Just saw "SICKO" - Posted by Terry Vaughan

import · November 17, 2007, 6:53am

Two C-sections and done counting - Posted by Penny

Posted by Penny on November 17, 2007 at 07:53:39:

We’ve been very fortunate in our health. I’ve had two C-sections, however. Without insurance, it would have been around $15k-$20k for each son.

Since we haven’t quit our day jobs, we still have coverage through employers. But family medical insurance is something we consider very carefully for down the road when we quit our day jobs. Knowing that our current employers contribute 3x what we pay for the medical premiums, it’s not cheap.

So I’m looking at our business entity structuring to see how to make some or all of it a deductible business expense.

From a tax perspective, the choice of business entity may help. If you have a C-corp, the company can provide medical insurance benefits and deduct medical premiums as expenses without exclusions for officers. The drawback of a C-corp, is the double taxation on profits. But the tax rate is only 15% on the first 50k. Managed properly, this is one approach to being able to deduct health care premiums as well as mnimize taxes on profits.

S-corp rules are different with its’ flowthrough. If you have an S-corp, you can also deduct medical premiums as a business expense for employees. I’m investigating how highly compensated employees or shareholder/employees are currently treated for both S-corps and LLCs. I’m not sure if there have been recent rule changes to include them in allowable premium deductions.

Back to good ol’ www.irs.gov. What fun.

import · November 17, 2007, 6:45am

It Ain’t the Insurance… - Posted by IB (NJ)

Posted by IB (NJ) on November 17, 2007 at 07:45:35:

it’s the western diet that contributes heavily to the deseases in the first place. How much money could we save if we enganged in a healthier LIFEstyle (as opposed to ‘deathstyle’) complete with exercise, a healthy organic and meat-free/low meat diet and relaxation/meditation?

Ib

import · November 17, 2007, 4:02am

Re: Just saw “SICKO” - Posted by Wayne-NC

Posted by Wayne-NC on November 17, 2007 at 05:02:41:

Althought not perfect, we still have the best system in the world. Why is it so expensive? Well, litigation is one reason and people who demand services that cannot pay is another as someone still has to. I could go on but that is another forum topic. The private market place is the best answer. That can be said for a lot of things. Government does not solve problems. They create a whole bunch of new ones in the process that the private sector has to fix. So, we really can’t “vote” solutions, we have to create them. Anything in there sound familiar? Hint: I learned a lot of that right here! Sounds to me like you need an HSA account. That may solve your insurance gap. At least you didn’t have to run to Canada or Great Britian for the surgery. BTW, glad it was a success. That is the most important thing. Without your health, nothing else matters.

import · November 17, 2007, 4:02am

9 Kidney Stones and Counting - Posted by Jimmy

Posted by Jimmy on November 17, 2007 at 05:02:19:

I feel you pain. I’ve had 6 lithotrypsy procedues over that past 10 years. no fun.

I have very mixed feelings about the government being involved in the delivery of health care. The reality is that the govt is already a huge player via medicare and medicaid.

On the one hand, the govt is horribly inefficient. and I do not trust liberals with more of my money and more people depending on them. [I also distrust conservatives–but for different reasons].

On the other hand, I am uninsurable (and not because of the stones). There are only two ways for me to get insurance. either take a job as an employee (forget that noise!!) or participate in a high-risk pool via the state of TX. so I do the latter. its expensive, but necessary.

I wish there were a way to create a large group of REIs which could get group rates for health insurance. My understanding is that the group has to be a employer-employee deal.

import · November 16, 2007, 10:38pm

Re: Just saw “SICKO” - Posted by Barry (FL)

Posted by Barry (FL) on November 16, 2007 at 23:38:15:

Terry, you’re a very smart guy and Michael Moore would be the last person I’d be taking healthcare advise from. The government runs things SO well. Do you really want them running your healthcare system?

