Health Care Crunch

Health Care, Health-care, Healthcare. It seems that any one of these iterations is acceptable so spell it any way that you want but no matter how you spell it, healthcare does not come cheap. This weekend we received our COBRA bill. COBRA (Consolidated Omnibus Budget Reconciliation Act - huh?) is the program that allows a displaced employee to remain in an employer's health plan for up to 18 months should they leave or lose their job, under certain conditions. It is a nice idea. After all, in our employer-based healthcare system, losing your job should not compromise your access to care.

However, I don't think healthcare costs were as astronomical when COBRA was conceived. Our COBRA bill is nearly $1600 a month. It is a little higher than the average family plan because we also participated in an FSA (Flexible Spending Account) healthcare auxillary plan, where we contributed $200 in pretax dollars each month to pay for out of pocket healthcare costs such as copays, over the counter and other costs that are not covered by your healthcare plan. This is another great program that can save you up to 30% on associated healthcare costs, depending on your tax bracket. But, it is calculated on a yearly basis and you can use all of these expected funds long before your total annual contribution is deducted. What if you lose your job before your year is up? Yes, it does get confusing, believe me.

Considering that unemployment in New York pays $405 per week plus an additional $25 that the Federal Government stimulus plan kicks in, adding up to a whopping $1720 a month (acknowledged that there are 2 months a year where there is a 5 week payout) that does not leave much. However, another part of President Obama's stimulus package allows for a 65% subsidy for COBRA costs for the first 9 months. Thank God! While we do not get a break on the FSA part, that cannot be reduced, we now have to pay a little less than $700 dollars a month. I jump for joy but theoretically that is still a lot of dough to "pony up" in these economic times which, of course, makes the President's campaign promise of healthcare overhaul even more prescient.

Last week, President Obama rolled out his healthcare overhaul platform in earnest. Already the waters have been muddied when it comes to the best way to reel in the costs and still provide quality service. Those of us who remember Secretary of State Hilary Clinton's attempts to reform healthcare back in the 90s when she was First Lady know the ugly fight that lays ahead. It goes without saying that Hilary was ahead of her time. Unfortunately, powerful lobbies, like the pharmaceuticals and healthcare insurance companies, will do as powerful lobbies do with laser certainty - mount an unyielding campaign to thwart and undermine any chances of real reform. Anyone remember Medicare Part D written by and for the pharmaceutical companies?

Pharmaceutical companies are killing us people, killing us. They have ads on TV telling us that they can fix x, y, and z unless the side effects kill you first. You are supposed to ask your Doctor, the one who has no clue who you are because modern healthcare, as dictated by the health insurance companies, requires him/her to see a gazillion patients an hour, whether some drug you have no clue about is right for you. Trust me, you don't need to ask, they will write you a prescription for all those drugs you see on TV in a heartbeat. Unfortunately, your healthcare company does not pay for name brand drugs, does it? I have come home in a groggy state from some procedure or another, after stopping at the pharmacy to pick up some drug that turns out will cost me $400, to get on the phone with the health insurer about what generic drug is covered or is the best substitute.

Lately, I have been to more Doctors than I ever have. Somehow, despite my healthy efforts - I quit smoking years ago, I exercise regularly, I do not eat any meat or fatty foods and I mostly drink wine when I do drink - my over-40-year-old-body has begun to show too much wear and plenty of tear. What's up with that? Every time I go for a test, I get referred to even more specialists. Part of me knows it is a racket because I get sent to specialists before the results of other tests even come in. I certainly do not want to do contribute to increasing the healthcare costs of all and I try to pay attention to what I believe are unnecessary tests and procedures; understanding that the premiums of any employer or associated group health plan are subject to the expenses of all the members.

Insurance is a funny thing, you pay it to protect yourself in the case of calamity but if you actually use that insurance, you will pay more for it after your insurer has paid out for a "qualifying event." If a member or their family requires specialized care that carries a hefty price tag, next year's premiums for the entire group will be higher. Make no mistake, every time someone, whether individually or part of a group, actually utilizes the benefits of insurance, be it car, homeowners, or fire, you name it, your premium will increase. The increases are even more deadly when it comes to health insurance. I won't proclaim how to fix it, in fact, I'm wondering if it is too late. Good Luck President Obama. Godspeed.