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How does Cigna's FSA work?

Cigna’s FSA works by making contributions through payroll. You will have claim forms to submit for each expense. Covered medical expenses or childcare should be in your enrollment packet. You have until March 31 of the year following the calendar year to submit claims for expenses. Also look into an HSA type plan if you are looking to cover medical expenses. You will have an opportunity to set up automatic payments to your providers and a debit card to pay for expenses. You also keep your money that isn’t used at the end of the year.

As a person who lives with universal health care, are the taxes and inconveniences worth it?

Hahahaha.You’ve been fed a line of bullshit.First, there is no “inconvenience”. I can go to literally any clinic, doctor, or hospital in the country and all I need to do is to show them my health card:Second, about those taxes: healthcare expenditures are mostly covered by various forms of income taxes, which means that you pay based on what you earn. If you’re a struggling new grad, you pay very little. If you are a rich old fart, you pay more. In both cases, overwhelmingly, people think that it is “worth it”. (And by the way? Just as an aside? In Canada, our taxes are actually lower than your taxes + health insurance + copays.)Here’s a great short video (by an American doctor) which explains the Canadian healthcare system really well:This article is well worth reading: https://www.washingtonpost.com/outlook/2020/08/06/health-insurance-canada-lie/?arc404=trueHere’s the text:In my prior life as an insurance executive, it was my job to deceive Americans about their health care. I misled people to protect profits. In fact, one of my major objectives, as a corporate propagandist, was to do my part to “enhance shareholder value.” That work contributed directly to a climate in which fewer people are insured, which has shaped our nation’s struggle against the coronavirus, a condition that we can fight only if everyone is willing and able to get medical treatment. Had spokesmen like me not been paid to obscure important truths about the differences between the U.S. and Canadian health-care systems, tens of thousands of Americans who have died during the pandemic might still be alive.In 2007, I was working as vice president of corporate communications for Cigna. That summer, Michael Moore was preparing to release his latest documentary, “Sicko,” contrasting American health care with that in other rich countries. (Naturally, we looked terrible.) I spent months meeting secretly with my counterparts at other big insurers to plot our assault on the film, which contained many anecdotes about patients who had been denied coverage for important treatments. One example was 3-year-old Annette Noe. When her parents asked Cigna to pay for two cochlear implants that would allow her to hear, we agreed to cover only one.Clearly my colleagues and I would need a robust defense. On a task force for the industry’s biggest trade association, America’s Health Insurance Plans (AHIP), we talked about how we might make health-care systems in Canada, France, Britain and even Cuba look just as bad as ours. We enlisted APCO Worldwide, a giant PR firm. Agents there worked with AHIP to put together a binder of laminated talking points for company flacks like me to use in news releases and statements to reporters.Here’s an example from one AHIP brief in the binder: “A May 2004 poll found that 87% of Canada’s business leaders would support seeking health care outside the government system if they had a pressing medical concern.” The source was a 2004 book by Sally Pipes, president of the industry-supported Pacific Research Institute, titled “Miracle Cure: How to Solve America’s Health Care Crisis and Why Canada Isn’t the Answer.” Another bullet point, from the same book, quoted the CEO of the Canadian Association of Radiologists as saying that “the radiology equipment in Canada is so bad that ‘without immediate action radiologists will no longer be able to guarantee the reliability and quality of examinations.’ ”Much of this runs against the experience of many Americans, especially the millions who take advantage of low pharmaceutical prices in Canada to meet their prescription needs. But there were more specific reasons to be skeptical of those claims. We didn’t know, for example, who conducted that 2004 survey or anything about the sample size or methodology — or even what criteria were used to determine who qualified as a “business leader.” We didn’t know if the assertion about imaging equipment was based on reliable data or was an opinion. You could easily turn up comparable complaints about outdated equipment at U.S. hospitals.