October 28, 2010 3:05 pm at 3:05 pm #592805
Since im off the books, and my boss ain’t offering health insurance, what should I do? I don’t want to pay $400+ a month for insurance, and I don’t think I qualify for medicaid or anyone of those programs, what do you ppl do/suggest?October 28, 2010 3:13 pm at 3:13 pm #704471
crdle, first ask your Rav the halachic ramifications of working off the books and start reporting your income to the IRS.October 28, 2010 3:14 pm at 3:14 pm #704472
Are you single or married with family? If the latter, $400/mo might be cheap, if the benefits are good.
If you are single, consider an HDHP with HSA.October 28, 2010 3:14 pm at 3:14 pm #704473SacrilegeMember
Do you qualify for Healthy NY?October 28, 2010 3:16 pm at 3:16 pm #704475Dr. PepperParticipant
Where do you live that insurance is only $400 a month? What kind of insurance is that? What does it cover? Our insurance is over $1400 a month (self plus spouse and children, my employer pays most of it).
You probably should look into getting a legal job. Health insurance is very expensive (and it’s going to increase drastically when the new stuff goes into effect).October 28, 2010 3:22 pm at 3:22 pm #704476ZosHaTorahParticipant
By “HDHP with HSA” Squak means: High Deductible Health Plan with a Health Savings Account.October 28, 2010 3:26 pm at 3:26 pm #704478
Start by working on the books. Cheating on taxes is asur (see Bava Kamma 113) and it is a chilul HaShem when an otherwise frum Jew gets caught.
Regarding health insurance, a lot dependes on where you live. But most private insurance with decent coverage, in most places in the US, will indeed run you $400+/month or even more. Any insurance agent should be able to give you the bad news. And if you have pre-existing conditions, you may not be able to get insurance at all outside of the new high risk pools that are among the first major features of Obamacare to take effect. The Republicans are going to try to end them but at least they could help for awhile.
One possibility is to make aliyah to Israel and take advantage of its excellent health insurance plans. Minimal fees for religious schools, too.
Good luck! I know many self-employed or underemployed people who constantly struggle with health insurance.October 28, 2010 3:27 pm at 3:27 pm #704479akupermaParticipant
How likely are you to have $5K of medical expenses (of the sort insurance pays) in a year? Remember that in case of a major disaster you would be unemployed and become medicaid eligible (and if you or a spouse might have a baby, there are special standards for medicaid maternity). Do you have substantial assets or are you “judgement proof” — meaning that if worse came to worst, you could file for bankruptcy if you had horrific medical bills.
If your typical medical costs are a few doctors outpatient visits, and some generic antibiotics you are will lost money by buying insurance at the rate of $5000/year.
Health insurance is a “bet” with the insurance company. You are betting you will be sick and injured and run up $5000 of medical bills, and they are betting you won’t (meaning they make a profit on the bet).October 28, 2010 3:30 pm at 3:30 pm #704480
One more thing: If you fail to report your income when applying for government benefits such as Medicaid, you have committed a federal crime. If they catch you, you will likely be spending a number of years learning in the Otisville Prison Kollel.October 28, 2010 3:34 pm at 3:34 pm #704481
Whoa. Charlie & SJS- it is possible that her employer pays off the books (which is his own problem, not hers) and she in turn reports her income fully to the IRS. I believe there is a way to do this without getting the employer in trouble.
I think this may be what the OP does, since she says that she does not qualify for government sponsored health plans.October 28, 2010 3:38 pm at 3:38 pm #704482
You really don’t want to place that bet. Medical providers are under no obligation to ever give you free medical care and even hospitals are only obligated to provide limited emergency care. And many of the lifesaving drugs to treat common medical conditions cost hundreds of dollars every month, with only rare discounts to those who don’t have insurance.
Finally, forcing the rest of us to cover your medical expenses because you have not provided for payment for your own care is the height of irresponsbility. I’m not sure why it would not be considered theft.October 28, 2010 3:53 pm at 3:53 pm #704483minyan galMember
crdle: I think you should move to Canada where we have universal coverage. Most of us still carry some private insurance to cover things that are not covered by the government program. In the province that I live in we pay nothing for our government coverage, but some provinces do charge a monthly premium but it is very low by American standards. What I cannot figure out is that, to date, nobody has been able to come up with a plan that combines the best of the Canadian system with the best of the American – yet they have figured out how to put man on the moon. You live in the world’s wealthiest country with the best available medical care in the world, yet so many of your citizens have no coverage. It is a shandah.October 28, 2010 4:01 pm at 4:01 pm #704484Dr. PepperParticipant
How much did the government spend to put man on the moon?
