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expat99

US Health insurance & Pension Problems

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Pam, I agree with a lot of what you say, but would suggest you rethink part of it as well: You said, in part, "........people with cell phones, cars and internet who ........... could function or have a job without these items in a 21st century society that depends upon technology and mobility to function....?" I do not believe that any of those items is necessary now, or ever was, in order to make a living. I may have had all three, but that was only because I wanted to have all three. I could have found work without a cell phone, and I could have gotten back and forth to work without a car, and without internet. So could you....it is all a matter of where you live, and how you want to live.

 

AG, I don't know what kind of work you used to do, but unless you are confined to an office cubicle, a cell phone is almost a requirement now in the workplace if any part of your job takes you outside the confines of the office. Same goes for the internet or the interoffice intranet. This has also become indispensable. As for cars, I got around well enough in the SF Bay Area to do without one. If needed, could always rent one.

 

I also have trouble with your report of someone who reportedly was refused medical insurance because they had a history of the removal of a corn....can you please cite for us exactly where we can find the NY Times article to which you make reference?

Another thing about health insurance in the states, and its availability: You know, during my working life, whenever I was out there looking for a job (on foot, if necessary, or by bus, etc.) one of the things that I always looked for was the availability of health insurance. I always had the option of accepting only positions that offered such, or refusing to apply for positions that did not offer such. So did every other working stiff I ever met.

 

I don't know about the NYT article, but I did know someone denied health insurance at their job because of a minor "pre-existing condition" - They had had a bad sunburn when a child. Now the nice insurance company did offer them a policy that excluded anything that might involve skin cancer, but they still wanted a much higher premium, just in case.

 

As for the option of choosing a job offering health insurance (HI) vs one that doesn't, well, good luck with that, even companies that do offer HI now don't or very rarely pay all or even part of your premiums now. At my last job, at first it was 100%, then as the premiums went up every year, it dropped to 80%, then 70%, then 60%, you get the idea. Oh, and by the time I left, my 50% was almost as much as the entire first premiums had cost my employer when I started with the company. In another couple of years we wouldn't have even been able to afford ANY insurance.

 

So I am glad you had the choices & options available to you back in the Good Old Days, but a lot of those choices & options just are not there anymore for those now entering the workplace, or whats left of it that hasn't been "Off-shored". Just ask my niece.

 

Dana J

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Pam, I agree with a lot of what you say, but would suggest you rethink part of it as well: You said, in part, "........people with cell phones, cars and internet who ........... could function or have a job without these items in a 21st century society that depends upon technology and mobility to function....?" I do not believe that any of those items is necessary now, or ever was, in order to make a living. I may have had all three, but that was only because I wanted to have all three. I could have found work without a cell phone, and I could have gotten back and forth to work without a car, and without internet. So could you....it is all a matter of where you live, and how you want to live. This reminds me of an argument that I used to have with one or more of my kids. It would go like this:

Me - get out and find a job!

Him - I can't look for work without a car (whining)

Me - you can't buy a car unless you find a job to pay for it! That's how I got my first car! I had a job, and then, I bought a car!

Him - No, you have to buy me a car, so I can go look for a job (more whining)

Me - Well, I guess you're going to be living in the streets pretty soon, 'cause I not only cannot afford to buy you a car, but I flat refuse to buy you a car!

and, so on...........I also have trouble with your report of someone who reportedly was refused medical insurance because they had a history of the removal of a corn....can you please cite for us exactly where we can find the NY Times article to which you make reference?

Another thing about health insurance in the states, and its availability: You know, during my working life, whenever I was out there looking for a job (on foot, if necessary, or by bus, etc.) one of the things that I always looked for was the availability of health insurance. I always had the option of accepting only positions that offered such, or refusing to apply for positions that did not offer such. So did every other working stiff I ever met.

