Health Insurance Unaffordability in USA

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As the people in USA get to review their latest health insurance endeavour, I wish to interject some points that most people do not consider. THINK DEEP THIS TIME!

First is that Health is our most valuable asset. When we have good health, we are able to do most anything. Once we get sick or break a leg and need time to heal, we limit what we can do.

This is where “Insurance” steps in to make a profit. Health Insurance is just a way to earn money off of gambling on people’s health.

Health Insurance companies make loads of money and support a huge number of people on their payrolls. It is a profitable business and why it stays around longer than the people who are insured.

Health Insurance has promised to help pay off big bills yet dropped so many of the  long-term sick in the past that many just died. Those people had paid their premium on time and yet the companies felt this person was too much of a liability to their profit line that  their health insurance was discontinued.

The ACA was created to stop this vicious murder of sick people through inhumane treatment of people. It was suppose to help people who did not work for large companies to afford or even find health insurance. It boasted it would be affordable, which in time we see it is far from it.

In order to agree to profit juggling through taking on those people they discontinued or would not insure, the Health Insurance industry got together and agreed only if the government made everyone pay in to Health insurance, so they can continue to make profits.

These Health Insurance companies imagined all the young healthy people paying in big dollars to continue their profit garnishing ways.

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What they did not factor is that most young people these days cannot make a living off of  wages paid these days. Many still live with their parents or on larger groups of people to share expenses.

Many youth need a car and other start up kinds of things for an adult life that Health Insurance is the least of their worries. Most youth that are making good money do not care about health insurance. If their company does not supply them with it, they do not care.

They know they are really paying monthly for sick people and not for their own health. They SEE the Ponzi scheme. They do not fall for scare tactics that selling insurance relies on.

They also see our undocumented/illegal workers and their families pay hardly anything and get full health services and for some very large families. The youth today is not so gullible.

Rise of the Health Insurance Business

Remember that businesses were bullied in to buying health insurance for their employees many years ago, feeding this beast of insurance. But it also made it harder for small business and entrepreneurs to find any at all. The Health Insurance companies were getting fat off of the business they had, why do anything to help more people.

Back a few decades, Health insurance stock was some of the highest profitable investment, as were pharmaceutical company’s stocks, and so most people in the medical field that could invest had some of their investments in these profitable companies. I am not sure how their stocks look today.

Affordable Care Act

So with Health Insurance companies agreeing to the ACA, the government now had to find a way to get more people to buy insurance plans. Their plan was to require by a law that people now must pay for health insurance or get fined, regardless of their income or ability to pay their heath care bills. To make it affordable the government provided subsidies for low incomes.

The government also figured they would pull out of the subsidy plan slowly over years and encourage people to create health savings plans on their own. That each year they would fix the premium rates higher and higher until the consumer paid the full monthly premium. This part is hardly every talked about. Yet there is evidence when you file your taxes with Turbo Tax  software as they ask about your investing in  a Health Savings Account. It is a subtle process of pulling the $$ rug out from the poor.

Creating a “black mail” payment to IRS if you did not have health insurance; it did make many of the young adults join in, only to find they were paying more than they can afford. Many could not find anything they could afford.

The entire cost of living today is very high and to carve out a payment higher than your car payment (or rent) is just illogical to young people. Many middle class people joined in and enjoy it as it fits their incomes.

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How does a business of chance get the government to force people to buy their product?

Fear. Black mail. Lobbyists. Big under-the-table-pay-off, with the profits of the insured. Jacked up prices for health care. Fear.

The ACA was created without much research or thought. They just pieced something together to give you that warm feeling, like urination on the leg.

What opened people’s eyes to join in was when they found that the government would pay subsidies; that is pay for part of their large monthly payments to have insurance. People went for that carrot, not knowing that each year the carrot got smaller.

If you were up to 400% above the poverty line then you could glem something. To the poor, it was a blessing. Yet the present ‘poverty level numbers’ seem a bit low as few people above that demarkation can afford to live these days; as food prices, rents, water and electricity  constantly increase.

Let the Consumer Pay

A single mother of one teenager, was making $19,000 a year. The cheapest health insurance monthly payment she could find was $634. per month.