How much does it cost to provide all citizens with the best medical coverage?
Does that answer your questionOctober 28, 2010 4:06 pm at 4:06 pm #704485ZachKessinMember
Failure to pay your taxes is a felony. If the IRS catches up to you they can put you in jail for that. If your boss is paying you off the books find a new job that pays you on the books! And file tax returns for the years that you didn’t! Really if you approach the IRS they will work with you. If they find you they will put you in jail!
Here is the thing about heath insurance, on average you will pay in more than you get out. However if things go really badly and need major care then you could find yourself with $200,000 in debt!October 28, 2010 4:07 pm at 4:07 pm #704486ZachKessinMember
Oh also if you work off the books all your life you won’t get social security. It might not be great but its a lot better than nothing.October 28, 2010 4:08 pm at 4:08 pm #704487
To:charliehall._Cheating on taxes is asur_ really?I thought, impose crazy taxes on people- asur and unconstitutional(At least according Rush Limbaugh)October 28, 2010 4:14 pm at 4:14 pm #704488
To:ZachKessin_ Are You sure that You will get SS even You paid all your life SS Taxes, After, let say 15 years from now???October 28, 2010 4:22 pm at 4:22 pm #704489akupermaParticipant
For the first $5000 of expenses (will cover anything less than major surgery) being uninsured makes a profit for the guy. Note the person didn’t mention a preexisting condition – normal people don’t run up $5K of medical bills. Even a broken bone or a trip to the emergency room won’t result in being out enough to make insurance cost efficient.
A serious “surprise” will probably result in the person becoming unemployed (remember, if he/she is paid off the books, they have little job security and no sick pay, and probably not a great deal of prospects of staying employed – leading to medicaid eligibility.
Hospitals have to take people in an emergency – and if they argue about the money you can threaten to file chapter 7.
If the person is actually likely to need insurance, and has assets, and has a real job- then they need insurance. But then, they wouldn’t be asking.October 28, 2010 4:26 pm at 4:26 pm #704490
First of all I do pay taxes, im self employed!!!!! Where is your hevei dan lkaf zchus?!?! regardless, to taxes this is about insurance. So is there a way to have let say a $200 a month insurance? maybe with a group? How on earth do all the families here have medicaid or healthy NY, they own houses, or even rent and the mother doesn’t work, yet they live on a really high life style? how on earth do they qualify?October 28, 2010 4:27 pm at 4:27 pm #704491chesednameParticipant
please don’t use 2 S together
makes me sick even if i know what u meant, sorryOctober 28, 2010 4:28 pm at 4:28 pm #704492aposhitermaidelParticipant
To: Minyan Gal – yes in Canada you have universal insurance but in many cases – the wait is too long for it to do any good. My cousin was diagnosed with aggressive Melanoma in June. He was given an appt to start chemo for mid Nov. B”H he has a lot of money and has been coming to the U.S. for treatment – because waiting until Nov would have been fatal. So yes – we need reform in the U.S. but copying Canada’s model is not the answer. Neither is Obama care. I get insurance through my employer but have been contributing 7K a year towards it. Due to Obamacare – my premiums went up $2400 this year. And this is with a large deductable even if going in-network. An alternative is buying catastrophic insurance – which will not cover most routine doctor’s visits and has a huge deductable – but will cover in the case of C”V a catastrophe.October 28, 2010 4:29 pm at 4:29 pm #704493chesednameParticipant
the shandah is the level of care, Canada gives.
I’ve spoken to Dr’s and they say it’s the worst!
u shouldn’t know from it, but by real medical issues, they have a long wait time (months for a cat scan, yes months)
and they prefer ppl dying it’s cheaperOctober 28, 2010 4:29 pm at 4:29 pm #704494
crdle, the statement “off the books” means “without paying taxes.” Otherwise, your statement should have been “my employer doesn’t set aside taxes from my paycheck.”
Sorry for judging your harshly. I hope you forgive me.October 28, 2010 4:52 pm at 4:52 pm #704498
If she is an employee and not a contractor it is both her problem and the employer’s problem even if she does report all of her income because she can’t file a Schedule C. And there is no way for the employer not to get into trouble. The IRS considers this to be one of the biggest tax scams going.
