Health insurance discussion continued

metlmunchr · Jul 20, 2013

Re-opening the previously closed discussion on healthcare costs and health insurance for anyone who cares continue the topic.

IMO, this is the biggest challenge facing both individuals and businesses in the US today. Even large corporations who self insure, and therefore avoid a large portion of insurance company overhead, aren't able to avoid the rapidly rising costs of healthcare itself.

At the individual level, health insurance locks potential entrepreneurs into jobs they'd love to leave tomorrow, and at the small business level a business with a dozen employees can have one employee who experiences serious health issues and see their group rates increase by an amount that consumes a significant portion of what used to be profit for that business.

It effects everyone at every level, and anything that sheds a bit more light on the real cost drivers has to ultimately be of some benefit. As Carbide Bob said in the previous thread, companies that pass on a large portion of annual premium increases may, if nothing else, get their employees pissed off enough that they'll start paying more attention. As it stands now, public ignorance is the strongest ally of those who would gladly use the healthcare industry solely as a means of personal enrichment while adding nothing of value to the process itself.

In light of all the above, I can't imagine any topic more deserving of discussion. Some may choose to ignore it, but no business or individual will escape its effects if nothing is done to get costs under control.

JoeE. · Jul 20, 2013

metlmunchr said:
.....if nothing else, get their employees pissed off enough that they'll start paying more attention.....

Might make a guy set up and take notice.... that it costs an arm and a leg...but it doesn't make one whit of difference in the long run on what it costs.

There are still the leeches we have to contend with. Insurance companies et.al.

The costs of the service and products used in the medical field seem to be exorbitant, and there is nothing "we" can do about it.

jamscal · Jul 20, 2013

People may remain ignorant as half the population will never have to pay for it.

Some portion of the population is interested in maintaining the status quo. Insurance co's may be "parasites" but they also employ a bunch of people.

I read these threads because I do worry about what's happening.

I have a very high deductible insurance policy for my family of five. I'm self employed.

But, we get the 'rates' the insurance company pays for stuff. (I'm being very general here, as we are generally healthy and don't use a lot, nor have I read the policy cover to cover.)

So the high deductible policy also covers a yearly exam.

We pay out of pocket for everything else.

One of my daughters broke her arm last year. Didn't panic, called the kids doctor and they saw her immediately...avoided the emergency room.

Paid for it all...didn't like it, but that's life.

A lot of people "can't afford" insurance but can afford a $500/mo car payment.

-James

jim rozen · Jul 20, 2013

"Insurance co's may be "parasites" but they also employ a bunch of people."

So do mexican drug cartels. Welfare employment is not a justification for
continuing this mess in the medical care arena. There simply is not enough
money available for insurance company ROI *and* treatment for the folks who
really are paying the bills: us.

I would suggest that one of the single biggest dragons in the industry right now,
is a staggering lack of transparency regarding costs and pricing. This, combined
with what appears to be illegal collusion among the insurance companies and between
insurance companies and hospitals, has produced the mess we see right now.

This system has been carefully optimized over many many years - to make money
for insurance companies and hospitals. It'll take a long time to change.

The quickest way to do this, I suggest, is to create a second, parallel path to
getting care for citizens, that does NOT involve insurance companies. The public
option that was so rapidly discarded by obama, or, by slowly expanding medicare
bit by bit to cover lower and lower aged people over time.

There's a reason that insurance companies fought tooth and nail to prevent medicare.
It would be "the end of the world as we know it."

jamscal · Jul 20, 2013

I didn't say that as a justification,

but meant those people who are employed by the system might want to see that system continue, right or wrong.

“It is difficult to get a man to understand something, when his salary depends on his not understanding it.”

-Upton Sinclair

SeymourDumore · Jul 20, 2013

JoeE. said:
There are still the leeches we have to contend with. Insurance companies et.al.

The costs of the service and products used in the medical field seem to be exorbitant, and there is nothing "we" can do about it.

Oh, and there lies the rub!

I for one am in favor of the public option for a basic healthcare coverage, not unlike what's in existence throughout the world.
Add to it the private insurance co's ability to provide the same coverage for the same price if they so choose, I think it could prove to be a fair compromise to both sides of the isle.

I could also envision some federally funded heathcare providers ( hospitals, clinics, specialized care ctrs etc ) with one very important caveat: They all have to be run as any private business is ran!
That is to say it must - at the very least!!! - break even financially. I know there are those with the belief that heathcare should not be a for-profit endeavor for all parties involved, but I also know that
we're all human and we all have some basic traits.... and I'll leave that at that.

