US Healthcare and deciding to move to the UK

How expensive is health insurance in the US?

The Aetna coverage provided by my husband's employer cost us around $150 a month to provide coverage for both of us.  Not bad.  But there was an individual deductible of $800 and a family deductible of $1500 - meaning they paid nothing until these limits had been spent.  After that, the coverage was 80/20 - meaning the insurance company paid 80% of charges and we paid the remaining 20% up to an "out of pocket" limit of $5000.00.

So essentially we were paying $150 per month for the opportunity to pay out at least $5000 in debt if we required a major procedure.

There was also a doctor's co-pay - we paid $20 if we went to the doctor for a checkup.

Prescription drugs were covered - generics were free and other medicines were either $40 or $60 for a three month supply, depending on whether the drugs were considered 'formulary' or 'non forumulary' by the insurance company.  We were paying about $120 every 3 months for my husband prescriptions.  The retail cost of these drugs is approximately $2000.

When my husband lost his job, his employer sent him a COBRA statement.  If we wanted to continue on the company's insurance coverage for 18 months, the cost of the premiums would go from $150 per month to $900.

When I lived in NY and worked for a big bad bank, I had amazing insurance: no deductable, $10 co-pay, could go to out-of-network doctors, and didn't need specialist referrals. Heaven, in other words. I needed surgery at one point, and for the whole shebang, with hospitalization, I was out around $700. And it cost me about  $46 a month in premiums.

Once I left that job and went on COBRA, I paid $687-a-month for it. And that's group rate. For one person.

ETA: And here's a thing I usually throw in the teeth of those idiots who call me a socialist commie bastard for being pro-health reform, when I get told I want something for nothing: even though I know most people are not in a position to do so, I'd even be willing to pay that much but I can't find insurance like that on the individual market in NY for anything under twice that in monthly premiums.

My sister has pre-existing heart condition so my mom pays right around $1000 in PREMIUMS ONLY per month.  Additional prescription, co-pays, etc on top of this.

My health insurance is essentially Blue Cross and costs me $31.85 (pre-tax) per paycheck (every two weeks) for myself alone.  Another $7.38 per check for Delta Dental (mega savings with my teeth!)  With this plan I have to use the University Health Services but can choose my primary care physician.  Cost $15 co-payment per visit.  Besides an annual checkup and bloodwork, I've been getting an annual mamm. plus clinical exam by a surgeon.  Have also had physio for sciatica, eye exams, etc.  Have had biopsy done at local hospital which was also covered.  We also get reductions on massage therapy and other "alternative" stuff.  And the ful shots are free.  I can't remember what the co-pay for hospitalization is, as I've never had to use it and now have Medicare for that.
I think the NHS is excellent for young people.  They really pull out all the stops especially for anything really major.  But I fear once you're over the hill they expect you to just molder away.  Case in point, DH is still waiting for his hernia op.  They say it "may" be Sept. or Oct. now and he first saw the GP back in January!  OK, its not life-threatening but its bloody uncomfortable and he spends most of his time lying flat.

We have Kaiser Permanente here. It's the cheapest plan on the government's list of providers. Guess Obama and Congress all have the top one!

So far we are pleased. The children have no co-pays with the pediatrician, only specialists. And somehow we didn't pay anything for the outpatient procedure DS had. Prescips are $5. We have seen some of the top docs in pediatric GI issues at the University of Maryland (on referral). We could also have been referred to Johns Hopkins.

BUT this year we are lucky. DH is a post-doc and this year his office found a large chunk of money to help pay the out-of-pocket cost that employers have to contribute to the plan. (I think it's 80/20 but not sure). Next year we may be responsible for the whole chunk and if I don't find a job by then, we will not be able to afford it.

The stress is getting to me about it as DS's issues are not resolved yet. The state of Maryland has excellent care for low-income folks, but I suspect we'll be earning too much for that, yet not enough for anything else.

We have Kaiser Permanente here.

The boys and I had Kaiser, (they denied DH because he has a puffer-thingy used to prevent asthma  ) and we were paying about $600 per month PLUS my husband's $250 per month for Carefirst.

We've since all moved to Carefirst, and are now paying less monthly than Kaiser, but have to pay out the nose for prescriptions and co-pays. Plus, every year the premium goes up, and this year it went up by $130 per month!

Kaiser reminded me a lot of the NHS.

In Ireland, healthcare is not connected to your employer. If you make over a certain amount of money, you're required to pay for your healthcare. If you don't make that amount, you are eligible for the national health plan. We pay a private company for our insurance and there are a few companies that we can choose from. For the two of us, we pay about 1200 euro for the year, so that's about $2000 I guess? There are lots of plan options to choose from and we certainly don't have the cheapest. So far I've been quite happy with the service I've received, more so than what I had on the NHS and I'd say that was adequate.

DH and I have been discussing what to do when his contract is up next year and moving back to the UK is an option. However, the wages are so low there (compared to Ireland and the US) that we couldn't even justify it by saying we wouldn't have the cost of healthcare to deal with. I wouldn't be concerned about moving to the US on my own (I had a great experience with the government's Aetna plan), but DH has asthma and uses an inhaler which makes me a little nervous.

