Health Insurance

Another important point brought up by a commenter on a recent post— how am I going to get health insurance if I leave my job? The short answer is that I’m going to pay through the nose for it!

This really is the crappiest part of trying to contemplate a sabbatical, or early retirement. I currently get pretty good health insurance through my employer, including coverage for Sweetie. I pay about $260 a month to cover our dental and medical insurance. I can see from my paystub that the employer covered portion of our insurance costs is about $1000 additional. Going on COBRA will also add some sort of administrative fee, so I’m budgeting that it will cost us $1,400 a month to pay for our insurance.

COBRA only lasts up to 18 months, so after that, assuming we didn’t have jobs yet, we’d have to buy insurance in the marketplace. I went to the NY State website to see what the costs would be under Obamacare. It looks like we make too much money from interest and dividends alone to qualify for any subsidies, so our costs for a “bronze” medical and dental plan for 2 people would be around $800 a month. “Silver” would be about $950, and “gold” would be around $1,150. Given that we are both currently quite healthy and don’t have any prescriptions we take regularly, it probably makes sense for us to try a bronze plan— this would have a really high deductible, so we’d be mainly covering ourselves for something catastrophic, and we have the cash to pay a big out-of-pocket maximum if we get hit by a bus. But that could be over $14,000 worth of charges we’d have to pay before the insurance kicks in. So maybe it’s worth it to pay about $350 more per month for the lower copays and out of pocket caps that we’d get with a gold plan?

Who knows… either way the whole system sucks. I know so many people from other countries that have single-payer systems, and they are perfectly happy with them and think that what we have to pay here is insane. Every time I see a drug ad on TV, I feel outraged that millions of dollars are being spent on all this pointless marketing, though I know that’s not the only reason healthcare costs are high. And of course, my numbers here assume that the Affordable Care Act isn’t completely destroyed by the Republicans. If the protection for people with pre-existing conditions goes away, I’ll be screwed, as I do have one hereditary thing that doesn’t require active treatment now, but would be considered a pre-existing condition and could potentially cause me to be charged a lot more for insurance in the future, or denied coverage for certain things.

So will we really be paying an amount equivalent to the rent on a small outer-borough apartment just to get health insurance? I guess we will, at least for a while. I’ve been googling “part time jobs with benefits” as that would be an ideal scenario, but I’m not sure we’ll get that lucky…

The Employee/Employer Relationship

I've been thinking a lot about this issue lately, for a number of reasons.

I'll start off with a story about a friend of mine who I'll call Karen. She has someone who comes in and cleans her apartment every week. Let's call the cleaning lady Tracy. Karen first hired Tracy about 15 years ago. At the time, she only had Tracy come every other week. As is typical for this kind of situation in New York, Karen paid Tracy in cash. Over the years, Karen raised Tracy's pay a few times, and when Tracy lost some of her other clients, Karen started having her come in every week so she'd have more work. Tracy has rarely missed a week due to being sick, but when she has, Karen pays her anyway. Karen also gives her a Christmas bonus every year. Tracy takes a couple of weeks off every year, which Karen doesn't pay her for, but if Karen is going to be away and doesn't need Tracy to come, she still pays her for the weeks she's canceled.

So is this a mutually beneficial, fair relationship? Tracy offered to do the work on her own terms, and I don't think anyone would describe Karen's treatment of her as in any way exploitative or mean. Of course there's a tax evasion issue-- as you might be assuming, Tracy wanted to be paid cash because she wasn't a citizen-- at first. But now she is a US citizen and could presumably get another job where she and her employer would have to pay taxes. She's already past the age when most people want to retire, and Karen is wondering what to do about it if Tracy does want to stop working-- she's never paid any Social Security taxes for Tracy, so it's unclear what, if anything, Tracy would be able to collect. Tracy's children might or might not be able to help look after her. Karen is thinking about whether she should give Tracy some sort of pension, out of a sense of what's right and also just because she and Tracy have an affectionate relationship and she genuinely cares about what happens to her. That's more than can be said for a lot of people you read about who feel they have to economize by cutting the hours for the hired help just because their mutual funds are down.

Do you think most people feel this sense of responsibility towards those whom they employ? Is this kind of arrangement between two individuals a fair way to decide terms of employment, or should the government always be involved in setting the rules and collecting taxes and providing benefits? Should there always be an obligation to take care of an long-serving employee after the employment has ended?

The other thing that's had me pondering these issues is the TV series Downton Abbey, which everyone seems to be talking about lately. Thanks to streaming Season 1 from Netflix, I can count myself among the fans! It's set at a point when the sun is starting to set on the British empire and the old ways of life for the aristocracy are starting to change. But amongst the servants on this big estate, you have a variety of attitudes towards their situation and the people who employ them. There's a rigid class system, but there's also a sense that master and servant consider each other family, at least in some ways. Of course, sometimes this turns into the masters telling the servants what's best for them, which usually involves their continuing to be servants-- it's a paternalistic relationship where the servants have no real dignity or autonomy or choice.

And then there's what's going on in the US in current times. Some politicians are trying to make laws against collective bargaining, more and more people have to work as "independent contractors" rather than as actual employees of corporations, pensions are underfunded, and some benefit packages have been so aggressively negotiated as to be unsustainable. People are yelling "get a job!" at Occupy Wall Street protesters one minute, and saying Obama doesn't deserve re-election because of astronomical unemployment numbers the next.

If there's anything I take away from all this, it's that ideally, we'd all work for ourselves... but that just isn't possible. How can we best maintain our dignity as equals when some of us have to work for the rest of us? How can people without much power be protected from those who do have power? Would most employers actually treat people fairly if they weren't forced to? What are the best ways for government to be involved? We live in a complicated world, and wishful thinking won't make it any simpler.

And to come back to Karen and Tracy, what would you do? Would you refuse to pay someone cash under the table, employ only legal workers and pay all the taxes so they could collect Social Security? Or would you pay someone cash and just figure they knew benefits were never going to be part of the deal? Or would you feel obligated to help take care of someone who'd worked for you after they'd retired?