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    Default Health Insurance Check in . . .

    We just re-upped and received an overall increase of 18.5% this year, however the increase was not at all like increases in the past.

    Our employees are now all age rated and it appears the happiest insurance age for just status quo is about 41 years old - his monthly insurance premium went up $8.00 of which his share went up $2.00

    Worst case employee is about 54 yo with spouse and family up 79% to $2790/mo with quite a few clumped together in this range.

    Best case employee is about 24 yo with a 40% reduction @ $280/mo now.

    So we went from $26.7k/mo to $31.6k/mo with 35 employees and related families where applicable covered. Add to this our HSA employer contributions to each covered employee's account and we are now at $523k / year for medical, dental and vision coverage.

    We have right at 55 employees now so 20 of our employees have opted out and are receiving health benefits from their spouses employer in many of these cases or they are under 26 and still on their parents health insurance. Scaling this from 35 to 55 employees would be a significant increase.

    A half million here and a half million there and pretty soon we are starting to talk about some serious expenses!

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    My theory is that Trump and his fellow republicans should all get off the government insurance plan and see how much it costs all those older guys in congress to buy health insurance on their own before thy cut working Americans off of insurance.
    I bet Dick Cheney would have a heart attack if he had to pay for his health insurance premiums on the open market.

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    Quote Originally Posted by Bill D View Post
    My theory is that Trump and his fellow republicans should all get off the government insurance plan and see how much it costs all those older guys in congress to buy health insurance on their own before thy cut working Americans off of insurance.
    I bet Dick Cheney would have a heart attack if he had to pay for his health insurance premiums on the open market.
    You obviously never been a billionaire . None of those guys understand what it means to raise a family of four on 50+K. Even at 100K+, it is making choices. What should alarm them is the cost to the employers and the inordinate proportion of the GDP spent on health care. We are inevitably moving toward a single payer system, there is just too much rhetoric on the insurance lobby side that prevents it from happening fast. If we do not get the health care expenditures to comparable level with the rest of civilized world we will be at a competitive disadvantage.


    dee
    ;-D

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    Holy crap! Let me get this straight, the insurance cost for the 54 year old and family is $33,480 per year. That's insane. I buy my own insurance for just myself and my wife, and we just downgraded our plan because we couldn't make ends meet. The only difference between secure comfortable living a decade ago, and not quite making it today, is health insurance. It's killing us. Everybody complains about Obamacare, but you have to remember the trajectory insurance rates were on before that. IMHO, there is no government plan that involves rearranging coverage that can work. Both pachyderm and ass are kidding themselves. Somebody has to address the costs; everybody in the health industry thinks it's a bottomless pit of money.

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    Mine, according to the company runs about 46,000$ a year for me, the wife and two kids. I'm 57 now. Granted, I work in what would be considered a highly dangerous occupation, working with both fuels and explosives. My cost last year was just under 6K of that. For 2018, it's going up about 400$ a year out of my pocket.

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    Quote Originally Posted by Conrad Hoffman View Post
    Holy crap! Let me get this straight, the insurance cost for the 54 year old and family is $33,480 per year. That's insane. I buy my own insurance for just myself and my wife, and we just downgraded our plan because we couldn't make ends meet. The only difference between secure comfortable living a decade ago, and not quite making it today, is health insurance. It's killing us. Everybody complains about Obamacare, but you have to remember the trajectory insurance rates were on before that. IMHO, there is no government plan that involves rearranging coverage that can work. Both pachyderm and ass are kidding themselves. Somebody has to address the costs; everybody in the health industry thinks it's a bottomless pit of money.
    Actually, that is the insurance premium only - we also kick in another ~$4100 / employee per year into their HSA to keep their out of pocket deductible to a reasonable amount. We elected to go to a high deductible plan + HSA so they could have control over more of the money for medical expenses on their own (typically used for things that insurance doesn't cover like braces, Lasic surgery, etc.) If they don't use it, it just rolls over to the next year and it keeps on building up. I suppose at some point they can use it to pay their portion of the premiums (not sure what the law is about this)