These do have the potential to equalize the playing fields..

But then we get to the rest of the story!

Do we want to ( or can we even think of ) setting up a federally funded medical device manufacturer, pharmaceutical company, research labs?
Do we want to take over a car manufacturer so we can build ambulances for low cost?
Will now federal prosecutors be tasked with being defense attorneys for the government run healthcare providers in case of lawsuits?

Michael did make a very good point in the other thread regarding costs, and PM being of a manufacturing nature, it is quite fitting.
Does a simple screw have to cost $250/piece?
Just how exactly does a 3/8 C/less ground shaft 10" long with 2 1/8 holes on each end become an $83 item to the end user? ( I make the shaft for $7.50 with material )
Can we explain the price differences in medications? Here is a link to a price comparison for Plavix: Plavix 75 mg Price Comparisons Among Online Pharmacies
While I cannot speak to the exact numbers quoted there, I do know for a fact that the out-of-pocket, no insurance costs for Plavix was at least 7 times higher in the US as it is in Hungary for a 30 day supply
back when there was no generic alternative ( '05 era )
I've worked for a division of Bayer, the makers of the real Aspirin. Why was I able to purchase 500 ct bottles at the company store for $.99 ?
Why was I supplying every diabetic friend and relative I had with Bayer glucose strips for literally 1/10 th of the price of Walgreens, CVS, Rite-Aid etc?

Interestingly, the same company store also carried film ( 35 and 70 mm ) made by us as well, yet the savings on those were only 50-60% when compared to the very same CVS, Walgreen or Rite-Aid stores.

Shouldn't we address and implicitly link these issues to anything we do about healthcare?

powerglider · Jul 20, 2013

each of us needs to take better care of themselves. We can't expect the system (any system) to be there to repair us at any expense and at any age. So for each person complaining, are you doing what you can to keep yourself healthy? Eating properly? Walking/exercising? Being cautious and limit the risks to injury? I fly paramotors and they are risky as any aviation related hobby. I would not expect anybody to be responsible to repair me should I have an accident. I expect myself to pay for the repairs or beg family/friends/become religious if I choose to do that if I don't have the money it costs to repair myself. Other then that I would expect to try and cope as best as possible with my broken self. So if you smoke why would you expect somebody else to pay to fix you up when you have lung cancer? Fixing every person up to live past 80 years old with quality of life is just something I don't think we are wealthy enough to afford as a society because we just have too many self inflicted problems. If you have money then pay for your own repairs, nobody fixes your cnc machine when it breaks do they?

lazlo · Jul 20, 2013

jamscal said:
People may remain ignorant as half the population will never have to pay for it.

Who are the "half the population" who gets health insurance who don't have to pay for it?

AFAIK, that category is only Medicaid, which covers 12% of the population. That 12% are predominantly women and children below the poverty line, elderly people and individuals with disabilities.

I have a very high deductible insurance policy for my family of five. I'm self employed.

One of my daughters broke her arm last year. Didn't panic, called the kids doctor and they saw her immediately...avoided the emergency room.

Paid for it all...didn't like it, but that's life.

Those catastrophic insurance plans (which is all you can get pre-Obamacare, if you're an individual) typically have $4,000 deductibles. So it cost you several thousand dollars for a broken arm, and most of that went to corporate profit.

You're the exact demographic that Obamacare was built for. In October, you'll be able to sign up for a group insurance plan on the Kentucky Insurance Exchange where you're paying about the same that you are now, with a low (or no) deductible.

So you're not getting "free" health insurance, but you won't pay several thousand dollars for a broken arm either.

lazlo · Jul 20, 2013

jim rozen said:
"Insurance co's may be "parasites" but they also employ a bunch of people."

So do mexican drug cartels.

Classic Jim!!!! :cheers:

lazlo · Jul 20, 2013

powerglider said:
We can't expect the system (any system) to be there to repair us at any expense and at any age.

Fixing every person up to live past 80 years old with quality of life is just something I don't think we are wealthy enough to afford as a society

Are you suggesting that we terminate Medicare coverage at 80?

I think you'll have a very different opinion once you hit retirement age

SeymourDumore · Jul 20, 2013

lazlo said:
Who are the "half the population" who gets health insurance who don't have to pay for it?

