Today registration opens around the country for the new Affordable Healthcare Plans (a.k.a. Obamacare) which will take effect on January 1, 2014. People on both sides of the fence are fired up and expressing their support or disgust for the plans. It got me thinking though: What does this mean for self-employed photographers?
I voted for Romney in the last election. I have not been the biggest supporter of Obama and the choices he has made so far. However I have got to say I am quite interested in what the new health insurance plan means for our industry. Let me explain.
Self-employed photographers finally have a way of purchasing a reasonable health insurance plan.
I have been working for myself for the last 3 years. I have 5 kids under the age of 12. My wife works for herself as well. We have managed to get by over the last year without any health insurance at all. Fortunately for us, our family has been healthy. I hate to admit this openly. But if one of us were to need health care, we don't have a plan. I think about this often. One broken bone, one sick child, one surgery, one hospital visit, any of these things could end up costing us a fortune. According to a recent study medical bills are the biggest cause of bankruptcies. Being uninsured is not the way to live as it causes a lot stress, praying everyone in the family stays healthy. (I hope my mother doesn't read this as she always asks about whether or not we have health insurance and I have just fibbed telling her we did as to not stress her out as well.)
Every couple of weeks I wonder if it would be better for me to have a full-time job with health benefits rather than work as a wedding photographer. But I just can't do it. I feel like it is my calling to photograph weddings and create photos that couples can cherish throughout their life. So while I have yearned for some kind of health insurance protection, my wife and I have just continued rolling the dice hoping we all stay healthy as a family.
Even with pre-existing conditions you still qualify for health insurance.
I didn't think much about this before. After all, my wife, kids and I have been healthy. But in one discussion inside a Facebook group of photographers one person spoke up. She explained that in her early 20's she was diagnosed with cancer. She fought the battle and won but as a result she has found it extremely difficult to find any insurer that will cover her. With the new Obamacare she can finally get the health insurance she desires and not have to worry about being disqualified because of her past condition. I was truly excited for her. It opened my eyes that there are a lot of people out there in her same shoes. These people are now going to be able to get the prescription medications and doctor checkups they need without having to pay out of pocket to cover all the costs.
More people will be able to follow their dream to become a photographer.
One of the biggest hurdles for people interested in becoming photographers is that as much as they would love to do it they just couldn't see how it was possible. Insurance was too expensive. Their child had a pre-existing condition. It was a risky choice for them to make and so more often than not they just stayed in their 9 to 5 job and did a little photography on the weekend. I have a feeling in 2014 we are now going to start seeing many of these people leave their "9 to 5" and find a more fulfilling life as they actually are able to do something they love.
Is Obamacare perfect? Absolutely not. Am I looking forward to paying an estimated $7,000 a year for my family to get the insurance or be penalized? Nope, not at all. In fact, when my wife and I first talked it over about a month ago we were fired up. We were angry that we were being forced into something we didn't want. But as we educated ourselves more and more about what this meant to us as a family we started realizing this was not such a bad thing after all for us. I have a feeling that on January 1, 2014 a lot of stress of worrying about my family needing health care will finally be lifted from my shoulders. Will we need to use it? I hope not. But it is there to assist us in case of an emergency.
You hear about outrageous hospital bills all the time. In fact, I bet if you asked around you probably have a friend that has received one for $50,000+ and hopefully they had insurance to cover it. My feeling is that as a family we might go years and stay healthy never needing a doctor visit. But when that one time happens. When one of us gets sick, cancer, Parkinsons, heart disease, I am grateful to know that we will be able to get the help we need without having to worry about breaking the bank or reaching our hands out desperately to family members to help.
When we buy a new car, before we drive the car off the lot we have to show them proof of insurance. Same thing goes when we get pulled over by a cop. It is required by law to have it. When we buy a house they often bill the cost of insurance right into our mortgage because the lenders want to make sure we are insured. Insurance is all of us pitching in a little bit today so that the person who needs the help tomorrow can find it.
I realize that Obamacare is not perfect. In fact far from perfect. But I do believe that for us self-employed photographers it does give us certain benefits that were once not available. I thought that was definitely worth mentioning. If you would like to find out more information about it you can visit this link, Healthcare.gov. I'd love to hear your thoughts in the comments. Please keep it civil and keep party lines out of it. While the new Affordable Health Care plan is not perfect, it is here, it is happening. What are some of the additional benefits we can get out of it as self-employed photographers? What are some of the disadvantageous? Chime in below.
