An option of choices and solutions to finding health coverage. Easy to read and understand.

The book did a great job walking through the complicated maze (or land mine) of finding health insurance. After 16 years on Wall Street I left my firm recently and not sure if I'll go back to a big company. The book helped explain what to do and not to do in finding my own family policy. The three biggest insights I gleaned were: 1) work with a broker who can tell you in advance if your application might be denied (you don't want this on your permanent record); 2) opening an HSA could save over $2K/year in taxes; and 3) don't use the funds in your HSA for medical expenses until you retire (because the investment builds tax free). I almost didn't buy the book when I read the Amazon review that questioned the author's credentials but after reading the book it's more about simplifying a complicated issue than having experience selling insurance. I'd highly recommend this book to anyone who is leaving corporate America to either retire early or become their own boss.

This book is a must-have for people who are thinking about or planning to travel full-time in an RV who are not yet eligible for Medicare. The New Health Care Solution walks you through the process of selecting health insurance. Since full-time RVers can choose a new domicile, the charts in Appendix A will help you make that decision, expecially if you have a preexisting condition.

There is a lot of information packed in this book. It is great to have it all in one reference book. In addition to explaining the laws relating to COBRA, HIPPA and Medicare (plus loopholes you can take advantage of), he covers ways to reduce your costs and find low-cost health care and prescription drugs. For those who have no health insurance or a high deductible, this can make a significant difference. It is definitely a keeper.

An excellent,indeed invaluable book with concrete, thorough information and advice on how to get good health insurance coverage, especially aimed at those not covered or unsatisfactorily covered by group health insurance plans. The author has done an immense service by writing this book. It is the best book I have found on this subject, by far!

An excellent,indeed invaluable book with concrete, thorough information and advice on how to get good health insurance coverage, especially aimed at those not covered or unsatisfactorily covered by group health insurance plans. The author has done an immense service by writing this book. It is the best book I have found on this subject, by far!

I found the book mostly informative and was excited to get the chapter for those with chronic illness, until I read the first paragraph... in which the author basically says have a job with some big corporation is his best advice for health insurance with a chronic illness. I am a Type 1 diabetic, young and healthy other than that. As a nonprofit director and consultant I thought I would get some helpful advice... However, the constant jabs at those with chronic illness and unhealthy lifestyles being the cause of such high healthcare were a little unbearable. The author used the words drug addicted, unhealthy, and chronic illnesses such as diabetes in conjunction with each other constantly. As someone who is is diabetic by no "fault" of my own... Diagnosed at age 4, not because I was overweight or ate the wrong foods, I found this lumping together insensitive and offensive. This book is a great resource if you are healthy, well-educated, and have a lot of time to do your own research... It's good to get educated about how best to use the system as is, but does little to look at or address the inequities and injustice of our current healthcare system in the U.S. It's a mess that deserves our creative attention! In the meantime, I'll keep paying over $580 a month for my health insurance plan without much hope of relief for something more affordable...

I found the book mostly informative and was excited to get the chapter for those with chronic illness, until I read the first paragraph... in which the author basically says have a job with some big corporation is his best advice for health insurance with a chronic illness. I am a Type 1 diabetic, young and healthy other than that. As a nonprofit director and consultant I thought I would get some helpful advice... However, the constant jabs at those with chronic illness and unhealthy lifestyles being the cause of such high healthcare were a little unbearable. The author used the words drug addicted, unhealthy, and chronic illnesses such as diabetes in conjunction with each other constantly. As someone who is is diabetic by no "fault" of my own... Diagnosed at age 4, not because I was overweight or ate the wrong foods, I found this lumping together insensitive and offensive. This book is a great resource if you are healthy, well-educated, and have a lot of time to do your own research... It's good to get educated about how best to use the system as is, but does little to look at or address the inequities and injustice of our current healthcare system in the U.S. It's a mess that deserves our creative attention! In the meantime, I'll keep paying over $580 a month for my health insurance plan without much hope of relief for something more affordable...

This book fills in all the wholes in the health insurance market that allows you to make informative decission on the direction for your health insurance needs for the family and being self employed.

The author tries to resolve many common problems revolving around the high costs of health insurance. His ideas are practical and, in fact, they will work for the majority of people who are trying to lower health insurance costs. Unfortunately, there will always be those who are uninsurable in the individual and family market and who cannot afford risk pool coverage, and this is not a problem that can be solved immediately. However, the author is urging people to obtain individual coverage at a young age when they can qualify, and while it is still affordable. If most people did this, and if people did not depend soley on employer sponsored plans in their younger years, the author asserts that it would not be as difficult to have and keep good coverage in the older years. That is the concept behind this book.

In the reviews below, many complain that the author tries to simplify the problem and make it sound like anyone can obtain an individual policy at an affordable price. I don't think that is the overall message he is trying to get across. Rather, I think his message is intended to try to help change the mentality of the average consumer as far as "entitlement" goes, and he really tries to help people understand that personal responsibility in obtaining an individual policy is important AND can result in huge savings as well as protect against the possibility of losing coverage because of the inability to work due to illness.

Contrary to what some of the other reviewers say, the author does not contradict himself when he says on page 10 "premiums on most individual/family policies cannot be increased". If you read the rest of the sentence it says..."cannot be increased, ... if you become ill". That comment is true. Individual and Family Health Insurance Carriers typically only increase premiums annually or semi-annually based on overall inflation in the market and overall claims experience and utilization of the entire group of it's members.