(Contacted by The Washington Post, an AHIP spokesman said this perspective was “from the pre-ACA past. We are future focused by building on what works and fixing what doesn’t.” He added that the organization “believes everyone deserves affordable, high-quality coverage and care — regardless of health status, income, or pre-existing conditions.” An APCO Worldwide spokesperson told The Post that the company “has been involved in supporting our clients with the evolution of the health care system. We are proud of our work.” Cigna did not respond to requests for comment.)Nevertheless, I spent much of that year as an industry spokesman, my last after 20 years in the business, spreading AHIP’s “information” to journalists and lawmakers to create the impression that our health-care system was far superior to Canada’s, which we wanted people to believe was on the verge of collapse. The campaign worked. Stories began to appear in the press that cast the Canadian system in a negative light. And when Democrats began writing what would become the Affordable Care Act in early 2009, they gave no serious consideration to a publicly financed system like Canada’s. We succeeded so wildly at defining that idea as radical that Sen. Max Baucus (D-Mont.), then chair of the Senate Finance Committee, had single-payer supporters ejected from a hearing.Today, the respective responses of Canada and the United States to the coronavirus pandemic prove just how false the ideas I helped spread were. There are more than three times as many coronavirus infections per capita in the United States, and the mortality rate is twice the rate in Canada. And although we now test more people per capita, our northern neighbor had much earlier successes with testing, which helped make a difference throughout the pandemic.The most effective myth we perpetuated — the industry trots it out whenever major reform is proposed — is that Canadians and people in other single-payer countries have to endure long waits for needed care. Just last year, in a statement submitted to a congressional committee for a hearing on the Medicare for All Act of 2019, AHIP maintained that “patients would pay more to wait longer for worse care” under a single-payer system.While it’s true that Canadians sometimes have to wait weeks or months for elective procedures (knee replacements are often cited), the truth is that they do not have to wait at all for the vast majority of medical services. And, contrary to another myth I used to peddle — that Canadian doctors are flocking to the United States — there are more doctors per 1,000 people in Canada than here. Canadians see their doctors an average of 6.8 times a year, compared with just four times a year in this country.Most important, no one in Canada is turned away from doctors because of a lack of funds, and Canadians can get tested and treated for the coronavirus without fear of receiving a budget-busting medical bill. That undoubtedly is one of the reasons Canada’s covid-19 death rate is so much lower than ours. In America, exorbitant bills are a defining feature of our health-care system. Despite the assurances from President Trump and members of Congress that covid-19 patients will not be charged for testing or treatment, they are on the hook for big bills, according to numerous reports.That is not the case in Canada, where there are no co-pays, deductibles or coinsurance for covered benefits. Care is free at the point of service. And those laid off in Canada don’t face the worry of losing their health insurance. In the United States, by contrast, more than 40 million have lost their jobs during this pandemic, and millions of them — along with their families — also lost their coverage.Then there’s quality of care. By numerous measures, it is better in Canada. Some examples: Canada has far lower rates than the United States of hospitalizations from preventable causes like diabetes (almost twice as common here) and hypertension (more than eight times as common). And even though Canada spends less than half what we do per capita on health care, life expectancy there is 82 years, compared with 78.6 years in the United States.When the pandemic reached North America, Canadian hospitals, which operate under annual global budgets — fixed payments typically allocated at the provincial and regional levels to cover operating expenses — were better prepared for the influx of patients than many U.S. hospitals. And Canada ramped up production of personal protective equipment much more quickly than we did.Of the many regrets I have about what I once did for a living, one of the biggest is slandering Canada’s health-care system. If the United States had undertaken a different kind of reform in 2009 (or anytime since), one that didn’t rely on private insurance companies that have every incentive to limit what they pay for, we’d be a healthier country today. Living without insurance dramatically increases your chances of dying unnecessarily. Over the past 13 years, tens of thousands of Americans have probably died prematurely because, unlike our neighbors to the north, they either had no coverage or were so inadequately insured that they couldn’t afford the care they needed. I live with that horror, and my role in it, every day.

