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Health care & your family's work set-up: Is it "working"?

2782154119_6b87c03ecf-1 I'm one of the lucky ones who has chosen  - and gotten - paid work that provides health insurance.  Good health insurance (a relative term, to be sure, in this country).  But my partner isn't; he works for himself.  Which, BTW, is a terrifically flexible parenting set-up.  But as the sole health-insurance winner in our family of (now) four, the provision of this treasured resource has dominated every. single. one. of my employment decisions as a mother.  Not exactly how I'd imagined pursuing a career. 

I bring this all up not just because of the explosive events occurring around the country right now related to national health care reform, or even the impressive health care series that a Portland mama is writing over on Activistas, but because I wonder, as fellow Portland parents, how much your family's employment decisions are driven by access to health care? 

While I am truly thrilled (which is in itself ridiculous) to have health care for my entire family through my work, I regret that the type and amount of work I do is driven by access to health care.  We tried me working P/T with no health care and, while it was wonderful time-wise, it was perfectly dreadful vis-a-vis everything else: it was complicated, expensive, different plans for adults and kids, and - importantly - one child denied (yikes).  No thanks, not again, not this mama.

Of course, "in this economy" it feels crazy to complain about any of this, honestly - I definitely get that.  Yet, because health care reform is very much on the table, it seems relevant.  I, for one, don't think access to health care should drive people's employment choices - parents or not.  But untangling that historical link ain't gonna happen this year.

What employment decisions has your family made to access health care?  Are they working?  Are you happy with them?  Or do you feel a bit trapped by it all, like I do?  Or maybe you've found an excellent end-run that the rest of us should know about?  If so, I'm all ears.  This work-family balance thing is hard enough, without forcing my hand so I can take my kids to the doctor and prepare for unforseen illnesses without bankrupting my family. 

It's a big topic, this health care reform.  Big enough to scare even an incorrigable activist away.  But when I think about it in terms of my family (and therefore all families), it seems important enough to dive right in.

[photo thansk to flickr CC & superhua]

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After the birth of my daughter (first child), I decided to switch to part time work. It drastically changed the cost of my own health care through my employer, and also was astoundingly expensive to add my daughter. We ended up adding her to my husbands policy (still expensive, but slightly less), but I am frustrated daily with the issues that health care coverage can cause. I work at a nursing home, so I see the problems from all ends of the spectrum (birth to end of life) and without getting too political, I will say that I believe we need a single payor system, completely unattached to work. This is the best, simplest way to ensure adequate coverage for all without the anxiety of employment and pre-existing conditions getting in the way. That's just the conclusion that I have come to based on my own work and life experience...

Check out the Activistas plans to attend (in person or call-in) an upcoming town hall on health care: http://bit.ly/AJY3R. There are a range of times that might accommodate varied work schedules. I know the 6-7 PM is best for me. Join us :-)

My part-time work doesn't come with benefits so we've always been covered by my husband's employer. When he was laid off last winter, it was a HUGE hit to the savings to pay for COBRA. Luckily he found new work, because he and I are uninsurable in the individual market, and the savings account was gone. (I've been turned down twice because I have a six-years-stable thyroid condition that requires annual monitoring. Go figure.) It doesn't work for me. It's so wrong.

I now live in Ca- lived in wonderful Portland for a bit. Still a regular on this website though I'm no longer a Portland mama. Health coverage is a big factor in relation to employment.At least in Oregon there was some sort of low cost kid insurance thru Blue Cross/ Shield -not sure how that worked. My husband has a health problem so is not working and has been denied disability and he needs health care regularly! So if I am to work more hours we'd lose our 'free low income' coverage for him and my son - I have coverage thru my work for $25 a month for myself. I could pay for them to be added but it would be $600 a month! And now the low cost health coverage for kids for working folks who make a bit more money (Healthy Families) is on hold because of Ca budget woes.So once again it is actually better health insurance wise to work less and be poorer.
Are there even full time jobs out there anymore that give your family full coverage without $600 monthly fees? And no I don't have a college degree. Have always worked and made it, but can hardly make it now.

