I visit a doctor once a year at the most, and I hardly require prescription medicine. The cost of my health insurance premium is about $800 this year for my HMO plan. My employer pays a larger percentage of the total premium, but the prices increase each year by a percentage much higher than inflation. A similar HMO plan, if I were to quit my job and buy individual health insurance in New Jersey, I would pay more than $800 a month, though there are less expensive options.
I’m lucky I don’t have any dependents.
The more individuals in the world with access to good and affordable heath care, the healthier the world will be in general, so I am in favor in reform that brings better care to more people. While reduced costs for me would be nice, that would be just an ancillary — and selfish — benefit. Will any of the various sets of proposed legislation succeed? I don’t know anyone who can answer that question with any sort of definitive answer. Health care is a monster, a complicated system with many moving parts that won’t be fixed right away.
The Congressional Budget Office released their cost estimates for the version of the legislation that is up for a vote within the Senate Finance Committee, and the numbers look better than expected: The bill would could $829 billion over ten years and actually reduce the budget deficit by $81 billion over the same time period. This bill doesn’t include a government-run plan, but it also leaves more people uninsured than some would like.
This legislation has a long way to go. The version of health care reform offered by the Senate Finance Committee needs to be combined with the version being considered by the Senate Health Committee. The Senate then needs to vote on and pass a bill. The House of Representatives also needs to vote on and pass its version of the health reform bill (H.R. 3200). Eventually the bills that pass both the House and the Senate need to be combined, voted on, passed and presented to the President.
None of this will happen without more changes and compromises, and even then it may not gain the votes needed to succeed.
Please share your thoughts and join the discussion. What issues should health reform address? What are your experiences with health care?
It’s been a while since I’ve taken the pulse of our readers on a hot topic, so I figured it was time. I’ve been paying closer attention than usual to the various proposals in Congress dealing with healthcare and health insurance reform, and I’ve made a list of the different things they’re trying to tackle. (You’ll notice there’s nothing in the list about assisted suicide or bureaucrats deciding who lives and who dies… that’s because nobody is proposing anything of the sort.)
So, press “Yay” on the things you want to see change in America, and “Boo” for those that aren’t important to you. If you think the state of healthcare in America is just fine the way it is, and you’re happy with healthcare costs rising three times as fast as wages, then by all means press “Boo” for everything on the list.
When I write about advocating for the consumer when he or she is in debt, I usually receive a good amount of feedback blaming the consumer for his or her situation. Yes, in many cases, households fall into debt because they buy more things they cannot afford, whether knowingly or unknowingly. In many cases, they ignore their own financial condition without worry for their future or while knowing that a declaration of bankruptcy can save them when life gets rough.
Not everyone falls into these categories, I remind the critics. Medical emergencies are expensive and cannot always be adequately planned for in advance. Credit card debt maybe the only option, or sometimes just a slightly better option that financing your bills directly from the hospital. Here is one example from the New York Times:
Mr. Kupka has multiple sclerosis. The Kupkas, who live in Lindstrom, Minn., have an annual income of $45,000 — a combination of her salary as an office manager and his disability payments. More than 20 percent of that income goes toward health care. Their annual insurance premiums total $5,400, and then there’s the $4,000 Mr. Kupka spends on drugs, doctor’s visits and lab fees before he fulfills his policy’s deductible.
In the three years since Mr. Kupka’s disability forced him to stop working as a mental health therapist, he has accumulated $12,000 in debt. “It’s frustrating,” he says. “We earn too much to qualify for state and county assistance, but not enough to stay ahead of the bills. I’ve thought maybe my wife and I should get divorced. But not only is it against our faith, it turns out it wouldn’t help…” [A]s Mr. Kupka’s situation illustrates, it’s not just uninsured patients who rack up large bills. Nearly two-thirds of those with debt problems… had health insurance.
The article offers tips for dealing with insurmountable medical expenses:
Confront, don’t ignore, your situation. If you don’t pay your bills and the hospital decides to use a collection agency, your hardship will increase. Your credit report and credit score will be adversely affected.
Review your bills. Health providers make mistakes on bills all the time, but many errors are not caught. Some procedures or services may have several names, identical is everything except price, so it helps to work with a medical expert if you have any questions. You can also resubmit your bills to your insurance company if coverage is denied. If you are still not satisfied, your bills may qualify for a third-party review.
Hire an expert. The article suggests working with the Medical Billing Advocates of America to find a qualified mediator to negotiate between yourself and the health care provider.
Don’t use a credit card. If you can help it, avoid paying your bill on a credit card if you can’t pay off the balance quickly. Interest charged for your use of someone else’s money will increase your debt. Watch out for credit cards offered by a hospital with immediate approval. These are like store credit cards; they might offer a 0% interest rate up front, but you might fall into a trap and owe much more interest than they’ll tell you when they’re busy saying, “You’re approved!”
