Tucson Citizen.com
Medicare and More -

Sen Kyl: Health Insurance Consumers Know Better than Washington

by on Feb. 25, 2010, under Health

During Thursday’s heath care summit, Senator Kyl said he believes consumers are better able to make choices about their health insurance than Washington.  Senator Kyl doesn’t like the idea of a Washington bureaucrat setting standards for health insurance plans.  What do you think?  Here are some choices you have if you are looking for individual insurance in Arizona.

I was just looking over coverage options for a 55 year old healthy woman and here are a few of her choices:

BCBS of Arizona:  Monthly premium: $148/mo with….
$5,000 deductible: She will pay the first $5,000 of her health insurance bills.
She gets three doctor visits per year for a co-pay of around $40.
60/40% co-insurance (She pays 40% of her bills after she has paid the deductible and until she hits her $4,000 maximum-out-of-pocket.)
So if she gets sick she pays $5,000 (deductible ) plus $3,000 (co-insurance) during the year.  This protects her against catastrophic costs by limiting her yearly out-of-pocket costs to $8,000.
 
 Or she can pay $198/month for a similar plan – except that it allows for six doctor visits per year for a co-payment.

Another company, Assurant, tells insurance agents to discourage clients from including doctor visits for a $35 co-pay.  They say that customers will save about $100 per month with their premium if doctor visits come under the deductible.  This means the consumer is buying coverage in case of large medical bills. The idea of going to the doctor to stay healthy is out of the picture.  The consumer only goes to the doctor if she is seriously ill – and she pays the full doctor bill, which is applied to the deductible amount ($5,000).

Senator Borasso, from Wyoming, said that people with catastrophic coverage (like the plans described above) are the best health care consumers because they think twice about getting care.  He was implying that people with more comprehensive coverage tend to use the health care system too much. This is known as “consumer-driven heath care” and it is the mantra of health insurance companies.  We can control health insurance costs by putting more and more of the cost onto consumers.

What do you think?

This entry was posted on Thursday, February 25th, 2010 at 8:36 pm and is filed under Health. Tags for this post: , , , . You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.

RSS feed for this post (comments)
  • leftfield

    It should be clear that making preventive care available to everyone will reduce costs.

    Socialize medicine and get rid of the insurance companies entirely!

    • medicareblogger

      The difference between Republicans and Democrats is very clear when it comes to health care/health insurance.  Democrats think everyone has the right to healthcare.  Republicans think health care is a priviledge that comes with a good job and/or money.

      Democrats think people need government to set standards for health insurance policies.  For example, all policies should include doctor visits for co-pays and cover preventive care under co-pays (and not under the deductible).

      Republicans think insurance companies should continue their current ways and put out dozens of plans with different deductibles, premiums, and small print about what constitutes “preventive care” and “diagnostic care” (thus affecting if the insurance policy or the individual pays for it).

      I’m an insurance agent (with a masters degree in business) and I don’t understand a lot of the small print.  I’m not against “consumer-driven” plans, but there should be minimal standards for health insurance policies when people are spending hundreds of dollars on premiums and yet they don’t want to go to the doctor because they can’t afford the co-pay or the full price (under the deductible).

  • Pingback: Health Insurance Individual - Sen Kyl: Health Insurance Consumers Know Better than Washington - Tucson Citizen « Health Insurance Individual

  • Pingback: uberVU - social comments

  • tiponeill

    Kyl knows he is lying, that is just a Repub sound bite that focus-tests well with the anti-big-government crowd.
    Everyone else knows that the choice isn’t between “the consumer” and Washington. It is between the Washington bureaucrat and the Blue Cross bureaucrat.
     

  • Entropy

    First off, I’m for “Obamacare”. I’m 39, relatively healthy (I can stand to lose a few pounds). I have a job right now (state worker), with abysmal healthcare through my employer (United Healthcare).  With the current fiscal budget, I haven’t received a raise in over 3 years, and it’s currently looking like we won’t get a raise for at least another 2 years. In that time, my healthcare payments have gone UP, so my take home pay has actually gone down! Also, co-pays, urgent care, and prescription meds have ALSO gone up, while my coverage has gone DOWN. 
     
    I live paycheck to paycheck so unless my arm is severed and dangling by a tendon, I won’t see a doctor simply because of the fact I can’t afford the co-pay even though I’m paying for healthcare now.
     
    I do remember getting “free” healthcare when I was in college. I had to have a large cyst removed, and I had no insurance. I went into Kino Hospital ER, waited 4 hours and was taken care of. I knew nothing of acchhs, so I received a bill for $1800. I chucked it. At the time, I barely could afford ramen soup. It never showed up on my credit report (even though I gave the hospital my SSN). 
     
    If I ever lose my job, or my insurance payments gets pricier, I’m going to drop it, and use this method to get free healthcare. My primary care physician will be whoever the doctor is at that moment.

    • medicareblogger

      People who are working but make don’t get health insurance can check out the Pima County Access Plan. You pay $50 per year to enroll and get discounts through the Pima County Health System.  There are income limits based on family size. 

      I’ve referred a number of people to PCAP.  Here is the link to their site:  http://www.pcap.cc

      • tiponeill

        Thanks I’m going to try again – I looked at them once but was discouraged by finding that there was no way to know if I was eligible from their web site. You have to “apply” and then they will let you know.
        It does mention that you “have an income between 100% and 250% of the federal poverty level” but I have no idea what that is – does anyone ?

        • medicareblogger

          I don’t know if this is still the case, but they used to have an in-house person who worked for PCAP and would meet with you and help you apply for the program.  You could set an appointment to meet with the rep and learn about the program and if you qualify.

        • medicareblogger

          For AHCCCS applications, the federal poverty level is $903 per month for an individual and $1,215 for a couple.  They allow $20 more dollars on top of that as well.

          • medicareblogger

            PCAP is for people who are above the federal poverty level but below  some upper level.  135% of the poverty level would be  $903 x  1.35 = $1,219 per month.  $903 x 1.50 = $1,354 per month for 150% of the poverty level.

          • tiponeill

            So it sounds like the upper limit is 250% which would be 903 x 2.5 = 2257.5 a month.
             

          • medicareblogger

            If that’s what their website says is the figure for a single person, then that sounds right.  I don’t know how they get their figures for familes of 2, 3, 4, etc.  It’s worth checking out.

  • Pingback: catastrophic health insurance

  • Pingback: Texas Health Insurance

  • Pingback: Egészségközpont

«
»