Dear Barack Obama - Please take the responsibility of healthcare out of the hands of the employer and offer a selection of affordable healthcare for your citizens that don't allow an insurance company to deny coverage based on pre-existing conditions.

I think what bmore describes is what I'd like to see the US healthcare be like. I'd rather that kind of system than the NHS.

I think what bmore describes is what I'd like to see the US healthcare be like. I'd rather that kind of system than the NHS.

Yeah.

In Ireland, healthcare is not connected to your employer. If you make over a certain amount of money, you're required to pay for your healthcare.

Whether or not it's a good plan would depend upon the threshold at which you are required to pay for your healthcare and the cost of health insurance.

One of the problems with the current US system is that many of the people who are deemed "too wealthy" to be entitled to government-provided health care cannot afford to pay for their own medical care or to pay for health insurance.

The threshold would have to be set so that someone deemed too rich for goverment health care would have to have enough money able to pay for regular living expenses plus health insurance premiums.

Whether or not it's a good plan would depend upon the threshold at which you are required to pay for your healthcare and the cost of health insurance.

One of the problems with the current US system is that many of the people who are deemed "too wealthy" to be entitled to government-provided health care cannot afford to pay for their own medical care or to pay for health insurance.

The threshold would have to be set so that someone deemed too rich for goverment health care would have to have enough money able to pay for regular living expenses plus health insurance premiums.

http://www.hse.ie/eng/Find_a_Service/entitlements/Medical_Cards/

Medical Cards

Medical Cards allow people to access Family Doctor or GP services, community health services, dental services, prescription medicine costs, hospital care and a range of other benefits free of charge.

Most people who get a Medical Card do so because their income is below a certain level. It is also possible to get a Medical Card if the costs of meeting your medical needs causes you financial hardship, or if you have entitlement under EU regulations.

Medical Cards are issued by the HSE's 32 Local Health Offices nationwide, and these offices also accept and carry out the assessment of your application.

For Medical Card Applications, the HSE only considers your income after tax and PRSI is deducted, rather than total income.  We also make allowances for expenses on childcare, on rent and mortgage costs and on travel to work.

In another part of the website, it states that 30% of the population receives medical cards (free healthcare). The link doesn't tell you the amount you need to make, you have to apply for the card and they'll tell you if you're eligible. Apparently, people over the age of 70 used to be automatically eligible for a medical card, but that's been changed to a means test. Now the 70 year old must make less than 700 euro per week and if it's a couple they must make less than 1400 euro.

And if the US government looked to dealing with uninsured people who become very ill, instead of trying to cobble together a complete US version of the NHS, we could whittle down the problem to something everyone could agree on.

No one is trying to cobble together anything that even looks remotely like the NHS. It's simply not on the agenda and it never will be: unlike the UK, the provision of medical services will always be private in the US even if they are at least partly paid for by the public (a la Medicare). As to whittling down the problem, well we can see from some tragic situations described in this very thread that the problem isn't just about the uninsured who become very sick. 75% of people who end up declaring bankruptcy because of medical bills had insurance when they first got sick; many had insurance when they declared bankruptcy!

No one is trying to cobble together anything that even looks remotely like the NHS. It's simply not on the agenda and it never will be: unlike the UK, the provision of medical services will always be private in the US even if they are at least partly paid for by the public (a la Medicare). As to whittling down the problem, well we can see from some tragic situations described in this very thread that the problem isn't just about the uninsured who become very sick. 75% of people who end up declaring bankruptcy because of medical bills had insurance when they first got sick; many had insurance when they declared bankruptcy!

You want to read about some real horrorshow? Try googling "rescission." If after reading that anyone still thinks US insurance is not in need of some serious overhaul, they're probably living "Just World" theory and don't think it can happen to them. Deluded, in other words.

No one is trying to cobble together anything that even looks remotely like the NHS. It's simply not on the agenda and it never will be: unlike the UK, the provision of medical services will always be private in the US even if they are at least partly paid for by the public (a la Medicare). As to whittling down the problem, well we can see from some tragic situations described in this very thread that the problem isn't just about the uninsured who become very sick. 75% of people who end up declaring bankruptcy because of medical bills had insurance when they first got sick; many had insurance when they declared bankruptcy!

The current bill, without changes, would likely drive private insurance out of business in short order. If government becomes the sole payer of medical bills -- if the even  services themselves were provided by nominally private medical facilities -- it is a defacto national health service of the kind most Americans want no part of.

As for the rest...yes, thanks, you've dropped that statistic into the thread once already. Change "uninsured" to "uninsured and underinsured" and my point stands. No-one is arguing that the current system is working. Just that all change isn't necessarily improvement.

The current bill, without changes, would likely drive private insurance out of business in short order.

I don't buy it. The only way private insurers will be driven out of the market is if they don't reform their unconscionable practices. It's not like the USPS has driven out competitors such as FedEx and UPS... And if they don't reform, well, I say good riddance.

If government becomes the sole payer of medical bills -- if the even  services themselves were provided by nominally private medical facilities -- it is a defacto national health service of the kind most Americans want no part of.

Oddly, retirees seem happier with Medicare than non-retirees are with insurance companies.