Arenal Grumbler , both my husband and I were raised with your same work ethic. We worked our tails off from an early age. And there was always work if you were willing to do it. As Dana J explained so accurately and so well the times have changed . It's not so simple anymore. We don't all have the opportunity to work for an employer who is willing or able to furnish affordable policies. Those same policies often result in inadquate coverage leaving many patients destitute anyway. I know many such individuals. It's scary out there. Before he retired my husband was a custom cabinet maker. It would have been absolutely impossible for him to do business in this day and age without a cell phone , the internet or adequate transportation. If he had chosen to forego having any of the above we would have had zero clientel. One can't function like a dinosaur and even hope to compete in the 21st Century work place. This isn't a matter of one's work ethic or lack thereof it's a matter of being equipped to survive. Even a teen ager , as spoiled and naieve as they may be knows what it takes to survive now. The good ole' days of simply " bringing home the bacon " are long gone. And in fact I'm grateful to be retired. In retrospect I realize that the challenges today's working people face are far more complex and stressful than what we had to cope with. To be honest I found the NY Times article on Google news earlier in the week and didn't make a note of the author's name or date of publication. If I had a paper copy of the NY Times , which I'd prefer to the internet, I could retrieve that information for you. But rest assured , I did not fabricate that story or embellish it in any way ! The scenario she described is woefully common place. As a health care refugee from the states I know how credible it is. Like many refugees , political or otherwise , I resent not being able to return to my own country if I should choose to do so. It's out of the question unless or until some kind of humane health care reform is up and running before I die. And that's that. Though I'm still a firm believer in the work ethic it takes alot more than that to survive now.

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For Pam, I thought we were talking about health insurance and necessities for employees, but you are referring to a need for a private business person, your husband. His need for and use of cell phone and internet services were costs of doing business, not something required by an employer. He had the option to deduct those costs of doing business from his taxes, and that is an unfair comparison, by anyone’s standards.

 

I really cannot address these issues that you have pointed out about people being turned down for insurance, but from the descriptions I saw in my Google search, there was something else missing. You see, as a Nurse, but also as a responsible head of household, I considered it important that my family have a primary care physician. What I tried to teach my patients over the years, and what most health care providers also teach is that it is not enough to say you have a family doctor, but each family member should see that doctor at least once a year for routine checkups. What I sensed in my Google search, and what I have heard, over and over, when people get turned down, or are told they have to pay extra for certain health care insurance, is that too many people have neglected to do this, and it was not always due to the high cost of that doctor visit, but to a mistaken belief that they could not afford that annual doctor visit. I haven’t seen these turned down folks insurance applications, but I bet you there was more involved than just a history of a corn being removed. I bet you there was a clear neglect of care going back many years, which increases the chances that this is a person who might well have health issues as a result.

 

For expat, which ‘lavish state pensions’ are you referring to, anyway? What state? Do you not realize that state pensions, and other government pensions are not funded solely by the given state’s annual budget? The portion of an annual budget that goes toward pensions and benefits is the normal cost of doing business for any large organization, and is just that: a portion. As for Medicare, it really doesn’t apply to me, or to most of us who have moved here, because we do not receive any benefit from it. But, meanwhile, just like with Social Security, please do not forget that we paid into both of those programs all of our working lives (or, at least since its inception, for Medicare). I grant you that both programs have provided too much to too many who never paid into them, but I can’t control that. I do know that I should be entitled to certain Medicare benefits, but I will never collect them, since I choose to live here.

 

But, I am more confused by your statement about education. “The adults in the system” are happy with what system? What, exactly is the ‘deal’ that they have? Who are these adults? Are you saying that teachers don’t deserve their pensions? Are you also not aware that teachers, across most of the U. S. are not eligible for Social Security, simply because they pay into their own retirement program? That’s right. They pay into the program. Not you. Not me. The teachers themselves fund their retirement (with a small matching contribution from their individual school districts, just as with any other pension program). Ultimately, I think you need to familiarize yourself better with just how these pension programs work, before you tell me that I need to accept less than what I contributed, or that my wife, a retired teacher, should do the same. I am one of the first to complain – loudly – about government waste, but employee pensions are not the culprit you seem to think.

