Thread: What options do I have for health insurance? Group plan.. etc

countryboy - yes that's the kind of group I had in mind. I know that there are several co-ops still available but they have gone down the same path as the insurance companies and as has been noted, they are not significantly cheaper than traditional insurance.

As far as who is to blame - take a look at this:

(The) SEC has reported that the 10 largest health insurers have reported a profit of 428% from 2000 to 2007. Health insurance CEOs averaged 11.9 million in compensation every year. The Labor Dept. Consumer Index has reported a 4.4% increase in health insurance for the 12 months ending in June–that on top of a 4.2% increase from the previous year. Wages in the private sector rose only 1.6%. Watson Wyatt 2 to 5-year survey show that employers expect salaries increases to remain the same or decrease. Given the consolidation of the insurance industry in the last 10 years and single insurer’s dominance in regional markets, if not a public option to get health insurers to compete to lower prices, what then? Reforming health care and help boost the buying power of consumers (70% of the economy) and help US busineses compete globally and maybe even hire.
— Toni Hagan

Originally Posted by Joe Miranda

countryboy - yes that's the kind of group I had in mind. I know that there are several co-ops still available but they have gone down the same path as the insurance companies and as has been noted, they are not significantly cheaper than traditional insurance.

Since Co-ops do not have profits, stock, dividends, or gigantic paychecks and golden parachutes for CEO's, and they dont take 30% for overhead, how can you say they "have gone down the same path as insurance companies"?

A Co-op pays the health care expenses, and no more. Completely different model from an insurance company in every way. Insurance companies dont own hospitals or employ doctors. What they do is make a profit on transactions.
And, a lot of the time, insurance companies make MORE money gambling the premiums on international stock, bond, and foreign exchange markets, than they do on the overhead costs they charge for the actual health care.

If you eliminate insurance companies from the equation, which Co-ops do, ALL of the monthly payment goes to paying health care costs.
Yes, its disapointing that its not a huge amount cheaper- but what that tells you is that you really arent getting as much health care from your insurance company.
What insurance companies do, and you dont see until you get sick, is cut you off when you actually cost them real money- they do this by lifetime limits, by excluding various treatments, and by denying pre-existing conditions, meaning that when your cancer bills break two hundred grand, they wave bye bye.

Obamacare eliminates all these tricks- which is why insurance companies hate it so much, and are paying so much money to try to convince you its communist.

Would be something if part of the mortality rate in the US came from the stress of dealing with healthcare insurance, I could see that giving a few people a heart attack if at all out of shape.

Originally Posted by Ries

Since Co-ops do not have profits, stock, dividends, or gigantic paychecks and golden parachutes for CEO's, and they dont take 30% for overhead, how can you say they "have gone down the same path as insurance companies"?

Since your co-op (which as I understand it runs as a HMO) has no gigantic paychecks and does not take the 30% shouldn't your rates be 40-50% lower than the typical HMO?
Given the numbers quoted by Joe you also don't have the 428% profit so your rates should be what, maybe $200 a month for no-copay, unlimited coverage on an entire family ?
Maybe someone in the co-op is stealing your money.

It seems that no matter how you set it up, you end up at about the same price as the traditional insurance companies after a few years unless you can find a way to exclude people who might get sick.
Bob

One thing to keep in mind, is that even with a group, you are paying for the unhealthiest person of the bunch.

Here in GA, when I was transferring jobs, I looked at just getting a policy on my own. The quote I got for a BCBS PPO2 (in GA) for a Me, the wife, and 4 kids was $402/month. Paid 70%, with a deductible of $5K. Out of pocket max was $15K. I think shit had to go really wrong for that to happen.

If having kids is not in your future, you can decline maternity, and that saves a good bit. Also think about getting a suplemental plan through aflac or someone for things like cancer, accidents, etc. Those are generally pretty cheap, and well worth the money.

Originally Posted by SamH

One thing to keep in mind, is that even with a group, you are paying for the unhealthiest person of the bunch.

I can't help but wonder what the USA would have been like if all settlers and pioneers had had the same attitude.
Home of the brave, healthy and wealthy?

Originally Posted by CarbideBob

Since your co-op (which as I understand it runs as a HMO) has no gigantic paychecks and does not take the 30% shouldn't your rates be 40-50% lower than the typical HMO?
Given the numbers quoted by Joe you also don't have the 428% profit so your rates should be what, maybe $200 a month for no-copay, unlimited coverage on an entire family ?
Maybe someone in the co-op is stealing your money.

