I wanted to take a few lines here to explain a real life scenario for our family and the implications of rising healthcare costs. We’re a middle class family being burdened by rising healthcare costs - and there is -NOTHING- we can about it.
My employer covers 90% of my healthcare premiums - just for me. That means I’m paying roughly $30.00 per month just for myself. That’s great in my eyes - I have most everything I could want in a plan. My out of pocket limit is set at $2,000.00/year after 20% coinsurance, I have a $1,000/year deductible and I don’t get sick very often. That’s a pretty good plan for me, so I participate. This doesn’t include dental - we pay seperately to my company for coverage for the entire family to the tune of about $42/month.
The problem is that my employer doesn’t cover my family. That’s pretty typical in small & medium sized businesses. Actually - they offer the availability for me to add Caitlin and Dominic to the policy, but the premiums would be over $600/month to add them. That is a lot of money. I mean - ALOT. So, we can’t afford to participate in my company’s policy. We needed an alternative.
There is a lot of talk of private health insurance. We particpate in that. But, there are even more problems with that system.
We bought a private policy just for Caitlin and Dominic about 2 years ago here in North Carolina. The premiums at that time were below $200/month (that’s post-tax money people). Even after doing all the calculations, we wagered we’d end up saving a few hundred bucks a month by using private insurance. Note - we can’t use our flexible spending account to pay for those premiums.
Now our monthly premiums though private insurance have climbed 10% a year in two years - up to $240/month. A meager amount, yes? But why? Why are they charging us MORE for health insurance when we have been healthy people? We’ve had no major accidents, incidents, etc… we’re just trucking along paying our premiums, sending Dominic to wellness visits, and seeing the doctor maybe twice a year.
I decided today to try and shop some new premiums, as you would with your car insurance every few cycles. Guess what I discovered? The premiums for the same plan we have are now offered in the $300-$350/month range. Even if I wanted to stick with the $240/month for my family, the closest premiums have twice the yearly Out-of-Pocket limit and twice the yearly deductible. This is just truly unacceptable.
What frustrates us most is that even private insurance doesn’t cover everything. It doesn’t cover dental. It doesn’t cover pregnancy. It doesn’t cover specialized tests unless we jump through great hoops, and even then we’re paying hundreds of dollars for those tests.
I’ll give a scenario - What if Caitlin and I decided tomorrow we wanted to have another child? What would we do? My best guess is that we’d have to actually drop our private insurance right before her first pre-natal visit, jump-ship to my company’s health insurance for the duration of the pregnancy and then hop BACK off my company’s insurance after the birth. After all this, we’d have to open a NEW private policy for Caitlin, Dominic and new-baby. Why would we have to do this? Because our private doesn’t cover it, and my company’s does (since pregnancy is no longer considered a pre-existing condition - thanks President Clinton).
What would a pregnancy cost us? About $3,200 in new premiums, plus another $1000 in out of pocket expenses and other etc. items. That’s to a tune of about $5,000.00. How in the hell can anyone afford that? When we had Dominic, we were covered under a large company’s health insurance plan for the majority of the time (my job) and Dominic cost us $35.00 —– yes you read that right —– $35.00.
If a hard-working middle class family like ours wants to have a child, we can’t. We’ve clearly struggled to have what we have. We’ve both worked very hard to provide our American Son with the right ideals and tools he needs to succeed. We’ve done the right things in life. We’ve payed our taxes, contributed to our economy by being a homeowner when it wasn’t the smartest thing to do, participated in rebuilding our community —- all for what? Not being able to pay for health insurance? Or… God forbid…. create another child to contribute to our country in the same way we have?
I’m not suggesting that government needs to step in a make changes. I just want answers on why this has gotten so out of control to where a decent family has suffered long enough. If you include all our flexible spending, we’re paying about $440/month in health costs for a family of three… and that doesn’t cover everything. Is that right?
Paying $440/month for health in our family may be tough, but we do it. It’s a priority to us. But what about that family of three down the street that doesn’t make quite as much money as our family - even though they’ve done the very same right things with their American Son or Daughter?
