We need to consider two contradictory statements: when they fall sick, the poor go to an emergency room and, if they are lucky, receive treatment that keeps them alive; when they are insured, the rich receive care that gives them better health. Except the international statistics show the US has higher mortality rates than most of the other developed countries. To help you understand, we need a comparison with Europe where there is a completely socialized healthcare service and better life expectancy. Both at a European and individual state level, there are panels of experts who decide what treatments and which drugs represent good value for money. States will only pay for treatment proven effective and safe, and will not pay drug companies the retail price they claim. Instead, the states will only pay for approved drugs at prices agreed in negotiations. In the US, insurance companies happily pay for a battery of medical tests and procedures even though there is no evidence any of this work is effective. This adds to the irony. Sometimes the rich die young even though they have received multiple treatments. This is because their expensive treatments are ineffective.

So long as the healthcare service industry remains profit driven, doctors have a direct financial incentive to perform endless tests and multiple procedures to justify big bills. There is no national body to approve treatments and then monitor their safety and effectiveness. Health insurance companies could challenge the medical profession to justify what they do and the prices they charge. But, for the most part, health insurance companies pay up without question. What is clear that until and until there are controls over medical costs, the premiums on individual health plans will continue to rise. Worse, there is no evidence to show that those who do pay these high premiums live any longer than the uninsured.

Because of the national anger, some companies have paused. WellPoint had proposed the increases take effect from March 1. Any increases, even if approved by the states, will now be delayed until May at the earliest. This decision is partly in response to the summons of WellPoint’s chief executive officer to Washington to justify the requested increases. Insurance companies find themselves in a difficult political situation. Their management teams accept a duty to maximize profits for the benefit of the stockholders. They look around at an America seriously affected by the recession. Increasing numbers of people are unable to afford the premiums, some because of unemployment, others because of a squeeze on credit. More worrying from the insurance industry is that more healthy people are deciding not to insure at all. This means the group of people left holding policies has a higher percentage of those with existing health problems. Without more healthy people in the group paying premiums and not claiming, it becomes more expensive to insure those less healthy people who remain. It is also a verified fact that hospitals and healthcare service professionals have also been increasing their fees and charges. The pharmaceutical companies have increased the price of almost all the most commonly used drugs. The insurance industry is under pressure from both sides. As Secretary Sibelius points out, however, this is not a completely accurate picture. Every year, insurance companies are required to submit reports to all the US states in which they are licensed to sell policies. This data shows many companies actually increased the number of policyholders during 2009.

The market in health insurance plans is complicated by the political situation. Democrats and Republicans are two armies unable to agree a truce long enough for some reform to be made. As it stands, there is no immediate likelihood that medical costs will be controlled. If the costs continue to rise faster than inflation, insurers will have no choice other than increasing their premiums. If they do not, they will not have enough cash in hand to pay out on all the claims. This means, for the average person, it will become increasingly difficult to find cheap health insurance. For those with a pre-existing condition, group health insurance will be the only option but, for those plans, premiums are rising at their fastest rates. For years, it has been obvious that the healthcare industry is broken. It would be ironic if, having come this close to some meaningful reforms, we not only saw the reform bills lost in Washington, but also found every major insurer imposing massive premium increases. That really would be the final nail in the coffin.

You are reading this article on the internet. When online, you can buy more or less any product or service across state or national boundaries. Although there are some restrictions, e.g. some states limit your right to import drugs from foreign countries, there is an almost free market where you can search for the cheapest price and buy whatever you need. There is no possible economic justification for retaining this historical privilege for insurance companies. All it does is preserve their ability to maximize their profits at your expense. For example, in Minnesota three insurance companies dominate 80% of the market for health plans. There is no doubt that, if more companies entered the market, the premium rates would fall. During his run for President, Senator John McCain was in favor of free markets for health plans. President Obama supports it and the proposal is in both versions of the healthcare reform bills currently stalled in Washington. But because the Republican party’s only policy is to oppose everything the Democrats propose, it seems even this simple change in the law may be lost. What will the result be? The anticompetitive behavior of the insurance industry will continue and you, the consumer, will suffer.