BTW, I’m an insulin dependent diabetic, my 10 yo has heart valve issues and my wife cancer issues. Hasn’t impacted us, just go buy another house as you’re so fond of saying. ;O)

import · November 26, 2007, 5:13am

In defense of the USA - Posted by Wayne-NC

Posted by Wayne-NC on November 26, 2007 at 06:13:26:

“Oh, I forgot, but we have the best health care system in the world, LOL, LOl, LOL, LOL.”
Your statistics are impressive all right. Question: Why does the rest of the world come here for major health care? It is the best in the world (but not perfect) if one chooses to use it. Ofcourse affordability is an issue. Anyway, I challenge you to name a better healh care SYSTEM in the world since this is your statement. Here’s another note. If the insurance companies take in all this money and don’t pay any claims as you say, then where is all this money? The owners have it, ie stock holders? Good investment there right? Like REI, collecting rents and not paying upkeep on the property. Some companies are owed by their policy holders. What happens then? Nice post but it contains too many opinions in my opinion.

import · November 19, 2007, 1:06pm

Re: Bring Capitalism to Medical Care - Posted by ken in sc

Posted by ken in sc on November 19, 2007 at 14:06:52:

For our 2nd childs birth, my wife and had elected before that not to purchase maternity insurance. So, I knew that I would pay for that birth. A month or so before the big day, I went to the hospital and found the person to talk to. I said “I am going to write you a check for this kid, how much if I write the whole thing now?” She said, “typically we would bill insurance about 5 grand for a normal childbirth, but if you pay me half now and half at the time, we can do it for a flat $2500”.

That’s right, I paid HALF because I paid directly with no insurance.

So, what’s the other $2,500 for???

For the record, this was cheaper than 5 years maternity insurance which I would have paid had I gone that route.

import · November 19, 2007, 10:15am

I’ve thought of this long ago - Posted by Wayne-NC

Posted by Wayne-NC on November 19, 2007 at 11:15:33:

Soon we will need insurance to cover the co-pays! Well, that’s already been done in a sense, it’s call medigap insurance or Medicare Supplement Insurance. How about major medical supplement insurance? It came in the form of an HSA account.
“When are we going to stop blamming everyone else and start taking responsibilty for our medical care cost.”
There’s your answer and it will grow and be modified over time. At least I hope so.

import · November 21, 2007, 11:36am

Nice… - Posted by Berno

Posted by Berno on November 21, 2007 at 12:36:17:

Thanks for your post, Doc!

import · November 19, 2007, 10:09am

Right On! - Posted by Wayne-NC

Posted by Wayne-NC on November 19, 2007 at 11:09:02:

Except I didn’t have the time at the time to explain what you have just explained.

import · November 19, 2007, 9:13am

Re: Response from a Doctor - Posted by Frank Chin

Posted by Frank Chin on November 19, 2007 at 10:13:55:

Ming:

Good post.

Just to add that my “brother in law” is practicing doctor for over 25 years, and also a real estate investor.

For many years now, he always had a full time person handling insurance claims, payments, followup with insurance companies on denied claims.

This, plus “malpractice insurance” is a major expense, which is passed on to the patients.

While it is true that if everyone is to get coverage, there won’t be enough doctors, or medical facities, other countries like China took care of the supply side of the equation with “barefoot” doctors. It seems that the consumer’s here can only be satisfied with the “state of the art” care.

Seems to me that so much of our resources is devoted to going thru the “insurance maze”, and any mention of simplification is attacked as “socialize medicine”.

And what do we have??

We don’t have socialized medicine, but have a private insurance maze that patients and doctors have to jump thru hoops, leave millions unuinsured, and supposedly so much better than socialized medicine.

Frank Chin

import · November 19, 2007, 7:58am

Good Post - Posted by Gene

Posted by Gene on November 19, 2007 at 08:58:49:

NT

import · November 19, 2007, 5:27am

Well Said - Posted by arlan

Posted by arlan on November 19, 2007 at 06:27:33:

NT

import · November 18, 2007, 5:35pm

profit driven healthcare - Posted by lukeNC

Posted by lukeNC on November 18, 2007 at 18:35:58:

and I hope you don’t buy in the BS that drug companies are here to help ya. What a croc. I guess you’re one of those who thinks we pay less for healthcare here than in “socialized medicine”. Think of all that we pay for. Co-pays, insurance premiums, on top of taxes, sales, income, payroll. Add all that up.