I should add that a person could get coverage for less than 600 a month on the outside maybe but not for preexisting conditions easily which a group plan can sometimes cover...all gets so complicated.

I had started a small consulting business that was becoming successful enough for me to hire an employee but my third appeal for my healthy 5 year old daughter with zero medical issues being denied coverage due to autism forced me to find a job with health coverage and give up my business. So much for the American Dream and so much for small businesses that can generate work for others.

I pay nearly $700 per month for health coverage pre-tax dollars. Kaiser for medical. My employer is a small group with goof number of employeesbeing over 50 and having had major surgeries in recent years, our premiums are higher. We have the option of opting out and seeking our own insurance but I have well-managed asthma and that puts me in the hard to insure category. As a single parent, a non-insured medical event would dissastrous, so there have been times in the past that I've had to have the kid uninsured to make ends meet because she is healthier.

My husband has a salaried job and I have my own business. We have used his health insurance for years--I can't even count how many years anymore. He has long wished he could quit his job and go out on his own, but he does not dare because of what the loss in regular salary and health care costs would be. Frankly, I haven't had enough time to really think about what I think about health care, but I do feel that, in order for everyone to enjoy health care, we all will have to make sacrifices--perhaps that elective surgery or service (tonsillectomy or mental health therapy for non-life threatening issues) will have to go by the wayside, but maybe my neighbor will get help with her autistic son. I think it will require a shift in our thinking about what health care should be. Maybe I am naive, but I think everyone deserves access to essential services, and I think our nation will benefit from that in the long run.

We have a small business - just my husband and I are employees - we're fortunate that we make enough to pay our $1400/month premiums. In Oregon, a small business can qualify for group health insurance with two employees (my understanding is that, with group health insurance, they can't reject you for pre-existing conditions). If we did not have this business, we would not be able to get insurance, due to those pre-existing conditions (which, as others have pointed out, can be serious or very minor - doesn't matter; they'll reject you anyway). If you are rejected - I think it's twice - you can apply for OMIP (Oregon Medical Insurance Pool) but you pay for the premiums and they aren't cheap and it's not great coverage, from what I've read.

It's a big ******* maze, truly, to figure out how to get coverage. I am deeply embarrassed by what the "richest country in the world" calls a health care system. It's a joke.
We keep paying the $1400/month but it's our largest monthly expense (we also have one child in college and that's about what his tuition, r&b, etc. costs...). After those two expenses and living expenses, there's not much left...
You can read a ton of stories like this at the Organizing for America site - warning: you could spend a lot of time reading these tales; many are pretty sad...):
http://stories.barackobama.com/healthcare?source=actioncenter

Like the previous commenter, my husband and I own a small business where we insure ourselves and 8 other employees. We pay an astounding amount to have excellent insurance with alternative care options and dental, etc. But we had to lay off about half our employees in the past six months as the economy tanked (we had about 20 employees last fall). Only one of those opted for COBRA coverage because our insurance is really expensive. Most are just uninsured now and it's heartbreaking.

Our company surviving the crisis is what stands between my family having insurance or not, and not just our family--all of our employees too. Not only is the cost of health insurance an unfair burden to small businesses (who provide at least 75% of the jobs in this country!), but it's an unstable system. We need a single payer system that provides insurance to each person throughout their lives.

We have it quite easy -- my husband's insurance covers all four of us at no extra cost per month. Still, even as a very healthy family, we pay hundreds, sometimes thousands, a year for things that our insurance doesn't pay for -- dental co-pays at 50%, vision care for myself and the kids (only my husband is covered), prescription co-pays (my older son has allergies), co-pays for occasional procedures, etc. Even when it seems like we're set, we still pay a lot....

