Health Care in America and Election 2008

I just finished reading several articles from various sources explaining the Presidential candidates' proposed health care plans and my reaction is that I am completely infuriated by the idea that any one of the proposed plans can correct the problem. Can you say 'elitist?'

Has any one of them, Obama, Clinton or McCain, had to read and complete the multitude of forms to sign up for her/his employer's 'cafeteria plan' for health insurance? First your attention jumps to the price scale of the group plan offered. What amount you will pay for your health insurance (or rather what amount will be removed from your pay before or after taxes are deducted) is based upon your age, whether you are male or female, whether you have children, how many of your family members will be covered by your choice, how much your selected deductibles and co-pays will be...well, you know the drill. You look at the costs and whether it will be taken out all from one check or spread out over the payroll cycles of a month.

Then you realize that the cost of just that portion to cover you, not including the rest of your family (thank goodness I have only me to pay for), is equal to one fourth to one third of your housing payment, not counting utilities! Then you say to yourself: "Well, I'm pretty healthy and if I get in a car accident, either my or the other guy's insurance will pay for it, right?" So you look at the latest thing in health insurance alternatives, the Health Reimbursement Account, which may be called a Flexible Spending Account in your company or region.

The Health Reimbursement Account (HRA) will reimburse you for cash outlays for medical costs, provided you have accumulated enough in it to cover the receipts you submit for those expenses. That's the downside. You have your employer deduct a specified percentage or amount from your paycheck each cycle and set it aside in case you need it. So you hope you don't need it until you have built up enough in your account to cover your submitted receipts. The upside is two-fold: you can choose to have your money taken out prior to any tax deductions, reducing your taxable income AND, quite often, your employer may match those funds up to a specified limit.

The average HRA also covers quite a bit, including cash outlays for office visits and emergency room visits, prescriptions, day-to-day expenditures for home health items such as aspirin, vitamins and band-aids, sometimes even deductibles and co-pays, should you have another health insurance carrier. What it won't pay for is your premiums for alternate health insurance plans, if you are able to find something cheaper than the group plan your employer offers. (Insert hollow laugh here.)

The Flexible Spending Account (FSA) is "a rose by any other name," performing the same function as the HRA, so whichever you have, this is what you get from it. Make sure those receipts don't end up going through the wash in your pockets when you return home from the doctor running the fever that you couldn't reduce with just aspirin. And keep copies, including the date you submitted it. It takes 8 - 12 weeks to get your money back, so don't count on getting your own money that you had them save for you in time to pay this month's electric bill. Or next month's. You might also want to take the direct deposit option on the reimbursement, or you may have to wait even longer to receive a check for your own money.

The rest of the 'cafeteria plan' details the availability and costs of Vision Insurance (for glasses and exams), Dental Insurance (not expensive, but hope you don't need to have root canal, caps, a bridge or dentures), Supplemental Insurance (if you don't take the group plan, you can't have this either), Long-Term Disability Insurance and Short Term Disability Insurance, which takes effect once you are unable to work for six weeks. What you pay your bills with for those six weeks is anybody's guess. This is where most Americans get behind on the rent or the mortgage, the car payment, lose their car insurance due to non-payment, leave the credit card minimum payment unpaid for two months, lose their health insurance because they have no paycheck from which to deduct the premiums....you see where I am going with this, right? Ok, Barack, Hillary and John, pay attention because here comes the best part.....

This also presupposes that you don't lose your job before your eligibility to receive the Short Term Disability insurance payments kicks in. (And you thought you had planned and were well prepared for this.) Yes, I said "lose your job," because even with a valid medical excuse, signed by your doctor, you receive warning notices for excessive absences in such quantities that you can be let go for cause. Getting fired for cause ensures that you are ineligible for unemployment coverage in your state without a lengthy appeal process. In the meantime, you have no income with which to pay for roof, food, utilities, medicine, continuing health care for your extensive injuries or illness and so forth.

So you end up homeless, and with no address to put on Social Security disability applications, Social services applications or job applications, you end up on crutches begging on the street corner. Oh, and since you got fired for cause ('cause you missed work due to your injuries that you had no health care coverage to pay for), you are not counted in the percentage of Americans in your state or country who are unemployed. But that's another story. Stay tuned!