I started to make this a reply in another of the health care threads but thought it deserved it's own. Might as well start a discussion on it in one single thread.
We have BCBS Plan 1 for our employees coverage currently. We cover the employee portion of the premium. It's the best they offer. These are the new rates after 17% increase this year:
Single male in my 30s it's $5,000 a year. (was $4,300)
Family in their late 40s: $24,000 (was $20,500)
Family in their late 50s: $31,000 (was $26,500)
Someone in their early 60s and spouse: $31,000 (was $26,500)
Median family income in the US is just over $50,000. So basically 50% goes to health care under this plan.
Now let me tell y'all a little story.
One of my employees and a very close friend is a 52 year old woman and married to a 63 year old man. Their coverage is $18,000 a year. This is because the spouse rate is based on the employees age and not the spouse. She pays the $9,000 it costs to cover him. He is retired and not quite Medicare age. In October of 2011 he had a heart attack. And no he is not obese nor unhealthy. They exercise and eat decent. He did like his beer though. 5'8" 160 lbs or so.
He recovered from it, but his heart began to decline rapidly. In August of last year, after getting to the point he didn't have the energy to even get up and move around, they went into the hospital. He ended up at Ochsner in New Orleans. He was put on the list for a heart transplant and listed as priority because his heart was failing. They waited as long as they could but no heart became available so they had to install a VAD in October. Basically a pump that helps the heart. Instead of a heartbeat, she says he mostly just hums if you listen to his chest. This device was supposed to give him another 6 or 7 years of life. Of course, after open heart surgery, he was taken off the transplant list during his recovery. He finally came home in November last year just after Thanksgiving. He has to wear a vest packed with batteries and plug himself in every night. He even comes with a car charger and D batteries in case of a power outage.
After recovering, he was put back on the transplant list but not as priority. They were told they have one 30 day period of their choosing to be listed as priority status. During those 30 days they had to be within 30 miles of Ochsner. They chose to start the 30 days on January 19th to cover Super Bowl and Mardi Gras. It's a little odd planning your schedule around a time when as many people as possible will be in the area doing things that might end up with them as an organ donor. But that's life. His 30 days was to end this past Sunday night at midnight. Super Bowl and Mardi Gras were over. Last Friday they started planning to come home Tuesday (today) after more blood work Monday morning. Friday afternoon 2:43PM, I finally got the text from her that I'd been hoping to get. "We are at hospital. He is getting worked up we have a donor." At 12:30am that night an 11 hour surgery began.
Finally getting a donor 2 days before his time was up was interesting itself, but they also found during surgery his old heart had an infection. Had they known, he would have been taken off the list because of immunosupressants he has to be on to prevent rejection. That's part of the reason the surgery took longer than usual. They also found his old heart was so damaged the VAD would have only kept him alive another 2 or 3 weeks had a heart not come in. And they told them, he was actually #2 on the list. #1 was in the same situation he was when he first got down there last year but the heart wasn't a match.
It's now 72 hours after the surgery. He is up and speech is slurred but asking day and time realizing how long he was out. I'm sure he's only beginning to come to terms with being alive and having a new heart. I can't imagine. Hopefully never will.
A bit of a long story but think about this. He was in the hospital for 3 months. Then had a major open heart surgery (broken open ribcage and all) to install a pump that alone costs $100k+. Was in the hospital another month recovering from that. On dozens of medications. Goes back in for another major 11 hour heart transplant surgery and will be recovering again for probably 6 weeks in the hospital. Then post operation check ups, more drugs. Also now gets to spend probably a year secluded because his immune system is suppressed. But he will get to live out the rest of his life which could be decades. Because he had the VAD surgery and the transplant, his medical bills will be over $2,000,000. 99+% of which will be paid by BCBS.
If you think the hospital didn't even think about the guarantee of payment on something like this, you're kidding yourself. I'll leave everyone to draw their own conclusions on how health care and the health insurance industry works and/or should work after reading this. But, if everyone had the same coverage, he probably wouldn't be alive today. And the average quality of health care overall would take a dive. Health care isn't a not for profit business. Nor should it be unless you want to cut the average intelligence of a doctor in half. This is the difference between health care being a right and health care being a privilege. It definitely needs to be more affordable and the "Affordable Health Care Act" isn't doing it.