The debtor is slave to the lender. Remember that on Oct. 17 too.
what a firestorm you started with this! geez! HA!
Until there is a federally enforced common fee schedule that healthcare providers must follow, regardless of what type of insurance a patient has, any notion of healthcare reform is pointless. Everyone is pointing their fingers at either the government or the insurers for the reason health care COSTS are what they are in this country (the highest in the world by a massive margin) but the providers are still given plenty of breathing room to game prices. Medicare is the only regulated price structure in the country, and pay-for-value systems vs fee-for-service is encouraging, but it does nothing more than introduce a new metric system that can be exploited, and doctors can still refuse to participate in it.
I oppose Obamacare not because I don't think healthcare should be accessible to everyone, but because the cost of healthcare has gone completely unchecked on any legal, effective basis and Obamacare simply doesn't have the chops to really control it. All Obamacare does is change HOW we pay for healthcare on an individual or household basis, and not how much it's going to cost the country: that money has to come from somewhere, and if the nation is the customer, we need to have some kind of price control power.
There's a doctor in Portland Maine who has decided to refuse to accept any health insurance at all, and published the prices of what his services cost. THAT is healthcare reform.
http://www.ciampifamilypractice.com/Our_Prices.html
All politics aside, I think what many people who are against this are forgetting to recognize is that many Americans who work for themselves and have pre-existing conditions making themselves uninsurable are finally going to get the ability to buy health insurance.
“Could a greater miracle take place than for us to look through each other’s eyes for an instant?” - Henry David Thoreau
Think about how these people must be feeling. Before this plan came out health insurance was unreachable for them.
And why are you a Republican sir. You have empathy. And you are a photog. I hope you dont shot Pentax as well :)
Trevor Dayley, with all due respect this article means very little unless you post actual comparisons showing the price differences between past and future options. Because EVERYTHING I'm hearing says that people in our income bracket are going to have to pay WAY MORE. How does this make it better for us? Can anybody tell me that they will be paying LESS than they were before? Don't get me wrong, the caveat about those with pre-existing conditions is awesome, but that has almost nothing to do with FORCING the entire nation to buy something....
Matthew, it would be way to difficult to get into the specifics and try to compare one plan from another with the amount of time I have to write this up. In this article I stayed away from talking about the specifics of ACA because I didn't want it to be about that. There are a lot of articles out there and websites to help people get all the details. What I shared here was just a few of my observations and things I learned about the plan after I took off my "I Really Dislike Obama" glasses and reviewed the plan for what it meant to my family and I.
What this means to us is we now have an option that can work. Before this some people had no options.
You ought to write up a detailed review using your income specifics for SLR Lounge. It would be an interesting read.
I did indeed do a little research, and it seems that there is a huge (and very lame) difference between those who make under $40K, and those who make over $80K. Essentially, your costs more than double in many cases, and almost double in the rest.
Basically, it seems like the true cost of it all is being masked by the discounts available to low-income people. If you make $39K for example, you get a ~$200 monthly discount on an >$400 monthly payment. So yeah, you're at $200 per month which is not bad at all, but as soon as you make more money, that discount starts to go away.
Before, it didn't matter how much I made. I could cover myself and my wife for under $200, even with "only" a $2K deductible on major incidents. Now, if I make $81K, It's $360 per month for a plan that has a $5K deductible.
Indeed, these numbers might be dramatically different depending on where you live, how large your family is, and whether you have pre-existing conditions. Lke you said, there are so many different variables, it would be tough to assess in a single article. But whenever I hear people talk real numbers, it doesn't look good.
Thus my point remains: If you had zero health insurance before, and you're all healthy, that's one thing. It may seem like "well now we have a viable option" ...but the reality is, you might have been able to afford the same coverage, for LESS, before. When you were in the process of having 5 kids, I assume you at least looked into it? Was it significantly more than $7K per year?
Honestly I'm with you on this- I'd love to love universal healthcare. Lots of other countries have it. I'd love for my fears and rough calculations to be proven totally wrong, and discover that my costs are actually going to go DOWN instead of up. But if you are a hard-working photographer who already CAN afford health insurance, and your costs are going to go UP the more money you make, ...how does that equal "more people will be able to follow their dream to become a photographer"?