Don’t let debt collectors take advantage of you. Know your rights for dealing with debt collectors in your state. They may only call you during certain hours, they may not harass you, and they may not threaten you. If they break the rules, you can file a complaint with the Federal Trade Commission.
Situations deteriorate faster if you do not have health insurance. Find a way to get covered if you are not a member of plan yet.
A former high-powered, strongly motivated boss of mine did not believe in sleep. In order to be the best in the world at what we do — and this was the goal, no doubt — sleep is an obstacle to be overcome. I disagreed, as it seemed to me at some point, bodies and minds will find what they need whether or not you try to control them.
While he was in his office until four in the morning many nights, trying to work, I was getting the sleep I needed to be effective during waking hours. Our disagreements about this as well as some other philosophies of life eventually led to my departure from the organization.
Scientific studies have long proven the importance of a good night’s sleep, but there’s some new research that links sleep deprivation and serious illness.
A 2008 research project at the University of Chicago’s medical school kept young, healthy volunteers awake for all but four hours a night for six nights running. The result: The levels of subjects’ hormones shifted – in particular a hormone called leptin that affects appetite. They became ravenously hungry, scarfing down pizza and ice cream long after they would have felt full normally, and their blood sugar shot up to pre-diabetic levels – an ominous result after less than one week of inadequate sleep.
…[T]he World Health Organization (WHO) has gathered data from around the globe showing that sleep deprivation depresses the immune system, to the point where WHO is considering labeling chronic sleep deprivation a carcinogen, comparable to tobacco and asbestos.
Sleep deprivation also results in an overestimation of health; people deprived think they have more control than they do.
One experiment at U. Penn’s medical school kept subjects up until 4 A.M., woke them at 8 A.M., and then gave them a series of tests designed to measure memory, alertness, and the ability to react quickly to new information. The researchers were startled to find that subjects’ mental acuity declined markedly after just one night and kept dropping with each successive night of four hours’ sleep. Even more worrying: The study’s volunteers were unaware of their impairment. One woman, so fatigued that she could barely say her name, was nonetheless certain she was able to drive home.
In addition to these studies, entrepreneurs surveyed about their sleep habits have claimed to come up with many of their ideas while asleep. So it seems that sleeping is good for business.
Rather than firing up the central air conditioning, you can keep it off or lower its power in the heat of the summer by exploring some of these low-cost alternatives.
1. Use fans. While fans don’t change the temperature of the air, they increase air movement, which will make you feel cooler by a few degrees. Look for fans with large blades. In general, the large blades will move more air with less power and less noise.
2. Cool the air naturally. If you hang damp sheets in front of your window, air coming into your house or apartment will lower the temperature of the air as it enters.
3. Wear light colors. Black fabric absorbs heat while light-colored fabric reflects. Light-weight fabric allows your skin to breathe. Fashion aside, proper summer clothing can help keep you cool.
4. Install shades and blinds. By keeping your rooms shielded from the sun, you can avoid direct light and heat. Keep the blinds closed during the day and open the windows during the night. There are window coatings available that let in light while keeping out heat. Try searching Home Depot for heat and glare control window films.
5. Wear a cooling bandana. Here’s a stylish way to keep yourself cool. Cooling bandanas can be soaked in water and are worn around the neck. As the water evaporates your body remains cool. You can find cooling bandanas on Amazon.com.
6. Avoid chores. Forget about using the clothes dryer or the oven; these appliances emit heat, so your cooling system must work harder whenever you’re cooking or drying. While the weather is hot, eliminating strenuous chores will help protect your body from dehydration. Alcohol and caffeine should be avoided as well for the same reason.
7. Spray yourself with water. Never was a wet tee-shirt contest a better idea. Keep yourself wet with sprinklers outdoors or spritzers (water bottles with a spraying handle) indoors.
8. Leave the house. Take advantage of large businesses that must keep their air conditioners running to keep customers comfortable; take a trip to the mall. If you do stay in and run the air conditioner, however, keep the thermostat high and supplement the house cooling with fans.
Where I live, the temperature has been above 90 degrees lately, with the heat index over 100 this past weekend. I don’t have it quite as bad as those in Texas, for example, but heat makes everyone uncomfortable. As someone I knew used to say, you can only remove so many layers of clothing.
If you’re moving into a new neighborhood, it’s usually easy to drive around (or walk around if the new neighborhood is a city) to find amenities and stores within walking distance. If you agree that walking is a necessary exercise, the ability to walk to destinations should be a large factor when deciding where to live.
Now you can find similar information with a handy web site called Walk Score. Type an address when prompted and Walk Score will provide a map containing local grocery stores, restaurants, schools, fitness centers, and more, including walking distance from the address. The web site uses an algorithm to develop a score, the “Walk Score,” for the neighborhood.
For example, here are the results for Princeton, NJ, not my neighborhood, but nearby.
The left column shows the closest location in each category, but is expandable to show all locations within walking distance. You can compare Walk Scores between neighborhoods to help determine an optimal place to live for your exercise needs.