Could the law change tomorrow and allow everyone access to cheap health insurance wherever it can be found? The problem is that the states have different sets of regulations and compliance leads to different costs. The playing fields are not level. So, premiums are significantly lower in those states which have the fewest consumer protections. It would not be fair competition if people living in Minnesota, which has strong consumer protections, could all get health insurance quotes from states with little or no consumer protections. The only way in which there could be a free market is to have a single set of federal regulations for the sale of health insurance plans. Sadly, the political parties do not want to talk about this even though we would all benefit. In the US, the political elite’s interests do not match the needs of the ordinary citizens.

In general, family insurance plans are individual health insurance policies that allow the policy-holder’s family to be included in it as well. A great number of employers instead of providing group coverage, offer their workers individual plans with including possibilities if they have any family members they want to add. The federal law also restricts the insurance companies from excluding family members with pre-existing conditions from group plans. And in most cases, the employer will pay a part of the worker’s yearly premium. This of course makes family health insurance less costly for an individual’s family budget. Still, if you lose the job your insurance coverage will also be taken away.

When speaking of individual plans, we speak about the health insurance plans you buy directly from a provider. Such plans provide a high degree of freedom, as you can freely choose the company to buy from or the type of coverage you want in your policy or not. In most cases, however, the coverage provided by individual plans will be somewhat inferior to the extents you get with a group plan, still if there’s no other option you can choose a plan that will meet your exact requirements. Keep in mind that in many cases individual health insurance plans won’t allow you to include family your members with pre-existing conditions.

For those who want to get the lowest health insurance quotes and the best coverage option the best choice would by taking a group health insurance plan. Such plans usually offer the most coverage for the lowest rates, and are way more inexpensive than separate individual policies in general. However, if your employer does not provide you with group health insurance you will have to invest some time in comparing group health insurance quotes from different providers as the difference in rates can be quite impressive. And also make sure to fully understand all the terms and provisions before actually buying and signing the policy.

Some elements to consider before actually buying the policy and shopping around: policy types offered, providers available in your area, coverage types and exclusions, benefit pay off procedures. You should also learn all possible options regarding the premium payment and deductible adjustment effect. Make sure you buy the policy from a reputable company licensed to work in your state and your insurance agent is able to answer all of your questions regarding the coverage options and special provisions of the policy. There should be no compromises when insuring your family because having good coverage really matters when there are any health problems.

Why think about it now? Well, let’s take the worst case scenario. Suppose you or one of your family are struck down. Suddenly, you are looking at big bills and worried about the extent of the cover available under the policy. This is not the best time to open negotiations with the insurer. You are emotionally weak. Worse, the reality of large losses will color the reaction of your insurer. The best time for these negotiations is when you are calm and all the losses for the insurer are in the future. This allows everyone to deal with hypotheticals and not get alarmed when big numbers are mentioned. So why do insurers start talking about big numbers? The national statistics show claims for long-term care almost always fall into the range of three to five years. That’s a big bill when you add in all the different services potentially required, whether in your own home or a nursing facility.

So what happens to people without long-term health insurance? The worst happens to those who have built up assets. Instead of providing for their families, they find all their assets sold to cover the apparently endless series of bills. Of course, some families have one or two who can be persuaded to act as carers. They sacrifice their earning capacity to provide home nursing. This, of course, is the worst case, where the losses just keep mounting up as families cope with the emotional and financial costs of the care. Health insurance provides protection for retirement savings and the assets readied for the children to inherit. Long-term policies cannot remove the emotional burden of living with an injured or dying loved one, but it can make the time less financially stressful.