Matthew, I hate to keep referring back to the pre-existing condition clause. But there are a lot of people out there that would love to do photography full time but can't because they need to have a job at an employer who offer health insurance as part of their benefit package. Previously the only way they could get insured was through an employee program. Those people now have an option. The definition of pre-existing conditions is wide open to interpretation...
"Most insurance companies use one of two definitions to identify such conditions. Under the "objective standard" definition, a pre-existing condition is any condition for which the patient has already received medical advice or treatment prior to enrollment in a new medical insurance plan. Under the broader, "prudent person" definition, a pre-existing condition is anything for which symptoms were present and a prudent person would have sought treatment."
What do we do with these people? What about someone that genetically has high cholesterol and takes meds for it. Do insurance companies view that person as undesirable and decide not to offer coverage? I just feel we all need to be more empathetic to what others are going through. Even if I have to pay a little more but it means others can get the treatment they need, then I am willing to do that.
P.S. I am a registered Republican. I could find all kinds of reasons to dislike the plan. But it has been voted on. It is happening. At this point rather than try to fight it I am trying to find the silver lining in it.
Indeed, I totally get that. But forcing the entire country to buy something, in my opinion, is a relatively un-related issue compared to simply changing the existing laws to discourage / disallow carriers from denying someone coverage due to pre-existing conditions.
We could say that "having everyone pitch in more" is absolutely necessary in order to start offering better options to a select few, but honestly I'm sure they could afford it.
Like I said, I don't know many real numbers or facts, but it seems to me like we're going about fixing a huge problem the wrong way. Simply pitching in a little more, instead of forcing the entire industry to be more competitive, is what pushes our country closer and closer to Socialism. I know most people will say "oh, jeez, here comes the freak who believes we're all doomed to be communist", but hear me out. Yes, maybe sometimes citizens need to pitch in a little more, but 90% of the time all it does is give "upper management" the green light to rape us all a little more.
I certainly believe in supporting the less fortunate, and neither do I believe we should turn around and rob the rich into oblivion. Going too extreme in either direction is still Socialism. I just think there is plenty of "cushion" somewhere in there, and it shouldn't have to come out of the pockets of those who make $40-80K.
Already in our neck of the woods, a full-time self-employed photographer is barely scraping by if they make even $60-70K, and that's if you just forget about retirement planning and healthcare altogether...
PS: personally I do not have any party affiliation, and I can see the good in both conservative and liberal (economic) tactics, however I think that both of the major parties are just too dead-locked to be of any good these days, and I think that the next generation really does need to start taking action or we're not gonna be doing too well in 10-20 years...
I agree that there are a lot of questions that should have been answered before this thing went through. A lot of changes could have and should have been made. But if you remember, one political party opted out of the debate. They instead spent their time telling Americans that this bill would kill your grandma and give Obama a private army. It was ridiculous.
If that same party would spend their time working on changing and improving the thing instead of grandstanding motions to repeal it, it might be a better law. My problem isn't with choosing a side in this debate. My problem there is only one side having the debate. The other side refuses to actually participate in governing at this point.
If you are making 80K statistically most likely are getting employer based care. And if you are not $360 is very reasonable to cover your family.
There is a difference between health insurance and health care. Many seem to use the terms interchangeably.
You are so right, but until the cost of healthcare comes down to an affordable level, insurance is the only option. And, insurers have a say in that cost. There was a great article in Time called "The Bitter Pill" that does a great job of showing how ridiculous the cost of healthcare is. It deals primarily with consumer cost without health insurance.
Will ACA help with regulating costs? Curious to know.
To be honest, I am not sure, but I doubt it. Hospital prices, in particular, seem to have no bearing on costs, profit and loss, or market values. Essentially, they charge what ever they want. And they are inconsistent in what they charge (ie. the same procedure in the same hospital could result in two very different bills). The only thing that had been limiting them was the bargaining power of the insurance companies and the contracts between them, but that dynamic has changed now that insurance companies are fighting for hospitals to accept their insurance instead of the other way around.
I really wish that Time article wasn't behind a paywall. It was very informative and more than a little bit scary.
