WMH is that for you and spouse? Good grief, I hope it's for at least 2 of you.

Earlier this year, I looked at what Ocare would cost in my area if we were to use it. 28K/year for my husband and I (if we were in our 60's). That "included" the premium, deductible, and copay.

Ha Ha, I hit two grand a month a bunch of years back. Carried if for years till I simply quit.

People like me quitting is now raising your rates.

If you still want to keep insurance, you need to constantly shop it around. Consider also separate policies. For families a spouse and children can be on one policy while the second adult is on another policy.

I've been objecting to insurance since I paid for my first auto insurance policy. Seemed like a scam. I watched insurance companies move out of Florida when they actually had to pay out on policies.

What goes on now in health care is actually criminal.

Smokowna: So, do you plan to just keep paying the fee/fine for not having it then? I am just curious.

- John...

I know a lot of people who either work for insurance or who are paying the fine. They decided the fine is less expensive than the insurance, which is out of control.

You just demonstrated why.

It should be clear to any one who isn't garbled by politics that ACA is unworkable. "Guaranteed insurance" cannot work, since by definition insurance pools money from a large group to protect a few people who suffer catastrophic loss. Insurance doesn't work when some participants are already in the middle of catastrophic loss (i.e. the previously uninsurable). ACA is nothing more than a subsidy plan thinly disguised as insurance to keep it palatable to a citizenry who, at least for now, continues to pay lip service to Liberty and Freedom. Ah, but give them bread and circuses and they'll sign away both of those on Nov 8th, regardless of party persuation.

The only alternative to our present mess is to get Govt out of insurance (buh-bye Medicare, Medicaid) and cut off guaranteed ER access. How many politicians would vote for that? I don't even think Gary J. would.

The problem is, it is NOT single payer. The insurance companies are still in the middle.

WHY should we still rely on JOBs (i.e. COMPENSATION PACKAGE) to get fair treatment on insurance costs?? It needs to be ONE BIG POOL.

We have the "means", we do not have the "will" to make these things happen.

David,

Group rates are horrendously expensive. They are much more than what used to be the private market rates.

The issue is that now everyone is forced to pay these high group rates that now are forced to cover those who are already sick. And many of those people get government subsidies. Those who don't pay the full cost. If not under an employer plan with no employer picking up a large part of the tab they really get hit hard.

Anyone need an example of inflated health care cost?

3 years ago, I was in minor auto accident with police/ paramedics on the scene. I was strapped down to a gurney and taken by ambulance to the ER. I spent 2 hours in the ER, had X-rays taken and was examined by an ER doctor who released me to walk out with some pain medication.

Two weeks later, I get a bill from the hospital for $5,500.00 for those '2 hours in ER'. The 2 mile ambulance ride was billed separate and it was $600.00 !! And this was 3 years ago,...I wonder what those same 2 hours in the ER would be billed today at.

I'm with Blue. The real problem here is that the single payer portion was dropped. If they were going to do it, then they should have done single payer -- it is the only way to have a system like this (that tries to cover everyone) actually WORK.

What we got instead is a horrible half-implemented program that simply can't solve the problems with insurance companies.

- John...

I pay $254 a month for myself and $311 for my kids. Out of pocket. That's tough for me and I'm young still.

David,

You're only looking at yourself. I was an employer. I know how or works. Why not ask your employer what your plan is costing him? Your portion is likely only 20% of what he's paying FOR YOU to have coverage.

When we had our company it would have cost us twice as much to be covered under the group plan offered by our business so we kept our individual plan which was about 50% cheaper since as greater than 2% shareholders we weren't eligible for our own company'/s plan unless we included it in our taxable income.

The issue is that there are still people opting out, like those I know choosing to pay the fine, and that the insurance companies are still in the middle.

Insurance is what ruined health care.

Take animal health care.

When I take my dog to the vet, I pay cash. An office visit fee is based on how long the visit is - but is generally about $50 - $75. Surgery, which I paid for recently, was under $500 (for abdominal surgery).

The Vet paid similar fees for vet school as my MD and PA did for their education.

The difference is that my MD pays a lot more for his malpractice insurance and has to deal with billing my insurance company. As a result, my MD charges $200 for a short office visit, then the insurance company says, no, we agreed to $125, pays 90% of it, and I get a bill for 10% of that, after I meet my deductible.

