My Darling Humana One TX HDHP PHP-R-Medical IPP,
It's high time I told you how I really feel about you…
Last year I found myself back in my hometown, working in the family business, quickly approaching my thirties. I realized I didn't have what I really needed in life - stability, certainty, and something to hold on to, in good times and bad. So I did what most people do these days when they're looking for a life partner - I went online. And there you were, on that snazzy health insurance comparison website I visited. Looking at your profile, I fell for you then and there. I was drawn to your low maintenance monthly premium, just 75-dollars. That's less than a cable bill! You're also really laid back. Some say maybe a bit too laid back. They look at your high deductible and ask me what will I do if, one day, I'm down on my luck, and in need? Will my health plan be there for me?
That's when I say hey, back off man, chill, it's all ok, she's got an HSA. The health savings account is the best part about our relationship. I can put more than 3-thousand dollars aside every year tax free. I can invest it wherever I want, and can use it whenever I need it for medical expenses. Otherwise, if I stay healthy until retirement age, I can use that money like an IRA. So I tell them, don't worry about me bro, you should check your own plan and see how good it is.
Now dear, I need to confess something. There are these other plans that everyone's talking about, these Affordable Care Act plans. Well, I went online and had a peek. You see, there was a wise calculator, the Kaiser Foundation calculator, that I used, just to try and picture what my future would be like with an A.C.A. plan. It turns out, I'd have to pay three times more per month for one of their plans, with no HSA benefits. So I found out what I knew all along, you are the best. For me, at least. So on this, the day of our five month anniversary, I'll say it…I love you. With you, my premium is low, my HSA will grow, and I'll get a tax break every year. What's not to love?
Subscriber ID 70052156 02
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October 1st is when insurance exchanges and new insurance plans open as part of the Affordable Care Act.
Dan Gorenstein covers health care for Marketplace, and says it’s a big day for insurance in the U.S. "What is really going to happen here is … state exchanges, and federally-run exchanges all around the country are going to begin offering people who are currently uninsured … insurance.”
Those new exchanges will be open on websites. “So you can go online to a website, similar to Travelocity, and kind of shop for the health care plan that makes sense for you most,” says Gorenstein. “People have from October 1st through March 31st to sign up for coverage.”
If you’re new to health insurance, you might not know what that entails. Health insurance on the exchanges will typically be comprised of monthly premiums, out-of-pocket, or co-pay, prices and figuring out what network of providers, hospitals, doctors and specialists you’ll be using.How do you know if you have good health insurance?
As for the price? It’s a little complicated, but it mostly depends on how much money your household earns and how old you are. “The sticker price, the price that you actually see on the website, is going to be anywhere from $150 to $650 per month,” Gorenstein says. “That’s before these federal subsidies kick in. Lots of people will be eligible, for some federal subsidy.”
Though the sticker prices you initially see will vary, Gorenstein highlights an example of a 28 year old and a 62 year old that both make $28,000 a year. Though their initial price will be different, once subsidies kick in, they’ll pay the same cost. “It’s really a calculation based on how much you earn,” Gorenstein says.
Still, people will still have the option to decline to purchase health insurance. What happens in that case, Gorenstein says, “is you’ll be fined 95$ or 1 percent of your income, whichever is higher. And that penalty ratchets up. It gets higher again in 2015, and higher again in 2016, and that’s when we’re not talking about 1 percent of your income, we’re talking about a penalty with some real teeth to it.”
Some of this might still be confusing, but there are resources for people to use to figure this all out. “The federal government has set up a website, HealthCare.gov,” Gorenstein says, to help people choose a health insurance plan. “There are people called navigators, or ambassadors, and I would strongly encourage anybody who’s really thinking about ‘what plan is best for me’ to have a conversation [with a navigator]. This is very dense stuff. You need to appreciate how much money you make a year, you need to understand how sick you and your family are, and depending on those factors it’s going to vary from person-to-person what kind of plan is best for you.”
