How do US Citizens living in the DR feel about Health Care Reform in the US

Status
Not open for further replies.

windeguy

Well-known member
Jul 10, 2004
32,287
885
113
I have been following the debate on health care reform in the US. It appears that all US Citizens will be forced to enroll into some type of health care plan under the new proposals.

http://www.nytimes.com/2009/07/27/h...=th&adxnnlx=1248697159-nfon8oxU3AUCnYTwY1G/ZA

From that article:

"Democrats this year would also require individuals to have insurance and would impose financial penalties on those who do not meet the requirement."

What do those Expats living in the DR think of such a situation where they are forced to pay for insurance they may not be able to use?
 

Chirimoya

Moderator
Dec 9, 2002
17,575
605
113
windeguy, I deleted the duplicate thread as requested.

To all posters: I hope that this thread will focus on the impact of such a plan on expatriates and not on the pros and cons of the plan in itself, for reasons that should be obvious.
 

cobraboy

Pro-Bono Demolition Hobbyist
Jul 24, 2004
40,966
919
113
Write your Congressman and U.S. Senators and complain about it.

Nothing much else to do.
 

windeguy

Well-known member
Jul 10, 2004
32,287
885
113
Indeed lets keep this DR related

What I am interested in discussing is how Expats from the US will feel about being forced to pay for a plan they will have little or no chance to use as I understand it is being proposed.

I am also interested in finding out what the plans cost would be for one adult and what the penalty would be for not purchasing a plan. I realize it is a bit premature for that information to be available since it is not yet law, but it appears there is an excellent chance this will come to pass and I would like to be prepared.
 

Black Dog

New member
May 29, 2009
1,761
154
0
In the UK we have a system called The National Health Service which is funded via National Insurance contributions. It came into effect just after World War II and was designed to ensure that everyone had access to medical care. The payments are made as a form of taxation and it is based on what we call “middle band earnings” This means that those who earn below a certain rate don’t have to pay but get credited as though they have paid and those higher earners only pay up to a certain level of income.
As an ex-pat having paid for a minimum number of years I can still return to the UK and have medical treatment. You can still take personal insurance cover which would give you faster access to non-urgent medical procedures but you cannot opt out of the national health care service.
Don’t want to highjack the debate on the US system but thought you might like to know how other countries work it.
 

Vacara

I love AZB!
May 5, 2009
710
84
0
What I am interested in discussing is how Expats from the US will feel about being forced to pay for a plan they will have little or no chance to use as I understand it is being proposed.

I am also interested in finding out what the plans cost would be for one adult and what the penalty would be for not purchasing a plan. I realize it is a bit premature for that information to be available since it is not yet law, but it appears there is an excellent chance this will come to pass and I would like to be prepared.
Half empty or half full. Don't look at it as people being forced to pay for something they don't need but rather as a solution to a problem that is bankruptying the US treasury and american citizens. 14,000 people lose their health insurance every day, medical bills are the number one reason of bankrupcy in the US so something have got to be done about this issue.

Also I don't think people living abroad have to pay for it but I'm not sure. If you got more info about it I'd like to see it.
 

Lambada

New member
Mar 4, 2004
9,478
376
0
77
www.ginniebedggood.com
As an ex-pat having paid for a minimum number of years I can still return to the UK and have medical treatment.
How long have you been away from UK, Black Dog ;)? This all changed back in 2004. If you're a UK expat you can get medical treatment but you have to pay for all but emergency treatment. Also for GP visits.

New NHS restrictions have repercussions for expats - Telegraph

There's been a huge hubbub about it among S.African expats, court cases, the works. Check the NHS website and you can google search it also.
 
  • Like
Reactions: Black Dog

cinderelli1

New member
Jun 24, 2009
7
0
0
We here in the US are having this plan forced down our throats. The bill is so huge that not even the lobbyist have time to read it all. Dems are saying that reform in our health care is needed to lower costs. My thougts are that a great place to start is to not look at just insurance companies but to look at the medical industry as a whole. Doctors, nurses, drug manufactures, etc. all are very high incomes. Plus we are expected to pay for insurance for all the illegall aliens in this country. There are too many other things to correct before we (and our future generations) are forced to pay for this as well as the bail outs.
 