A big reason that I keep working is that my health insurance is above and beyond what my husband has been offered in his last three jobs... with two kids, our out of pocket costs are minimal to nil, which has been a blessing. If I were to quit working, my husband's plan would charge us for every well-child appointment, etc. and make it difficult for us to manage on one income.

I am considering going to 24hrs/week to accommodate spouses schedule and minimize/eliminate childcare costs. I will lose my employer based coverage and my spouses PT work doesn't offer bennies. I currently pay approximately $500/month for premium care for family of four('low' co-pays $30/office visits, low family deductible $450, low max out of pocket $6K/yr, 10% co-insurance) ie, just had a non-complicated epidural vaginal delivery at St. V's and my out of pocket costs were $2K (10% of the $20K bill!) Ouch! Compared to 3 years ago when I only paid $150, times are a changing.

I have been looking into Lifewise of Oregon though from reading these comments my infant may be 'rejected' as he has numerous food allergies. Did they really reject someone for pre-existing hypothyroidism?!?! Sheesh.

So now I may be staying full time:O( But I'll keep y'all posted if I follow thru with Lifewise.

My husband and I both work full time. He has insurance through his work, and I have insurance through my work. I was surprised to learn that is was less expensive to purchase an individual plan through Kaiser for my son than to add him to either of our employer provided plans. Needless to say, remembering the rules, fees, and phone numbers for 3 different insurance companies and doctor networks is SO RIDICULOUS!! Our US systems is straight screwed up!

I have also considered changing my work situation, but a switch to a different job with the same pay actually looked like a loss of $4,000 of insurance coverage. So, I stayed.

After reading everyone's comments I am so glad that I was a student when I got pregnant and completely broke. I ended up on OHP and everything has been free. Hooray for being poor!!

FYI, it is very typical to be rejected for coverage for pre-existing thyroid issues. Some years ago I had applied for an individual plan (I was single and no dependents at the time) and while I had a history of hyperthyroidism, my condition had been in remission/non-occuring for almost 5 years. I faxed copies of lab results over several years where I was tested and although results were all within "normal" levels (had self-regulated at that point without Rx) they still rejected my application for coverage. This was Kaiser, btw.

Just a thought on health-care (uncovered right now, been covered thru employer before)... most hospitals will let you set up a payment plan with no interest. We had to do that to pay off the 20% that wasn't covered for a preemie/c-section. Took a few years, but it cost less per month than insurance. Made me much less afraid to be "uncovered", especially because the only insurance I can find that will cover the alternative care my son needs for his autism is Lifeways. I may bite the bullet and sign up before school, since classrooms are full of little germ factories. But that "no-interest payoff" is something not always mentioned in the debate - as is the number I saw that most people that go bankrupt due to health reasons HAD health insurance. Please, pass a single-payer system and let's actually fix this mess.

When people ask me if I work or stay home with my son (a loaded question full of judgement that we've all discussed to death...), I say I work for health insurance. Initially, my costs for working: daycare, parking, etc. were a wash (improving recently...) My husband's work pays for our lives, my work gives us insurance. My coverage is excellent - my job has been dull. If I had a chance to go back to the non-profit arts world I came from I would love it for me, but I couldn't do it for my family. That one thing - insurance - has colored ALL work choices I've made since I began contemplating having a family.

My employment decisions are driven almost entirely by health care. I have great health care as a teacher and my husband also has good health care. Being double covered means we pay nothing out of pocket for health care for almost everything. However, I would like to go back to school, maybe try my hand in the private sector or go part time. I have diabetes and I've already been down the road of being denied by every health plan on the planet when I graduated from college and got kicked off my parent's plan. Luckily, I got a teaching job during a tough year for employment...I was so thankful as my prescriptions alone run over $400 per month just for my diabetes supplies. Now, with two kids, of course we need good insurance.

I just wanted to put this out there- Kaiser has just started offering free healthcare to non members whose whole household income falls below 200% poverty guideline. My friend who is a divorced Mom with 3 kids just got 6 months care and prescriptions with just a quick phone call.You need to talk to the financial counselors at Kaiser.