Most of us get health insurance through our jobs. Usually, your company gives you one or two plans to choose from and each payday, a little comes out of your check to pay for it. Now, there's a new trend emerging at some major companies like IBM and Time Warner. They're offering retirees and active employees private healthcare exchanges, where you get a set amount of money, and then pick from a bunch of different plans. It's an example of how the health care system is changing for everyone, not just people buying insurance under the Affordable Care Act. Bloomberg News health reporter Alex Nussbaum has written about this.
"These are websites, generally, where you can go and find a menu of insurance options. The idea here is that the individual worker or retiree can go choose their own insurance as opposed to taking the one or two options that your company can provide you through an employer sponsored plan," Nussbaum says. "At least the argument from the companies is that more choice will lead to a better deal for their workers or retirees. You don't have to take the one-size-fits-all plan. If you're relatively healthy, you can choose a plan that has higher deductibles but a lower premium, maybe choose a plan that holds down costs by favoring generic drugs over brand name ones."
Of course, companies wouldn't consider this if it didn't save them money in the long-run. Nussbaum says some employers who have tried this have offered employees anywhere from $2,500-$3,000 per year to shop with on private health exchanges. That amounts to less than they'd have to pay for insuring workers under traditional company plans on average.
"Health care costs, while they've been slowing in recent years, they've still been going up faster than inflation for over a decade -- certainly faster than employee wages are going or the fixed income that retirees are on. So the argument is that this saves the company money and that it might save the individual who's buying insurance money," says Nussbaum. "For retirees, depending on where you live, the Medigap or Medicare Advantage plan you can find might be a better deal for you than what your company can offer."
Nussbaum says that if this trend takes hold, workers will have to be much more involved in their own medical coverage options than ever before.
"The burden of choice is going to be much more on you," he says. "There's going to be more choices, more flexibility. But, it's going to be up to you to figure it all out. I liken it to the move from pensions to 401(k)s that we've seen over the past couple of decades. Right now, you are really responsible for your own investments and choosing the right one and, of course, for a lot of people that's a real headache and [it] induces a lot of anxiety. But for other people, they probably like the freedom."
If your company adopts private health exchanges, and you're confused about your coverage options, ask for help -- either from your employer or from the insurer.
As we approach the fifth anniversary of the day Lehman Brothers went bust, Marketplace has been taking a look at how the crisis unfolded in America from a variety of angles. And the effects of the financial crash reverberated across the globe where entire economies went bankrupt. Marketplace's European editor Stephen Beard covered the events in real time and joins Morning Report host David Brancaccio to discuss.
Click the audio player above to hear more.
Torrential rains around Boulder and nearby areas have led to at least three deaths and numerous washed-out roads. Forecasters warn that while the downpours should taper off Friday, even modest rains could cause more flooding.
When it comes to health care, costs during the last two years of life are the most expensive in the industry. According to the Dartmouth Atlas of Health Care, which investigates health care costs and issues around the country, "patients with chronic illness in their last two years of life account for about 32 percent of total Medicare spending, much of it going toward physician and hospital fees associated with repeated hospitalizations."
Why are those costs so high?
According to Dr. James Weinstein, president of the Dartmouth-Hitchcock Health System, much of it has to do with how difficult and complicated that time can be for families. "Caring for a loved one ... [there's] always a challenge in that, I don’t want to feel like I’ve left them down," Weinstein says. "I lost my daughter, who wasn’t a parent, or grandparent, but a child. And the dilemma that my wife and I went through at the end of her life, not wanting her to be in the hospital, but certainly wanting to do everything we could, really puts it in my heart. I think we knew that the end was near, but we also had to talk about it."Learn more: The cost of caregiving
Dr. Weinstein says those conversations are important not only from a financial standpoint, but a personal one as well. "I think that a lot of families don’t know how to talk about it, but I would encourage the listeners and the families to try as hard as it is to have open and honest discussions as a family," Weinstein says, "and then spend that time so that you’re not in a hospital doing a lot of things to a loved one that won’t matter, as far as saving their life. And I think that amount of money in the last couple of years really is a product of what we’ve gotten used to as a society, right or wrong, and I don’t sit here judging it. I sit here saying I question it, whether people who were well informed and had the right discussions would want heroics in those last few moments, more ICU bed days ... would they really want that if they had that honest discussion?"
