What is wrong with our current health system

[Skyhi]

Here's a post from the installer zone at satguys:


Hey guys about 3 months ago i fell off a ladder while getting off a roof , im a subcontractor for a wireless internet company in TX , i was getting off a roof to get my cordless drill when the ladder started sliding away from the roof line and there i went , i guess i tried to catch my self and i fractured my radius (Wrist) pretty badly , i tought i had hit my back also so iwas taken to the ER in an ambulance .

Well 3 months later , after 2 surgeries being in 3 different casts i get hit with the news that my wife's insurance (she's a teacher) will not cover my medical bills because of my accident being work related. So i guess i owe them 30,000 dlls now , 13K for the firs surgery , 18k for the second , 2k for anesthesia during surgery , 3k for ER and ambulance and about 3K for upcoming therapy.

So that's got me pulling my hair and completely stressed out that the idea of being a sub makes me sick now , i wish i woud have been employed by some company or have my own personal accident insurance.


Be careful out there guys , it can happen to any of us when we least expect it. !

http://www.satelliteguys.us/installer-zone/183501-fell-off-ladder-what-nightmare.html

First off, how can two wrist surgeries cost $33,000? That's obscene.

He had insurance, he's still on the hook for the entire bill, and the slimy insurance underwriters are laughing their way to the bank with billions in hand.

I don't know what the solution is, but the system is catastrophically broken. I have a hard time believing a single iota of dissent for the current plan because I know the insurers will say anything to preserve the goldmine that is the current system.

[Derwin0]

Did he not qualify for Workman's Comp?

[msmith198025]

Did he not qualify for Workman's Comp?

Good question.
I would bet there is more to this story than the poster (not Sky) is telling us.

[msmith198025]

I don't know what the solution is, but the system is catastrophically broken. I have a hard time believing a single iota of dissent for the current plan because I know the insurers will say anything to preserve the goldmine that is the current system.


Sky, forget the insurers, looking at the bill as it is, do you think it is a good idea? Do you think the plan is laid out correctly for us, and do you think it is affordable for the nation? Do you think our small companies should be on the hook for this or pay a fine?

If we want to fix what is wrong, should we not take our time and get it right? Why rush through a bill that half our lawmakers have not even read?

[vurbano]

First off, how can two wrist surgeries cost $33,000? That's obscene. you must be kidding right? My son shattered his ankle and was in surgery for 5 hours., 3 metal plates, about 15 screws and chicken wire to put him back together. Im positive it was more than 30k.

[Derwin0]

He should have realized that his wife's policy doesn't cover work accidents. Same as it won't cover work accidents for his wife either (her school's workman's comp picks that up).
My personal car insurance won't cover me if I'm on travel for work, work has to pick that up.

My guess, the installer just didn't pay his workman's comp premiums in order to save some money.
I hate to say it, but he gambled and lost.

[Skyhi]

Sky, forget the insurers, looking at the bill as it is, do you think it is a good idea? Do you think the plan is laid out correctly for us, and do you think it is affordable for the nation? Do you think our small companies should be on the hook for this or pay a fine?

If we want to fix what is wrong, should we not take our time and get it right? Why rush through a bill that half our lawmakers have not even read?

I have no idea about the bill because there's no way in hell I'm going to read it. I believe pretty much nothing I hear about it because both sides have an agenda and have a tendency to massage the facts. As far as small companies go, I heard that small businesses who do not net 250k/yr are exempt from the program. Is this true? I don't know...maybe it's just more massaged facts.

[Skyhi]

you must be kidding right? My son shattered his ankle and was in surgery for 5 hours., 3 metal plates, about 15 screws and chicken wire to put him back together. Im positive it was more than 30k.

It was MORE than 30k? Let's say it was 30k.....that's $6,000/hr parts and labor. That's completely absurd...I'd like to see an audit of where exactly every penny went.

[Skyhi]

He should have realized that his wife's policy doesn't cover work accidents. Same as it won't cover work accidents for his wife either (her school's workman's comp picks that up).
My personal car insurance won't cover me if I'm on travel for work, work has to pick that up.

My guess, the installer just didn't pay his workman's comp premiums in order to save some money.
I hate to say it, but he gambled and lost.

There's definitely some truth to what you're saying. I still think it's a major problem that this guy (and his wife's employer) have been paying 8k-12k/yr (who knows for how many years) and they're sticking him with a 30k bill.

[msmith198025]

I have no idea about the bill because there's no way in hell I'm going to read it. I believe pretty much nothing I hear about it because both sides have an agenda and have a tendency to massage the facts. As far as small companies go, I heard that small businesses who do not net 250k/yr are exempt from the program. Is this true? I don't know...maybe it's just more massaged facts.

$250,000 a year is not that much though for a company, even a small one. I think there is an employee limit as well, but from what I understand (and this may be incorrect) the limit is 5 and below.

[Skyhi]

$250,000 a year is not that much though for a company, even a small one. I think there is an employee limit as well, but from what I understand (and this may be incorrect) the limit is 5 and below.

You must be living large, because $250,000 net profit is a ton of money in my opinion. :)

[msmith198025]

You must be living large, because $250,000 net profit is a ton of money in my opinion. :)

It is a little different having that as net income as an individual vs running a business though.
It would not seem like it perhaps, but it is. It is alot easier to lose that much the next year (or more) in business vs working for someone else.

[Skyhi]

It is a little different having that as net income as an individual vs running a business though.
It would not seem like it perhaps, but it is. It is alot easier to lose that much the next year (or more) in business vs working for someone else.

