Health Insurance 44

[tbonebanjo]

I was just wondering how many companies still have good insurance and how many have gone the way of Obamacare. I am in a small MEP firm in Maryland. Our health insurance just changed, our premiums went up and our coverage went way down. I have maximum out of pocket expenses of $12,500 per year, $4000 deductable per person, tnen start the copay schedules. Should I start looking for other employment or are all companies being affected this way?

 

[weldstan]

Not all have been similarly affected; however, many premiums have increased with increased out of pocket expenses. Mine and those of others, who I know, have not icreased/decreased as severely as yours appears to have been.

 

[rb1957]

excellent ... a topic less politicised than climate change !

is this a company benefit (ie no charge), or a taxable benefit ? or can you opt out and arrange your own insurance ??

another day in paradise, or is paradise one day closer ?

 

[JohnRBaker]

Another argument for a true single-payer healthcare system for all Americans. What we need is Medicare Part E:

http://www.commondreams.org/views/2009/09/09/medicare-part-e-everybody

John R. Baker, P.E.
Product 'Evangelist'
Product Engineering Software
Siemens PLM Software Inc.
Industry Sector
Cypress, CA
Siemens PLM:
UG/NX Museum:

To an Engineer, the glass is twice as big as it needs to be.

 

[zelgar]

Working for State government in Indiana, we've been forced (they say we have a choice, but this is the cheapest option) into High Deductible Health Saving Accounts. When it started a few years ago, for the family plan the State would put around $3k in our accounts, have a max Out of Pocket of $8k (actually $5k when you take out what the State would put into our account) and no premiums. Now, the State is only putting in $2.25k and our premiums have gone up to $1k per year and Max OOP is still $8k.

 

[ornerynorsk]

Zounds and Gadzooks! Am I to understand that Obamacare didn't magically cure all insurance ills?

My employer pays a respectable share of my insurance, but after everything, my premiums still run very close to 10k annually, sans dental coverage. A flex plan helps keep my OOP manageable, somewhere around 4 or 5k for the family, if memory serves.

It's not that the healthcare system is broken, the US still has the finest in the world, it's just that the door is now wide open for gross opportunism with the whole insurance thing.

The cost to my parents for me to be born in a hospital, doctor's bill and the whole nine yards, was less than $200. Yes, the dinosaurs had all died off by that time, for those of you wondering. For my children, the 3 who were born in the US started somewhere in the $6 to 8,000 range (20+ years ago). Had basic commodity items followed that same curve, we'd be paying north of $25 for a gallon of milk and $100k for a new Chevy. Healthcare is just totally disproportionate from everything else, reality included. I'd greatly prefer healthcare in step with other costs, and the reasonable ability to opt out completely and just pay-as-I-go.

My afternoon rant thus concludes.

It is better to have enough ideas for some of them to be wrong, than to be always right by having no ideas at all.

 

[KENAT]

"It's not that the healthcare system is broken, the US still has the finest in the world" - sure if you happen to have the right insurance, location and/or money to work around those 2 limitations.

My employer pays most of our healthcare and it's a pretty good PPO. I forget the exact numbers but I think I end up directly paying less than half the amount ornery mentions in premiums.

Posting guidelines faq731-376

http://eng-tips.com/market.cfm?

(probably not aimed specifically at you)
What is Engineering anyway: faq1088-1484​

 

[glass99]

Health insurance is appallingly expensive in the US. I run my own office and pay $1700/mo for an ordinary HMO family plan by Aetna which doesn't even cover the doctors we want to see, let alone dental or optical. There are so many snouts in the trough, ranging from doctors to insurance companies to pharmaceutical companies, it makes me want to vomit. But not that I would actually vomit and go to the doctor because I can't afford the copay.

 

[JohnRBaker]

I guess I'm lucky as I've always had pretty good insurance from where I work. Of course, years ago when I worked for McDonnell Douglas, it was really good. The company paid for it 100% and we had small deductibles and it covered dental and optical as well.

Now we have to pay part of the cost and the deductibles are much higher and the dental insurance is a separate policy, but optical is still covered (at least an eye exam and one pair of single vision glasses per year).

For my wife and myself, I pay about $3,500/year for medical and another $450/year for dental (pre-tax dollars). Note that it's a traditional PPO plan with deductibles of $500 per person and there's a $25 co-pay for doctor visits ($40 for specialists). Perscriptions are included with a co-pay based on a percentage of the retail cost. Generics are very low cost (I'm on 2 Rx's for high blood pressure, a thyroid replacement, a statin for my cholesterol and oral medication for my diabetes, and it costs me less than $40 every 3 months with the thyroid replacement being the most expensive, accounting for about a 3rd of the total).