I am talking about the illusion that people do not think about.

Now the ACA would subsidize this payment and she would only need to pay $60. per month, her share; but what no one considers is that agreeing to high payments means the prices stay high and higher.

That as the government pulls out slowly of the subsidies, the consumer will eventually need to pay it all in full, and at much higher prices; just for those Health Insurance companies to make their profits.

The government is not planning on paying subsidies for long. Was it in just six years? I cannot remember. So hypothetically, this single mom would need to pay the full premium in a few years.

As a struggling single mother, she did the math, $634. times 12 months equals $7,608. per year. Nearly half of this single mom s yearly wages. No way in six years could afford this!

Stop and think before you say “subsidies” and remember that rarely spoken about clause of making the people take on the full payment over time.

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We are all “in training” by the Health Insurance companies. They have inserted themselves in our lives, and hold our health in the balance.

The ACA propaganda says that no premium would ever be higher than 10% of a person wages, and yet here it is, about 44% of this womans wages for her premium.

What they are twisting is that the figure of the premium left after subsidies might be 10% or less; not actual premiums. And what they say less of is when the consumer will be REQUIRED to pay for it all in full, regardless. If the government pulls out of the subsidy business tommorrow, the consumer must pay the full price!

This mother I am speaking about could barely pay rent of $850. plus bills, and a $60. a month payment took food out of their mouths. You do not eat, you get sick. A Wicked Twist.

She had to drop health insurance the next year. Yet she paid $160. directly to  doctors for their appointments, for her son and her self; that was affordable she told me. It was the only care they needed that year. But in that they must stay healthy and have no accidents. She was scared and confused.

Consumers Lose, Hospitals Lose, Doctors Lose and Health Insurance wins $$$$

Another women showed me a chart of what the ACA actually paid for. Her daughter had pancreatitis and needed to have her gall bladder removed.

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What she discovered over time was that anyone who did not have insurance paid the highest price for all services.

The Health Insurance companies negotiated to reduced fees for many services. Per her chart, it looks like Hospitals and various medical tests did not receive much from the agreements.

A hospital ultrasound test normally cost $1268.50, yet insurance paid only $435.46, and the woman had to pay $262.22. So in all, the hospital receives a total of $697.68.

The ultra-sound was reduced by $570.82 so that the insurance company can make profit$.

But that price is not offered to people paying cash. They have to pay $1268.50.

Hospitals lose money with ACA.

People who pay out-of-pocket pay the highest bill.

Doctors also receive reduced reimbursments as they are in the cross-hairs of Health Insurance companies to give them a reduced rate. Many doctors do not participate in ACA.

Health Insurance Business

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Health Insurance is just another business and must pay employees, and stockholders, to run the business of being in the middle of a patient and a doctor. They are not required to hold any medical degree either, just that their employees can run calculators and fill in paperwork.

They are just another business trying to succeed. They rob from the healthy to pay for the sick.

The sad thing is that Health is not just a commodity. Health is serious.

It is not like a car or some cell phone that can be replaced. Once the body is messed up beyond repair, we die.

Health should never be not a “profit” area.

I have always wondered why our Religious Right are not all over this.

And Jesus entered the temple and drove out all who sold and bought in the temple, and he overturned the tables of the money-changers and the seats of those who sold pigeons. He said to them, “It is written,‘My house shall be called a house of prayer,’ but iyou make it a den of robbers.” Matthew 21:12-13

Is not our Body considered a Temple of our SOUL?

We are not a car with interchangeable parts. We have a body designed by God that works so fine that no one really knows all of HOW it does it! Science just discovered a new organ!

Mothers Make Do

The single mom above had to drop her ACA plan as they kept going up on her monthly payment. She and her son have no insurance. They make too much for welfare systems, so it is all out-of-pocket for them. She makes just 120% above the poverty line, so she cannot even get food or housing help.

She falls in the a hideous gully where no congressman/women really looks or thinks it exists. They live in a state of denial, thus this oversight in part of their way of life.

The second mother whose daughter had surgery, had lost her husband in an airplane crash a few years back. A single mother and sole provider in her family of four. She also had to drop her health insurance.

