Tag Archives: healthcare

Two weeks notice: health insurance

I mentioned in my first post in this series that I need to figure out healthcare for my family now that we’ll no longer be covered under the company’s plan. We spent some time digging into this recently, and basically came away with these points:

  • We are going to be paying significantly more per month than we used to. That is obvious and expected.
  • Buying through the health insurance marketplace is not much different than buying direct through BlueCross BlueShield. Comparing a few plans, the prices seem about the same. Hopefully we’ll get a tax credit discount based on our family size and the fact that I’ll probably be making less money this year.
  • We will need to stay in a PPO to keep the same doctors. This is non-negotiable for me, even though it will mean higher premiums.
  • Deductibles will be much higher than what we’ve had so far. The budget will be tight and we can’t justify the crazy-high premium that would be required to lower the deductible and out-of-pocket max. We’re leaning toward some medium-level plan.
  • It’s too expensive to continue my existing health coverage through COBRA for very long. Switching to a new policy soon makes the most sense. It should be fine to do COBRA for a month or so since we’ve already met our deductible and have a couple doctor visits coming up.
  • One of the main differences between some of the plans is whether there’s a copay for doctor visits. We are going to prefer plans with a copay and flat prescription drug charge.

We’re still learning details about this process every day, so some of the above may not end up representing our best options. Just yesterday we realized that there’s some flexibility in what we continue with under COBRA. For example, sticking with existing dental and vision but choosing something else for primary healthcare.

Since it’s already nearly August, I’m trying not to worry too much about these decisions. If we choose poorly, we’ll be stuck with mediocre insurance for a couple months (until my wife starts a new job in the fall and we can consider her group options) or until the end of the year (when the enrollment period for the Affordable Care Act resets).

Related, from 2009: Matt Haughey on the entrepreneurial case for national healthcare. And, more recently: Paul Krugman on the triumph of Obamacare. With everything else to worry about as an indie, at least it appears I won’t have to watch the progress we’ve made on healthcare start to unravel.

Paul Krugman on the triumph for Obamacare

Writing his op-ed for the New York Times, Paul Krugman reacts to just before and after the Supreme Court upheld a crucial part of the Affordable Care Act:

“Was I on the edge of my seat, waiting for the Supreme Court decision on Obamacare subsidies? No — I was pacing the room, too nervous to sit, worried that the court would use one sloppily worded sentence to deprive millions of health insurance, condemn tens of thousands to financial ruin, and send thousands to premature death.”

He continues by countering many original arguments against the law, from not insuring enough people to costing too much. He wraps up with:

“Put all these things together, and what you have is a portrait of policy triumph — a law that, despite everything its opponents have done to undermine it, is achieving its goals, costing less than expected, and making the lives of millions of Americans better and more secure.”

And that’s not the only big news from the Supreme Court. Nice way to end the week.

Healthcare fallback plan

In the software world, the best strategy is to ship early and often. Get something out there that solves a real problem, then fill in the missing pieces and continue to improve it. Iterate. In politics, though, we often only have one chance in years or decades to get it right.

The healthcare bill passed the Senate and is on its way to becoming real, even if it’s a shadow of what it could have been. We should be thankful that we got anything — the changes do matter — but at the same time I can’t help thinking it was a missed opportunity.

Who’s to blame? I wish Democrats had fought harder; I wish they’d framed the debate correctly from the start. I still like George Lakoff’s focus on calling the public option the American Plan, but I also like John Neffinger’s point that maybe the real mistake was in not starting with a single-payer plan so that the public option would look like a moderate compromise. It feels like many Democrats were resigned to failure early on.

In an unrelated tweet a few weeks ago, from comic artist Kazu Kibuishi: “If you have a fallback, you will fall back.” My failures reflect that too. To shoot for greatness you have to put everything you’ve got into your first effort.

I keep coming back to something Hillary Clinton said in a debate with Obama early in the Democratic primaries of 2008. It struck me as so true at the time that I wrote it down:

If you do not have a plan that starts out attempting to achieve universal healthcare, you will be nibbled to death.

And that’s what happened.

Bush veto

Yes, it’s a politically-themed post. Probably the only one before 2008, so don’t run away just yet.

The Bush veto of the bipartisan children’s health care plan a few weeks ago really made me angry, but it wasn’t until “Justin Miller responded”:http://twitter.com/incanus77/statuses/310113392 to “my tweet”:http://twitter.com/manton/statuses/310110182 that I started to think about why. Here’s the reason.

When Bush was elected in 2000, I expected this kind of stuff from him. Vetoing stem cell research? Killing children’s health care funding? Sure, par for the course for this Republican. But then 9-11 happened and everything changed. The war. Our president’s priorities changed.

Bush got a free ride from the media during the 2000 election, and again after 9-11. He would make the most incompetent and clumsy mistakes and yet be cut slack because, frankly, expectations are just so much lower for him than any other president in recent history.

At some point in 2004, opinion started to shift, led by folks like Howard Dean (who I’ve “written about before”:http://www.google.com/search?q=site%3Amanton.org+howard+dean). Eventually, after Bush won re-election, there would be enough anti-war momentum to matter. And that brings us up to now and this veto.

Everyone is focused on the war. Everyone understands the significance, the mistakes. Most of the country wants it over but we know that it’s complex, and the consequences for any given action will be felt for a decade. Compared to the lives lost in Iraq and the harm done to the stability of the Middle East, the rise of a new generation of terrorists — what does a health care bill matter? Is it worth fighting for?

Democrats in power by a slim majority probably think they have to choose their battles, have to give in on some issues so they can hold on to the important ones, like the war. But I say no. The only thing that works against this stubborn ass in the White House is to take the fight to him. Cut him off at every turn. Don’t give him a freakin’ inch. Call for an override vote again and again.

Every. Single. Day.

That’s how you win. You put people on the ground in every state — organizing, protesting, getting out the vote. You put letters in the hands of our representatives — email, blogs, editorial, flyers. You put a loud voice to what you feel and never, ever back down.