As little as 20 years ago, I remember my MD giving a cash discount, but no longer. Medicare now says that if he charges anyone less on any day, then the Medicare patient must be charged that lowest fee on that day. So, no cash discounts. That really screws it up for things like CT Scans and MRIs.

Haven't really planned anything out. I don't pay it much attention.

If luck is on my side maybe health care insurances will all implode within the year.

"I'm from the government and I'm here to help you."

MAN! I wish I could be political here!

I AM amazed they are doing this right before elections!

BRAD

David: Comparing what you pay for an employer-subsidized plan really means nothing and isn't a fair comparison at all. It'd be like a Section 8 recipient that gets $600 of their $700 apartment paid for saying that they "rent a 3-bedroom for only $100, so I don't see why people are complaining about the high rent prices."

It's just completely disconnected from reality to say something like that.

- John...

Smokowna: I don't see how you can just not think about it. Assuming you make enough money to not qualify as an exempt person, you'll have to pay "2.5% of your household income above the tax return filing threshold for your filing status" as a fine for not having insurance in 2016.

I don't know how old you are or how much you make, but this number is probably $1000 or more. (And it would have been close to that for 2015 -- which you would have already paid on your taxes.) So, it just seems really odd to me to say that you "don't pay much attention."

You don't pay enough attention to know if you gave away an extra $1000 (or possibly much more depending on how much you make) last year?

I get that the fine is still less than insurance, of course. But I'd still know either way whether or not I gave away an extra $1000 last year...

- John...

"They are doing it right before elections" because that is when open enrollment happens every year. No other reason.

Before the ACA my insurance regularly increased 28-36% per year, every year. Plus I had preexisting conditions (as we all will at some point!!) that were exempt from coverage.

Those of you with insurance thru your jobs are now just feeling what those of us that have paid for our own insurance have felt for years.

I've said it before and I say it again; This is how this ends: insurance becomes too expensive. People quit paying for it. Hospitals (who must take everyone) start going under due to non payment. Hospitals complain to their shareholders who then complain to their lobbyists who then complain to their Representatives. BOOM single payer.

John, regarding the cost comparison for employer provided plan vs. ACA...very well put!

Regardless of whether folks think I'm inconsistent or not with being critical of the ACA while having insurance via my military service, the fact is over the past few years the system is starting to show its worst weaknesses. Insuring those who already have catastrophic costs have caused premiums to rise sharply. The young healthy folks who were supposed to be the back bone of this system are not signing up in the numbers needed to level out the costs. Folks didn't get to "keep their plan." Providers are moving out of states leaving less competition. It simply is NOT a workable plan. Although the hints and info is already out there, the real bomb shells that show up on people's bottom line are expected to start dropping just AFTER the election. The timing is everything. Low informed voters will check the box in Nov, then freak out in Jan because they were not paying attention.

If you like your dr., you can keep him.

If you like your insurance plan, you can keep it.

You must see that this absolutely relates to landlording, right? People that want to do this full time will eventually need to buy their own insurance. It is very much something that landlords should be discussing.

- John...

We are professional landlords. We don't HAVE W-2 jobs. Insurance is a critical issue for us. We are in our 60's so can't blow it off by saying, 'We never get sick' because we do and will, it's a fact of aging.

The plans differ from state to state, so what David sees in MI is substantially different from what we see in NC.

Long ago I mused, " Hmm, people who don't have insurance generally don't have money." I continued talking to myself "therefor, the fines won't be very large".

That is about where I stopped thinking about it.

Are you saying the fine is 2.5%? If I do the math in reverse...Health insurance for the year is $24,000. So if I earn nine hundred sixty thousand dollars a year, then my fine will be equal to what I paid in past years for a policy?

Regrettably, I do not currently earn $2,630 per day.

A thousand dollar fine is just equal to health care coverage starting January first and ending January 15th...of the same sad year.

When insured, I will have paid well over a grand before most 26 year old college students, still living at home, finish watching a Rudolph then a Seinfeld marathon and return for the start of the spring semester.

You can't compare the fine to the maximum out-of-pocket costs of a policy. That's not how INSURANCE works. Insurance is there in case you have some (usually currently unknown) accident or health issue that would cost you much MORE than the insurance costs.

So, this isn't about paying for a policy that you don't use versus what the fine would be for not having it. It is about whether or not you might have an emergency situation or life-threatening disease that would cost you hundreds of thousands of dollars to try to cure/help/whatever. THAT is why many people pay thousands per year instead of paying the fine -- because they want that insurance to be there.

