The Health Insurance Dilemma - Part 1

Note: This was posted earlier this week, but in the process of uploading the length of this blog posed a problem.  So we have broken it into 2 blogs. This blog focuses on current practices and the second focuses on the position of the candidates and the facts used here.  It is up to you, the reader, to decide if which candidate speaks to you, athough we hope you share you thoughts.

After reading Amy Tenderich’s piece on Together RX, I went back to thinking about healthcare and the issues, for about 5 minutes before I needed to go for a run!  Health insurance is one way to ignite a fire with me!

Why does this topic ignite a fire?  My husband is an insurance broker and I get to see first hand the business of health insurance.  My husband worked in fundraising for several years and wanted a place that would use his compassion for people.  With insurance, he felt he could offer his compassion and integrity to help clients identify what’s critical for them and the issues they face. To his credit he is doing just that. So many of us crave these qualities and bark at the fact we have so little of it in sales.

He is for universal health insurance, which would make his job harder, but he feels that it would level the playing field between corporate profit and the people who need help the most. But the issue of deciding which candidate offers a plan for you requires understanding the current business and that is complicated at best.  The place to start may be looking at the current process of buying health insurance.

Here in Virginia, as a type 1 diabetic, I’m ineligible for individual coverage.  My business took out a group policy so that I could have coverage, and I pay through the nose for it!  If I lived in Maryland, just 30 minutes away, I could apply for MHIP, a state mandate that gives equal opportunity to have healthcare. Maryland hired Blue Cross Blue Shield to administer the program.  The price for an MHIP eligible person age 40-44 in a PPO would cost per month: $311.00 with a $500.00 deductible, $246.00 with $1000.00 deductible, $132.00 with a $2600.00 deductible, or $488.00 for a $0 deductible HMO. Is this a good thing?  I think Maryland is a great example of a state run program!

What’s interesting is that different states have different rules about health insurance.  Virginia is interested in keeping the cost down, so people can be refused healthcare coverage on an individual basis.  Massachusetts is a guaranteed issue state, which means no one is denied coverage.  What’s the difference?  I took a Blue Cross/Blue Shield PPO policy in Virginia that cost $217.00/mo for an individual with no health issues and compared it to Massachusetts.  In Mass, a very similar Blue Cross/Blue Shield PPO policy is almost double costing $414.00/mo, so everyone is helping pay for the burden of providing guaranteed healthcare.  In Maryland, MHIP coverage costs the MHIP applicant more, but as a state everyone’s policy does not increase to cover MHIP participants.