Zach's dress-down day, making a funny face. The Jedi In Training.
Thursday, April 1, 2010
Ainsley's Dress-Down Day
Ainsley's Diva Dress-Down Outfit consisted of black plaid walking shorts with a boy-tie as a belt, a turquoise tank top with attached necklaces, and a black knit cardigan with a sequin star on the back.
Sydney's Dress-Down Day
The only school day that the children were given permission to wear street clothes instead of their uniforms was Spring Picture Day. Syd and Ainsley began planning for this day back in January.
Tuesday, March 23, 2010
Insurance questions
It has been many years since we have paid for health insurance, so I have been out of the loop on what my friends and family have to pay for their health care. I am not even sure what percentage an employer pays for their employees' insurance premiums. If you feel comfortable sharing how health care factors into your benefits package, that would be great.
I have wondered how much people spend on insurance as compared to what they would spend just paying the doctor fee for service. With a quick online application, I discovered that, without any help from an employer, we would pay at a minimum $21K/year for comprehensive coverage. This price does not include maternity and the breakdown leaves out the 20% of any hospitalizations after the $15,000 family deductible, unexpected ER visits, antibiotics for when we are sick. The $20K annual out of pocket expense limit includes the deductible, but not the premiums. Here's the breakdown:
$436 monthly premium X 12: $5232 (I'm assuming the premium covers all 6 of us and is not per person)
$7500 deductible X 2 People (for the family rate): $15,000
$30 office visit X 2 visits per person each year: $360 (This includes 1 physical and 1 sick appt)
$15 Rx Co-Pay X 7 meds we get each month X 12: $1260
This is where the employer benefits come in. How much do they pay of this cost? Is this really what people pay?
I also looked at buying only the insurance plan that covers hospital stays, surgery, etc. It allows you to have a Health Savings plan, and I thought it would be much less expensive than the regular route. Here's the breakdown:
$10,000 deductible
$430 premium X 12: $5160
Once you hit your $10,000 deductible for the family, you pay nothing out of pocket. It turns out to be less expensive, but only if you would actually spend that much money on health care costs and spend it early in the year. Since you are paying cash to the dr until you hit your deductible, would they give you a price break? Neil says no because they would still have to turn that claim in to your insurance company to verify that you are paying your way up to your deductible and that the dr could get sued by the insurance company for charging you a rate lower than they charge the insurance company. Could you still use the $4 generics price at Wal-Mart with this insurance?
Just a thought. I recently read an idea for controlling costs: avoiding building new hospitals where there is no need. Apparently in New York or Texas (the paper did not specify), a hospital administrator wanted a transplant service and wing at his hospital, but the local and state governments turned him down because there were three other transplant services in the vicinity. So the administrator appealed to a state congressman with whom he had political ties, and the new hospital service and wing were on their way. If the gov't pays for health care costs, or if the costs are run through the gov't, there won't be any new shiny hospital wings operating at less than capacity.
I have wondered how much people spend on insurance as compared to what they would spend just paying the doctor fee for service. With a quick online application, I discovered that, without any help from an employer, we would pay at a minimum $21K/year for comprehensive coverage. This price does not include maternity and the breakdown leaves out the 20% of any hospitalizations after the $15,000 family deductible, unexpected ER visits, antibiotics for when we are sick. The $20K annual out of pocket expense limit includes the deductible, but not the premiums. Here's the breakdown:
$436 monthly premium X 12: $5232 (I'm assuming the premium covers all 6 of us and is not per person)
$7500 deductible X 2 People (for the family rate): $15,000
$30 office visit X 2 visits per person each year: $360 (This includes 1 physical and 1 sick appt)
$15 Rx Co-Pay X 7 meds we get each month X 12: $1260
This is where the employer benefits come in. How much do they pay of this cost? Is this really what people pay?
I also looked at buying only the insurance plan that covers hospital stays, surgery, etc. It allows you to have a Health Savings plan, and I thought it would be much less expensive than the regular route. Here's the breakdown:
$10,000 deductible
$430 premium X 12: $5160
Once you hit your $10,000 deductible for the family, you pay nothing out of pocket. It turns out to be less expensive, but only if you would actually spend that much money on health care costs and spend it early in the year. Since you are paying cash to the dr until you hit your deductible, would they give you a price break? Neil says no because they would still have to turn that claim in to your insurance company to verify that you are paying your way up to your deductible and that the dr could get sued by the insurance company for charging you a rate lower than they charge the insurance company. Could you still use the $4 generics price at Wal-Mart with this insurance?
Just a thought. I recently read an idea for controlling costs: avoiding building new hospitals where there is no need. Apparently in New York or Texas (the paper did not specify), a hospital administrator wanted a transplant service and wing at his hospital, but the local and state governments turned him down because there were three other transplant services in the vicinity. So the administrator appealed to a state congressman with whom he had political ties, and the new hospital service and wing were on their way. If the gov't pays for health care costs, or if the costs are run through the gov't, there won't be any new shiny hospital wings operating at less than capacity.