My family has always been extremely fortunate with regard to healthcare. My husband and I both have always been covered by our employers, me at no additional cost, and my husband at a small additional cost around $80/mo. And since we have both always been healthy we rarely used the healthcare we had access to and I never gave it much thought. Then in 2007 when we had our daughter we ended up paying upwards of $$2,500 for a normal/vaginal/epidural delivery at Good Sam. We chose to deliver at a non-member hospital requiring 10% additional, but we did not mind paying since it was our choice. However, I was astonished that it cost that much ($12K-ish)to deliver a child with no complications. I decided to quit my job after my daughter was born to stay home with her since coverage through my husband's employer was only $180/mo for a family (Amazing!). I then started working part-time with no benefits when our daughter turned one.

Fast forward... my husband was just recently let go and I was shocked to find out the COBRA premiums were going to be $1,200/mo. Are you insane?!?!?! Who can afford that, especially with a job loss. So, my company was kind enough to allow me to bump up my hours from 20 to 28 to be eligible for benefits but required that I reduce my hourly rate to make up for their cost of providing my family benefits. So I'm now working 8 hours more per week with no net increase in pay. Honestly, I'm happy to have a job (even if it is only part-time) and even happier to have family coverage. Although this arrangement is not ideal in the long-term it removed the urgency from an otherwise urgent situation. To answer the original question, yes, access to employer-provided healthcare coverage will absolutely dictate my employment decisions.

Just a note to anyone who might benefit from this information: workers who have lost their jobs may qualify for a 65% subsidy in COBRA continuation premiums for themselves and their families for up to nine months under the American Recovery and Reinvestment Act of 2009. In my example above, if I was not able to secure coverage through my employer, we would have had the option of continuing our $1,200 COBRA premiums through my husband's prior employer for only $420/mo (for nine months). Hopefully all employers are providing this information as they should be.

H - two posts ago - I'm thinking the free Kaiser insurance is only for the kids, right? I think it's for families with up to 250% of the federal poverty income level. But I'm pretty sure it only covers the kids...

Jen- Its for adults,just opened up until the money runs out-so call asap. They did everything over the phone for my friend and she saw the doctor at urgent care the next day.

I work for insurance too. It's sad that if it wasn't for that, I would be able to be at home with my son. I am lucky that for now I myself am completely paid by my employer. If I wanted to add my family though it would be completely out of pocket. upwards to between 7-900 a month. My husband hates his job but keeps it because he can have our son on his insurance. If I didn't work we couldn't afford the extra cost to add me. After expenses I only take home about 200 a month or so, but if you figure health insurance it's more so I am grateful. It's so sad that so many of us get lost in the middle. Too "rich" to qualify for assistance, but cant afford it on our own....

Same here... I bring home a good portion of our $bread and all of our insurance. Luckily I can earn good money in my industry working PT as an engineer and get benefits. Though, that said only certain employers will offer PT bennies and it has DEFINITELY affected my job choices. I left a job earlier in my career b/c they wouldn't let me work PT and get health coverage (changed their minds on me), and I'm talking 32 hrs here. Some people were surprised I left b/c of it, but I guess they didn't have a newborn and weren't given a choice between working FT or work PT and leaving their family w no health insurance. A crock.

Sometimes I feel strapped to my industry by my salary and benefits but luckily for now I truly love my work. I think things need to change though.

The other side of the coin is that my husband can work FT in his service industry and can get crap-for-benefits. So he works PT too. He's awesome at what he does, is well trained, is a contributing part of the workforce and has been at his company for 14 years, but has no way to get decent health insurance for his family. Something is wrong with this whole system.

has anyone seen the movie "Sicko"? and what did you think? the guy in france said there would be a revolt if the govt. didn't provide for the citizens (actually, if the govt. tried to reduce services). why do we americans keep taking it up the pooper when it comes to health care, education? sure, they pay through the nose in taxes, but they are well compensated to make up for that including 5 or more weeks paid vacation and a ton of other social services that are available. makes me sick. i'm this close to becoming an expat.