    So the total health care expense for this employee and family is more along the lines of $37,580 / year. Add in medicare, SS, L&I, etc. and OH hourly rate for medical and wage related costs is close to $30/hour. Then add in business insurance, building, phones, IT, equipment, etc. and it is easy to see how Overhead per employee is close to $100k / year plus the actual salary itself over and above that. This is why we need to charge upwards of $110/hour shop time and $149/hour for engineering.

    The employee does pay 25% of the base premium (roughly $700 / month in this case) . . . but still, I remember when the entire premium was on the order of $700/mo for everything rather than it being just the employee's portion of the payment

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    Quote Originally Posted by Conrad Hoffman View Post
    Holy crap! Let me get this straight, the insurance cost for the 54 year old and family is $33,480 per year. That's insane. I buy my own insurance for just myself and my wife, and we just downgraded our plan because we couldn't make ends meet. The only difference between secure comfortable living a decade ago, and not quite making it today, is health insurance. It's killing us. Everybody complains about Obamacare, but you have to remember the trajectory insurance rates were on before that. IMHO, there is no government plan that involves rearranging coverage that can work. Both pachyderm and ass are kidding themselves. Somebody has to address the costs; everybody in the health industry thinks it's a bottomless pit of money.
    Mine as a 36 year old with family was $20K last year. Spent about 50K in insurance over the last three and a half years trying to start up. I'm no longer self employed. Couldn't keep up.

    This is all about eroding the middle class and turn them into corporate sheeple.

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    Quote Originally Posted by Conrad Hoffman View Post
    Both pachyderm and ass are kidding themselves. Somebody has to address the costs; everybody in the health industry thinks it's a bottomless pit of money.
    They THINK they are kidding US, not themselves, and that changing the branding or package colour now and then will be good enough to let it go on forever.

    Nobody is EVER going to "address" it but their victims. We Chik'ns.

    Or not.

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    Quote Originally Posted by countryboy1966 View Post
    This is all about eroding the middle class and turn them into corporate sheeple.
    I said that years ago. Your system is unsustainable. It's going to fail, the only question is when.

    Perhaps people in one of the States where there's citizen initiated legislation should start the ball rolling by passing a law saying that everyone has to pay for their own health cover, and no elected representative may have cover provided for themselves by any 3rd party.

    California is big enough to be a good experiment. It'll never happen of course. More likely that a law making the Govt responsible for health insurance would pass - and lead to a collapse.

    Entertaining for me anyway.

    PDW

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    I wrote a paper in graduate school concerning health insurance costs. One author I quoted said something like, "It will come to the point where a business owner must now know more about and pay more attention to the cost of health insurance than to the cost of actually running his own business."

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    Quote Originally Posted by motion guru View Post
    We just re-upped and received an overall increase of 18.5% this year, however the increase was not at all like increases in the past.

    Our employees are now all age rated and it appears the happiest insurance age for just status quo is about 41 years old - his monthly insurance premium went up $8.00 of which his share went up $2.00

    Worst case employee is about 54 yo with spouse and family up 79% to $2790/mo with quite a few clumped together in this range.

    Best case employee is about 24 yo with a 40% reduction @ $280/mo now.

    So we went from $26.7k/mo to $31.6k/mo with 35 employees and related families where applicable covered. Add to this our HSA employer contributions to each covered employee's account and we are now at $523k / year for medical, dental and vision coverage.

    We have right at 55 employees now so 20 of our employees have opted out and are receiving health benefits from their spouses employer in many of these cases or they are under 26 and still on their parents health insurance. Scaling this from 35 to 55 employees would be a significant increase.

    A half million here and a half million there and pretty soon we are starting to talk about some serious expenses!
    And yet there seems to be a majority (or a very powerful minority) against tax financed healthcare that would virtually eliminate that problem.