I don't necessarily agree with the author's suggestion to small employers to establish an HRA to pay for employees to obtain their own individual policies. This is dangerous ground, as it could lead to discrimination if there is an employee who can't qualify for individual coverage. Also, what if someone didn't purchase maternity benefits, and then gets pregnant or has a family member that becomes pregnant? In essence, by paying for employee's individual policies, the employer has committed to a "group" benefit, which by state law requires "guaranteed issue of coverage" and maternity coverage. Therefore, the employer may put himself at risk with crafty "ERISA" attorneys who may find a legal way to make the employer responsible for claims of sick employees who can't qualify for their own coverage or for maternity claims for pregnant women. (This is just my humble opinion). Colorado residents....You may be interested in www.efsbenefits.com as a reputable place to purchase health insurance online.

Pilzer's general proposition is that the market place will take care of the health insurance issues in this country if we just let the free market operate. He maintains that individual health insurance is widely available at reasonable cost and people, including employers and employees, should take advantage of the individual market for health insurance. I believe he tends to force the facts to fit this basic proposition.

He is easy to read with a breezy style. The book has pretty good explanations of HIPAA and COBRA and a number of good tips. However, health insurance in the United States is complicated. The price he pays for simplicity is accuracy and thoroughness. It is a pretty good book if you are 35, perfectly healthy, and thinking about buying insurance. But what is good for when you are 35 is not necessarily good 5, 10 or 20 years later. (Should I pay for drug coverage?. . . pregnancy coverage?) I would never rely on this book for making policy decisions or for forming opinions on healthcare in the United States. I strongly disagree with many of his policy recommendations.

Some problematic propositions from the book:

1. Several places in the book he claims that insurance companies in the individual market only turn down or place exclusions on 20% of applicants and 80% are accepted as healthy. He uses this statistic to support his idea that most people can get coverage in the individual market. I don't know about the accuracy of this statistic, but one problem is that people who are uninsurable often do not apply for insurance on the open market. They stay on their employer plan. They go into a risk pool. They buy a conversion plan. Etc. Even Pilzer advises against applying for insurance if you think you might get turned down. So the healthy gravitate to these plans and the unhealthy do not.

Pilzer doesn't discuss what "healthy" might mean and his discussion of the underwriting process doesn't describe what are the typical issues that exclude people from coverage. He does not address the possibly of the healthy fleeing to cheap plans while the unhealthy are trapped in what they already have, causing greater cost disparity.

2. For those who say they can't afford health insurance Pilzer claims that "If your annual income is below the federal poverty line, about $20,000 for a family and $10,000 for a single individual-you probably qualify for Medicaid."

This simply is not true, unless you have children at home, are disabled, or meet some other special category. Low income alone does not qualify a person for Medicaid.

In this same vein, he claims that of the 45 million uninsured, 16 million earn more than $40,000 for a family of four ($20,000 for a single) and 29 million earn less. He assumes that the 29 million earn at least $20,000 if a family and $10,000 if single. Otherwise he claims they would be on Medicaid. He maintains that these low income families could easily buy a low cost HSA plan. But how are they going to pay those big deductibles? Also, his cost data is for people age 35 and their families. In most states, the older you are the more expensive insurance gets. In this discussion, he ignores the issue of underwriting and possible exclusions for preexisting conditions and ignores the fact that in most states, this population could not afford the risk pool which runs on the average, 200% the cost of the same plan for a healthy individual.

3. "Despite what you read in the newspapers, there are health insurance optionsavailable for every American, although it may take you some time, effort and expense to get them." This is one of his soundbite quotes he uses in advertising materials for his book. This is misleading. Insurance on the individual market is not available for many people. The risk market policy will have preexisting condition exclusions and may have coverage riders unless you are coming off of a group plan and have HIPAA rights. The risk market may be unaffordable. If you don't have HIPAA rights, there may be no option for you at all in some states.

4. He states that "the premium you pay for an individual or family policy cannot be raised each year, nor can the policy be canceled based on your health or your prior year healthcare costs." He mentions this several times in the book. At best this is a case of overgeneralization, at worst it is a misleading statement to support his thesis that individual health insurance is the solution to our insurance woes.

I have read a lot about health insurance. Federal law requires guaranteed renewal of individual health insurance plans. Does this mean that rates cannot change based on your health status? Many state's insurance regulators think so. But that does not make it law. Most states allow rates to increase based on age. Some states' laws do provide that your rates can't go up based on your personal health situation. But other states have no laws that apply and in general, the individual market is not highly regulated. From what I have read, experts are not in agreement as to the extent re-underwriting occurs on renewal and insurance companies are not very forthcoming with information about why a particular person's rate increases. Some experts believe that re-underwriting is occurring more and more by a number of insurance companies. Also, some insurers have durational rate settings. This means that your insurance costs can go up considerably after a few years. At that time, you can reapply for a lower cost policy, but can be denied if you are not in good health.

4. Pilzer repeatedly claims that individual health insurance is cheaper than employer provided insurance. It probably is cheaper if you are 35 and healthy. Probably not if you are 60. This is because employers charge the same rate to everyone, whether you are 20 or 60. Also, only 4% of people in the US have insurance on the individual market. So it is a small part of the overall market. Pilzer doesn't break down what that market looks like as to age and health of its participants.


5. Pilzer's discussion of the uninsurable and state subsidized programs like riskpools leaves much to be desired. Mostly because there is so much state variability. This is another circumstance where I really disliked that he used figures applicable to a 35 year old male. The costs are considerably higher for those 50 and over. He fails to mention that some risk pools have low lifetime limits and other restrictions.

6. Pilzer pushes the idea that small employers should go to a reimbursement model, leaving their employees to buy health insurance on the individual market. Employers with older/sicker employees are in fact facing higher costs. However, their employees are going to have problems getting insurance on the open market and may end up with only very high cost options. The employer that has a young and healthy workforce already has lower costs.