Black Dog

New member
May 29, 2009
1,761
154
0
Although I'm not from the US I have been watching the debates etc on TV and I had dinner on Sat with a doctor who is one of the president's advisors on the reform project. So, I have a question if I may
Is the need for change a) to reduce costs or b) to provide access to healthcare for ALL US citizens or would the answer just depend on your political viewpoint?
 

whirleybird

Well-known member
Feb 27, 2006
3,093
211
63
Sorry, windeguy, if I am also deviating from your OP but I can only assume that Mr WB must be covered by this paragraph "In addition, people who are resident for tax purposes and therefore paying UK income tax are likely to be classed as resident and therefore exempt from charges even if living abroad." in Lambada's post. Mr WB's total diagnostic and treatment bill back in the UK for the past 10 months would probably have been in excess of ?100K but, under the excellent NHS system into which we have paid all our working lives, the cost to us was nada.
 

cinderelli1

New member
Jun 24, 2009
7
0
0
I have heard both. BUT when we look to reduce costs let's not just look to a government run policy and expect that to be the cure. I believe that it will be necessary to reform all areas of health care, not just insurance. I believe that all LEGAL US citizens should have a right to health care but NOT at the expense of everyone else. I am far from wealthy and have been down the road of bankruptcy from medical bills before. What my insurance company did not pay should have been considered "unreasonable charges" and the medical provider should have been forced to write off the extra. The current outlook from our administration is that people who are successful should pay a much higher rate of income taxes than other tax brackets. But where is the incentive then for anyone to be successful and work hard?
 

bienamor

Kansas redneck an proud of it
Apr 23, 2004
4,860
316
83
This is where it gets sticky

Although I'm not from the US I have been watching the debates etc on TV and I had dinner on Sat with a doctor who is one of the president's advisor's on the reform project. So, I have a question if I may
Is the need for change a) to reduce costs or b) to provide access to health care for ALL US citizens or would the answer just depend on your political viewpoint?
I guess I really don't understand when they mean when they say reform Health Care. I believe what they are all really talking about is Health Ins. Coverage. As far as I know the Health Care does not need reform as there are a whole lot of foreigners going to the USA for Treatment(if they can afford it) than there are US Citizens going to foreign countries for treatment(except elective types). This would mean that there is quality health care in the US.
Most people are covered either through company/private health ins. or Medicaid, Medicare. Then there are those that have opted not to have coverage, their own choice either not to have via company or private, not my problem to pay for their coverage if due to their choice they cant pay for an illness.
Myself I don't mind the Surgeon making lots of money as he is keeping me alive, would rather have the best, rather than second or third best. And until they reform Tort law in the US which requires mountain's of Mal Practice ins, will they begin to resemble other countries Health Coverage, heck my daughter who is a registered nurse is considering picking up some sort of Malpractice practice ins. because she works in a trauma ICU. they are always looking for somebody else to include in the law suit,

Hope that SKing weighs in on this
 

las2137

New member
Sep 1, 2008
290
60
0
I have been following the debate on health care reform in the US. It appears that all US Citizens will be forced to enroll into some type of health care plan under the new proposals.

http://www.nytimes.com/2009/07/27/h...=th&adxnnlx=1248697159-nfon8oxU3AUCnYTwY1G/ZA

From that article:

"Democrats this year would also require individuals to have insurance and would impose financial penalties on those who do not meet the requirement."

What do those Expats living in the DR think of such a situation where they are forced to pay for insurance they may not be able to use?
As it's all very new, I'm not sure what it would mean for US citizens residing abroad. I imagine it would be similar to current taxes and benefit withholdings in the US.

If a US citizen is not residing in the US or receiving a salary there, I would assume they would not have to pay into the system.

Conversely, one would. For example, I reside abroad but technically am paid in the US by my employer. Since I meet the qualifications (ie, not paid a high salary and spend less than X amount of days in the US per year) I do not have to pay federal taxes. The only thing that is withheld from my paycheck is social security, with the assumption (HA!) that I will collect on it in the future.

For me, the last part is key- I, for one, would be willing to pay into something even though I would not immediately benefit from it. I see this as a public good- the better the access to health care, the healthier the population and the healthier the society.
 

windeguy

Well-known member
Jul 10, 2004
32,287
885
113
BUT, I don't live in the US

Write your Congressman and U.S. Senators and complain about it.

Nothing much else to do.
I don't live in the US and do not have a Congressman or a Senator. I live in the DR. Contacting a Congressman or a Senator is not an option for me. In my case it will be a form of taxation without representation.
 

windeguy

Well-known member
Jul 10, 2004
32,287
885
113
My understanding is that all US Citiziens must have a plan

Half empty or half full. Don't look at it as people being forced to pay for something they don't need but rather as a solution to a problem that is bankruptying the US treasury and american citizens. 14,000 people lose their health insurance every day, medical bills are the number one reason of bankrupcy in the US so something have got to be done about this issue.

