New Teaching Contract

[OakLeaf]

You know what's most distressing to me about this thread?

The expressed and implied resentment toward others who have barely adequate coverage.

What Irulan described as "Cadillac" coverage (a metaphor that was devised to set working stiffs against each other) is barely adequate. It's more like a Nissan Versa with 100,000 miles on it. It'll get most people where they need to go most of the time, but if you put any serious demands on it, you'll find it isn't enough.

Take my coverage, just for example. By today's standards, it's good coverage. I might consider a higher deductible lower coverage plan if it were available to me, but because I have a couple of minor but chronic pre-existing condition, I'm stuck with the conversion plan that I transferred from COBRA in the early 1990s. I'm not insurable on the open market, and I'm not eligible for open enrollment unless I go uninsured for six months, and I'm not ready to take that risk. I'm aware that I'm very lucky to be able to afford EITHER my insurance premiums OR the medical care I need, so go ahead and resent me for my good luck. But I want to illustrate what so-called "Cadillac" coverage really is.

Just take physical therapy - something lots of us have been through and many more will need. My plan gives me 20 sessions. That's plenty for someone who's working out a bit of plantar fasciitis or a back strain. Have a stroke or get in a serious accident? Not so much. Remember that so-called "out of pocket maximums" apply only to benefits that are covered in the first place. So, if you need months of physical therapy, after the first 20 sessions they're all out of your pocket. My deductible is $500, my out of pocket maximum is $2000, and I wound up paying over $10,000 out of pocket last year ... yep, the equivalent of almost four months' premiums. And that's with relatively minor injuries, no hospitalization, no surgery, no scans outside of a few plain films, no super expensive medications.

Also: manual manipulation counts as "physical therapy" and it's subject to the session limit regardless of whether it's performed by a PT and billed as PT, or performed by a DO and billed as OMM. But a hand injury that's normally rehabbed by an occupational therapist with stretching, strengthening and massage - the same modalities a PT would use - is not covered at all, because it's OT.

Dental? (got my sixth crown this year) Zilch. Vision? (thank goodness my vision at least is uncomplicated and I'm just wearing single vision contacts) No coverage there either. Mental health coverage? That depends on the diagnosis (talk about crazy). Acupuncture? Forget about it. But it covers my prescriptions and my allergy shots, covers the emergency room when I need it. So that's considered "Cadillac" coverage.

That's what I pay, I don't have a choice of insurance, but I'm lucky enough to be able to afford it. Think about how most people would be able to pay for insurance. Think about what someone who's really sick or badly hurt would have to pay.

Then you start to understand why there are constantly fundraisers for people to cover their medical expenses ... let alone their living expenses while their ability to work is reduced or nonexistent. And you really understand whose interests it serves to have us resenting each other, rather than the ones who are profiting from all this.

[lph]

I'm finding this whole thread rather distressing. I wish you could all move here.

[Becky]

This thread reminds me of why I still work where I do and why I'll be here for at least another 10 years.

[Selkie]

This thread reminds me of why I still work where I do and why I'll be here for at least another 10 years.

Me, too, but I'm down to 73 months and 4 days until I can retire at full pension (but who's counting?).

I hope that the health insurance reforms that are going to be implemented have a positive impact on the system. I'm ashamed to admit that I haven't paid too much attention to it because I am blessed to have a good plan. That said, I pay a good bit in premiums and every year, my premiums increase (while my salary has been frozen for the past two years and looks like it will be for 2013---another year without a COLA).

Early in my adulthood, I had no health insurance and was out of pocket for everything. I will be forever indebted to Planned Parenthood, which provided me healthcare when I otherwise would have been without.