There are some modest measures, but it's going to be a long time before we know if they work or not. The main point of cost control in the ACA is "value-based payment" vs "fee for services." The basic idea is, a huge part of the problem has been doctors getting reimbursed based on how many procedures they perform, without any recourse as to whether or not the procedures were necessary at all. The patient didn't care because their co-pay hid the massive costs that were being incurred. Now the idea is, give doctors monetary bonuses for being "cost-effective" (whatever that means, and whoever determines what that means.) It sounds ok, and in principle, it is, but it sounds way too ambiguous, and it only applies to patients covered by medicare, as far as I understand. I also take issue with giving doctors bonuses from the federal government just for doing their job well. Some of the problem, to be sure, is administrative: Doctors have a hell of a time getting up-to-date information on referred patients, and they don't know what procedures have already been done, so they cover their asses by doing redundant procedures. So, I don't see how that kind of cost control could be effective without tort reform, and I think hospitals should be FINED for not creating cooperative environments.
I personally don't believe implementing the ACA is the solution to the healthcare problems, or even the end of this particular issue.
I lived in Britain for a while, and I liken this to the creation of the NHS. When it was created, they had the exact same arguments and rhetoric we are hearing now in America. However, once it was implemented, soon the focus shifted to improving the NHS. Now, there is still a minority that would like to do away with it, but generally the debate in Britain is about making the NHS work better.
I think we will see the same thing. Once insurers are footing the bills for all Americans, and other Americans are underwriting that, there will be a demand for accountability from the hospitals.
1. The risk pool is spread wider and includes more people.
2. People will have access to preventative care that would catch serious condition before they become catastrophic and more expensive to treat
3. Companies must use 80 cents of every dollar on providing care, with a profit margin of 20 cents. Anything else is returned to the consumer.
4. Hospitals will be given incentives to ensure people stay well and they will be sanctioned for doing to many procedures.
5. electronic record will make care delivery more efficient and will cut down on errors an waste.
6. Better data will be collected to head of disease trend sooner. Because more people will be getting care the quality of the predictive data will improve.
7. More access to prenatal care will head off many expensive neonatal problems saving money.
8. Healthier people who have a better body image book more photo shoots. :)
Any if you need me to go on I will.... :)
None of these things effect cost in the matter of the actual price of any given medical service, which has over and over been demonstrated as to the actual problem with the medical system. What the ACA does is take some of the measures from other countries, and bolts them onto a system that has a runaway pricing issue, without actually addressing the pricing issue. Anything less than an actual 30% drop in healthcare pricing over 15 years is just simply not healthcare reform. IF all those things worked, you'd MAYBE see a 5-7% decline, and that'd be miraculous.
By cost of heath care it generally means the cost of service delivery. Prices are inflated because of excessive profit harvesting. It is now capped at 20% But if you can see that the costs have started to go down based on what has been implemented so far then for you only time will tell..
The medical loss ratio has literally nothing to do with how much a provider charges for any given service, it only regulates how an insurer (not a provider) spends your premium. I'm less concerned about individual premiums, because realistically, it's going to be a totally scattershot result on the national scale. I mean, look at the comments, some people saved money, some people lost money, etc. We are being forced to buy into a private system with absolutely no pricing controls. The providers can still charge whatever they want depending on what kind of insurance you have, and nobody outside of an insurance company has any negotiating power at all, but you have to participate. In fact, I'd say the medical loss ratio could aggravate the problem: If insurers can only take 20% of my premium, raising my rates (which they are allowed to do under the ACA at a rate of 9% year over year with no explanation) brings them a larger dollar amount, and the so the inflation of the prices of medical services can continue at a ridiculously horrifying clip.
Excellent!
On a lighter note, if universal health care has been a part of the American system, we wouldn't have Breaking Bad =D
http://www.upworthy.com/why-people-in-other-countries-wouldnt-get-the-pr...
Here in the United Kingdom, we have the NHS (National Health service) which was the brainchild of a politician and Prime Minster Aneurin Bevan.
The taxes we pay enables us to have the best care available across the board. Old or young, you will be looked after. Sure there are good and bad tales of how this really translates in life, but on the whole it is very good.