Note that we also have a pre-tax medical savings account that I can put in up to $2500 so at least we can cover the deductibles and co-pays with tax-exempt dollars.

John R. Baker, P.E.
Product 'Evangelist'
Product Engineering Software
Siemens PLM Software Inc.
Industry Sector
Cypress, CA
Siemens PLM:
UG/NX Museum:

To an Engineer, the glass is twice as big as it needs to be.

 

[davefitz]

I think that if the US retains the current health care model than all health insurance cost should be considered as if it were a mandatory tax , and as such should be tax deductible and including in statements of US tax rate vs foreign tax rates.

I am in favor of a single payer model, and it may likely require the addition of a national VAT to pay for it, as with most other countries. As I recall, 18% of the US GNP is ascribed to health care costs under the current model, yet there are many towns and counties in the US where there are no hospitals within 100 miles and no doctors within several 100 miles that would accept new patients using medicare.

It is strange that there is a hysterical reaction against "socialized medicine" but there is absolutely no complaint when we socialize the costs of the education system, the police, the military , the various welfare programs ( including corporate welfare via tax credits etc), and of course the government in general.

"Whom the gods would destroy, they first make mad "

 

[CELinOttawa]

Without a chip in your game, I can say I've lived under/with several health care system types and single payer is best. I hope you all eventually get a "Medicare part E" style system.

Should this be of interest, your senate has been looking at international systems. I simply loved watching, and adored what happened when the Republican tried to spank the Canadian:

Watch: Canadian doctor schools American senator on health care
EDITOR'S PICKToronto physician Dr. Danielle Martin appeared before a U.S. Senate committee March 11, 2014, to speak about health outcomes under different health care models.
Toronto physician Dr. Danielle Martin appeared before a U.S. Senate committee March 11, 2014, to speak about health outcomes under different health care models.
PHOTO: CPAC/SCREENSHOT
COMMENT
Ishmael N. Daro
Published: March 12, 2014, 11:35 pm
Updated: 6 months ago
A A A
Dr. Danielle Martin is about to become a national hero, at least to those who value Canada’s universal health care system.

The Toronto physician was in Washington D.C. Tuesday to speak to a Senate subcommittee about the virtues of the single-payer model employed in Canada, the U.K. and most other Western countries.

But when North Carolina Republican Senator Richard Burr had an opportunity to question Martin, he tried to paint the Canadian system as riddled with inefficiencies that had doctors fleeing in droves.

“Why are doctors exiting the public system in Canada?” Burr asked.

“If I didn’t express myself in a way to make myself understood, I apologize,” Martin noted with a hint of irony. “There are no doctors exiting the public system in Canada, and in fact we see a net influx of physicians from the United States into the Canadian system over the last number of years.”

The most pointed exchange, however, was about Canadians dying due to long wait times for surgeries.

“How many Canadian patients on a waiting list die each year?” Burr asked Martin. “Do you know?”

“I don’t, sir,” said Martin, “but I know that there are 45,000 in America who die waiting because they don’t have insurance at all.”

Ouch..

 

[CELinOttawa]

http://www.c-span.org/video/?c4486962/dr-danielle-martin-senator-richard-burr

 

[moltenmetal]

Rich Americans have excellent healthcare, plenty of options etc. But overall, the simple accounting shows a key difference: we Canadians pay around 11% of GDP to insure 100% of our population in our single payor system, despite our amazingly low population density compared to the US which should make care coverage more expensive. Other full-coverage jurisdictions manage to provide care of similar quality for an even lower fraction of GDP. You Americans pay around 17% and you're still not covering 100% of your population. Our outcomes are similar to yours. And despite this fact, I'm sure there are a few people here who will continue to maintain, contrary to this evidence, that the private sector is still and always more efficient than government could ever be. Even when the "commodity" in question isn't a commodity but rather much closer to a human right.

Friends of mine run a mobile X-ray/ultrasound service. A few years ago they had 15 full time employers, five of whom were dedicated entirely to billing the 2000 or so payors, each with their own forms etc. Yep, that's private sector efficiency for you!

The Canadian system is far from perfect. We treat doctors as little "businesses" rather than as government employees who go where the work is. Dental care, which is essential healthcare too, is not covered publicly at all. We continue to make specialization much more attractive than family practice. We should be setting up more multidisciplinary practices which would take care of the majority of family physician visits with much lower-cost staff (dieticians, nurse practitioners, midwives etc.). We continue to clog up hospital beds with people who can't find subsidized long-term care beds, which can't help but affect wait times for somebody. But at least here, your coverage is NOT tied to employment, and there's no "pre existing condition" horsesh*t to worry about. Healthcare here is NOT a payroll tax- it is hence not a powerful disincentive to employment.