By a curious irony, both the insured and the uninsured now often face the same problem: to find prices on the internet for the treatment needed. In the same way you might shop around for an HD TV to replace your old set, you start asking, “How much does this operation cost?” followed closely by, “Where can I find a better price?” A number of doctors and healthcare facilities have begun to cater more directly to the uninsured market and now post their prices online. More importantly, some will negotiate on these prices. The fact you have a policy does not prevent you from taking advantage of this opportunity. But you need to move with care (as always). There is never just one price for any procedure or operation. So many different factors affect price starting with where you live and who the local providers are. The prices will differ depending on whether you ask a hospital, clinic or individual doctor to quote. The root of the problem is often the insurance industry. The companies offer many types of policy and, depending on the volume of business directed to doctors, clinics and hospitals, negotiate different prices for each treatment option. It’s not unusual for there to be ten and more prices for the same treatment depending on who is paying.

So you cut through this arbitrary pricing structure and find the real prices. If you have a health insurance policy, ask your insurer for the provider prices for the networked doctors. The better companies help you find the lowest price treatments. On the internet, there are search engines giving you lists of doctors in your area with the best prices for the treatment you need. Did you know thirty-three states require hospitals publish their prices? Shopping around really can save you money on your health insurance!

For some years, the federal government has recognized that children are the future of our country. If they do not grow up strong, the future may not see the US remain so dominant internationally. So, with federal encouragement, states have been offering a safety net for children. The alternatives are Medicaid and the State Children’s Health Insurance Program (SCHIP) which was established by the Balanced Budget Act of 1997 to expand health insurance coverage to uninsured children in families with income too high to qualify for Medicaid. For the record, Congress has provided about $40 billion to fund SCHIP through 2007. Federal funding is currently available. Outside the federal and state programs, some elementary and high schools group together to offer health coverage for their students where the families are uninsured or underinsured. Some states have not set generous criteria for access to their SCHIP and the group policies help the modestly well-off families bridge the health plan gap.

Once children turn adult at 18, they are mostly on their own. If you as parents provide private coverage, this can represent the best outcome as they work their way through college and university. Otherwise, this leaves the young adults to live with the risks of no cover, or accept one of the “affordable” policies offered by their college or university. It’s a sad fact your children will consider themselves invincible. Many are lucky and survive the education part of their life without accident or illness. But if anything serious goes wrong, they will add significant medical expenses to the burden of loans and credit card debts. Local community clinics can only provide basic care. The college or university policies are often highly affordable. More importantly, starting a health insurance policy at low student rates gives them track record when they later seek coverage as an employee. But one word of caution. These are not comprehensive policies and they often limit or exclude serious injuries or disease. As parents, you may feel it wise to top up the basic cover. Get multiple health insurance quotes to find the best value additional cover. Even if your children are enrolled as medical students, they cannot expect anything more than routine treatment from the medical professionals in their area. They will be treated as “ordinary” students when it comes to paying the deductible and any copayments.

Today, conventional wisdom says you can find cheap insurance online. These words are intended to encourage you to look at what’s on offer. There is, of course, never any obligation to buy. But, if no-one looks, there is no chance for the insurance company to make a sale. The marketers have to say something to provoke you into looking. So, when you see the word “cheap” applied to policies for sale through a website operated by a single insurer, read on with caution. This is an old sales technique and it fools only those who never shop around and find out what the competition quotes.

All of which brings us to the online search engines that obtain quotes from multiple health insurance companies. Here, when you see the word “cheap” it’s more real because you can compare and contrast all the different offers from the different companies. The headline premium rates quoted give you a starting point from which to judge value for money. Read the detail of the coverage offered, being clear on what is included and what is excluded. Identify what the deductible will be, how much the copayments are and whether you have to pay for your drugs or meet out-of-pocket expenses. Only when you have finished can you decide whether you have found the real bargain offer. It’s possible you will find one or more policies that are sufficiently good value-for-money to justify being called “cheap”. If you do, you calmly seal the deal and pay the low premiums. This is the cheap health insurance you were looking for. But if the quotes prove universally poor value, you move on and try somewhere else. It’s the old, “If at first you don’t succeed, try again.” all over again. The newer breeds of online only companies are offering genuinely low rates. This competition is slowing the premium increases from the traditional companies. Keep searching until you find the best deal on offer.