Lazlo

Didn't you in the other thread mention that most large corporations ( specially the financial ones ) provide a mostly employer-paid healthinsurance?
While working for a similar size company, my monthly deduction was exactly $47.80. The rest was paid by the corporation, which I know for a fact ( had Cigna and wife worked for Cigna at the time )
to be much, much more than $47.80

Now, I ask you. Do I really give a rat's ass if my insurance premium doubles while the company still only passes on a small percentage of the total?
That's exactly what Munchr and James is trying to say!
While I don't know if it's half, 47% or whatever that pays only a small fraction of the policy, the fact remains: They really don't care what it costs, and care even less why it costs that.

That is exactly why I've said - once again in that other thread - that EMPLOYER!!! contribution must be capped!

jamscal · Jul 20, 2013

lazlo said:
Who are the "half the population" who gets health insurance who don't have to pay for it?

/QUOTE]

I said will, not do.

When everyone is covered, not everyone will pay for it.

Broad generalization on my part, sorry.

Ries · Jul 20, 2013

powerglider said:
each of us needs to take better care of themselves. We can't expect the system (any system) to be there to repair us at any expense and at any age. So for each person complaining, are you doing what you can to keep yourself healthy? Eating properly? Walking/exercising? Being cautious and limit the risks to injury? I fly paramotors and they are risky as any aviation related hobby. I would not expect anybody to be responsible to repair me should I have an accident. I expect myself to pay for the repairs or beg family/friends/become religious if I choose to do that if I don't have the money it costs to repair myself. Other then that I would expect to try and cope as best as possible with my broken self. So if you smoke why would you expect somebody else to pay to fix you up when you have lung cancer? Fixing every person up to live past 80 years old with quality of life is just something I don't think we are wealthy enough to afford as a society because we just have too many self inflicted problems. If you have money then pay for your own repairs, nobody fixes your cnc machine when it breaks do they?

Sorry, but this is a fantasy.

Let us assume you are flying your paramotor, and you crash.
Unless you have "do not give first aid" tattooed on your forehead, whoever finds you, unconscious and bleeding, is going to call 911, the paramedics are gonna come, and they will take you to the hospital. Then, they will put you in intensive care, give you brain surgery, set your broken bones, stitch up your wounds, and wait for you to wake up.

How the heck are they gonna know you would prefer to die, as opposed to get more medical care than you can afford, or want, to pay for?

We live in a civilized country, where we try to save people's lives first, and worry about ideology later.

Nobody should have to die, or go broke, if something "fixable" happens to them, and they work at Mcdonalds or Walmart.

Every other civilized country has figured out how to have universal health care, and to do it for half or less what we pay.

powerglider · Jul 20, 2013

it is unsustainable for a society to keep paying the costs we are paying now to sustain quality of life for our population over 70. So we need to make a choice on what amount we want to send and guidelines on what age group to send on. Without it, we spend 80% of our money keeping people over 80 barely alive for an extra few months. Would any of you apply the same strategy to any of your machinery? Would you spend 80% of your maintenance budget to keep your oldest and most obsolete machinery going for another day or 3? It's tough love to examine people the same we do with our machines and it doesn't need to be done if our resources are unlimited. Unfortunately we have limited resources so tough choices any needed and they aren't fun for old people. Again if you are rich pay what you want, repair yourselves to your satisfaction.

I see it first hand with my mother and father in law. They are 88 and 85. Every time they have an ache off they go to get "fixed". First thing they get is a bunch of tests (over and over), followed by a meeting to discuss the tests. End with a trip to the pharmacy. No mention of what diet they are following, what exercises they have done lately, nothing.

lazlo said:
Are you suggesting that we terminate Medicare coverage at 80?
I think you'll have a very different opinion once you hit retirement age

lazlo · Jul 20, 2013

jamscal said:
lazlo said:

Who are the "half the population" who gets health insurance who don't have to pay for it?

Click to expand...

I said will, not do.

You've been misinformed. Obamacare isn't "free". In fact, that's why Fox says you should be angry about Obamacare, because the government is forcing you to pay an insurance premium.

More importantly, there are only 45 million "takers" (including yourself*) who are currently uninsured, that will have coverage through Obamacare starting January 1. That's only 15% of the nation. About 35% of the nation has health insurance through the Fed: Medicare, the VA, the Federal Employees Health Benefits. The remainder of the nation are privately insured through their employer.

