[TheForge] Marginal Blacksmithing Question

[Andrew Vida]

Ries Niemi wrote:

> I live in Washington State, I have 2 kids and a wife, and I used to have 
> Blue Cross, with about a $1000 deductible- and when it went up to over 
> $700 a month, I dropped it, and changed over to a Northwest HMO called 
> Group Health. Now I pay $414/mo, with an even higher deductible- $2500 
> for the family, I think it is. This means I pay the insurance, and THEN 
> I pay all my families medical bills, most years. Sounds like a waste of 
> $5 grand a year, but really, its not, for several reasons.

	Basically, what you have is a major medical policy, even though the 
company will deny that this is what it really is.  It sucks ass, but 
these days I cannot think of a single company that doesn't.  For that 
kind of money you might want to see if you can get a major medical 
policy.  No doctor visits or anything like that.  You use it when you 
get hit by a bus, and that is about it.  If you don't spend $2500/year 
on visits, then there is no reason to have that sort of policy.  I don't 
know if the companies even bare bones major medical anymore.  Wouldn't 
surprise me if they did not.  After all, why would they let you get away 
when they can stick it to you every way possible?  SOBs.
> 
> 1- I can usually deduct most of it from my taxes. This may vary, 
> depending on your tax situation.

	That deal is just another screwing.

> 2-Even though I pay all the bills myself, most of the time I get a big 
> discount for belonging to the HMO. I live way out in the sticks, so I 
> dont go to their HMO hospitals or clinics- I go to my own doctor, and 
> then they send the bill to the HMO, and the HMO says, wait, we dont pay 
> this much for this procedure- its only this much. Then they send the 
> bill to me, and I pay the lower, HMO cost. If I paid in cash at the 
> doctor, I would be paying 20% to 50% more in most cases.

	Which is prima fascia proof that you're getting it in the neck by your 
doctor as well as the insurance company.

> 3- Every once in while, fate rolls you snake eyes. My son broke his arm 
> while skateboarding- $2500 right there. And if something more serious 
> happens, which with 4 people, 2 of us 50+, it could, the insurance will 
> pick up the big unexpected tabs.

	And that's all it is really good for, and the devil help you if you get 
caught without it as you will face ruin, unless you're Bill Gates. 
People like that don't need health insurance.
> 
> Its a racket, and I  hate it, but as a parent and husband, I have to pay 
> it. Cant take the chance.

	It really is a racket.  The only laternativce I can think of is to 
place all your assets into a corporation and declare Chap.7 if you amass 
huge medical debts.  That, too, is pretty shitty, but in some cases one 
isn't given that much choice.

> But in most areas, you really only have 2 or 3 choices- usually some 
> variant of Blue Cross/ Blue Sheild, and maybe a HMO like Kaiser or Group 
> Health.

	I had US Healthcare when I was with Bell Labs.  They were great for the 
sirts few years.  In 92 when I had my first Lyme disease, I think I 
racked up almost $100K in expenses... I was sick as blazing hell and 
treatments such as IV Rocephin for 30 days @ $1100/day will wreck you 
pronto.  But after about frou years, they were pulling all manner of 
hanky panky... raised deductibles, decreased coverage, increased 
paperworkd, decreased eligible doctors...  As you say, it is a racket 
and I would go so far as to call it legitimized fraud.

 > Some states have special programs for low income people, and
> there are a few local HMO hybrids out there. I would go and talk to your 
> local doctors office, and ask them what companies they deal with, and 
> which ones people have problems with- those ladies at the front desk of 
> a clinic know a lot- as long as you dont go to some mega hospital, but 
> instead a small clinic.

	Sage advice.  You can get a lot of good info from them.

	-Andy