Tuesday, March 16, 2010
Health Care, Part IV: Doctors and access to care
How about this: Obama and subsequent Presidents can forgo all but $100K of their $400K salary each year, reduce their travel budget to $10K from $19K each year, and their entertainment fund can be taken from part of the salary that they are forgoing instead of needing it's own budget. That would buy a lot of health insurance for people with pre-existing conditions. If you want cheap healthcare, and you don't mind doctors getting up to -41% pay raise from CMS/HHS over the next decade, then the president and congress can do the same with their salaries. BTW, did you know that Congressmen's 401 Ks are matched by the federal gov't, but military members are not? I wonder why people are fine with doctor's salaries going down? Is it because they believe that it's not fair for someone else to make money? Should we be fine with everyones' salaries going down? That's the slippery slope we are on.
Who willingly goes into a career where they can expect negative pay increases? I get that some people have experienced unemployment or underemployment in the last two years. It stinks on ice. So people look at that field and say, "Wow, that field is shrinking. I better go into something else so that I can find a job to feed my family."
That will happen to doctors. There will not be enough people going in to medicine, willing to put themselves through what we have done-a total, after Neil finishes at Harvard, of 17 years of school/training after high school- if they know that their income will shrink every year for the foreseeable future. Your best and brightest will figure out that if they are making $40K, they will not work past 4:30. They are not going to want to work until 7 every night or work on weekends missing out on life. They will not even be able to live comfortably and still pay back their medical school loans and credit card bills that they racked up while their peers were out working at a well-paying job. Less people will go into medicine with a single payer system, so with less doctors, you will have access issues. Or you might, instead, have hospitalists that work for the hospital, not the patient, and then you lose continuity of care, or seeing the same provider that you always go to. It won't matter because your records are on the computer, but there is something to be said for having a dr know their patients, especially in peds and geriatrics. Also, if the patient is not the customer, and the govt or an insurance company is, then the patient loses in customer service, at least.
Or on a positive side, drs would feel no need to rush through seeing patients because they get paid regardless of how much time they spend with a patient. The patient is happy because they feel they have been listened to, thoroughly worked over for their illness, but you cannot see as many patients in one day at that rate.
Thanks for reading through my thoughts. If there are errors, please comment. If there are grammatical errors, please overlook them. Audrey has been helping my type for the last two days, and I am out of time for editing and revising.
Who willingly goes into a career where they can expect negative pay increases? I get that some people have experienced unemployment or underemployment in the last two years. It stinks on ice. So people look at that field and say, "Wow, that field is shrinking. I better go into something else so that I can find a job to feed my family."
That will happen to doctors. There will not be enough people going in to medicine, willing to put themselves through what we have done-a total, after Neil finishes at Harvard, of 17 years of school/training after high school- if they know that their income will shrink every year for the foreseeable future. Your best and brightest will figure out that if they are making $40K, they will not work past 4:30. They are not going to want to work until 7 every night or work on weekends missing out on life. They will not even be able to live comfortably and still pay back their medical school loans and credit card bills that they racked up while their peers were out working at a well-paying job. Less people will go into medicine with a single payer system, so with less doctors, you will have access issues. Or you might, instead, have hospitalists that work for the hospital, not the patient, and then you lose continuity of care, or seeing the same provider that you always go to. It won't matter because your records are on the computer, but there is something to be said for having a dr know their patients, especially in peds and geriatrics. Also, if the patient is not the customer, and the govt or an insurance company is, then the patient loses in customer service, at least.
Or on a positive side, drs would feel no need to rush through seeing patients because they get paid regardless of how much time they spend with a patient. The patient is happy because they feel they have been listened to, thoroughly worked over for their illness, but you cannot see as many patients in one day at that rate.
Thanks for reading through my thoughts. If there are errors, please comment. If there are grammatical errors, please overlook them. Audrey has been helping my type for the last two days, and I am out of time for editing and revising.
Health Care, Part III: The public option
Eventually the scenario will occur where most everyone is paying for the public option. Would the govt be able to sustain the low rates, go without the overhead and profit, with an entire country to cover? It sounds like a great plan and something that should work, but is it wise to change the entire system when it might not work. How can they undo this if the financials don't work out as planned, if it costs more for the govt to run the healthcare system than they thought it would.
Or what if some other govt agency takes the money earmarked for health care? It has been known to happen before. Roads in San Antonio received funding, but the money was taken to pay for other things; Children Health Insurance Plan was given funding in Texas from Tobacco lawsuits, but the money went elsewhere. Education funding was supposed to come from the new state Lottery... See a pattern? Is it possible that this happens in other states as well? Ask the people in Oklahoma and Illinois who are fixing to be asked by their state gov'ts to pay $9K and $32K respectively.
This entire issue all comes down to a person's fundamental belief in either competition among insurance companies and less federal regulation leading to better practices or the gov't taking over and coming up with their own best practices. My money is not on the federal gov't. Sorry.
There are many things wrong with this huge industry, and I think people would be glad to support some of these reform measures right now. This would give Washington more political capital to work out the larger problems without the rush we have experienced in the last six months.