I certainly don't wish to be argumentative here. You'll note that my posts don't address the pension issues but rather health insurance issues. In that , the former context , I see nothing unfair about my comments as they pertain to health insurance at large or their important relevance to " main street " America , small business owners and the self employed. They have an equal stake in the current crisis as do those who are not self employed. I'm well aware that there are many who abuse the health care system or fail to take responsibility for their own health. As a nurse you've seen enough of that I'm sure. There are however many people like my husband and myself who have always had a primary care physician, with or wothout health insurance coverage , and who have always considered any threat to our health a threat to our ability to earn a living. We have always promptly paid a visit to our physician or a specialist to nip any ailment in the bud or keep it under control as best we can.The cost was money well spent in light of an ailment's threat to our earning power and also because the idea of living " on the dole " and not being personally productive was abhorrant to us. There are still those of us who live by those values and there are currently amongst us many who for one reason or another have been denied access to health care for no fault of our own. My horror stories are too personal and too traumatic to revisit in a public forum but you can be assured that we exhausted every alternative to care for ourselves before coming to the stark realization that we would have exhausted every cent we worked so hard for and considerably more just to stay alive. Hence we realized that though CR's health care system is far from perfect it would work for us.

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Come on, Dana......if your employer requires that you use either the internet or a cell phone in connection with your job, then the cost of those things must be borne by the employer, not by you, the employee! Not knowing the particulars of either of the two cases now having been cited as denial of insurance due to pre-existing conditions, I can only say, show me the articles, show me the data.....had to have been more to it than sunburn......

Oh, now AG, you are just quibbling. Sure, the big law firm I used to work for in SF provided and paid for a cell if it was needed.

But I knew a few people in Sonoma Co. (real estate) that HAD to have a phone, but the firm only reimbursed them for business related callson their own phone. Which meant that each month they had to go thru their bill line by line and itemize each call and submit the list for reimbursement. What a pain. Many didn't even bother...

 

As for the sunburn, she showed me the letter from the insurance company! What more do you need? And she don't know how they found out this piece of ancient history either, which was what surprised her, because she had completely forgotten about it.

 

DJ :huh:

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nyone’s standards.[/size]

 

I really cannot address these issues that you have pointed out about people being turned down for insurance, but from the descriptions I saw in my Google search, there was something else missing. You see, as a Nurse, but also as a responsible head of household, I considered it important that my family have a primary care physician. What I tried to teach my patients over the years, and what most health care providers also teach is that it is not enough to say you have a family doctor, but each family member should see that doctor at least once a year for routine checkups. What I sensed in my Google search, and what I have heard, over and over, when people get turned down, or are told they have to pay extra for certain health care insurance, is that too many people have neglected to do this, and it was not always due to the high cost of that doctor visit, but to a mistaken belief that they could not afford that annual doctor visit. I haven’t seen these turned down folks insurance applications, but I bet you there was more involved than just a history of a corn being removed. I bet you there was a clear neglect of care going back many years, which increases the chances that this is a person who might well have health issues as a result.

 

Again, AG, you seem to be out of touch with the "Normal" daily work world, where many professional and non-professional people work long days, and just don't have the time to visit a Dr. on a regular basis, but only do so when they are feeling sick.

A lot of the people I knew & worked with USED to see the PCP once a year for a basic health check up. But in a lot of corporations now sick & vacation days have been rolled into a singular "Paid Time Off", with of course a reduction in the total number of days allotted for such time off. So most people refuse to take time off for sickness, and instead come into the workplace while ill (after all, its only the Flu, right?) so as to save their time off for vacation. This is a common place occurrence in almost all current businesses, from the F-500 to the little 5 person office.