I experienced the US healthcare system a few years ago when my youngest smashed his nose open in a Disney park. He was rushed to A&E in an ambulance, had a Doctor, two nurses and a child psychologist look after him. The Child Psychologist was there to 'take his mind off having his face stitched up'. She cried the whole time the procedure was carried out as my son was wailing so badly. It was me that had to physically hold him down and reassure him throughout the stitching, but we were still charged for her involvement. Furthermore, because I didn't have my travel insurance documents to hand, I had to pay for the initial treatment immediately with a credit card. When we returned to the U.K, we were given a final bill of $5,600 which we passed to our insurance company.
What I would genuinely say to you is embrace the 'free' healthcare. It is the single most important piece of legislation that you will vote for.
I would also say - be very aware that this will attract 'tourist' patients from foreign countries who have to pay for healthcare. There are many many stories of people with existing health conditions who are travelling to the U.K and pretending to be on holiday, purely to book themselves into one of our hospitals to have a procedure carried out for free.
James, how are foreign "tourists" getting free healthcare. When I was there, you had to have an NI number or else you were billed. Is this an EU thing?
Sure you need an NI number if you are a British Citizen, but if you are visiting the UK on 'holiday' and suddenly fall ill then you will be treated as an emergency and won't be turned away.
An EU visitor should have should have an EU health-card to ensure there isn't a charge incurred along the way.
All Emergency A&E cases, walk-in centres, minor injuries etc are all free of charge. If you are admitted to hospital, some charge may be incurred.
The Government figures that the NHS loses somewhere between £12m and £200m per year on health tourism. They don't know exactly how much but have initiated an audit to do so.
If you are a non UK resident and travel to the UK, book yourself into an A&E with an existing health problem, receive diagnosis and admission to hospital. Have treatment, maybe an operation etc and then just leave - who will the NHS charge?
I'm in the Netherlands, which have a fantastic health system. I pay a basic fee of €100/m for health insurance, which covers a wide range of medical care. You can get additional insurance for more coverage and it can go up to €250/m. Since I've saved enough money to e.g. pay for the dentist or 'smaller' care costs, so I set my "own risk" to €750/y, which gives me a monthly discount of €20. Additional to this, we pay alot of tax (33% for the lower income, up to 52% for €55.000/y and higher). Sure this might be shocking to some, but it can be assured that the Netherlands is very nice, save and easy place to live. From a European point of view, Obama is (after Clinton) the best what has happened to the USA.
People think that countries with government healthcare pay so much more in taxes than we do, have a much worse bureaucracy and worse healthcare than we do. In fact, the US pays a higher percentage of our GDP than any other country in the civilized world. Canada's health care costs are 10% of their GDP, ours is 20% and rising. And they have 100% coverage for medical expenses for 100% of the population. Canadian taxes are on a par with those in the US, but they get so much more than we do, including no medical bills, cheaper advanced education, Medical bills are the highest percentage cause of bankruptcies by for in the US, despite the fact that 85% of the population has 'full coverage'. Thousands of people every year go bankrupt and have full coverage every year. The US ranks 21st in the world in health care outcomes despite having the best medical facilities in the world because of the cost of health care.
Emergency care is the most expensive health care out there, and those people who are going to the ER because they don't have insurance are screwed twice: 1st because they're paying 2-4 times as much for the same care than somebody who has insurance, and 2nd because they already can't afford to pay for insurance, how are they supposed to pay for their medical bills?
No, the ACA isn't perfect, but it's a start. Nothing right off the bat is perfect, but if you don't start somewhere then it'll never get fixed.
Healthier people who have a better body image book more photo shoots. Thank you Obamacare
There is no such thing as insurance for preexisting conditions. That is welfare. No is asking how to reduce the costs of healthcare, they just want taxpayers to pay for it. There's nothing affordable about it. My companies rates with BCBS went up 40% this year because of this tax. Yeah, we dropped them real fast. I don't need the insurance anyway, oh wait, now gov't agents will steal my money if I don't have any. If I go to the hospital, I pay for it. What a novel concept.
"There is no such thing as insurance for preexisting conditions. That is welfare." << Try telling that to a friend that has been fought a battle with cancer for a few years while in there 20's but is now back on their feet again having won the battle. Healthy, now running a profitable business, raising a family and contributing to our economy. Sadly though because of their 'pre-existing condition' they have absolutely no ability to purchase health insurance. Doesn't seem like it would be welfare to me. It seems like we would be giving them the same shot at being insured for their future as everyone else is getting.