Also I don't think people living abroad have to pay for it but I'm not sure. If you got more info about it I'd like to see it.
It is very difficult to get any answers on this point, but it is my understanding that all US Citizens are obliged to participate. Unless I want to give up my US Passport, it won't matter where I live. This is certainly what is of prime interest to me.

I do agree that something needs to be done, but being a Libertarian, I am very much against government mandates that tell me what I must do.
 

mountainannie

Well-known member
Dec 11, 2003
14,940
404
83
elizabetheames.blogspot.com
I don't see that there is any point in starting anything here until there is something more concrete that comes out. Every state in the US requires every driver of a car to have insurance. But the medical insurance companies vary WILDLY from state to state. You can have great coverage in one state and be dropped by the same company when you move to another state. I am going to wait to see what happens as the bill shakes on down towards some sort of resolution.....

I think that the issue is the entire medical system in the US is based on a for profit model and perhaps this is just not an area in which there really should be too models.

As an expat, I don't pay state taxes, only federal ones. For years I paid school taxes which support public education even though I have no children but I believe in public education. I pay for the US military, even though I am opposed, to a great extent to the uses to which it has been put. But I have enjoyed the privileges of the US citizenship, and carry the passport, so I am content to pay the taxes I owe. I think it is a travesty that we have such a large portion of our population who is uninsured and so many of our bankruptcies due to medical bills so I am really willing to go with this plan.

I know that this goes totally against Cobra's politics, but you could apply for a Dominican passport and renounce the US passport completely, Cobra and then be free of the US tax burden completely, would that be ok by you? I mean here you pay no state tax, no real estate tax, and no tax on income made here on anything under 80k.

So if you pay a portion of tax for the uninsured, that is not a burden.

If you live here, they are not going to make you carry a policy for there.. that is pretty certain... but then, of course, they aren't going to treat you there either.
 

cobraboy

Pro-Bono Demolition Hobbyist
Jul 24, 2004
40,966
919
113
I know that this goes totally against Cobra's politics, but you could apply for a Dominican passport and renounce the US passport completely, Cobra and then be free of the US tax burden completely, would that be ok by you? I mean here you pay no state tax, no real estate tax, and no tax on income made here on anything under 80k.
I pay plenty in taxes, and will continue to do so. I have never considered giving up my U.S citizenship. Being self-employed for nearly 30 years, I have purchased plenty of health insurance for myself, my family and my employees. I know the trials, tribulations, paperwork and costs.

I'm not going to get into the US healthcare reform debate. I am sceptical it will pass now that the entire proposal to date has come out. There is a reason DC has been trying to ram it through under the cover of darkness.

And anyone with a parent on Medicare, or who will be going on Medicare themselves should pay VERY close attention to denial of care provisions in the current iteration of that bill.

I'll just toss this out for consideration:

Markets depend on supply and demand to meet at a point of stasis, where supply=demand. In healthcare, supply is the total costs and demand is the access to services. How can one increase demand (^# of insured) while maintaining current supply (=fixed costs)?
 

mountainannie

Well-known member
Dec 11, 2003
14,940
404
83
elizabetheames.blogspot.com
I just have my doubts that anyone who does not have a residency in a STATE will be expected to have coverage unless this actually goes to true federal system. And while I admit that I have not read the bill or even the 98 page summary of it.... I cannot imagine that it will apply to those of us who are living here. We will either have to have local or international medical insurance or Medicare for coverage when we are older and then decide if we are going to pay all the supplementals, etc...or for a good policy here....

I have an international policy that it transferable to anywhere in the world, including the States if I decide to go back..
 

gringosabroso

New member
Oct 16, 2004
494
8
0
68
American Ex-Pats? Medicare? Supplementary Ins.?

I'm an American Ex-Pat, who has been living here for 13 years, POP. I had some of these same questions @ 1 year ago.
1. I called & emailed Blue Cross - Blue Shield, my supplementary carrier. BC-BS sent me a regular mail letter; the gist of it: a. If I am seriously ill & can make it to FL or any other American state, I'm fully covered. b. If I am seriously ill in the DR & can not leave ASAP, I must be treated & pay my own medical bills; BC-BS will reimburse me when it received copies of my bills.
2. I don't know if all, or most American, health insurance companies have similar policies? It pays to ask. & get something in writing.
3. It pays to have a legal residential address in the USA; or? You may not be eligible for BC-BS, etc.
4. I heard a rumor from somewhat reliable [?] sources that the new HOMS, Santiago. had been inspected by the USA federal health insurance officials & been rendered eligible to render Medicare services to Ex-Pats @ the Govt's expense?? Any other similar information available? Thank you.
 
Status
Not open for further replies.