One concern that so many people have with this particular version of reform is the fact that someone has gone on the record as saying they are going to pole vault over the People to get this done. Wow, that doesn't sound right! I think it makes people defensive and wonder why they would need to do that if it was the right action.
I'm still offended by Obama's comments at the State of the Union where he said that people against his health care reform are wondering what's in it for them. He needs to get a clue. Even if congress and the president are being 100% up front about everything, the people are pushing back hard because their ability to choose is being taken away from them.
If I thought that our gov't could do something efficiently and streamlined, I might agree with you. Our family has been on a govt insurance plan three times: SChips for my kids, medicaid for myself, and tricare. I love free or reduced cost health care and I think many people love the idea of not paying very much for health care. But if this became the norm, you would get what you paid for, in terms of updated equipment and meds and caliber of dr.
Another thought is that the health care providers in the military are great, but the military medicine system is so large that it is hard to change course, to update, to somehow make decisions based on a short-term and long-term basis. There tend to be access issues due to the sheer volume of patients.
On the other hand, China is a great country to look at as they try to combine socialism with capitalism. Because the Chinese govt does not worry about political games, they are free to consider the long term. China obviously has socialized medicine, but they are attempting to update that system and offer other options. Is it possible for the private system to run side by side with a public option? Watch China, but don't write anything bad about them on the internet.
My overarching concern with this bill is financial: most people who oppose this bill worry about the cost. Will it really be as inexpensive as they say it will, where will the money really come from? Would it be possible to set aside tax revenue and premium payments without other gov't agencies taking it? Also, people look at the Social Security program and even state pensions and wonder how we will fund healthcare if we can't fund these other programs.
The gov't just does not have a great track record as far as keeping costs low. Ask Hillary Clinton who recently authorized $5.4 million dollars in lead-free cyrstal for freaking entertaining at American embassies around the world. Really? My left-leaning friends wonder why I worry about health care costs staying affordable and this legislation staying under budget.
BTW, look for the picture of Obama on the Great Wall of China shaking hands with some diplomat. Read Obama's body language and tell me what you think he's saying. That's the next bump on the horizon.
Or what if some other govt agency takes the money earmarked for health care? It has been known to happen before. Roads in San Antonio received funding, but the money was taken to pay for other things; Children Health Insurance Plan was given funding in Texas from Tobacco lawsuits, but the money went elsewhere. Education funding was supposed to come from the new state Lottery... See a pattern? Is it possible that this happens in other states as well? Ask the people in Oklahoma and Illinois who are fixing to be asked by their state gov'ts to pay $9K and $32K respectively.
This entire issue all comes down to a person's fundamental belief in either competition among insurance companies and less federal regulation leading to better practices or the gov't taking over and coming up with their own best practices. My money is not on the federal gov't. Sorry.
There are many things wrong with this huge industry, and I think people would be glad to support some of these reform measures right now. This would give Washington more political capital to work out the larger problems without the rush we have experienced in the last six months.
One concern that so many people have with this particular version of reform is the fact that someone has gone on the record as saying they are going to pole vault over the People to get this done. Wow, that doesn't sound right! I think it makes people defensive and wonder why they would need to do that if it was the right action.
I'm still offended by Obama's comments at the State of the Union where he said that people against his health care reform are wondering what's in it for them. He needs to get a clue. Even if congress and the president are being 100% up front about everything, the people are pushing back hard because their ability to choose is being taken away from them.
If I thought that our gov't could do something efficiently and streamlined, I might agree with you. Our family has been on a govt insurance plan three times: SChips for my kids, medicaid for myself, and tricare. I love free or reduced cost health care and I think many people love the idea of not paying very much for health care. But if this became the norm, you would get what you paid for, in terms of updated equipment and meds and caliber of dr.
Another thought is that the health care providers in the military are great, but the military medicine system is so large that it is hard to change course, to update, to somehow make decisions based on a short-term and long-term basis. There tend to be access issues due to the sheer volume of patients.
On the other hand, China is a great country to look at as they try to combine socialism with capitalism. Because the Chinese govt does not worry about political games, they are free to consider the long term. China obviously has socialized medicine, but they are attempting to update that system and offer other options. Is it possible for the private system to run side by side with a public option? Watch China, but don't write anything bad about them on the internet.
My overarching concern with this bill is financial: most people who oppose this bill worry about the cost. Will it really be as inexpensive as they say it will, where will the money really come from? Would it be possible to set aside tax revenue and premium payments without other gov't agencies taking it? Also, people look at the Social Security program and even state pensions and wonder how we will fund healthcare if we can't fund these other programs.
The gov't just does not have a great track record as far as keeping costs low. Ask Hillary Clinton who recently authorized $5.4 million dollars in lead-free cyrstal for freaking entertaining at American embassies around the world. Really? My left-leaning friends wonder why I worry about health care costs staying affordable and this legislation staying under budget.
BTW, look for the picture of Obama on the Great Wall of China shaking hands with some diplomat. Read Obama's body language and tell me what you think he's saying. That's the next bump on the horizon.
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