I really hate reading articles like this. You voted for Romney and now you are all glowing about The Affordable Health Care Act? I am sure you could have purchased healthcare Insurance through PPA, your local Chamber of Commerce or many other groups. And to be quite honest, with five kids you should have! But guess what... you won't have those options or choices for long. The Government Health Insurance does not have to make a profit... most likely they will loose money just like most government run business... (Post Office). So they can undercut and run all the insurance companies out of business... Is that what you think is right? Do you think that is a good idea? Please wake up people!!! And please don't ramble about making a profit. We all need to make a profit... that is how we stay healthy as an economy. One of the only positive sides of the Gov Health Insurance that I've seen so far is that it will cover pre-existing condition... did we really need to pass a law forcing all Americans into this 2000+ page, we need to pass it to see what's in it law? Of course private health insurance companies can't cover pre existing conditions because it would force them out of business! But guess what... the government health insurance can do it because they won't go out of business, they can just raise taxes forcing more companies to leave the country. The Gov can pile on more debt to cover the conditions. The Gov Health Insurance will cover kids till they are 26... how pathetic is that... do you think Insurance companies can do that and stay in business? For heaven sakes... George Washington was working as a surveyor earning a living at the age of 15, but the 26YO "kids" need to be on their parents plan..... WAKE UP!!!! "You can keep your existing Plan", we were told... well guess what... I can't keep my existing plan because my Insurance Company was forced to do away with my plan. You can keep your Doctor... ya, if my Doctor goes along with what my new forced plan dictates. I am sooo frustrated reading this crap about how great this Affordable Health Care Act is.... well let me tell you its not great, it is down right destructive and will send this country into a spiral that will be hard to come out of! Enough from me I need to get back to WORK!
Well David, guess what....unless you can tell the future you have no idea if any of what you wrote is true. And guess what...the idea of having more people pay premiums to cover the cost of the sick is a novel idea called INSURANCE! Its been around for a while and has worked pretty well. Oh, and guess what....if I was still under my parents insurance until I was 26 I would have gone and gotten my masters and doctorate, but I couldnt because I had to work pay bills so it had to be put off. Finally, guess what....? Chicken Butt!
Maybe I am mistaken, but I believe Mitt Romney enacted an law quite similar to this one while governor of the state of Massachusetts in 2006. Hmm... I might be wrong though.
"More people will be able to follow their dream to become a photographer." So it's now the law that I must subsidize my competition...
"When we buy a new car, before we drive the car off the lot we have to show them proof of insurance. Same thing goes when we get pulled over by a cop. It is required by law to have it. When we buy a house they often bill the cost of insurance right into our mortgage because the lenders want to make sure we are insured. Insurance is all of us pitching in a little bit today so that the person who needs the help tomorrow can find it." You only have to insure a car if you drive it on the road - to protect yourself against liability if you hurt someone else. Insuring your house is part of the contract because the property belongs to someone else until you pay off your mortgage. If you pay cash for a house, you don't have to insure it at all (but is wise to do so). This is just a tax for living.
This should be a proclamation of how great something is but a thank you letter to everyone who is subsidizing your life. I didn't see that part anywhere.
I think its the very minimal responsibility of a country to take care of its citizens safety and health! How can you even remotely question this? How can you let people die because they can't afford medication or an operation? We're talking about the US, not Simbabwe that is.
Now of course, if you willingly decide to risk your health by eating only at McDonalds and insisting on smoking and base jumping as your every day hobby, then maybe you should just pay a higher insurance fee...
I am a wedding photographer also. I paid $221 a month for "catastrophic" health care coverage. Now my plan is being cancelled and I have to choose another health care plan. Every single one of the plans being offered are at least $100 per month more AFTER subsidies. But here's the real kicker, I calculated out 8 different usage scenarios from no usage to double catastrophic. Under every scenario, the Obamacare plans are thousands of dollars worse than my current plan. I wouldn't mind paying more for a better plan, but the fact is, these plans are just plain worse in EVERY usage scenario.
Just book more weddings right? The problem is, if I book more weddings, I LOSE the subsidy.
Obamacare is horrible for wedding photographers. One of us might have to go get a "real job" and give up wedding photography because of this.