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?

 

[cranky108]

That's a crual joke, make the medical arenia transparent, but not goverment.

The medical arenia is just like universitys, in that with insurance, the bill is tailered to what they can squeeze out of each victim/ patent. It's called an imperfect monopoly. They need to be regulated like the utility companies in each state.

 

[IRstuff]

"They need to be regulated like the utility companies in each state."

Not sure where you've been for the last 20 yrs, but the state utility companies were deregulated, which is one of the reasons why PG&E has exploding gas mains.

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[cranky108]

I haven't been in CA. Most other states still have regulations on rate of return.

 

[IRstuff]

I don't see much difference between for-profit and non-profit hospitals, so regulating the return wouldn't seem to me to be doing much.

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[cranky108]

Local goverments regulate hotel rates, so why not hospital rooms?

 

[glass99]

An easy first step would be if they posted their rates online. Classic move is that a hip replacement costs between $15k and $90k for basically the same thing, depending on what hospitals think they can get away with. If there was transparency there could be competition.

 

[GTstartup]

Personally I think it should be illegal for an employer to provide health insurance. Make everybody write a check each month and see what happens. It will be similar to the change in attitude that is experienced when an individual leaves an employer and starts a small business and has to write that quarterly check to the IRS.

 

[beej67]

The problem with health care costs is not rising profits, it's rising revenues. It's the Cost.

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[glass99]

GTstartup: Agreed that health insurance should be held by individuals. Part of the idea with Obamacare is to make it easier for individuals to get health insurance. Individuals will pay more attention to what their individual needs are rather than assuming the 100,000 employees of Ford Motor area all the same. Up until recently, it was practically impossible to get individual coverage because insurance companies assumed you had cancer and were not telling them. It became a self fulfilling prophesy because the rates became so expensive that only people motivated by having cancer would front the $3000/mo, thus starting a vicious cycle.

 

[KENAT]

GTstartup, unless you also remove the legal requirements for Emergency care to all comers any idea like that can't work.

If we're going to have a requirement for ER's etc. to provide Emergency care to all comers then shouldn't 'all comers' (i.e. tax paying public) be paying for it?

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[GTstartup]

Kenat,

My point is that if companies did not include health insurance as part of a compensation package but instead gave the cash, when you had to write the check every month, you might pay more attention to whether or not you have the correct insurance and whether or not you have the best deal. If you cannot shop around because your employer provides insurance through xyz company then competition is stifled.

 

[IRstuff]

"If you cannot shop around because your employer provides insurance through xyz company then competition is stifled."

Competition is stifled, regardless. I don't think I'll get the same deal as an individual for the coverage I have now from a group coverage. Volume discount makes a big difference.

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[moltenmetal]

Increase that "volume discount" to include everyone and you have the Canadian system. As an added bonus, you get no "pre-existing condition" problems- everyone is covered, always, irrespective of their employment status etc.

 

[glass99]

Are there economies of scale in health insurance? Seems like doctors and drug companies set their prices, and insurers just pull them out of network if they are too expensive. It does not seem like they have much purchasing power.

Also, if running a health insurance bureaucracy is anything like running a consulting engineering office, the bigger you are the more overhead you have.

 

[JohnRBaker]

Also, if running a health insurance bureaucracy is anything like running a consulting engineering office, the bigger you are the more overhead you have.

I don't think anyone has EVER argued that this was NOT the case. Executive compensation alone can eat up millions of dollars that could have been used to pay benefits.

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[TenPenny]

Increase that "volume discount" to include everyone and you have the Canadian system. As an added bonus, you get no "pre-existing condition" problems- everyone is covered, always, irrespective of their employment status etc.

Indeed, and despite what some in the US say, the Canadian system works well.

 

[glass99]

Part of the reason that the Canadian and European systems are as cheap as they are is that the "engineering" component of their costs is significantly bankrolled by US consumers, especially drugs and medical devices.

 

[KENAT]

glass99, maybe a little bit but I suspect more goes on the administration of the insurance and coding and...

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[glass99]

Kenat: correct, there are many factors contributing to cost. But if the US had a single payer system like Europe, global advancement in medical technology would slow. That plus US military R+D are little gifts of engineering that ordinary Americans give to the rest of the world.

 

[beej67]

That's a cost, one of many costs, buried in our system. But the greatest cost is the cost of people not managing their own expenditures, since the costs are shared.

I hurt my knee playing soccer in June.

I went to the PCP. He said, "probably strained MCL or ACL, you'll be out six weeks, get an MRI." Gave me a number for a specialist. I paid $20, he billed the insurance company $200 or something.

I wait two weeks for my appointment with the specialist. She says "No, it's probably a bruised miniscus, go get an MRI." Gave me the MRI joint's number. I paid $20 and she billed the insurance company $500 or something.

I go to the MRI joint. Walk in, walk out, they tell me nothing, give me no data, and bill my insurance company $3000 or something.

Specialist never calls me back. I call them, they say they can't give me the results on the phone, I have to come in. Wait two more weeks for my appointment. I go in, lady says "well the MRI says it's just tendinitus, but I know that's not true because I can do this" (repeatedly pops my knee) "so here, do these exercises." "But what's wrong?" "We don't know." Sends me on my way, I pay another $20, and they bill my insurance company $500 or something.

So add all that up. $4,200? Something like that?

Europeans don't do this song and dance.

The song and dance is where the cost is.

If I was told I had to pay for all that crap out of pocket, I would never have gone to the doctor at all. I would have googled up some knee rehab exercises, and been doing the same thing the lady told me to do five thousand bucks later. But under our system, you're damn skippy I'm going to got to the doctor and go through the song and dance, because I've already paid for it. If I don't, then I don't get the value for the product I've already bought. It's pre-bought, and you lose it if you don't use it.

If everyone pre-bought into a shared "Food Plan," you think more folks would order lobster? Of course they would.

It's systemic.



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