Drug companies just want to drug you up. There’s a pill for everything. A pill for “restless legs syndrome”?

I don’t believe healthcare should be a profit driven enterprise.

import · November 18, 2007, 2:50pm

Amen to that Dave!!! (nt) - Posted by RichV(FL)

Posted by RichV(FL) on November 18, 2007 at 15:50:02:

$

import · November 18, 2007, 8:17am

Re: Just saw “SICKO” - Posted by Killer Joe

Posted by Killer Joe on November 18, 2007 at 09:17:28:

Eric,

Your comment about working for medical device company reminded me of this story, and I thought Iâ??d share it with you.

Back in the early 90â??s I was on a team of 6 people who developed the first battery powered large bone saws and drills. I occasionally see these devices used during operations when my wife is watching those hospital themed cable shows. We were working with Linvetec/Hall Surgical at the time, and came up with a concept for a device to harvest boneâ??patellar tendonâ??bone grafts for ACL surgery with the bone plugs having a rounded shape as opposed to the common triangle cut shape.

About $2MM into the project the lawyers from Bristol-Meyers, the parent company to Linvetec, called us up and we were told to put the project on hold. This was after we had a marketable system with all the kinks worked out. It seems that some individual working as his own think tank had filed for a patent on the very same idea, and the PTO had just granted him a patent.

Now the reason this has any relevance here is just to give a behind the scenes look at what can cause health care issues to skyrocket in cost. In this case, it is related to ACL surgery, but it shows how individual greed, for lack of a better word, can affect HC costs and the viability of new techniques being offered to the public.

In our case the inventorsâ?? claims directly touched on fundamental processes needed to facilitate the workings of our invention, and hence we would be infringing on his claims. We subsequently were granted patents on portions of the procedure, but I digress. The inventor we were up against demanded an upfront royalty payment of $3.5MM, and an additional $35.00 royalty payment per operation. This, of course, was out of the question, and everything ground to a halt at that point.

Having found a superior way of harvesting ACL grafts we found it truly unfortunate that the general public, and their surgeons, could not take advantage of the technique due to the financial stranglehold placed on the process by that inventor. What would have been a better-cheaper-faster way to repair a torn ACL was relegated to just another good idea shelved for the sake of outrageous profit. Had that inventor presented reasonable royalty demands to the good folks at Bristol-Meyers our machine would have been free to go to market, and thousands of ACL patients would have benefited from the technology. Subsequent improvements to the process due to field experience would no doubt have made this instrument even better than the original over time.

KJ

import · November 17, 2007, 4:03pm

Funny, I’ve never - Posted by Barry (FL)

Posted by Barry (FL) on November 17, 2007 at 17:03:49:

been denied any type of treatment or diagnostic tool from my insurance coverage. Could you give us some examples of what you have been denied?

import · November 17, 2007, 6:59pm

Re: Just saw “SICKO” - Posted by Clyde

Posted by Clyde on November 17, 2007 at 19:59:16:

Good for you Cletus…I tried that with that thing that “Bob” advertises for male enhancement…worked like a charm but the insurance company turned it down. Said it was not a permanent fix and a wig does not go well there.

import · November 17, 2007, 9:01am

Re: Dental is the worst scam… - Posted by James

Posted by James on November 17, 2007 at 10:01:54:

I’ve got a friend of mine who’s a dentist and LOVES cash-paying clients.
Offers a discount too.

Ins comp. take forever to pay…especially our government and then it’s only what they want to pay.

James

import · November 17, 2007, 8:24am

Remedy - Posted by Wayne-NC

Posted by Wayne-NC on November 17, 2007 at 09:24:20:

I get sick only once a year. It sure beats 12 times! It is a vicious cycle. Anyhow, that struck me as funny. It’s not often I laugh out loud by myself. Thanks.