Cadillac or clunker health care?
IN RESPONSE to the "The 'Cadillac tax' scam" by Helen Redmond and Alan Maass, I wanted to let people know what's its like to ride in a "Cadillac health care plan"
I am one of the rare Americans who both works for a large, non-union employer and doesn't pay a lot for health care. I pay $1,000 a year for my coverage (single, no children), with my employer picking up the remainder of the cost. By comparison to others, I have pretty decent health care, but here are a few of the "luxuries" I get for my money: I pay a $15 co-pay for routine checkups with my primary care physician (PCP). Not bad. I also get $400 credit per year towards gym membership. Also, not bad.
However, anyone who lives in a city knows that gym memberships cost over $500 per year, so "getting healthy" which is supposedly "my personal responsibility" to keep health care costs down, will cost me upwards of $200 out of pocket per year.
Another problem--my PCP doesn't work Mondays, Fridays or weekends. If I need to visit a doctor on those days, I am referred elsewhere, and the co-pay is $40 for non-specialist care. For specialist care, it's more.
Last month, my knee locked up, and I was unable to walk for a couple days. Fearing the worst, I was referred to a specialist for x-rays. If you're keeping count, that's $15 for the consultation with PCP, plus $45 for specialist care, plus $15 for x-ray services, for a total of $75 just to see what was wrong.
Luckily, it was nothing serious, only tendonitis. However, a follow-up appointment was necessary with the specialist (which I wrongly assumed was covered completely). This cost me another $45 co-pay. In the end, I got an x-ray and was told to buy anti-inflammatory medication, which I also purchased myself, for a total of $125 when all was said and done. I also had to buy expensive, arch-supporting running shoes if I was going to be able to continue rigorous exercise, which was another $75.
If I had gone to emergency care, it would have cost me $500 out of pocket, and then any costs above $2,000 as well. If this injury had happened outside of my "coverage area," which extends just beyond the city limits, 100 percent of the cost would have been out of pocket.
That's right, this "Cadillac" only drives 40 miles from my house before turning into a pumpkin. I don't know what would happen if I ever became seriously ill, as the fine print on the plan is so inaccessible and confusing that I wouldn't be able to predict how much it would cost.
On top of my student loans and the skyrocketing costs of gas and heating my apartment, these extra costs put my earnings below my bills some months.
Compared to the uninsured and the many who are "underinsured," I have it pretty good, and I don't do much complaining. However, with the Democrats' "Cadillac health care" tax and a proposed 75 percent minimum mandate for employer contributions, all of this is now up in the air.
On a practical level, in a tight economy with thin profit margins, this means all my employers' competitors will feel the pressure to drop their contribution level above 75 percent down to the minimum. In a world of blind competition such as capitalism, the 2 percent profit margin advantage that competitors gain by doing this will certainly trump any good will my employers may have toward us. Along with rising premiums that are untouched in the current bills, this could mean the end of the road for us.
On an ideological level, since the unions went along with this and secured protection for a select number of unionized employees at the expense of the rest of us, my co-workers rightly blame Obama and the unions for jeopardizing our good situation. The lesson that I try to argue--that without a union, my employer can do whatever it wants (including disciplining me for writing this letter)--is lost amid the immediate implications of this betrayal. Thanks guys.
Just the term "Cadillac health care plan" implies that there is such a phenomenon as "getting too much health care." The notion that people are getting poked and prodded by doctors and taking a weekend journey to the emergency room to get an MRI "just for fun" is preposterous."
The real culprit here is the gigantic "farm" corporations who feed us shitty food and pollute our communities so we breathe shitty air and drink shitty water. It's giant, non-union employers like Wal-Mart that work us long, shitty hours, and pay us shitty wages. And it's the HMOs and private hospital chains who give us shitty health care and tell us that it's our fault that we feel so shitty.
The Democrats and unions, by repeating this nonsense term, only reinforce the notion that working people are to blame for the health care crisis, instead of the real villains. Furthermore, they set back the fight for a single-payer, universal health care system, instead of "taking baby steps forward" as they claim. For the Democrats and Obama, who receive millions in contributions from the HMOs and drug companies, that seems to be exactly what they want.
It's high time the unions help people like me who want a measure of control over our lives and working conditions, and it's high time people recognize the Democrats for what they are--willing accomplices in the squeezing of working people of their earnings and their lives.
Brian Lenzo, Rochester, N.Y.