Common Cents # 23 - Health Care

 

Common Cents – Health Care 

It is easy to see from the many TV and Social Media Ads that we’re approaching the Insurance Open Enrollment Period that will have new insurance plans and prices take effect on January 1, 2021.  It is easy to become overwhelmed and even paralyzed by the decisions that must be made.

The United States is the only country in the world that has health insurance connected to a person’s employment. There are about 70% of Americans that have insurance benefits through their employers.  These plans may not renew on January 1 of each year, but many do.  For those this year who have lost these benefits because they’ve been furloughed, have become part-time or have lost their jobs all together, it is usually a shock to learn the amount of the premium the employer has paid as a part of the job when we hear the amount that COBRA Continuation benefits will cost.  It often causes us to feel better about our employer when we understand what that has cost them each month.

The ACA Marketplace (Obamacare) is still available to individuals and will be continuing to offer plans to those who do not have insurance options at their place of employment or want to pursue other options than the plans their employer has decided is the best they can afford to offer.  Some people can obtain subsidies or discounts to these plans based on certain criteria and the amount of annual household income that they receive.

There are also short-term policies that can now be in force for as long as one year that may be a good choice, especially if there are no or limited pre-existing conditions since these are not usually covered on this type of insurance plan.

The important thing to remember is that the cheapest option is not necessarily the best. It is so important to spend the time to see what really is the best plan for each person.  We need to find the person in our world who can give good counsel on this part of our monthly financial investment.

It is interesting to note that there are four actual systems that provide medical care in the USA. 

System One: The hospitals are owned by the government or government agencies, the doctors and medical staff are government employees and health care is free to all.  This type is available to the military, government officials, and qualifying veterans.

System Two: Hospital are owned by for-profit or not-for-profit organizations and doctors are self-employed. A government-run insurance company pays the bills. This system is called Medicare and is available for people over sixty-five or Medicaid, available to many low-income families.

System Three: Same for-profit system as number two except for-profit insurance companies pay a good part of the bills. The insurance premiums are most often paid by employers who consider the expense part of payroll which would otherwise be used to increase salaries and wages of employees.  The rest of the hospital bill is paid by the employee and part of the premium is deducted from the employee’s payroll.

System Four: The hospitals are for profit and doctors are self-employed except that only the individual receiving the care pays the entire bill.  Private insurance is available for self-employed and other people who don’t have employee benefits and can afford to purchase it.

Unfortunately, many people are not participants in any of these four systems.  They go without health care or health insurance, being served by aid organizations such missionary groups, free-clinics and so forth.  They also rely on the benevolence of these four systems when their need for care becomes more than their normal providers can accommodate. Individuals and families in this kind of situation are in in great need for a reform to occur that does not leave anyone out of a category of care. It is certainly hoped that this will change as proposals and recommendations are made in our nation’s future healthcare legislation and decisions.