How do you explain to non Americans that the US essentially has universal health coverage (90%)? Unlike many countries, national policies are not federally administered but at the state level often in collaboration with private and nonprofit sector?

Let me (a non-American) explain why you’re wrong:First off, 90% of 327.2 million people means that 10% (or 32.72 million Americans) aren’t covered by such a system. That, for reference, means that the system isn’t nearly close to universal.Your system is a profit-led healthcare system: in other words, you have to buy into it via insurance policies. Although some are paid for by your employer (which is considered part of your renumeration, and therefore means you’ll receive reduced wages compared to a country with a universal system), many have to purchase private insurance policies. That can prove to be absurdly expensive.That being so, bear in mind: you’re not simply covering the cost of healthcare for yourself when you purchase your policy. You’re covering profits for the health insurance industry, as well as those of the various hospital bureaucrats and administrators needed to process your insurance. And then there’s the profit for the hospital, which of course has to be added into the equation. All that before you receive a single minute of treatment.Also note that insurance is based off possibility of illness/injury. If you take out a policy and never claim for treatment, your insurance company has made a significant profit without giving you anything in exchange. You might want to take note of examples like these:Big 8 health insurers rake in more than $7B in Q3, setting up strong finish to 2018Here's how the top insurers performed in the 2nd quarter of 2019Cigna raises full-year earnings target for 2019A universal healthcare system isn’t focused on making profit, but rather on provision of healthcare by providing full coverage for every single member of society. This is paid for by taxation: everyone pays a little (someone earning £25,000pa would contribute roughly £5000 in tax, with 1/5th of that going to the NHS). Compare that to the US: for the average individual, a reasonably comprehensive policy will cost around $300–500 per month, which comes to $3600–6000 per year, and that’s not including co-pays or deductibles.Speaking of which: the US system also charges co-pays and deductibles: amounts that must be paid by you before your insurance kicks in. That can add up fast - and isn’t something that exists in a universal system. In the UK, we pay a flat £9 fee per prescription (regardless of the medication) - the painkillers I take for my spinal damage would cost me 1,289.71 in the US for a 30-day supply at three tablets per day. Here? It cost me £9. In the US? Seeing a doctor for a quick assessment about a minor problem can set you back $250 before cost of any treatment provided.Dental and Eye care is also supplemented in a universal system - in some countries, it’s completely free, though most employ a subsidised system that sets a fixed cost for dental treatment and eye tests, with additional charges for purchasing glasses etc (depending on the frames/lenses you buy).Do bear in mind: that means that every other aspect is free at point of access. You’re not charged for being transported by ambulance (whereas, in the US, it’s around $1000 for an ambulance, and an air ambulance is around $15–20,000), nor for check-ups or any other form of treatment. That includes scans, tests, surgery, physio…you name it, it’s paid for.This is primarily derived from a single-payer system: there’s only one entity paying for services, and that’s the government. As such, any company that wants to provide services or equipment must negotiate a contract with the government, and that means that it’s easier to bring prices down: after all, companies will want a contract, and that means they must bid for them at a competitive reasonable rate. There’s no inflation of charges in the way that you’ll find with a private system.I’d also note that the US has a significant problem beyond merely provision of care: if it’s going to cost you $250 out-of-pocket just to go and see a doctor, you’re far less likely to seek medical treatment early on. Combine that with a lack of sick pay for employees in many instances, and you find yourself dealing with employees who will go to work even when they are sick (and thereby putting themselves and others at risk!), in addition to the fact that many will avoid seeking treatment until such time as their condition becomes severe enough to demand it. That invariably costs more than it would have done had the individual simply seen a doctor when their symptoms first developed.The US is the only major developed nation in the world not to employ a system of universal healthcare. If you think yours is universal…try seeing a doctor without having to fork over a co-pay. Try getting surgery without being landed with a significant bill, for things not covered by your insurance. Just try and obtain treatment without first having to go through a truckload of paperwork to confirm that you’re insured. Better yet - try seeking treatment from a hospital that’s not within your insurance company’s coverage area.I live in a country with universal healthcare. I can walk into any doctor’s surgery or hospital anywhere in the country, and I’ll never be asked for insurance details, nor charged so much as a bent penny for seeing a doctor or receiving treatment, beyond perhaps the cost of my prescription (again, £9 for whatever I need!). I don’t have co-pays or deductibles, and I’m not burdened by a huge tax rate that leaves me unable to pay my rent and other expenses.If you think you’ve got universal care, you’re wrong. Worse still, if you think having more than 30 million people being unable to access any form of healthcare is appropriate for a wealthy developed nation…I’d say you need to reassess your values.The US needs to catch up with the rest of the world, and start treating her citizens as something of value that must be protected and cared for, rather than as an expendable resource that exists solely to be exploited.

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