She invested in a local doctor run clinic where she pays $200. monthly to get all the health care she can get. There is no ‘company’ in the middle. There is no confusing who pays what/when and how.

The clinic gets all the money to work hard on providing people better health. The clinic is proactive on preventative care and requires some education of those moving in to or having chronic diseases. This clinic is able to do it so far. There is no one skimming off the cream as it is blended in to the services of all people who joined.

Hospitals are Poorly Funded

Years ago I was talking to a friend of mine’s father, who had been a Hospital Administrator for many years. He said that hospitals operate in the red all the time; in other words, they cannot pay bills timely. He said many of them were three to six years behind.

Thinking about how Hospitals are the easy target for Health Insurances to require much lower bill from, just made me feel sick inside. They remind me of leeches, sucking the blood off the Hospitals ability to function.

This hospital administrator told me that the Health Insurance companies took a minimum of six months to pay the hospital, and many others even a year or more. This is why you will find some places do not honor certain companies.

On top of that the government, ACA requires certain taxes and fees from Health Insurance companies to be a part of their plan, and so that is passed down to the consumer in the ever higher monthly payments.

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Insurance is the act, system, or business of insuring something in consideration of a payment proportionate to the risk involved.

Healthy people are now penalized for being healthy with high premiums to offset the very sick people needs who pay the same premiums through a business that puts margins and percentages on top of everything, in or out.

Supporting the Profit Beast

The real questions everyone needs to ask themselves is;

Do they want to be paying high premiums that support insurance employees wages and stock holders when in reality they have nothing to do with their health?

Does anyone really realize how much supporting this industry is costing our health and how many people have died due to lack of proper health care options?

Do we really need it? Do we really want it?

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Could there be a more direct way of supporting great health services to all healthy to very sick people?

People may not be thinking about putting all that money in to their local health care structures directly.

Do the numbers, if 50,000 people in one town pay $800. a month to have health insurance, that is 40,000,000 a month and $480,000,000 a year.

Just an idea I had once, wondering what an island could do with their health care systems if they had no middle man. This one island was struggling to build a much-needed hospital while most of the health care money was leaving the island to health insurance providers living far away. That money only came back for those requiring services. If all that money was redirected to local health care they could build that hospital.

Riding the Bell Curve

Yet due to the cost heights the whole health care system has gone to, maybe my idea of money staying in that island is not enough. Our health care systems is expensive!

People will travel just go to another countries dentists or surgery, and they still save money even with the airline tickets, hotels and such.

In the USA, Health Care pricing is just getting higher and higher, and by very cleaver maneuvers.

Where is the Real Parasite?

Another friend of mine reported to me that he had intestinal parasites. He went to a clinic to get a prescription for a very successful pill that cost about $45. One pill did it all.

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He took his prescription to the pharmacy and found it was not the pill he knew about and the script would cost in $2540. for one pill. He said he nearly cried on the spot.

The pharmacist called the doctor and they found another pill for $342. What? Ralph was stressed out and had to sit down he said.

The pill he was looking for was taken off the market for no apparent reason, and it was the most successful of them all.

Ralph went home, wondering how to pay rent, so he researched the internet on the $2540. parasite pill to see how magnificent it was.

There it was in Wikipedia and to his shock this pill costs on the average around $3000. in the USA, but in Africa they pay 7 cents for one pill, the same pill.

The pill itself was not magnificent; it was priced high where people would pay high and priced low for where people could pay low.

I had to listen to Ralph for an hour, vent about this over coffee one day. How he could openly talk about having parasites got me! Most people would not say a word! And yet, he proved to me how Big Pharma is the real parasite.

The doctors resources they go to now on the internet had posted expensive drugs and removed all signs of the affordable drugs. The pharmacist knew and helped her locate something to work. The pharmasist also indicated to Ralph that there was some subversive manuevers about that $45 pill and that only “special” pharmacies had privileges to sell it.

When does all this reach a tipping point? How much more confusing can this get? How pays who to pay who that pays who?

True insurance is taking care or your health every single day.

I have no answers. After writing this I think I need a tall scotch and water! Water makes it healthy, right!

Stay Healthy my friends!

~ Rus

 

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