be passed down when you die. If people paid for more of their own preventative care, they would be more cost conscious and prices would come down. Cash is always cheaper, except when you have a major event.

  26. You didn’t address the TARDIS in the background…

  27. I’m perplexed by all of the Canadians commenting about how the US healthcare system is terrible. First, anyone in the US can come into an emergency room and receive care under EMTALA. And if he/she can’t pay, it is not an issue. They might send you a bill, but most people dont pay them. This is one of the main reasons our system is in trouble. People don’t see their regular doctors and use the ER as their primary healthcare provider.
    Also, Canadians are the first in line in our emergency rooms and physician’s offices to get better, quicker service here in the states than in Canada.
    When I went through chemotherapy 8 years ago, I was shocked to see three Canadians getting treatment right along side me. I was even more intrigued to find out two were in the healthcare field and came to Phoenix to get quicker treatment.
    I think a solution is needed. My concern about the ACA is the expedition of care when a patient has a serious health issue. And when I see patients not even be able to afford a $5 copay how are you going to get them to spend $200+ a month?
    Disclaimer: I’ve been an emergency/trauma nurse nearly 19 years.

  28. We have an insurance guy too. Invaluable. He has helped us navigate and save money. We are seeing our premiums go up, but at the same time we’ll be saving money, as my husband has had to stay on COBRA in order to access mental health coverage from the provider he uses. I also was on COBRA for a bit with my daughter as I was declined coverage due to infertility treatments several years ago. So for us, I am excited for the changes coming in 2014. I am sure others might have issues, but as self employed we will save money and have access to quality care.

  29. Wow! Great post and great discussion! I’m so thankful that my family of 6 is covered under my husband’s health plan at work. I’m thankful to not have to navigate the ACA maze (yet!). While there are downsides to the ACA, it’s what we have to work with now; healthcare costs have been spiraling out of control. I don’t know if there is a perfect answer for our country’s healthcare system. But, for this moment I’m praising God that I get to kind of sit back and see what happens. Thank you for the helpful advice that I can give to friends to help them out. :)

  30. avatar
    Melissa Webb says:

    This won’t apply to everyone but our family has opted for an alternative to insurance. We are members of Samaritans Ministries. It’s a health care sharing program for believers. It’s been a huge blessing for us. It also means we won’t have to pay the uninsured penalty…merely a perk.

  31. So, if we searched for an ELP to help us navigate the website does he receive anything for doing so? Would he benefit from trying to steer us in the direction of certain choices – to make a commission? I don’t understand how the system works at all – so these may be dumb questions.

  32. Sorry, I’m confused. When you say “insurance guy” do you mean a broker? and is he selling you the insurance policy or helping you navigate the exchange? or both?

  33. We also buy our own insurance over here (family of 3 in Ohio – self-employed, PhD student, part-time jobs, etc) and the ACA is actually a HUGE blessing to us.

    Right now our premiums are low ($130 a month) but our deductible is high ($10K PER PERSON).

    With the health care exchanges, we’ll pay $12 more a month, but our out-of-pocket expenses are cut down to less than half. I literally cried when I read that (helpful calculator here).

    I hate that healthcare, a basic human right, has become politically polarizing (I even cringed when I saw this topic – “She’s brave!” I thought). It makes me even more frustrated that SO many of the people against reform already have great health insurance. What about the rest of us who fall through the cracks, you know? Anyway.

    My family needs this and I’m SO excited. The website is finally working and I started selecting our plan today. Finally, I don’t have to be afraid of getting sick because of what it means financially. AND that is how it should be.
    Ashley // Our Little Apartment´s latest post: A Fews Odds and Ends – On Having a Three-Year-Old, Cutting My Hair, A Work Update, and More.

  34. Hey Tsh,
    I’m sorta fascinated by the U.S. healthcare system. We live in Australia and for all the normal stuff like regular doc appts, immunisations (ugh) and having babies healthcare is completely free because of medicare. I don’t have any insurance because I did the maths (we say maths, not math here!) and paying for insurance was way more than coughing up for my odd chiropractic appointment or my husband’s physio appointments. I hope that the U.S. can find a system which makes basic healthcare free for everyone. I had my first baby at the local public hospital and they were wonderful, all my midwife appointments, free, all my follow up care with the local maternal and child health nurse, free. And if I were to have a car crash tomorrow and need emergency treatment, also free.
    Australia gets it wrong on many levels (horrible to refugees and asylum seekers, slightly awkward political leaders and regrettable indigenous history) but I am happy that this is one thing I think that is going well. Not to mention a recent law to enable better free care for people with disabilities.
    Ok, enough from me.
    Good luck wading through the info! I feel the same about sorting out childcare rebates and benefits with our ‘centrelink’ website. Ugh.
    Jo

  35. My husband and I use The Health Co-op (which includes Samaritan Ministries). It qualifies under the Affordable Health Care Plan. We pay a little over $300 a month (to another member that has medical bills) and will only have to pay the first $300 of any major medical bill (other members would pay the rest – medical cost sharing).

    The Health Co-op also offers a number of other services and discounts including negotiating your bills and 24/7 phone access to a physician.