We had great insurance through my husband's employer, but he was laid off in January and the COBRA was more than we could afford. We have the baby on the OHP and I am currently looking for work that offers part time benefits so that I can stop the daily worry and guilty feelings that come along with using state funded healthcare. And, so that my husband and I can also be covered. I do not mind essentially working for nothing, other than health care. You do what you have to do. I wish it wasn't so. Tried to talk hubby into moving to Canada, but he spent 12 years of his life trying to get here from Cuba (where they have free healthcare, but a shortage of medicine) and won't consider it. Also I hear it's difficult to become a Canadian resident?

Sounds to me like we all are frustrated and agree the system is broken/non-sustainable, and forcing us into bad/worse choices for our families. So someone explain to me WHY all the wing-nuts have come out of the woodwork to shout-down open discussions of these issues and make it look like we Americans don't want healthcare reform? I just don't get it - are they all covered and happy? If so, tell us how they managed it!

Nif, what I find most fascinating is the protesters who appear to be at the age of Medicare coverage which is socialized medicine. These folks need to do a little research and find out why we have Medicare and ask if they want to return to those days before Medicare. Medicare is bankrupt and the boomers have just begun to enter the system. It needs a major overhaul. Either we continue to provide the extensive care this age group 'requires'/'demands' and we increase taxes to pay for it or we limit care and require more out of pocket for aggressive care. Tough decisions need to be made.

Quite frankly I am tired of hearing about families selling everything, draining 401K's, etc to provide care for sick children, tired of seeing the dang bake sales and garage sales to raise $ for these kiddos while we throw everything and the kitchen sink at some very old folks prolonging the inevitable. Yes, I sound cold and harsh but we do not have unlimited resources.

I am not totally thrilled with the idea. I rEalize this makes me unpopular on this forum, but in the end someone still has to pay. I hate the idea that the highest earning 40 percent will be covering the cost ( this months Fortune magazine went into detail) It fairly well known that in Canada there have been horrible problems with their health care system, the talented Drs. leave to practice privately. A trillion dollars is so much money to pay. What is each person or family expected to bring to the table? I don't get why everyone feels like they should be given somehing for free...
I do think it has gotten crazy, and it mAde more sense to be able to pay a dr or hospital bill at the time of service because it was a reasonable expense. Very clearly it isn't now.
I guess to answer the original question, no we don't choose employment for insurance, but would I like to have our monthly premiums back, yep.

My partner and I both work for ourselves and cannot get insurance through employment. We pay individual health insurance for ourselves($400+/mo.) and luckily get Oregon Health Plan for our baby. We pay our health insurance before we pay our rent some months. Healthcare is our second largest expense- And we're still in our 20s!
My partner was at one time offered health insurance through his work (after he already had individual health insurance) but it wasn't going to be any cheaper than paying for it all out-of-pocket for some reason.

Not sold,

Here's the problem: Americans pay considerably more for healthcare than any industrialized nation, but receive considerably less coverage. http://www.scienceblog.com/cms/americans_pay_more_get_less_for_health_care

Where is all that money going (yes, the money from your ever-increasing premium)? To people making lots of money from sick people: insurance companies, drug makers, shareholders of these companies, etc. Health care is just another for-profit industry in the US gone amok.

Those of us able (old enough and healthy enough to work) should definitely put into the system, but the money in the system isn't going in the right direction right now. Our system is broken.


Small Business owners are largely forgotten. Thats why I only focus on them. I have experience several members of my family file bankruptcy due to small business failures. I also I suffered through 2 destroyed businesses due to failure however, in my failings I have learned some of the secrets to success. (Who can say they know it all?)

www.onlineuniversalwork.com

Not everyone is as lucky as you are, I agree. There are some things you don't consider until you realize you need them. Health care is one, along with adult day care centers or nursing homes.

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