Do you have health insurance right now? If so, who pays for it and how much does it cost you? If not, why not?

Health care and insurance is a mess here in the U.S. So while I normally avoid politics like the plague here, I’m interested in what might change in the U.S. healthcare-wise depending on who gets elected. It directly affects my pocketbook. But before we can talk about what might change, I wonder what things are like now for people. (If you’re outside the U.S., I’m interested in your experiences too.)

Over the years I’ve had no coverage, minimal coverage (student health center only), full coverage, catastrophic coverage, and now I’m back to full coverage. I’ve had HMOs, PPOs, and done private pay. I’ve had my doctors assigned to me, and I’ve gotten to choose my doctors. (While paying extra for the privilege.) I’ve had doctors who got me in the same day (sometimes the same hour) and doctors that I had to wait months to see. I’ve had claims pre-approved and then denied despite pre-approval. I’ve had to argue with insurance companies to get payment. I’ve had providers who told me, hey, pay whatever you can afford and we’ll accept that as payment in full, because it doesn’t look like the insurance is ever going to pay. I’ve had doctors say that they could no longer see me unless I wanted to do private pay because they no longer took my insurance (or because I lost coverage.)

The one thing all the policies that I’ve had have in common is that they’ve all been expensive and full of exclusions. They’ve been expensive up front, and then even more expensive if I actually had to use them. Still, they were all a lot better than nothing. I discovered that having ANY insurance at all gets you a discount from medical providers, while having no insurance means you pay full price.

So what about the future?

If Obama wins and gets his policies enacted, it sounds as though things will pretty much continue as-is, with the exception that people without coverage now will be eligible for the same insurance that federal employees are. What do federal employees pay for their insurance, does anyone know? As-is is not the greatest, but at least additional people could be covered, which is an improvement. But what about the people who can’t afford whatever federal employees pay?

If McCain wins and gets his policies enacted, it sounds as though there will be some major changes. People with employer-provided health insurance will be taxed on it as income. Right now I pay $80 per month for my share of my employer-provided health insurance. I’m going to guess wildly and say that that’s probably 1/3 of the actual cost of my plan. (And I have a high-deductible plan.) So say $240 per month just for my own coverage. That’ll bump my taxable income up by $2880. Well if just my insurance alone is $2880, what about my husband’s and my son’s coverage? What about families of more than 3? There is the $5000 credit per family or $2500 for individuals, which I am completely and utterly confused about. Here is what the McCain site says about it: “While still having the option of employer-based coverage, every family will receive a direct refundable tax credit – effectively cash – of $2,500 for individuals and $5,000 for families to offset the cost of insurance. Families will be able to choose the insurance provider that suits them best and the money would be sent directly to the insurance provider.” It then goes on to link to something even more confusing. I can’t tell what they’re proposing. But I do wonder how a tax credit will help people that can’t afford health insurance now. They have to come up with the money FIRST. That’s how credits work. First you pay, then you get it back.

What do you think?