I follow the torah as elucidated by Chazal and Rishonim, not by Rush Limbaugh. (And I bet he pays all his taxes!)
You don’t understand the nature of insurance. It isn’t an investment, or a gamble, it is about avoiding risk. And the worst risk one can make is with ones health.
If you are in fact self-employed why did you say you are “off the books”? That is the term that is universally used to mean that one is hiding their income illegally.
The US system is clearly worse than Canada as measured by objective health outcomes, and it costs far more. And the primary reason for recent premium increases is not Obamacare (which doesn’t take effect until 2014) but the fact that insurers use earnings from investing their premiums to defray the cost of claims. And because of the economic collapse that Obama had nothing to do with, they have lost tons of money on their investments, particularly in real estate.
My wife is a physician and she has also talked with Canadian doctors. Things are so much better there that we seriously considered trying to emigrate. Doctors never have an HMO telling them what to do. Doctors never have to worry about getting paid. Doctors send ONE bill to the provincial government, rather than dozens of bills to as many health insurers, and the government pays the bill the first time rather than arguing. And had she gone to medical school in Canada she would have a lot less debt.October 28, 2010 5:18 pm at 5:18 pm #704499Ben TorahParticipant
If you knew a patient in need of serious care in Canada, who was on a “waiting list” for his life saving treatment, your view would be corrected.October 28, 2010 5:32 pm at 5:32 pm #704500
To :charliehall_ Dino de malchuso -Dino, its not so easy understand in our time, in this country.I’m sure in some circumstances(If Health insurance vital to your life), you can get getter to withhold(do not show) some of your income.October 28, 2010 5:45 pm at 5:45 pm #704501myfriendMember
While y’all were debating the merits and demerits of nationalized healthcare or the virtuousness of taxes, y’all forgot the OP had a question that hasn’t been answered.October 28, 2010 5:46 pm at 5:46 pm #704502
OK. Popa’s turn.
I love talking about health insurance.
Health insurance is a problem that will never go away unless we change the premises.
Technology is improving in all fields at a rapid pace. In most fields, we don’t invest in it, and don’t use what could be available, because it costs too much.
In medicine, we use all the most sophisticated advances, and invest heavily in making new ones. This is not surprising; we will pay everything we have to be cured when we are sick. Therefore, we will continue to invent new, necessarily more expensive, procedures and machines, and all pay to use them. We will only stop when we run out of available credit and assets.
So, is there no way out? Health care costs cannot go down, they can only go up. If a new machine is invented, we will want to use it. It will cost more.
As long as we insist that everyone must have access to the highest quality health care, costs will always go up.
There are two ways out.
A. We can prohibit new research. In five years, todays technology will be cheap, and health care will be cheap.
B. We can supply a fixed amount of care, and ration it based on need, not based on money. It will be illegal to pay for health care. Then, we only supply the amount that society can afford. (This is what Canada and Europe do. Yes, it is.)
If neither of those options is palatable, we need to rethink our assumption that everyone should get highest quality health care. Maybe it is ok for society to allow everyone to get the level they can afford. We can allow companies to sell insurance policies which cover 1995 technology only. Or, foreign educated doctors only. Hey, Japanese in 1995 weren’t so terribly neglected.October 28, 2010 6:01 pm at 6:01 pm #704503HomeownerMember
Despite the gibberish you posted, it seems like you are suggesting that one can get a heter to commit tax evasion.
Are you nuts?