    Who doesn't want you to have cheaper and better healthcare?

    Health Care Index by Country 217 Mid-Year

    USA is #27. Not good considering you pay most.

    1 Most Expensive Countries for Healthcare in the World | Zero Hedge

    And yet again, in most countries HEALTHCARE IS NOT RUN BY GOVERNMENTS - IT'S ONLY FINANCED BY THEM.

    Wake up and look around you, while you still can.

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    Yikes. I've spent maybe a couple hundred bucks at the doctor's and a couple thousand with the dentist over the past forty years. So at this rate, the insurance companies would have made about $ 1,200,000 off me.

    That's kinda ridiculous.

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    A huge part of the problem is costs that didn't exist 20 years ago. And the requirement that policies cover these treatments. Not who pays for it.

    Colon cancer treatment(2009 prices):
    Folotyn $30,000/month Questioning a Cancer Drug That Costs $3, a Month - The New York Times
    Erbitux: $10,000 a month

    Lung cancer treatment: Avastin about $8,800/month

    Skin Cancer Treatment( Pfizer, Merck KGaA's $13,-a-Month Cancer Drug Wins Approval - Bloomberg ):
    Bavencio, $13,000 a month

    10 most expensive(Forbes Welcome
    The ten events or conditions that are most commonly expensive are as follows. These are average costs, so many patients even with these conditions will not reach the $100,000 per year mark:

    1. HIV $25,000
    2. Cancer $49,000
    3. Transplant $51,00
    4. Stroke $61,000
    5 Hemophilia $62,000
    6. Heart Attack including Cardiac Revascularization (Angioplasty with or without Stent) $72,000
    7. Coronary Artery Disease $75,000
    8. Neonate (premature baby) with extreme problems $101,000
    9. End-Stage Renal Disease $173,000
    10. Respiratory Failure on Ventilator $314,000

    Gender reassignment surgery ( http://time.com/money/4092680/transg...y-costs/):over $100,000.

    Chronic Hemolysis( What are some of the most expensive medical treatments? | Health Insurance ): Soliris, by Alexion $409,000/year.

    Heart Transplant ( https://topthreez.com/2017/07/29/top...-in-the-world/ ): $997,700

    Only when we make the hard decisions between "can we" and "should we", will we be able to control costs.

    P.S.

    Medical coding (determining how to enter a procedure into the system for billing) had 179,500 employed as of 2010, and in 2016 206,300. Job Outlook, 2016-26 13% (Faster than average), hourly rate range of $15.23 to $24.54.

    Machinist Number of Jobs, 2016, 468,600. Job Outlook, 2016-26 1% (Little or no change) hourly rate range $16.30 to $26.70

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    Quote Originally Posted by PDW View Post
    I said that years ago. Your system is unsustainable. It's going to fail, the only question is when.

    Perhaps people in one of the States where there's citizen initiated legislation should start the ball rolling by passing a law saying that everyone has to pay for their own health cover, and no elected representative may have cover provided for themselves by any 3rd party.

    California is big enough to be a good experiment. It'll never happen of course. More likely that a law making the Govt responsible for health insurance would pass - and lead to a collapse.

    Entertaining for me anyway.

    PDW
    You make very good points.

    Te cost of US health care did not escalate until the majority of the population started to get covered by a third party payer. When everyone was writing the checks themselves and paying the bills, there was much more scrutiny of costs and a tendency for people to question why we need every single test done.

    When we paid our own bills, we had a better relationship with the health care providers, malpractice was much less, and we had better outcomes.

    Where we are today is much different. Somebody else writes the checks so there is a complete disconnect between the services provided and the costs.

    Having the friendly Congress critters have the same plan that they want us to have that is so wonderful is an excellent place to start.

