America’s Unfair Health Insurance System

There are a few inequities in health care coverage in America today.  Here’s the top 10 on my list that illustrates the inequities.

1.  Congress/Federal employees

The Federal Employees Health Benefits Program (FEHB) is great.  You are a member of a very large risk pool and you get to pick a health care plan from competing insurers.  What’s even better, if you’re a member of Congress, you can keep your coverage when you leave at the same low price!  What’s not to like?

2. Tricare

Tricare provides civilian coverage for military personnel, retired military and their dependents.  Great coverage at great prices.

3. Veterans Administration

Health care coverage for veterans.  No reasonable person would deny this for those who have defended our freedoms.  Unfortunately it’s only practicably available to vets who live in proximity to a VA facility.

4. Medicare

Heard at town hall meetings on the public option: “Keep your hands off my Medicare!”  Says it all.

5. SCHIP/Medicaid

You really need to be down on your luck to qualify.  And you need to be in a state that has enough money and will to fund it.

6. ASO plan

You work for a large enough company that they self-insure.  They use insurance companies for Administrative Services Only (ASO).  They generally cover all employees equally.  Good deal.  But you still sacrifice a lot of your potential earnings for health insurance.

7. Large/Medium/Small company

For those companies that can’t fit an ASO, you shop for plans from insurance companies.  The larger your employee base, the better your premiums as you expand your risk pool.  Smaller companies pay more.

8. Self employed

The bad news is that you have a risk pool of one, so the insurance companies can gouge you.  The good news is that you can take the cost of your premiums off of your adjusted gross income on your taxes.

9. Unemployed or employed without health insurance benefits

You’re screwed.  Unlike the self employed, you pay for your premiums with after tax dollars.  And like the self employed, you pay much more than if you were employed by a large company.

10. No health insurance

You’re really screwed.  Not only are you paying for all of your health care with after tax dollars, you have no position to negotiate with your provider for health care costs.

There are a number of permutations on the above.  For example, your health care plan may provide a Health Savings Account (HSA) which will allow for some of your health care costs to be paid with pre-tax dollars.  Note your health insurance premiums do not qualify.  Another issue is for companies that require employees that to pay part of their premiums.  You can’t deduct this from your taxes unless it exceeds the 7% of your AGI when you itemize deductions.

This inequity puts an interesting face on the current health care reform debate.



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21 responses to “America’s Unfair Health Insurance System

  1. d you’ve presented a sterling argument for single payer!


  2. nannymm

    Good morning.
    Nicely laid out piece, dnd. I agree with Brian; you’ve laid out the case for single payer.

  3. dnd

    If you think this is a compelling case for single payer, just wait for my next post…

  4. nannymm

    I’m waiting with bated breath. 🙂

  5. Breaking News Alert
    The New York Times
    Thu, October 22, 2009 — 1:46 PM ET

    Fed to Step Up Reviews of Compensation at Banks

    The Federal Reserve announced a plan on Thursday to eliminate
    pay packages that in the past have encouraged bankers to take
    the kinds of reckless risks that contributed to the housing

    Read More:

  6. nannymm

    Another Republican Fuck Up:
    When North Carolina state senator Phil Berger (R) trucked a wheelbarrow stacked with Republican surveys into the governor’s office, he thought he was delivering a neat blow to Democratic Gov. Bev Perdue.

  7. Nanny I don’t get your post, is there a link or something to go with that?

  8. Lawrence O’Donnell Battles Joe Scarborough Over Cheney’s Fear-Mongering (VIDEO)

    Read more at:

  9. I’m assuming you’ve all seen this, but in case you haven’t, a real heart breaker of an ad.

  10. Morning peeps

    Healthcare for Christmas: Reid under pressure to slow down

  11. Cheney’s “dithering” salvo was just the latest attack on Obama from the former vice president and his daughters. Lee Siegel on a family crusade worthy of Ancient Greece.

  12. Palin Endorses Hoffman, Snubs GOP Candidate In New York House Race

    Read more at:

    Things are getting hot up your way nanny!

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