In recent years, the majority of children have been covered by health plans paid for by their parents’ employers. Unfortunately, the cost of family plans has been rising more steeply than for individual coverage. With employee contributions rising faster than inflation, many parents have been forced to drop out of group cover. This has left Medicaid with the increasing task of providing cover for low-income families. Where parents earn more than the maximum allowed for Medicaid eligibility, SCHIP targets families who cannot afford private coverage. Unfortunately, two factors have combined to increase the number of uninsured children.

As the recession hit in 2008, unemployment rose and the amount of tax collected fell. This meant the individual US states responsible for supporting SCHIP began to run severe budget deficits. Since the idea of tax increases is politically impossible, this has forced states to cut back on all discretionary spending. Consequently, many have redefined the level at which they intervene to provide health coverage for children. As if this was not bad enough, there has been a reduction in the publicity given to the SCHIP plans. Parents are no longer prompted to apply for coverage even when their income would make their children eligible for support. Put the two together and the Congressional Budget Office confirms the number of uninsured children has been rising steadily.

This is a difficult time for healthcare in the US. Almost everyone agrees the current system should be reformed, but there’s no real sign of agreement between the political parties on what should be done. While Washington struggles to enact legislation, more children should be brought within the existing schemes — SCHIP was reauthorized for a further 10 year term in 2007 with bipartisan support. Almost all the children currently uninsured would be eligible under either or both Medicaid or SCHIP. All it needs is a properly run advertizing campaign to alert families to their entitlements and the political will to make funds available. So long as private health insurance policies remain unaffordable for the majority of families and employer-provided group plans are imposing sharply increased premiums, the number of uninsured children will rise steadily. This trend will accelerate as unemployment rises during the recession. It’s a national scandal that the health of children is being put at risk by denying adequate health insurance coverage. If no co-ordinated federal plan is put in place, families should protect themselves by applying to both Medicaid and their local SCHIP for help. It’s important to remember that the Congressional Budget Office confirms almost all the children currently uninsured would be entitled to access Medicaid or SCHIP. This is your right and it protects the future of the country. Everyone loses if children die or suffer inadequate health care because health insurance is denied.

COBRA is available to the majority of those who lose their employer-provided insurance, whether by termination, lay-off or voluntary termination. It can also apply when people lose hours and no longer qualify under a health plan, go through divorce or lose cover through the death of a spouse or parent. The umbrella of protection lasts for up to eighteen months in the ordinary case. Where a family member is disabled, the protection can extend to twenty-nine months. If the conditions are met, ex-employees are allowed to buy health coverage at group rates. This is more than the cost of the plan run by their employers (plus a 2% administration fee), but less than the cost of private coverage. The coverage runs from the date the employment terminates. If there’s a delay in putting the COBRA policy in place, the premiums have still to be paid as from the date employment terminated. This can sometimes be quite a large lump sum to find. The COBRA policy ends when the ex-employee or family member gets another health plan, no payments are made on the COBRA policy, or the period of protection ends. The advantage? While it’s in force, the insured and family get the same basic entitlements as under the employer’s plan.

The COBRA scheme has been working well in providing a subsidized breathing space during which people may find new employment with a health plan or with a rate of pay that can support private health cover. Unfortunately, with unemployment rising towards 10%, it’s growing increasingly difficult for people to find new employment. Thus, as savings run out, families are dropping out of the group COBRA coverage and into uninsured status. It’s a sad fact of life that if a family cannot afford a COBRA premium, it cannot afford a private health insurance policy. The best place to shop around for replacement cover is online. Term health insurance can be an economic way to fill the gap until full coverage can be restored. Hopefully, the economy will pick up and more jobs will come. As the economy revives, more will be able to find affordable health insurance online.