The NEA on Health Care Reform

This is from an email newsletter I got:

NEA opposes any tax on health benefits, including a tax on insurance companies, which would be passed off to consumers in the form of higher premiums. Many public education employees have traded salary increases for the long-term security of a comprehensive health plan. Telling them benefits will be cut or that they will pay more taxes would unfairly penalize them.

In addition, such a tax would place the burden more heavily on some workers than others. Coverage is more expensive for employers whose workforces are older or female-dominated such as education.

I remember McCain proposing a tax on health benefits during the campaign, and we blasted him for it. It's weird to see the idea coming back to life when the Democrats control every branch, and while I get that it's only supposed to be on super-duper-cadillac-A1 plans, as someone who gets heavily subsidized by the state for his insurance, I worry.

Read more here, if any.

Health Insurance Redux

The other day I chided Rep. Condotta for his attack on insurance benefits for public employees; today's mail brought more ammunition.

My district offers 12 different insurance plans, which in and of itself might be a problem. Today I got a packet about our upcoming benefits fair that contained a spreadsheet comparing all of the plans that we offer, showing what the co-pays are, deductibles, benefits, etc.

I'm on the Group Health $15 Copay Plan, which is by far the most expensive of the Group Health plans but looks reasonable when compared to Premera. Go down to the lines about "Hospitalization" and "Outpatient Surgery" and you'll see why the thought of one of Rep. Condotta's high deductible plans terrifies me:

Hospitalization
$15 Copay Plan: $300 maximum copay, then covered in full
$500 Deductible Plan: $1,000 maximum copay, then covered at 80% after deductible is satisfied.

Outpatient Surgery
$15 Copay Plan: $15 copay
$500 Deductible Plan: $100 copay, then covered at 80% after deductible is satisfied.

I've talked before about my profoundly deaf daughter. Her left ear works for now with a hearing aide, but her ENT doctor has said that she could easily be a cochlear implant candidate if her hearing degenerated any farther. Given that the surgery and equipment can cost $50,000 a shot, even 80% coverage would still mean that I'm out $10,000 (or, 5 months of take-home salary) to pay for the procedure.

NYC Educator has been doing some incredible writing about health insurance, the health care industry, and how it all relates to teachers. My project for back to school, before I speak to the membership, will be to line up our health plans with the state offerings and see if they compare. If they do, maybe that's the way we go. If they don't, then we keep doing what we're doing.

It's going to be a fight either way.

Read more here, if any.

Why I Worry, Health Insurance Edition

Take a minute to let this press release from Rep. Cary Condotta wash over you:

"Let's get back to true insurance instead of prepaid health care. It worked before and it will work again," said Condotta. "Now if we could just make Health Savings Accounts available to all state employees, as is required under House Bill 1383 signed into law in 2006. This type of option could actually reduce costs and premiums for all plans. Now is the time for bold action to reverse the perverse cost increases in health care caused by low deductibles and co-pays. Steve Hill and the board have taken the first step, now let's get the HSA option in place and watch health care costs decline and people's health improve accordingly."

Get that? $15 co-pays and $100 deductibles are THE PROBLEM, and Rep. Condotta has a solution: health savings accounts! Never mind that there's ample evidence that HSAs make existing systemic problems even worse. Marguerite Roza of the University of Washington has written before about the "above average" health insurance that teachers receive, the clear implication being that we're getting something we haven't earned and that something should be done about it.

I carry the insurance load for my family. My wife is self-employed, and with my special needs daughter in the picture I'm a power user of our Group Health plan. This year I've paid $442.86 a month, and next year preliminary estimates say that it'll be more like $470. I also put $100 a month into an American Fiduciary flexible spending account, and I'll easily use all $1,200 of it before the year is done.

Granted, I'm not typical. Single employees, employees who are covered by their spouses, and employees with no kids in the home usually end up contributing to the insurance pool that gets split up among people like me who pay out-of-pocket. If you cover your family a proposal like Rep. Condotta's screws you over twice, when your rates go up AND there's less of a pool to help you out.

The problem that's been identified by everyone is the cost to the system. Any solution that relies on making things harder for teachers isn't a solution that deserves to go anywhere.

Read more here, if any.

The Over Paid Teacher

There’s a lot of people out there who talk about teacher salaries in the abstract—“They’re overpaid! They’re underpaid! They’re paid just right!”, etc. Since teacher salaries are a matter of public record there’s not a whole lot to be argued about there, but what about the other numbers like benefits, retirement, etc.?

On Friday I got my annual statement summarizing all my paychecks for the year. I give you those numbers here so that you can know exactly what it’s like.

• Social security wages: $42,864.02
  
• Wages, tips, other compensation: $35,822.74
  
• Federal income tax withheld: $4,390.32
  
• Social security tax withheld: $2,657.56
  
• Medicare tax withheld: $621.53

That’s basically the information from the W2. The central number is the second, because that was nominally my take home pay after taking out the income tax and social security.

Oh, but there were other deductions:

• L&I: $48.72
  
• Section 125 ME: $4,077.82
  
• Union Dues: $732.64
  
• Retirement: $7,041.28

The total of those deductions is $11,900.46. When you subtract that from the line above it leaves about $24,000, or $2,000 a month.

What’s that Section 125 ME number? That’s what I pay in health insurance out of pocket per year, or about $340 a month. If anyone tells you that all teachers get their health insurance paid for, slap them with a trout. Know too that I voluntarily put far more into my retirement plan than I have to, but on TRS3 if you don’t save for yourself you’re absolutely screwed.

This is my reality. What's yours?

Read more here, if any.

Daughter Update

I've come over time to believe that the phrase "Sleep like a baby" is a load of horseshit, because my dear daughter doesn't sleep. She kicks her daddy in the ribs, she flails, she hits her head against things--she puts out more energy sleeping than I do awake.

My official diagnosis for my daughter right now is congenital cytomegalovirus (CMV or CCMV, depending on where you look). The way that it's manifested itself the most is deafness--she was born with total hearing loss in the right ear, and a 70-80% loss in the left--and the concern with CMV is that she could also lose her eyesight, which would leave her deaf-blind. Yesterday we received a bit of hope from her ENT doctor, who said that the hearing she has is maintaining nicely, and that with CMV kids most of the problems are there at birth, and almost certainly by age three. We're halfway there, so it gives us a target.

Insurance is a pain in the ass. Couldn't live my life right now without it, but it's still a wonky, wonky system. My daughter is qualified for physical therapy and speech therapy, but they only authorize for 12 visits at a time, and the referral has to come from her family doctor, not from the office where we get PT and speech. That means that I have to do some careful calendar watching to make sure we're not running out of referrals, then call the family practice, who calls Group Health, who calls the PT center, who confirms with Group Health, who then sends out a referral. We do this every 10 weeks or so. With my daughter, who is certainly going to need both for the forseeable future, wouldn't it make more sense to give me a 1-year authorization with a reminder to stay under the 60 visit cap that's in the plan?

Such is life with a special needs child.

In other news, we're still efforting getting an appointment with the pediatric neurologist to go over the results of her MRI and find out what exactly that scar tissue in her brain means. That'll be a big appointment. In two weeks we have her eye appointment, and we're praying hard for that one to be where we want it to be. If you're of that bent, and candles lit would be appreciated.

Happy weekend!

Read more here, if any.