Please delete this chilul Hashem from CR.October 28, 2010 6:12 pm at 6:12 pm #704504so rightMember
You can get a heter for abortion but not tax evasion? That’s nuts. If you don’t have bread on the table, but have an IRS bill from years ago, you can’t get a heter?October 28, 2010 6:14 pm at 6:14 pm #704505
To:Homeowner_You Are Correct.Lets not talking about this publicly at all !Sorry If I hurts somebody feelings.October 28, 2010 6:15 pm at 6:15 pm #704506aposhitermaidelParticipant
Or – we can have market rates apply to health care – like they apply to everything else. Because in today’s insurance driven system we are totally out of the loop in terms of cost. For example – when Lasik eye surgery first came out – the costs were about $5000 an eye. This treatment was not covered by insurance -so guess what – once the costs were in the hands of the people – the price went down – because nobody was going to pay so much money. The problem with our current system is that because we have insurance we don’t shop around for the most economic price – we don’t care if our insurance company is billed $3000 for an MRI. If we only had catastrophic insurance – and everybody would be paying for routine tests and appts ourselves – the prices would go down. One more factor is the huge malpractice premiums that US doctors pay to protect themselves against frivolous lawsuits. I definitely agree that there should be a financial penalty if a doctor makes a careless mistake (like taking out the wrong kidney) but today everybody is out to make a mountain out of a molehill and the doctors have to protect themselves. Those costs are passed down to us. Until we have Tort Reform – prices will not go down.October 28, 2010 6:18 pm at 6:18 pm #704507
So right, why would you need a heter to steal to put bread on your table? We have plenty of frum and non-Jewish organizations that will help with food.October 28, 2010 6:36 pm at 6:36 pm #704508
Ok ok children calm down!!!
First of all sorry for all those who misinterpreted my words, or actually for me not properly explaining. This discussion isn’t about high risk health care, or hospital stays, it’s about expensive and cheap health insurance and how to obtain that!
I don’t get paid on the books, but i still pay taxes as an independant so indeed ill get social security in 40 years from now! And for all your information, taxes as an individual are way more expensive!
Oh and I just got myself a quote with Empire for $312. I still think thats nuts, since b”h i go to the doctor maybe once a year, i just feel like it wuold be such a waste of money to pour that down the drain each month!October 28, 2010 6:38 pm at 6:38 pm #704509
crdle- so it seems you are single applicant. In that case, definitely look into a High Deductible Plan. Premiums are very low, and there’s a good chance that you will be able to build up a lot in HSA savings tax free.October 28, 2010 6:41 pm at 6:41 pm #704510
what on earth is HSA savings?October 28, 2010 6:41 pm at 6:41 pm #704511
If it’s advice you need. Make less money and sign up for medicaid. Also, if you are not getting Social Security for 40 years, you are mid twenties. Under a law going into effect in January, you may be able to get back on your parents plan until 26.
(In effect, this law makes it illegal to buy a policy which will not cover your kids until 26. Does anybody support such a thing? Why should parents need to cover kids until 26?)October 28, 2010 6:43 pm at 6:43 pm #704512
Google is your friendOctober 28, 2010 6:45 pm at 6:45 pm #704513
LOL Poppa, make less money to qualify for medicaid! I hope u were kidding!!!! lollllllll im cracking up here.October 28, 2010 6:51 pm at 6:51 pm #704514
I guess I’m your friend too, just this once 🙂
This is what Wikipedia has to say:
A health savings account (HSA), is a tax-advantaged medical savings account available to taxpayers in the United States who are enrolled in a High Deductible Health Plan (HDHP). The funds contributed to the account are not subject to federal income tax at the time of deposit. Unlike a flexible spending account (FSA), funds roll over and accumulate year to year if not spent. HSAs are owned by the individual, which differentiates them from the company-owned Health Reimbursement Arrangement (HRA) that is an alternate tax-deductible source of funds paired with HDHPs. HSA funds may currently be used to pay for qualified medical expenses at any time without federal tax liability or penalty. However, beginning in early 2011 OTC (over the counter) medications cannot be paid with HSA dollars (Sec. 9003 of H.R. 3590). Withdrawals for non-medical expenses are treated very similarly to those in an IRA in that they may provide tax advantages if taken after retirement age, and they incur penalties if taken earlier. These accounts are a component of consumer driven health care.
Proponents of HSAs believe that they are an important reform that will help reduce the growth of health care costs and increase the efficiency of the health care system. According to proponents, HSAs encourage saving for future health care expenses, allow the patient to receive needed care without a gate keeper to determine what benefits are allowed and make consumers more responsible for their own health care choices through the required High-Deductible Health Plan.
Opponents of HSAs say they worsen, rather than improve, the U.S. health system’s problems because people who are healthy will leave insurance plans while people who have health problems will avoid HSAs. There is also debate about consumer satisfaction with these plans. Some opponents believe medical expenses should be tax deductible for all individuals, not only those who have a savings plan.