It seems that no matter how you set it up, you end up at about the same price as the traditional insurance companies after a few years unless you can find a way to exclude people who might get sick.
Bob

Just like customers who come in to my shop, and tell me what the job should cost in their mind, with no idea of what actually goes into it, I would be foolish if I decided what my health care "should" cost, without any idea of how health care really works.

Group Health, which I belong to, has been member owned since the 40's- nobody is stealing any money. It costs what it costs- I live in a pretty high cost part of the country, and Group Health doesnt kick out old people or sick people like ordinary insurance companies do, so their costs reflect the real costs of serving a broad spectrum of the community.


Insurance companies make their money by managing risk- that means by NOT insuring people who would actually cost them money. They have lots of tricks for this, which are widely documented.

So, they just give you less, for the same money, than my plan does. They edit their base of covered individuals, to allow for their big profits.

Sure, you could pay less if you had a plan that didnt cover people who actually got sick- but the problem is, sooner or later, everybody gets sick, and a lot of it is not predictable. So you could pay less a month now, if you were willing to have no coverage when you actually needed it...
Doesnt sound like any way to run a railroad to me.
And there are a lot of reasons, beyond just morals, ethics, and compassion, why you dont want citizens dying on streetcorners when they get old, or get cancer, or have a serious car accident that wasnt their fault.

There is a proven method, which every other industrialized country in the world uses, to keep costs down- single payer, universal coverage. It works, it has been proven to work in any climate, with any ethnic background, any diet, any industry, in 3 dozen countries for 50 years or more. Its cheaper, it doesnt cause bankruptcies for unexpected illnesses, and its just plain civilized.

Anyway, Group Health is a capitalist health care solution, without insurance companies, that has been proven to work, and is about health care, not finance. Its too bad its also not about free rainbows and unicorns, as opposed to the real world of actual costs, but thats life.

Originally Posted by SamH

One thing to keep in mind, is that even with a group, you are paying for the unhealthiest person of the bunch.

Here in GA, when I was transferring jobs, I looked at just getting a policy on my own. The quote I got for a BCBS PPO2 (in GA) for a Me, the wife, and 4 kids was $402/month. Paid 70%, with a deductible of $5K. Out of pocket max was $15K. I think shit had to go really wrong for that to happen.

If having kids is not in your future, you can decline maternity, and that saves a good bit. Also think about getting a suplemental plan through aflac or someone for things like cancer, accidents, etc. Those are generally pretty cheap, and well worth the money.

You must be pretty young and healthy, if you think $15k in a year requires shit to go really wrong.
Basic routine stuff that happens to us all as we age can easily hit $15k in a year.
My kid broke his arm skateboarding last year, and that was about 4 grand.
I had a kidney stone- thats not a big deal, its not like cancer or diabetes or something- but this one was too large to pass, and I had to have it blasted with laser beams (no shit- thats how they do it)
Took an hour. I was better in a day.
Cost well over 12 grand, if you had to pay retail.

One little car crash, some old lady cant see and runs a stop sign, and you could be out 40k in a heartbeat. A few titanium plates from a ski accident- twenty grand before you blink.

Dont even think about long term stuff- many totally treatable cancers can run 200k a year.
Diabetes care if you need Dialysis- figure a new house every year. If it comes to a transplant, that house might be in Beverly Hills.

Originally Posted by Ries

You must be pretty young and healthy, if you think $15k in a year requires shit to go really wrong.
Basic routine stuff that happens to us all as we age can easily hit $15k in a year.
My kid broke his arm skateboarding last year, and that was about 4 grand.
I had a kidney stone- thats not a big deal, its not like cancer or diabetes or something- but this one was too large to pass, and I had to have it blasted with laser beams (no shit- thats how they do it)
Took an hour. I was better in a day.
Cost well over 12 grand, if you had to pay retail.

One little car crash, some old lady cant see and runs a stop sign, and you could be out 40k in a heartbeat. A few titanium plates from a ski accident- twenty grand before you blink.

Dont even think about long term stuff- many totally treatable cancers can run 200k a year.
Diabetes care if you need Dialysis- figure a new house every year. If it comes to a transplant, that house might be in Beverly Hills.

OMG. How anyone in the USA can be against a sensible national health care system is simply beyond me.