One option for patients dealing with chronic illnesses, Weinstein says, is palliative care, which focuses on relieving pain and suffering of patients. "Most patients just assume and their families assume that wherever they’re getting care, that their insurance or somebody else is going to pay for it. When you’re in an environment in a hospital, the dollars that we spend to do every little thing, runs the cash register up faster than you can imagine."
And despite the lower costs, Weinstein says the care is just as effective. "The patients I visited in hospice palliative care facilities, it’s really just dealing with their pain and discomfort, so they may pass on to their next world in a safe and comfortable way," says Dr. Weinstein. "I hope more people ask those questions. Could my mother be in a place to keep her comfortable that might be less expensive and better for her?"
The tech industry's sometimes sexist "brogrammer" culture came into focus this week, when an offensive app was presented at an industry hackathon. So we asked developers, community leaders and others in the tech sphere to share their ideas for addressing the industry's cultural schism.
The hardest part about telling the story of Sioux Falls, S.D., was figuring out which part to tell first.
The city has a strong economy -- the unemployment rate is at 3 percent. They’ve got white-collar jobs that are relatively new additions to the area (Citibank’s only been there for about three decades). But just outside of downtown is a meatpacking plant that’s provided blue collar jobs for over 100 years. An even older industry that still powers Sioux Falls? Farming -- the city is surrounded by corn fields that go on for miles.
But at the same time, the city has a surprisingly national reach. Companies in Sioux Falls make food that ends up on your dining room table, in hotel breakfasts, and school lunches. The legislation their state government has passed has meant changes in the way credit card companies across the country do business -- and that means you pay a higher interest rate because of it. And the satellite technology one Sioux Falls company has developed means farmers can drop fertilizer directly on top of the corn seed they planted weeks before -- growing more, with less.
Take a listen to the full story of Sioux Falls, our first stop on our American Futures tour with The Atlantic’s Jim and Deb Fallows, and Esri. We’re exploring the way the real American economy works today, telling it through the voices of the people who live it.
Although a Free Syrian Army commander has said his fighters haven't yet gotten any "lethal aid" from the U.S., sources tell NPR that some small arms are being delivered to "moderate" rebels. Meanwhile, U.S. and Russian diplomats report progress in their discussions.
Also: J.K. Rowling will write a screenplay set in the magical world; Tina Brown is coming out with a memoir.
Norman Rush's newest novel takes a geographic hiatus from Botswana, his usual literary location. Instead, reviewer Drew Toal says the book is instead full of irritating intellectuals, postmortem scandal, and a group of collegiate clowns who come together after the death of an old friend.
Republican leaders recall how their party was blamed for the shutdowns of the mid-1990s and earnestly want to avoid a repeat, especially heading into an election year.
The Obama administration's decision not to challenge pot legalization in Washington and Colorado is reverberating in states where regulation of medical marijuana has been scant.
The brutal attack shocked the nation and led to changes in India's laws about violence against women and sexual assault.
This final note today, just to remind us that while Lehman Brothers was an American bank, and collapsed a full five years ago, the financial crisis was a) global and b) lasting.
Greece, as you know, has been through the wringer. Two EU and IMF bailouts. Austerity budgets as far as the eye can see.
Which gets us to this today from Reuters: The government in Athens has scrapped a 24-year-old perk enjoyed by public sector workers -- six extra paid days off a year, if your job involved sitting in front of a computer more than five hours a day.
Which is my job, now that I think of it.
Five years after the collapse of Lehman Brothers and the start of what became a global economic crisis, the final moments of a failed financial institution unfold at a Dublin auction house, where the auctioneer sells off the art collection of Anglo Irish Bank -- Ireland’s most notorious lender.
It and other banks in Ireland made scores of bad property loans that cost taxpayers billions of dollars and forced the country into a bailout.