You seem to be ignoring the purpose of insurance.

In any case, my point in asking you about this is that I still think it is very odd to basically just go "I don't really think about it and don't know if I've paid any fines or not." I find it very odd that you still don't seem to have any idea if you paid a $1000+ fine last year or not. I mean, I guess maybe a CPA just does your taxes and you pay whatever he says without looking at it? Still seems odd to me that it didn't even come up.

Also, is your plan to just risk it, have no insurance, pay the small fine, and hope you don't have a stroke or get cancer or whatever at some point in your future? Because, again, THAT is the real gamble when it comes to insurance. It isn't about comparing the fine to your premiums like you appear to be doing...

- John...

From Salon, today: Meanwhile, the increase in customers that these health insurers received under ACA has helped raise the stock prices of the top five insurers — some 80 percent for Anthem and 165 percent for Aetna since the high court ruled on June 28, 2012 that Ocare was constitutional.

While Americans continue to fork out more money, insurers are doing great. On Thursday, Aetna reported $734 million in profit on $15.8 billion in revenue for the three months that ended Sept. 30. The nation’s third-largest health insurer by revenue handily beat Wall Street estimates for the quarter. Chief Financial Officer Shawn M. Guertin cited “solid performance” in the company’s core health insurance business that offset “pressure” from its business under the Affordable Care Act.

If my math is correct, in paragraph 2 from Blue's post...

$734 M / $15,800 M (a.k.a. $15.8 B) = 4.6% of revenue is profit.

I'm not impressed. My margins are considerably higher.

Paragraph 3 talks about revenue increases but, big numbers makes it seem like the amount of money being paid is obscene. Consider this: $1.98 Billion additional revenue came from 955,000 new customers who signed up. That equals $2000 per person. It's not exactly earth-shattering considering some of us have tenants who pay more than that PER MONTH in RENT!

Anyone here have a rental that tops $2000 per month? I guess your livin' large.

SId, did you read the last paragraph??

Here let me repeat it for you

From what I've read Sid "gets" it quite well.

Except he gets his insurance from the government. Yes thru his "compensation package' for playing soldier once a month.

I have had my own insurance for at least 25 years. At first it was $50 month for me and my son.

Before the ACA it was $670 something per month for just me with a $10K deductible (we had insurance on my son thru college as it was much cheaper). No copays for doc visits, everything out of pocket.

They had me over a barrel for picking the wrong parents. Everyone gets older and the machinery starts breaking down. Some people are just unlucky.

Just because he gets his coverage through a different means than you may doesn't mean he doesn't know how it works, what the flaws are, etc.....so that's not really a fair accusation.

Our system is seriously flawed.

My opinion is everyone should be provided with a government catastrophic plan only fund by a national sales tax (everyone contributes who spends money here).

I WAS very CLEAR when I wrote THAT I DIDN'T give THE matter MUCH thought.

I DID not SAY what YOU imagined IN quotations, so I can't SPEAK to FINES nor WHETHER the ACCOUNTANT is A he OR she.

To your question. "So, do you plan to just keep paying the fee/fine for not having it then?"

Yes, It is working out very well. I haven't given it much thought but I've noticed that saving two grand a month for all these months has really added up.

Some people on this board earn just $200 dollars a month from a rental home. Saving two grand a month is like owning ten of those houses.

Maybe in a month or two insurance prices will fall and I'll buy a policy then.

Maybe not.

Actually, since pre-existing conditions are now covered, your plan might make more sense. You could always just pay the fine and save the premiums and wait until something really bad happens (cancer/whatever). THEN you can buy insurance after the fact, right?

As long as you can get it in place in time to get treatment, then that could work.

Still seems like a big gamble though. If you find out you have cancer in between the enrollment periods, you could be paying hundreds of thousands out of pocket (or just not getting treatment).

That seems like a big gamble to me, I guess. If you have hundreds of thousands in reserve for "just in case", then I guess it might be worth the gamble. For people without those kinds of cancer-medication-level reserves though, just paying the fine to save $1-$2k/month might not be worth the risk.

Again, that's the whole point of insurance -- paying now for the gamble in case things don't go right...

- John...

Some tort law reform might help control the cost of medical coverage. If someone goes to school for 14 extra years to become a doc, I don't think they are doing it to intentionally make mistakes.