Maybe in the most volatile of businesses, but I'd imagine 95% of most small businesses do not experience such fluctuations. For those that do, they can get a sizable tax refund from previous years using a NOL carryback and I would hope that somewhere in the 1000+ page health bill there is a provision for NOL carrybacks and carryforwards as it relates to mandatory coverage.

[msmith198025]

Maybe in the most volatile of businesses, but I'd imagine 95% of most small businesses do not experience such fluctuations. For those that do, they can get a sizable tax refund from previous years using a NOL carryback and I would hope that somewhere in the 1000+ page health bill there is a provision for NOL carrybacks and carryforwards as it relates to mandatory coverage.

Is there any other kind? lol

I am not sure about all businesses of course. Just going off of experience in our particular field, and I would imagine most manufacturers are similar.

Edit: I may make it seem like many are losing that much on a bad year after gaining that much the year before. I did not mean it that way, I simply meant it is very possible.

[Skyhi]

Is there any other kind? lol

I am not sure about all businesses of course. Just going off of experience in our particular field, and I would imagine most manufacturers are similiar.

I doubt doctors, lawyers, accountants, restaurant owners, car mechanics, florists, funeral homes, specialty shop owners, vets, plumbers, electricians & carpenters (to name a few :)) experience a 500k net income swing year-to-year. :)

Manufacturers bottom line may trend with the current economic cycle, but there are provisions in the IRS code (and hopefully the health bill) to smooth out the volatility.

[msmith198025]

I doubt doctors, lawyers, accountants, restaurant owners, car mechanics, florists, funeral homes, specialty shop owners, vets, plumbers, electricians & carpenters (to name a few :)) experience a 500k net income swing year-to-year. :)

Manufacturers bottom line may trend with the current economic cycle, but there are provisions in the IRS code (and hopefully the health bill) to smooth out the volatility.

Doctors, lawyers and accountants maybe. Several of the others though will probably see a fluctuation in income given the econimic climate of any given period. I know many plumbers, electricians, and carpenters that are out of work or doing very little compared to the past. Restaurants would probably see a downturn depending on the economy as well. People are making less, they are staying home and cooking more. Florist too for that matter. I know my wife is not getting as many flowers as she used to:)

I am just telling you what I see. If we as a company are forced to offer this plan or pay an 8% penalty based on our payroll we will seriously consider either laying people off to help offset it, or even (and I do not want to think about it) shutting down. Many I have talked to, in several different areas are saying the same thing.

[vurbano]

I don't think the system should cover people with net profits over 250k a year.

[msmith198025]

I don't think the system should cover people with net profits over 250k a year.

So they should pay for it, but not have access to it?

[vurbano]

So they should pay for it, but not have access to it?

correct, you should pay for me you rich b@st@rd :)

[msmith198025]

correct, you should pay for me you rich b@st@rd :)

Lol, I never said I personally made that kind of money:)

It would be nice though. I was talking about small businesses making that profit.

[stevenl]

Sky its not his wifes insurance companies fault he got injured at work. Its clearly in their rules they do not cover this, he should of gotten supplemental insurance to cover such indicdents. Ala Work mans comp, etc.

We recently had a baby, cost us over 20k. That was for a C-Section.

[sniffin aroun]

biggest mistake this guy made was to tell them
he was working instead of installing something for a friend.
sometimes to keep from being screwed, you must screw first.

[msmith198025]

biggest mistake this guy made was to tell them
he was working instead of installing something for a friend.
sometimes to keep from being screwed, you must screw first.

I for one am glad more people do not do this

[Bear Paws]

Here's a post from the installer zone at satguys:



http://www.satelliteguys.us/installer-zone/183501-fell-off-ladder-what-nightmare.html

First off, how can two wrist surgeries cost $33,000? That's obscene.

He had insurance, he's still on the hook for the entire bill, and the slimy insurance underwriters are laughing their way to the bank with billions in hand.

I don't know what the solution is, but the system is catastrophically broken. I have a hard time believing a single iota of dissent for the current plan because I know the insurers will say anything to preserve the goldmine that is the current system. "the system is catastrophically broken." BS. The system is fine. He just tried to circumvent the system and it bit him in a butt..

Whats the problem here?? He is a subcontractor. He is self employed and gets paid on a 1099. Its up to whom ever he is contracting to to demand proof of insurance, both Workman's comp as well as liability insurance with the contracting company named as a co-insured on the policy too and he may have had that when he signed on..But if he stopped paying his premiums there is no way the contractor would know in order to terminate his contract. .Around here the Insurance company does inform the co-insured. The question is how quickly. Who does he expect will pay if he rips the customer's roof up or hurts someone. The guy was gambling with the 1099 laws, he didn't want to pay the insurance and pocket the money and lost.

If he was not required to have insurance to get contracts then he does not pass one of the most important subcontractor tests. The contracting company may be liable for him as a employee.

He wishes he worked for someone? Fine. But he would have been making 1/4 or less of the compensation he was getting as sub. There is a thing called cost of doing business. That's why you get paid more than a employee. To cover those costs. No sympathy. None.

[vurbano]

Lol, I never said I personally made that kind of money:)

It would be nice though. I was talking about small businesses making that profit.

You are so easy. you really need to recognize a joke when you see it. I was doing my bob Haller imitation

[msmith198025]

You are so easy. you really need to recognize a joke when you see it. I was doing my bob Haller imitation

I know....lol;)