Posted on Wed, May 27, 2009
Is affordable health coverage possible in the United States? While many ideas are being shared and argued over in the name of health care reform, it can be next to impossible for the average person to know what the best options for affordable medical insurance are. One idea is to create a publicly funded insurance pool to help provide affordable health coverage to the uninsured. Other people are in favor of the opposite approach – market based policies.
What are Market-Based Policies?
Market-based medical insurance policies look to the private sector for insurance coverage rather than the government. Supporters of market-based policies believe they are the only way to give the consumer control and choice, as well as fostering competition to keep costs down and quality high.
Why are Market-Based Policies Better than Publicly Funded Health Care Policies?
Market-based policies are more cost effective for the government – and therefore the taxpayers- than publicly funded healthcare. According to the Kaiser Commission on Medicaid and the Uninsured, January 2005, if every uninsured individual was covered by a government program such as Medicaid, the cost to the federal and state governments is approximately $2000 each. If, however, low-income and modest-income Americans could purchase their own health insurance by utilizing a $1000 tax credit, the federal government would save 50% of that money. With over 45 million uninsured Americans, that savings would be substantial indeed.
Market-based insurance would not only be more affordable medical coverage, it would also provide consumers with more choice. Because savings come from a tax credit, the option to choose insurance companies, policies and doctors is left to the person who purchases the insurance, not a group of politicians. Health insurance needs vary widely from one individual to the next and having the ability to choose the options that work best for an individual’s circumstances is fundamental to quality health care.
Several different market-based solutions could help low and modest-income individuals and families find affordable health plans. Tax credits, tax deductions, health savings accounts and high-risk pools are all market-based options to make affordable medical insurance a reality for uninsured people who are working, but cannot afford medical insurance.
Tax credits allow people to keep more of their income on a monthly basis in their pay so the can purchase coverage. Because tax credits enable people to make their own choices of providers, plans and doctors, they are considered to be a preferred market-based solution for affordable health coverage. Tax credits enable working people to pay for their own health insurance without having to fall back on Medicare or other government health programs. Because a tax credit would cost only half the amount of Medicare per individual, the burden on all taxpayers is also reduced, saving everyone money.
Private health insurance can be affordable health coverage for every working American. By working with market-based solutions, health care reform can be a workable solution to the millions of Americans living in fear of a medical crisis because they have no medical insurance.
Posted on Tue, May 26, 2009
Trying to maintain affordable healthcare costs can be frustrating. With employers cutting medical insurance premium costs by raising employees’ deductibles, co-pays and out-of-pocket spending limits, it becomes even more important to find ways to save money on medical costs wherever possible. You can take some steps to keep affordable medical insurance costs affordable and still get quality healthcare.
It may seem obvious, but your medical insurance costs will be lower if you take care of your health. Maintain a healthy weight, exercise, don’t smoke and get an appropriate amount of sleep at night in order to keep your body as healthy as possible. You may get lower premiums by being a non-smoker or other healthy lifestyle choices.
Understand your benefits. If you don’t have a clear understanding of what is covered and what you are responsible to pay for yourself, you may miss out on ways to save money outlined in the benefits manual.
If your plan requires you use healthcare providers within a certain network, do all you can to stay within that network. When you are seeing colleagues of your network provider, make sure they too are in the network. If you are having surgery or other team-based procedures done, find out if all the team members participate in your network. When you choose providers outside your network, you can wind up paying as much as 50% more for those services than you pay would for an in-network provider.
Negotiate! If you must see a doctor or other healthcare professional from outside your network, talk to them and ask if they will reduce their fee. Prepare yourself by talking with your insurance company’s customer service department first and find out what they pay a network physician for the service you need. Use that figure to negotiate with the out-of-network doctor. Many times, you can also get a discount rate if you can pay cash at the time of the service. It can be worth hundreds or even thousands of dollars to shop around a bit and negotiate a rate before having a procedure done.
Use a Flexible Spending Account, if you have one. Many employers offer Flexible Spending Accounts or Medical Spending Accounts that allow employees to set aside pretax earnings to be used for reimbursement of qualified medical expenses not otherwise covered by insurance. It is possible to save several hundred dollars a year by taking full advantage of a Flexible Spending Account. You can also save money at tax time by keeping track of your out-of-pocket medical expenses and they add up to more than 7.5% of your adjusted gross income.
If you are able to set aside a “self-insurance” fund and you are in good health, you may be able to switch to emergency only medical insurance. Emergency medical insurance carries a high deductible. With a substantial deductible, you would use your own money to pay for things like doctor visits and prescription costs, as well as minor medical procedures and rely on your insurance in the case of larger, unexpected medical expenses. By carrying a very large deductible, your premium costs are significantly lowered, saving you money and providing you with more affordable health coverage.
You can save money on your medical insurance and keep affordable healthcare a reality but understanding your policy, utilizing employee benefits and making wise lifestyle choices.