 

[ornerynorsk]

davefitz, that is a good point you bring up. I think people rant and rave about socialized medicine because the payer would end up being socialized (tax base) whilst the payee would largely remain private. Kind of like the military/industrial complex, no?

It is better to have enough ideas for some of them to be wrong, than to be always right by having no ideas at all.

 

[davefitz]

The Canadian system seems to be a hybrid system, in that the wealthy yet have the resources to visit a hospital in the US if they cannot wait for the Canadian system to address their immediate needs, and much of the cost can be back-charged to Canada. The remaining blue collar workers are covered, but there remains issues with the ability to attract health care workers to work out in the boonies. The waiting period for some procedures can be several years if you do not live in Toronto , Calgary, or Vancouver. And another characteristic of socialized medicine is that in order to convince the government to improve the services, it is necessary to plaster the local newspapers with stories of insufferable waiting periods etc.

A hybrid system can work in the US as well ( or a 2-tiered system) with the lower tier similar to the VA hospitals ( socialized) with the 2nd tier of boutique hospitals and clinics, and there is always the availability of "medical tourism" to other countries for those that cannot afford the wait but can afford the airfare. Unfortunately , medical tourism brings with it the risk of transporting new diseases from overseas back to the US.

"Whom the gods would destroy, they first make mad "

 

[cranky108]

In other countries (this may not include our friends to the North) they have goverment hospitals with doctors who can't be taken to court for malpractice, and the cost is reasonable. But the care is very poor. I can stand for that here, because they also have privite hospitals which require you to pay up frount, with Visa or mastercard, or an insurance card.

The bigest problem I would have with a single payer system, is the same problem I have with the post office, or DMV. Workers who are underpaid, and no longer care about the customers.

The comment about people not having a hospital within a hundred miles, is true, but it is also true some people live more than a hundred miles from any towns.

It is my openion that the free market, if allowed. will be able to solve many of these problems (towns in Alaska have doctors, because the state helpes pay part of the education costs).
Part of the problem is the political will, or lack of free market to provide the solutions.

 

[IRstuff]

"It is my openion that the free market, if allowed. will be able to solve many of these problems (towns in Alaska have doctors, because the state helpes pay part of the education costs).
Part of the problem is the political will, or lack of free market to provide the solutions."

That, by definition, is not free a market. A free market would not have a government subsidy or incentive. A free market will NEVER have incentive on its own to serve customers where profit cannot be made.

TTFN
faq731-376

Need help writing a question or understanding a reply? forum1529

Of course I can. I can do anything. I can do absolutely anything. I'm an expert!

 

[cranky108]

You said the magic word "profit". If a market is not big enough to suport a doctor, hospital, etc. and the people of that community want that, there local goverment can be a method to make such a venture profitable.
However, complaining about a problem, in hopes that privite industry will fix the problem dosen't work.

One new trend is doctors limiting there selves to fewer patents, but requiring upfrount yearly payments for being there exclusive patents (less the other fewer patents), is an idea taking hold. The problem is my insurance dosen't work that way. The advantage is less waiting in line for an appointment, and no fees (or reduced) for office visits.
The advantage for the doctor is they know there income, provided they manage there office correctly. And they get to better know there patents better.

 

[JohnRBaker]

In other words, you think we should be moving toward a system of 'country club' doctors where only the wealthy will have access to medical care, eh?

John R. Baker, P.E.
Product 'Evangelist'
Product Engineering Software
Siemens PLM Software Inc.
Industry Sector
Cypress, CA
Siemens PLM:
UG/NX Museum:

To an Engineer, the glass is twice as big as it needs to be.

 

[IRstuff]

"One new trend is doctors limiting there selves to fewer patents, but requiring upfrount yearly payments for being there exclusive patents (less the other fewer patents), is an idea taking hold. The problem is my insurance dosen't work that way. The advantage is less waiting in line for an appointment, and no fees (or reduced) for office visits.
The advantage for the doctor is they know there income, provided they manage there office correctly. And they get to better know there patents better."

Right, but only those who can pay. So who's going to take care of the 40 million that couldn't pay before Obamacare, as well as those that are currently getting shorted because their companies can now get away with it? And how well will the US handle the as yet to appear next pandemic disease, when all those people without insurance get really sick?

TTFN
faq731-376

Need help writing a question or understanding a reply? forum1529

Of course I can. I can do anything. I can do absolutely anything. I'm an expert!