Dublin resident Ronan Farren stopped in to have a look at the paintings, and to reflect on just what’s happened to Ireland over the past few years.
“It’s been a disgrace how the country has been sold, if you like, because of the mistakes of the bankers,” says Farren.
Indeed, the crisis was so deep in Ireland, it’s worked its way into every aspect of Irish life and culture.
At a theater rehearsal in Dublin, the characters in a play called “The King’s Feet” are a couple ground down by financial worries.
“There are debts we haven’t cleared,” says one of the leads.
“Baby, baby, we’re both professionals, alright. We’ll both be working soon. I promise,” her partner replies.
But faced with long-term unemployment, they do what a lot of young Irish people have done lately -- they leave Ireland to find work.
Danny McCoy of Ireland’s Chamber of Commerce says the crisis has caused too many people in Ireland to either emigrate or essentially put their lives on hold. But he says that’s partly because the narrative about Ireland has been overly negative.
“The Irish story has been exaggerated out of all proportion,” says McCoy. “People perceive Ireland as some kind of poor, backward European country, which couldn’t be further from the truth.”
He says Ireland is already well into recovery. Sure it's still in recession, but exports from Irish software and engineering companies are rising by more than 15 percent a year.
The one thing that’s missing, McCoy says, is confidence on the home front -- the confidence to spend.
“Households start to spend again and believe in their own future, they’d kick start a very virtuous circle of growth,” says McCoy.
In fact, for a country brought down by a property bubble, his message is one that many thought they wouldn’t hear again for a long time in Ireland.
“Buy a house,” McCoy urges. “Buy a house. There’s plenty of them.”
It’s advice that might not be too far-fetched. Near Dublin’s waterfront, real estate agent Owen Reilly shows me around the city’s technology and financial services district.
In the wake of Ireland’s crash, he says real estate values here dropped by more than half. But demand for housing and office space is on the rise in Dublin. In the past year, Reilly says prices in this neighborhood have jumped 15 percent.
“And I would predict, before this year is out, they’ll increase another 5 percent,” says Reilly.
He notes an average two-bedroom apartment now goes for upwards of $400,000 dollars. And many, like Danny McCoy of Ireland’s Chamber of Commerce, fear another housing bubble is already brewing in the Irish capital.
McCoy says that’s because supply hasn’t kept up -- practically no new housing or office space has been built in the past five years.
“We’re going to need to start building -- need start building fast,” says McCoy. “There’s always a danger that we’ll go headlong into property again, but you know, have a good time along the way.”
Of course, having “a good time” is what got Ireland into trouble in the first place.
An Indian court has sentenced to death the four men convicted in the December gang rape and murder of a young New Delhi woman. The death sentence, handed down Friday, must be confirmed by India's High Court. The men can appeal their case to the Supreme Court, and ask the president for clemency.
The short-message social media company Twitter wants to sell many little slices of itself to the public--it filed for an IPO yesterday. Naturally, the company announced the news in a tweet. Marketplace's Mark Garrison joins Morning Report host David Brancaccio to discuss what it means to confidentially file for a public IPO and what the company will do with the money it raises.
Click the audio player above to hear the interview. And to hear more about Twitter's future plans and who the company is acquiring listen to David's conversation with Ben Popper, business editor at The Verge.
It's quiz time on Marketplace Tech. 69.63 kilobytes, 84.1 million, 12,000 resumes, and 3: Can you guess what these numbers mean?
We put Jon Gertner, editor-at-large for Fast Company and author of “The Idea Factory: Bell Labs and the Great Age of American Innovation" to the test for our latest edition of Silicon Tally.
Click on the audio player above to play along.
Some pretty big news in under 140 characters. There's been talk for months about whether the popular micro-blogging site would go public. But Twitter's filing was a bit unconventional. The company filed for an initial public offering of stock with the help of a provision in the JOBS Act. Zach Seward, senior editor at Quartz, joins Marketplace Tech host Ben Johnson to discuss.
Click the audio player above to hear more.