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will work for health insurance
By | April 12, 2009
my kids, like a lot of people, have precarious jobs with tenuous health insurance. so i am always reading the economic news. there have been a bunch of recent stories about the changing (worsening) health care environment. i take it personally! here is some news from the front lines of the economic collapse:
first of all, as you know, a lot of folks do not have health insurance. One in six adults and one in seven children in Oregon do not have health insurance, according to a February report from the Office for Oregon Health and Policy Research.
and a lot of folks only have insurance some of the time. About one in three Oregonians younger than age 65 has gone without health insurance for at least a portion of the last two years, according to a new report from Families USA… 75.8 percent – more than three out of every four – were uninsured for at least six months.
on-again, off-again insurance, and changes in insurance, make it hard to manage health care: Ellen Pinney, director of the Oregon Health Action Campaign, refers to it as “churning,” when people move in and out of the health care system based on their inability to get – or to afford – insurance for months at a time… “One-third of Oregonians are churning. They do not have the ability to establish a relationship with a provider.”
most folks’ insurance is tied to their job, and you know what’s happening with jobs these days… As of February, an estimated 3.7 million working-age Americans… had lost their health insurance since the start of the economic decline, according to a recent report.
even those with stable health insurance can have a hard time finding a doctor: The number of Americans who are “medically disenfranchised” because they lack access to primary care physicians increased by 4 million between 2007 and 2009 to 60 million, according to “Primary Care Access: An Essential Building Block of Health Reform.” That study was released March 24 by the National Assn. of Community Health Centers.
so as you can imagine… Millions of Americans suffering from at least one chronic health problem are putting off care, not taking needed medications, and resigning themselves to feelings of isolation and depression. So reveals a new poll commissioned by the National Council on Aging… With the economy in recession and many Americans losing their employer-based health insurance, the problem may only get worse.
…Those who have put off care suffer the consequences: 45 percent are “always” or “frequently” in pain (vs. 28 percent of those who sought prompt care), while 49 percent were always or frequently tired (vs. 28 percent of their counterparts) and 40 percent were stressed (vs. 17 percent of those getting care)… One-quarter of those with jobs reported having had to miss work due to health concerns.
i’m sure you recall that, at the end of 2008, half of u.s. hospitals were operating in the red – and that report didn’t even include the rush of jobs out of the u.s. and/or out of history. well, now “Databank, which collects statistics from 658 hospitals, reported a decline in overall patient visits in the fourth quarter, compared with the same period last year. There were drops in inpatient surgeries (2.2 percent), ambulatory surgery visits (1 percent) and emergency visits (2.8 percent).”
Dentists, too, say patients are postponing care. When that happens, “small problems end up becoming big problems,” said Dr. Mustafa Shah-Khan, who owns a dental practice in Charlotte. “An out-of-pocket (bill) that would have been $200 ends up being a $3,000 problem.” Instead of paying for crowns and root canals, two or three of Shah-Khan’s patients have chosen to have teeth pulled.
even drug companies are feeling the pain. Sales growth of prescription drugs in the U.S. slowed for the second straight year, with the economic downturn playing a key role, according to IMS Health Inc.
i know you already did your taxes (right?), but did you take all your medical deductions? Most people skip the tax deduction for medical expenses because the threshold to qualify for it is so steep, but if you or your spouse lost a job… it might be worth digging out those health-care bills… Total all your medical expenses and subtract 7.5% of your adjusted gross income (line 38 on Form 1040). Any amount remaining is deductible on Schedule A…
[including] Hearing aids, eyeglasses,
contact lenses, contact lens cleaning solutions,
root canals/crowns,
special education fees for an autistic child…
In vitro fertilization and surgeries to enhance fertility…
Costs of an abortion, acupuncture… Treatment received
from a Christian Science practitioner.
Newly eligible for deduction this year are charges for
annual physical examinations,
a full-body electronic scan
and pregnancy test kits…
Travel expenses to and from exams and treatment
also are deductible, ranging from taxi, bus and train fares
to the use of your own car, including tolls and parking fees…
Hospital meals and lodging…
Transportation and entry fees… for attending a medical
conference related to the chronic illness of you, your spouse,
your child or another qualifying family member…
Medical, dental and vision insurance costs are deductible…
and premiums for Medicare supplemental insurance policies
and Medicare B, C and D coverage.
Insurance co-payments and deductibles are eligible. woah!
a final note: post-boomers, beware:
A recent survey showed a large portion of Generation-X is not fully prepared for the effects of long-term health care… More than half (52 percent) of the people surveyed born between 1960 and 1980 fell either partially or completely unprepared for the financial burden of long-term health care. Another concern for this group is the immediate need for affordable medical insurance… “Many Generation-X people understand the need for quality and affordable health coverage; however, they tend to underestimate the actual costs of long-term health care and individual medical coverage,” said Tom Carolan, Director of Client Services at BestHealthcareRates.com. When surveyed, half of the respondents thought that annual nursing home stays cost between $20,000 and $60,000 a year, when in reality, the national average annual cost of a nursing home stay is over $75,000.
…In order to handle the costs for long-term health care, 36% cited they would depend on government assistance, such as Medicaid, to provide long-term care. The majority of these people do not realize that Medicaid can offer some support; but in most cases, the people have to spend their life savings to the point of poverty before assistance becomes truly effective.
take-home messages?
one is that preventive care and early treatment (dental work, women’s exams, shots, blood pressure control, etc.) really are preventive, and save time, money, and heartache in the long run. it’s like changing the oil in your car – you don’t wait until you see the smoke!
another is the logical extension of “an apple a day keeps the doctor away”: quitting smoking, exercising, losing weight, stress management, enough sleep and a healthy diet, can reduce doctor bills to the bare minimum. this is like driving the speed limit and using your turn signal before you change lanes, even if you secretly want to live in the fast lane.
and the last one is my favorite, and one we always forget when times are tough: health insurance is not the same as health care! everybody needs a personal doctor who knows them well, who’ll teach them what they need to know, and who’s available… and everybody also needs their grownup shots, their birth control, a dentist, and the ability to get mental health care, a new pair of glasses, dentures, a hearing aid… all things currently regarded as fripperies.
it’s like having comprehensive car insurance that will fix scratches and dents as well as giant disasters, replace stolen stuff like your car stereo or trailer hitch, jump your battery or fill your tank if you get stuck, and cover you temporarily if you lose your job or become disabled.
it’s the kind of coverage that, once upon a time, everybody expected, and that still is enjoyed by everybody else in the western world. it’s what i want for my kids!
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