Some Facts: I live in MA. I’m a Biz Owner/Entrepreneur. My Health Insurance Premium Went Down. I Received a Rebate.


File this under ‘other stuff’ but I feel compelled to comment on this.  I am a small business owner/entrepreneur and have been paying my own insurance bill since the 90’s.  I am registered independent and like to think I vote the issues and not the party.  Is it difficult to educate oneself on all of them.  You bet.  Do I try and pick a few that resonate with me and learn more, yes.  And do I sometimes identify more with a party because I hope they are aligned with my ideals and will vote accordingly, well not usually, I seem to be a contrarian by nature.  However, health care effects every one.  I just wanted to point out my experience with the system here in MA.  We have something here called the health connecter and it allows individuals, families, etc. to find and price out all different levels of health care.  I’m a fan of a high deductible PPO, that is pocket the money you would pay if you were in a first dollar coverage plan for a rainy day, or to build a ‘savings’ account that would cover the deductible, and if you are relatively healthy you can continue to pocket the difference, if you need, it’s there to cover you.  Unfortunately, over the last couple of years we ran right into that deductible because of health issue that effects too many, the ‘C’ word.   However, we were covered.  And while I thought that we would get bumped into a high risk coverage pool or somehow our premiums might balloon.  Imagine this, my annual premium went down this year, and I received a rebate because in Massachusetts, Insurance companies must spend 88% of premiums on health care, and mine did not, hence, rebate.

As a business owner I am a bit skeptical of any government state or federal mandating something, and when I look at the mandate to spend 88% of my premium it gives me pause, however, weren’t these companies essentially set up to achieve economies of scale and release doctors of the burden of the paperwork, back office, etc. so if essentially they are a pass through, and a non-profit at that, it starts to make more sense.

What happened if I wasn’t covered.  While it’s been awhile to pull on my economics minor from under grad, here’s my take.  We pay out of pocket for the mammogram and subsequent testing.  If I could not afford it, do we let the disease fester?  It gets worse and we enter the health care system in worse shape requiring emergency room visits, and acute medical care that is far more expensive?  And if we could not pay for that, and the care, that ‘loss’ gets passed on to paying customers anyway in the from of higher premiums to cover the imbalance of ‘paying’ customers and ‘non-paying’.  Fact is, if people use the emergency room for medical care it is far more expensive than a visit to a doctor’s office, however, in the emergency room they are legally bound not to turn anyone away, so who pays for it?  The people who are already paying.  Is it too much to ask that everyone should pay?  is the real argument should it be at the state or federal level?  The fact that one party cloaks as a ‘freedom’ issue seems to be specious at best.  The government mandates a whole load of stuff for the public’s health, clean air, clean water, seat belt laws, anti-dumping, etc. so for me that doesn’t hold water.

The Republican Party when it seemed to stand for fiscal prudence was one I could get more behind, and in fact, the individual mandate which I am sure many of you know, was originally a Republican idea, but now, somehow it’s toxic.  It was proposed by Stuart Butler  from The Heritage Foundation in ‘Assuring Affordable Health Care for All Americans.” and it was also taken up by Bob Dole during his presidential run as an anti dote to the Clinton administration first crack at universal health care.  Whatever happened to Republicans coming up with something seemingly better, or even a different plan, than at least we can start an argument that A) Health Care Good and B) We look at it differently but how do we come up with a plan so all of us can get to A).  I have to imagine every American is sick of this, lousy pun not entirely intended. So if we are sick and tired of this let’s just cut off all their funding, hello tea party.

However, the fact remains is that everyone who does already pay into the health care system is picking up the slack for everyone else who doesn’t and so the health care providers would simply charge high and higher premiums, so does it not make sense to have more people paying in the system, have more preventive care, than acute care?  Well, at least for this sample of one, it does.  My premiums went down for the first time ever.  That’s either a miracle or a better system than the previous one, or probably a bit of both.

Update 1:

There is an excellent article in Forbes, I should have referenced earlier.  In it there are rebuttals of the individual mandate and The Heritage Foundation as well as, Stuart Butler running as far and fast away from the individual mandate as possible.

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