The reason you're paying a ridiculous amount for health insurance with a $4,000 deductible is because the insurance companies know they have individuals by the balls. When large groups like a Fortune 500 company negotiate rates, they get non-catastrophic insurance with no deductible for the same rate you're paying for catastrophic insurance.

So the only thing that changes on January 1 is that the government will have a health exchange market where United Health Care, Cigna, Kaiser et al compete for group insurance plans. In other words, Obamacare aggregates the 45 million uninsured into state-wide group plans which have the same negotiating power as the Fortune 500 companies.

*Extreme sarcasm, if you can't tell...

lazlo · Jul 20, 2013

SeymourDumore said:
Didn't you in the other thread mention that most large corporations ( specially the financial ones ) provide a mostly employer-paid healthinsurance?

In white collar jobs, the employer typically pays 75% of the insurance premium. The employee pays the remaining 25%.

Do I really give a rat's ass if my insurance premium doubles while the company still only passes on a small percentage of the total?

That is exactly why I've said - once again in that other thread - that EMPLOYER!!! contribution must be capped!

You should! Because insurance profiteering has increased the cost of insurance plans by 250% since 2000. Seriously! What costs $1,500/month now for my employer and I to provide health insurance for my family of 4 cost $536/month in 2000!

Gordon B. Clarke · Jul 20, 2013

SeymourDumore said:
But then we get to the rest of the story!

Do we want to ( or can we even think of ) setting up a federally funded medical device manufacturer, pharmaceutical company, research labs?
Do we want to take over a car manufacturer so we can build ambulances for low cost?
Will now federal prosecutors be tasked with being defense attorneys for the government run healthcare providers in case of lawsuits?

For Heaven's sake make the issue as complicated as possible. It's about giving health care to all. Not the "government" taking over businesses. Why not take a serious look at the countries that seem to do it almost right and take it from there?

All this "What if" is for losers.

Gordon

SeymourDumore · Jul 20, 2013

Gordon B. Clarke said:
For Heaven's sake make the issue as complicated as possible. It's about giving health care to all. Not the "government" taking over businesses. Why not take a serious look at the countries that seem to do it almost right and take it from there?

All this "What if" is for losers.

Gordon

Gordon, for Heaven's sake, please, just once...
Read what I wrote and to what I've replied!

I've claimed no sides nor made argument for or against anything!!!

I've only commented on the issue of cost and it's sources without offering any solutions or ideas.

So what are you picking a bone with!!

SeymourDumore · Jul 20, 2013

lazlo said:
In white collar jobs, the employer typically pays 75% of the insurance premium. The employee pays the remaining 25%.

You should! Because insurance profiteering has increased the cost of insurance plans by 250% since 2000. Seriously! What costs $1,500/month now for my employer and I to provide health insurance for my family of 4 cost $536/month in 2000!

Grrrr...

Aren't you actually making my point?

With only 25% skin in the game ( I actually paid maybe 15% at the time ) your out of pocket went from $134/ mo to $375 in the 12 years.
Perhaps a day's salary of actual increase to you.

Now imagine if you lived in Germany and you were responsible for 50.9% of your insurance premium.
You'd have gone from $268/mo to $750/mo.
You'd be a bit more interested wouldn't ya?

Gordon B. Clarke · Jul 20, 2013

SeymourDumore said:
Gordon, for Heaven's sake, please, just once...
Read what I wrote and to what I've replied!

I've claimed no sides nor made argument for or against anything!!!

I've only commented on the issue of cost and it's sources without offering any solutions or ideas.

So what are you picking a bone with!!

I'll certainly agree with you that all you've done is " .. commented on the issue of cost and it's sources without offering any solutions or ideas".

What I am protesting against is when you write stuff like,
"Do we want to ( or can we even think of ) setting up a federally funded medical device manufacturer, pharmaceutical company, research labs?
Do we want to take over a car manufacturer so we can build ambulances for low cost?
Will now federal prosecutors be tasked with being defense attorneys for the government run healthcare providers in case of lawsuits?"

That kind of BS certainly makes any decision impossble and things one thousand times more complicated than they are. Jeez man, taking over the auto industry to make ambulances? I once agreed with much of what you wrote but have you had failed brain surgery in the last few months?

Try something original. Make some suggestions or come up with some ideas that will improve health care for all in the USA without it costing more than it does today. Either that or stand on a corner with a sign around your neck saying THE END IS NEAR or some other type crap.

Gordon

Health insurance discussion continued

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