A serious question. What would you do if you were unemployed and out of cash?
Second question. If you had the assets (house, car etc.) but didn't have the necessary money in the bank then what?

Gordon

If you dont have insurance, in most cases, they wont do anything but emergency care.
Yes, if you are bleeding to death, they will sew you up. They wont give you dialysis every week for free at the emergency room, though, or a CAT scan if your back is sore, or treat many long term diseases. Certainly they wont give you expensive cancer drugs or treat many permanent conditions.

If you have a house, and you need treatment, you would have to sell the house- there is indigent care, but you have to have almost nothing. It varies from state to state, but in many cases, you cant even own a car, and get indigent care, and even then, it would only be for some things.

Preventative care, for example, they dont give you no matter how broke you are.

Originally Posted by exkenna

Here's the question: How do you small shop owners and lone rangers shop for health insurance for your families? Are there any options for group plans? Are there any health insurance companies you have had good or bad experiences with? Please.. no politics here. Let's talk about insurance plans and experiences, good or bad.

TIA

X

Aetna has small group. I have 5 employees, one opted out, one has full coverage through his wife's employer, the other two are part-time operators. I have a group of one. To cover my wife, myself, and 2 kids, the rate is $1650 monthly, and will go up next year when I hit 55.

As you can guess, I am looking at options, however my wife has health issues that exclude private coverage. Best of luck to you, insurance is a drain.
I am also a florida corp.

Originally Posted by Ries

...

Insurance companies make their money by managing risk- that means by NOT insuring people who would actually cost them money. They have lots of tricks for this, which are widely documented.

So, they just give you less, for the same money, than my plan does. They edit their base of covered individuals, to allow for their big profits.

Sure, you could pay less if you had a plan that didnt cover people who actually got sick- but the problem is, sooner or later, everybody gets sick, and a lot of it is not predictable. So you could pay less a month now, if you were willing to have no coverage when you actually needed it...

This varies a lot by state.
Here in Michigan BC/BS operates as a non-profit and is the "insurer of last resort".
By law they can not stop your coverage as long as you make the payments.
They also can not turn anyone down who wants to sign up based on age or condition.

They can (and do) have a 6-month preexisting condition period where they pay nothing.
They have to go to the state to raise rates for a plan but this is basically a "rubber stamp" process.

Not only do we have a totally crazy system in this country but if you cross the state line all the rules change. Even if you kept insurance companies but had one standardized system and some kind of standard billing practices we would save a ton of money in paperwork and clerks.
Bob

Originally Posted by Ries

If you dont have insurance, in most cases, they wont do anything but emergency care.
Yes, if you are bleeding to death, they will sew you up. They wont give you dialysis every week for free at the emergency room, though, or a CAT scan if your back is sore, or treat many long term diseases. Certainly they wont give you expensive cancer drugs or treat many permanent conditions.

If you have a house, and you need treatment, you would have to sell the house- there is indigent care, but you have to have almost nothing. It varies from state to state, but in many cases, you cant even own a car, and get indigent care, and even then, it would only be for some things.

Preventative care, for example, they dont give you no matter how broke you are.

Sounds to me that the time for an enraged public outcry is long overdue. The key factor is that all profit organizations must be kept out of it and the only government involvement should be to find the funding through taxes ear-marked for health care.

If that can't be done then for God's sake find out who is blocking common sense and why. Is there really any issue that is more important than health care for all citizens?

Gordon

and once again http://www.youtube.com/watch?v=C7NEr...eature=related

Originally Posted by Gordon B. Clarke

If you had the assets (house, car etc.) but didn't have the necessary money in the bank then what?Gordon

Most hospitals would put you on a payment plan around here.... kinda like buying a house maybe but still so much a month.

I live in AZ and they eliminated indegent care for adults. My friends mother has cancer and they told her that she must come up with the money for treatment they wont even offer palative end of life care. She is not sure how long she has with out treatment but aspirin is not cutting it right now. To get decent coverage that wont leave you bankrupt you will be paying at leat 1500 a month for a healthy family of 3. If you have any health problems at all you will be denied coverage. My brother has some minor health problems and he is 40 years old he is currently paying 2800 a month for himself. If you hire someone make them get a physical first or they might be uninsureable. My brothers foreman wants health insurance for himself and his daughter but he has high colesteraul. No company will take him they have been trying to get him insurance for 2 years. Someday physicals will determin who gets a job and who gets to starve, because they might cost too much to insure.