the irony of our healthcare

Interesting, not sure of the difference between an HRA and HSA, but my HSA is my money to use for medical expenses and goes with me from job to job or into retirement. My current HSA plan puts $75/month in the account automatically. It's a high deductible plan, so if your healthy it's a good deal, it is not if you have a lot of medical expenses.

the HRA is something where the employer puts in, to offset the high deductible. so when my wife was at a huge bank (the one that was based in MN), the deductible was $3,000 (ha it's bigger now), and they put $2800 into an HRA, effectively making the deductible $200. But you don't keep it if you are fired or leave the co. She went to another co. and we didn't fret about leaving $2800 behind, it's employer funds that were put in. And seriously, it isn't like we can concoct a charge or need, unless elective surgery I suppose.

But I pay so much every month now that in a way I care about losing it--my co. eliminated the HRA, just like that. And it was a year when I avoided doctors, so a true win for insurance and really my employer since they are self-insured. Otherwise, it would normally roll when not used. A HSA you keep no matter what, even if fired or leave the company.

p.s. another funny thing about the HRA setup. Providers these days, file claims, just to see if the insurance will pay. If they will, they will, if they won't, they won't.

I caught a provider who got away with 3 claims that should have been denied. I called the insurance, look, you see this claim? You paid it 3 months in a row, then denied it month 4 as it's not covered. Well, I want you to deny the previous 3, they should not have been paid. Why? Because the money came out of my HRA. You guessed it, insurance did nothing, and the provider got away with it.

My company had what they called an HRA but they didn't contribute anything. The amount of money I chose was simply deducted from my paycheck and deposited in the HRA tax free. It was forfeited at year end if not spent.

After 2 years of losing money, I put it an interest bearing savings account instead of the HRA. Yes, it was after tax dollars but when you add the interest it earned with the forfeited $$, I was always ahead of the game.

Back then, it was simply a gamble as to how much money you would need in the coming year. The office joke was that you should buy stock in Baer since aspirin sales would peak on Dec 30th when everyone tried to spend their remaining HRA dollars.

These plans have come a long way since then with some employers contributing to their HRA's but it's still a big guess as to how much to contribute on your own.

how your health system works. I dated a 50 year old young lady and it cost her US $ 500.00 per month for insurance. Another woman, though a bit older, I know pays US $ 800.00 plus per month.

Currently I see dozens of different commercials on TV, yes I have satellite TV in Mexico, where they promise you the moon. Free prescriptions, free doctor visits, free transportation to doctors, free meals, no co-pays and even free if you live in certain zip codes. But you must sign up before Dec. 7th.

They are spending millions on advertising to give you something for free???

What gives with all this crap???

Many of those ads are targeted to Medicare/Medicaid recipients for Medicare Advantage health plans. The "free" part applies to low income or disabled folks that get additional govt. assistance. The reason it applies to specific zip codes has to do with whether a state has adopted the enhanced Medicare/Medicaid programs. That is my understanding anyway.

Insurance is a concept. I don't know about anyone else but yes, I had a car accident 10.5 years ago. Other than that? Never. It cost my insurance co. $2600 and they raised my rates by about $400/6 mos (I switched and got a lower rate with the accident than what I was paying as a safe driver go figure). Imagine how many thousands of dollars going in, and $2600 came out. Big win for insurance.

A friend worked in healthcare, he would tell me, we just got 400k new members in SC! Big win for the co. I would say so you're gonna go on a hiring spree? Answer, no, we use the same people we have now. When those SC members call in, everyone waits longer.

Another friend works in transportation, got a contract in OH, for a food co. He said, we are short 50 drivers and 30 tractors. I said, ha, that's a good problem to have. He said, no it isn't. We can't hire anyone and we don't have trucks for them to drive (they were on back order, this is 2019) so we have to farm out the work, which throws our profit margin way off, almost as if we're doing all this work and have no profit.

Do you see what I mean? In both cases, new business was awarded. Only in 1, was there any more work to truly be done, people to be hired, capital to be invested in.

So it sounds to me like those tv ads are competing for medicare money. Remember the Dire Straits tune with Sting doing the intro? I want my MTV, and Money for Nothing...

Melaq, be thankful you don't have to understand this. If you did want to learn on your own, it can be done but you'd need to understand all of the following to see how what you've reported above applies:

Medicare (Parts A&B*, possibly C**, & possibly D***; Plans A-?? except for three states that do things differently)
Medigap****
Medicaid
Annual Open Period

And then, Medicare is typically only available to most seniors 65 or older but few others, so younger folks in the US either have insurance through private insurance, possibly "Obamacare" or insurance subsidized by their employer. Some religious groups I think have the ability to do something completely different.

Even worse, I'm sure others will say that I've skipped entire categories of healthcare insurance in the USA and they'll probably be totally correct

* Typically thought of as traditional Medicare when people mention it
** Medicare Advantage which replaces traditional Medicare, offers extras but limits which doctors you can see and can offer much more
*** Prescription Drug coverage unless provided by other private insurance, Medigap or Medicare Advantage
**** Also called Medicare Supplemental since traditional Medicare doesn't fully cover Medicare expenses and doesn't cover some expenses at all