As you can see above, Princeton, New Jersey has a Walk Score of 85. But what does that mean? The web site provides this guide to help you interpret the numbers:
90 – 100: Walkers’ Paradise. Most errands can be accomplished on foot and many people get by without owning a car. 70 – 90: Very Walkable. It’s possible to get by without owning a car. 50 – 70: Some Walkable Locations. Some stores and amenities are within walking distance, but many everyday trips still require a bike, public transportation, or car. 25 – 50: Not Walkable. Only a few destinations are within easy walking range. For most errands, driving or public transportation is a must. 0 – 25: Driving Only. Virtually no neighborhood destinations within walking range. You can walk from your house to your car!
My neighborhood’s Walk Score is 60, an accurate evaluation of my opportunities for ambulatory errand completion.
Walking should be a strong factor in your decision. According to the Walk Score website, walking increases your health, reduces greenhouse gas, increases your social capital, strengthens local businesses, and allows for more public transportation options.
I certainly don’t walk enough as I should. I have a grocery store practically across the street from where I live. Rather than making smaller shopping trips more often in order to walk, I usually wait and make large trips less often, requiring the use of my car to transport the bags of groceries required.
This is one habit I should change for my own benefit.
In two short weeks, 2007 will come to a close. If you have money in your Flexible Spending Account when the new year comes around, and your company doesn’t offer a grace period, you will lose those funds.
A Flexible Spending Account is a savings plan offered by many employers that lets you put aside some money from your paycheck each week. The money is saved in an account held by your employer. With a Health or Medical FSA, the most common type of FSA, you can use the account for medical expenses. Either you can receive a debit card linked directly to the account for use when paying medical expenses or you can apply for reimbursement of expenses paid otherwise.
The primary benefit of these accounts is the money used for reimbursement will not be subject to income tax. However, you have to use the funds put aside by either the end of the year or by a date such as March 31, depending on your employer’s rules. Since you enroll in the FSA in the prior year, you have to predict your future medical expenses. If you have a pretty good idea of what your expenses will be, you can determine how much you’ll save through the use of an FSA account. It’s just a question of subtracting your used medical expenses from your gross income (upon which tax will be deducted) rather than your net income. This is a particularly good option if you don’t itemize your tax deductions or if your health expenses won’t reach the threshold of 7.5% of your Adjusted Gross Income to qualify.
A poor prediction means you’ll be leaving money on the table at the end of the year. If your prediction was not far off, there are still some options that will prevent you from losing the money you put away. Here is what I would suggest. Go to the pharmacist and pick up over-the-counter medication. I probably spend about $25-$35 a year on regular strength pain relief medication (naproxen). If I had a Flex account, I would stock up at the end of the year. Cold and allergy medicine qualifies as well, and the weather makes the end of the year a good time to stock up. First aid supplies qualify as well.
In many cases, the FSA can be used to cover expenses for your family members, as well. Make sure you have been reimbursed for every medical expense throughout the year by going through your receipts if you’ve kept them. Speaking of receipts, it’s important to keep documentation for all medical expenses you’ve paid, whether directly from your Flex account via a debit card or for reimbursement later. In many cases, you will be required to substantiate the qualification of your expenses.
By the way, if you end up leaving unused money in your FSA at the end of the year, that money goes back to your employer, not to you. Also, you will owe income tax on the remainder even though you won’t “receive” that income.
Note: This article is a contribution to the Money Blog Network Monthly Group Writing Project. This month, the focus is on year-end financial strategies. Here are the other articles included in the project, all with great ideas for things to think about as 2007 comes to an end.
My company was offering vaccinations today for any employees wanting to gain protection from the flu this season. By the early afternoon, they ran out of vaccine and added another date a week from now to the schedule for those who did not get a chance.
I’ve never opted for the flu vaccine. It has always been my method of operation to take my chances and deal with the flu (without prescription medication) if the virus finds its way into my system. Last year, however, I had a tough time, and was out of commission more often than I would have liked. I suppose this comes with the territory of having a girlfriend whose job is to spend 8 hours a day with twenty-five ten-year-old germ balls.
I’ve always held the opinion that I shouldn’t need to introduce any more medication into my body than absolutely necessary. Not only that, but the vaccine works only against specific strains of influenza but is not very effective overall. As a relatively healthy individual, I do not have a high risk of complications from the flu, so other than missing a few days of work feeling sick, I don’t think it will hurt to skip the vaccine. Doing so might even mean that there is one more shot available for a young child or elderly individual with high risk for complications.
How about you? Will you be receiving the vaccination?
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I’ve always held the opinion that I shouldn’t need to introduce any more medication into my body than absolutely necessary. Not only that, but the vaccine works only against specific strains of influenza but is not very effective overall. As a relatively healthy individual, I do not have a high risk of complications from the flu, so other than missing a few days of work feeling sick, I don’t think it will hurt to skip the vaccine. Doing so might even mean that there is one more shot available for a young child or elderly individual with high risk for complications.