Plus of course, every time you see the Dr., this gets entered into your medical history and will eventually get reported to the insurance company. Ever hear of the Medical Information Bureau?

So this also leads to increased insurance premiums. Of course, using your logic, a nurse working for such insurance company will look at your file and say that you haven't seen the Dr. enough, so you have the potential of getting sick, so they should raise your premiums. And it goes round, & round again....

 

Dana :huh:

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Dana, as you said, it was their choice. Personally, I can assure that if any employer of mine ever required me to use something of my own in connection with my job, they paid for it, and I was more than willing to use company time to make sure that happened. And, as I said, there had to be more to your friend's being turned down for insurance than simple sunburn.....but, didn't you say originally that the insurance company wanted to simply exclude coverage for skin cancers, or something? That doesn't mean she was turned down completely, now does it?

And, why couldn't she go to another insurance company?

 

Really, you ask "why she couldn't go to another" co? You do know that they share information, don't you? You have heard of the Medical Information Bureau (MIB), haven't you? Its an medical information clearing house where all your info is shared between insurers. Ever read the 'fine print' on the back of an application? It gives them permission to share all info provided to the MIB, and for them to get any info they want from the MIB. If you refuse to authorize this, your application will be denied.

And I didn't say she had been turned down completely, but with the "requested" higher premium, they might just as well have, as she could barely afford it.

If she hadn't died, she would not have been able to afford it in a few years anyway.

Are you sure you weren't a nurse working for an insurance co denying claims? Sure sounds line one to me.

 

DJ

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As far as 'lavish' pensions bankrupting the states goes, the problem is not the pensions per se, but how the states have funded them, or failed to fund them. I work for the state of Arizona. Our pension fund is over 98% funded even though we have one of the worst budget situations in the country. The reason for this is that state law mandates the pension be funded and re-adjusts the contribution amount of the employees and the state semi-annually to account for what the fund is earning. Oh, and the state government CANNOT touch any money in the fund. Ever. The problem isn't greedy employees, it is that many states have simply failed to fund their pension obligations for many many YEARS, and, now that the bill is coming due. they are trying to blame the employees. In my opinion it is obscene to blame state employees for the financial mis-management of their respective legislatures. BTW, Arizona's annual contribution to the pension fund is relatively trivial and is easily met even in this environment. It is only when the funds are left underfunded for years that they become 'budget busters'.

 

Social Security is almost exactly the same. The ONLY reason it is currently under-funded is because the federal government has been 'borrowing' from the trust fund for decades to offset the deficit. Now the baby-boomers are retiring and the situation is not good because we have been spending money that was supposed to be committed to the retirees. It is financial irresponsibility that has gotten us where we are, not excessive pensions.

 

Healthcare, including Medicare, is a whole other ball of wax.

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[some states really are going bankrupt. Unfortunately too many States have indeed overpromised benefits,...

 

Yes, they are, but not because of this year's pension obligations, or last year's, or the year before's. Their pension funds have now put them into a deep financial hole because they refused to properly fund them even when times were good and state coffers were full. Now that babyboomers are retiring and the states are being asked to pay what they promised to pay, they are in deep *&$#. What is unconscionable is that they are blaming their employees because the states have failed to plan for their obligations. This is not news. All of these states have been aware that the bill was coming due for a long time. If I were cynical, I would assume that they probably even intended to meet their obligations to begin with.

 

If we make an agreement that you pay me $100 a month for 20 years and then I'll pay you $200 a month until you die, and then I take your $100 dollars to pay for my groceries, its my fault there's no money to pay you, not yours.

Edited by induna

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Arenalgrumbler

 

Is what you did and what I am persently doing sounds alot alike. Were you in Case Management? I provide all sort of services for people at no charge to them. Free. free, free they do not keep appointments for free and will not take free medicines often. They will complain that they had to wait and threaten legal action. No matter the problem started 5 years ago it must be resolved now for free.

 

Ed

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