    We are so happy to have a way to deal with huge medical bills so they won’t wipe us out financially.

  36. I’m just so grateful to still have coverage through my husbands employer. It’s such a blessing!
    Lisa´s latest post: The Art of Creating

  37. We don’t have health care, such a pain to worry about. Still paying a hospital bill from two years ago. Didn’t know 12 hours could cost so much.
    We contacted several insurance agents, including one from the DR site. We still don’t understand any of it. We just gave up and decided it was easier to not sign up for something we didn’t understand. If you ask to meet in person, they act like that is the weirdest thing to possibly want. We are visual people, so someone explaining something on the phone is hard, because then the other one has to explain it to the spouse. That doesn’t work here. It’s so frustrating. Plus, I heard there will be a fine? When we are already in the hole? Then what, they will take my house because I don’t have healthcare?
    I live with a heart condition called afib, but can’t afford a cardiologist. They call me to have a recheck and I just tell them no, not at this time.

  38. I am in Canada, so thankfully this isn’t something I have to use my brain space for. My husband & I both have benefit packages through our employers, so drugs, dental, physio, chiropractor, massage therapy, etc. are mostly covered.

    Thanks for reminding me how lucky I am. We often take these things for granted.

  39. There’s a huge difference between health care, and health insurance.
    Health care is where you get sick, or break an arm, and it is treated. You then have to pay for the treatment, either with cash, or via taxes, or via insurance.
    Health insurance is where you pay every month whether you need health care or not, and when you do get sick, or break your arm, the insurance company does its best not to pay for the treatment. It’s a stressful, miserable way to do things.

    In the US the price of health care is hugely inflated by the need to cover the cost of medical malpractice insurance, and the bills of those of can’t pay. The high prices tend to decrease the number of patients, and thus reduce waiting times for treatments, allowing wealthy people from other countries to come to the US for health care. It’s a great way to “export” US services!
    However, the less wealthy in many other countries do at least have access to health care, without worrying about how they will ever pay for it. A medical crisis is not automatically a financial crisis, as it often is in the US.
    For our family, here in the US, the ACA has meant a 40% increase in our premiums, with lower-paid employees at the same company being subject to increases of 120%. We’re not eligible for the Exchange, because the company’s plans meet affordability guidelines. But a 40% increase is not affordable for us at all!
    Obviously, in order to insure the uninsured at reduced cost (because if they could afford the full cost, they would already be insured), those already insured have to pay higher premiums. But is all this actually making it easier for any of us to obtain health care, and pay for it? It seems to me that this is just socialized health insurance, and not health care at all.

  40. We have used an insurance broker that we know & trust for the last 5 years (free of charge), while my husband was self-employed, and they were a God-send. I totally recommend using a broker if you need individual coverage! Several of my friends have saved a lot of money thanks to our insurance broker.

  41. Great article! We did the same thing after learning all about insurance from our Financial Peace class! We also pay our own insurance, since we are self-employed. Sure makes you think twice about running off to the doctor or emergency room! We are healthy, so we got a high-deductible policy with a health savings account. It really only covers us in case of emergency, so we are very pro-active with our health in other ways. Organic foods, high-quality supplements, chiropractic adjustments, breastfeeding, etc.

  42. Wow.
    I’m Australian.
    We pay for private health insurance, at about $2700 a year for a family of five with mid-level cover. We’re not covered for everything – we had to pay out of pocket for my husband’s vasectomy, around $1800 all up. But when our medical costs go above $2000 in a financial year, we will get 20% of the amount over $2000 taken off his tax.
    But, having health insurance means that for some things we can go through a private hospital rather than wait in the public system.
    We can go to a GP for free, though some do charge extra. An eye exam is free. I’ve had three babies in the public hospital and have had to pay for one ultrasound.
    Our taxes aren’t excessive. My husband’s income tax is effectively around 22%.

  43. I think this post was to provide information to readers who may benefit for it. For those of you who are more than satisfied with what they have now, I suspect you may just want to stay with it and not worry about other opinions. I am a Canadian who spends about 6-8 weeks a year as a snowbird. While I see flaws in the Canadian system, I am thankful for it. I carry a lot of health insurance with me to the US, purchased for that purpose. I can only assume the Canadians referred to above that flock to the states do so as well, or are independently wealthy, and extremely so.

  44. We started having to buy our own insurance about 18 months ago, when my husband went to work for a startup (I’m self-employed, so we had been relying on his employer-provided coverage). Our group coverage had been through Blue Cross Blue Shield, and we were pleasantly surprised to find that they were willing to waive their pre-existing condition waiting period for us if we transitioned into one of their individual plans. That was a big deal for us because our daughter has a chronic health condition. They assigned an agent to work with us, and she was very helpful; we found a plan that actually gave us better coverage than we’d had with our group plan, and for slightly less money. It’s still a high-deductible plan, but it does the job. It’s one of the plans being cancelled because of the ACA, but it’s looking like that’s going to work in our favor. Based on what our BCBS agent has found so far, it looks like we’ll be able to get an ACA-compliant plan (which means more coverage that will really benefit us) for not much more than, and maybe even less than, what we have now.
    Kathryn´s latest post: I’m Thankful for: My Grandmother

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