You can also use any HSA savings left at retirement age for non-medical purposes, without tax implication.October 28, 2010 6:57 pm at 6:57 pm #704515
There are tens of millions of people in America who are on permanent waiting lists for care should they ever get sick because they can’t get health insurance at any price — possibly more than the entire population of Canada. Fortunately Obamacare will fix this problem.October 28, 2010 6:59 pm at 6:59 pm #704516
“Oh and I just got myself a quote with Empire for $312. I still think thats nuts, since b”h i go to the doctor maybe once a year, i just feel like it wuold be such a waste of money to pour that down the drain each month! “
That offer might be worth grabbing. Empire is a good insurance company with a large network of providers. Should you get seriously ill or have an accident, you will be very glad you did. Remember that insurance is to guard against the unexpected, not to provide the expected.October 28, 2010 7:08 pm at 7:08 pm #704517
We need to decide if we would rather divide a fixed amount of services based on money, or government decision. I vote for money. You vote for government decision. I voted against Obama(I didn’t care for McCain either). You voted for him.(I assume)
You might reword government decision to “need”. That would not change my opinion. This is largely because the need will be more than the supply, so I will not get it when I need, if someone else needs it more. I would rather it be rationed by money.October 28, 2010 7:08 pm at 7:08 pm #704518
hmmm Ill think about. ThanksOctober 28, 2010 7:10 pm at 7:10 pm #704519
“One more factor is the huge malpractice premiums that US doctors pay to protect themselves against frivolous lawsuits.”
Actually that is not the case. With the exception of a few specialties like neurosurgery or obstetrics, actual malpractice premiums are a small part of the total cost of health care in the US. A bigger problem are all the unnecessary tests and treatments that providers use in order to protect themselves from lawsuits.
“If we only had catastrophic insurance – and everybody would be paying for routine tests and appts ourselves – the prices would go down.”
That is true in theory, but it doesn’t work for people who aren’t wealthy enough to pay for the routine tests and appts.
Furthermore, the cost of health insurance in NY is driven up by the many mandated coverages — and one of the most expensive is the assisted reproductive technology that all insurers, including Medicaid, are required to cover. The frum community lobbied long and hard to get this coverage so that couples would be able to afford the mitzvah of pru urvu. I personally know frum kids who WOULD NOT EXIST without this expensive mandate.
” Until we have Tort Reform – prices will not go down”
In fact, prices have not come down in the states that have instituted Tort Reform. Texas is probably the worst example. When George W. Bush was governor it was his signature achievement. It did not help and Texas now has the worst healthcare system in America, with many Americans going to Mexico for health care!
I should add that it may be a Torah right for someone to sue and collect for actual damages, including health care and loss of income. The punitive damages are the problem. We really need a no fault system.October 28, 2010 7:11 pm at 7:11 pm #704520
“I’m sure in some circumstances(If Health insurance vital to your life), you can get getter to withhold(do not show) some of your income. “
I don’t believe you. Please cite a living posek who agrees.October 28, 2010 7:14 pm at 7:14 pm #704521
“We need to decide if we would rather divide a fixed amount of services based on money, or government decision. I vote for money.”
So someone without money who needs medical care should die?October 28, 2010 7:14 pm at 7:14 pm #704522
“we can have market rates apply to health care “
We do! There are thousands of health insurers and there is a tremendous amount of competition. The problem is that health care is very expensive!!!October 28, 2010 7:19 pm at 7:19 pm #704523
“If a new machine is invented, we will want to use it. It will cost more.
As long as we insist that everyone must have access to the highest quality health care, costs will always go up.
There are two ways out.”
There is a third way: A lot of those new “machines” (drugs, too) offer little or no improvement in clinical outcomes. We desperately need comparative effectiveness research to sort out the wasteful stuff from the good. This is one reason why places like Canada, France, Israel, Japan, and Hawaii have better health outcomes at lower cost: The government restricts access to new technologies until they are actually shown to work!
Unfortunately some Republicans are campaigning to eliminate the kind of research needed to determine this, while at the same time screaming that health care costs too much. Their hypocrisy is costing us twice — by higher health care costs, and by not promoting the best health care.October 28, 2010 7:21 pm at 7:21 pm #704524
“High Deductible Health Plan “
This is not a bad idea even if you don’t have a Health Savings Account, as long as you don’t use it as an excuse to skip your preventive care and appointments. When you have going five years without ever filing a claim, bless your Creator for giving you such good health. Remember that insurance is to cover the *un*expected, not the expected.
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