    Add to this about 40-47% of the US population does not pay any Federal income tax and many even receive an unearned income tax check. This makes a fertile segment of our population for the politicians to pander to for costly promises for the the other half to pay for, insuring the politicians re-election.

    We where promised with the Obama care that you get to keep your doctor, costs savings would be $2500 per family, and it would fix everything. None of this happened, which I didn't expect to happen any way.

    What I did despise was that my old deductible going to an Obama care compliant plan went from $2500 for the family to $5000 with a $2500 copay in addition to the pharmacy plan changed. All totaled, it was about an $8500 per year hit to my income with the switch.

    There are several major things that are driving the US health care costs in an upward spiral.

    One is that there is a complete disconnect between services provided to the patient and the costs of the health care. There is no financial incentive for a health care consumer to be judicious in there consumption of the services.

    There is also an underlying problem in the US with a subliminal thought that with technology, we will live forever. I have a doctor friend that says that 100% of his patients will die. His job is to preserve his patients health and prolong their useful lives. This means that there is a time to be born, a time to live, and a time to die. If we as a society understood this better, we would make wiser lifestyle choices.

    The other big item driving the health care costs is that in the US, emergency health care is supplied to everyone. That means poor, criminal, rich man-poor man, non citizens, and probably even Martians if one showed up. Much of the emergency room medicine is not paid for by the patients insurance because they have non or are Medicaid. That means that the taxpayer and insurance providers are picking up the tab.

    Requiring a lower middle income person to buy an insurance plan with a huge deductible and a large monthly premium is just plain stupid. This group of people only have X number of dollars to spend per month. Diverting their health care dollars to a useless insurance plan is worthless as they can't pay the deductible since all of their available health care dollars went to the insurance premiums.

    This means that they would be much better off financially if they were on welfare where everything is covered. This only exacerbates the total healthcare costs for everyone and increases the welfare roles.

    Unlike many other countries, we do not have people dying in the hospital hallways because they do not have the cash or an insurance card. Not to pick on Mexico but unless you can pay, there will be no services provided, especially if you are a non-citizen. Mexican citizens that I work with tell me this often and that we, the US needs to keep some perspective on our health care costs vs services provided.

    Technology costs money. This means that much of the R&D costs are being shifted to the insurance providers. This is why many of our new meds cost what they do and yet, you can buy them outside of the US at a significant discount. In essence this implies that much of the R&D that the US develops is being carried by the US health care system. When the US can no longer support the existing system, the rest of the world will then see their costs jump and new technology start to slow down.

    Ultimately, the only way to control health care costs is to limit how much is spent. That means that we have to get off the open checkbook wagon. We need to provide a financial incentive for people to not want to spend needless dollars on unwarranted expenses.

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    Ziggy2 - have you even looked at or thought about how virtually all other countries do it?

    "Unlike many other countries, we do not have people dying in the hospital hallways because they do not have the cash or an insurance card. Not to pick on Mexico but unless you can pay, there will be no services provided, especially if you are a non-citizen. Mexican citizens that I work with tell me this often and that we, the US needs to keep some perspective on our health care costs vs services provided."

    Care to name a few of those countries? Maybe the reason you don't have "people dying in the hospital hallways" in the USA is that they don't get admitted unles they have insurance? Name a few countries that "lets you die" and I'll apologize for that remark.

    Even as tourist here if you get suddenly ill or in an accident you'll get treated as a citizen would and not charged. OTOH come here looking for free treatment and you'll be sent back to where you came from or get a bill.

    Of course travelling abroad without medical insurance is stupid.

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    Fwiw..
    We pay 1950€, per year, total, for 2 adults under 50, and 1 4 year old, including global coverage & travel, dental.
    From alliance, a global multi-billion firm who makes money at these rates.

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    Quote Originally Posted by Ziggy2 View Post

    Te cost of US health care did not escalate until the majority of the population started to get covered by a third party payer. When everyone was writing the checks themselves and paying the bills, there was much more scrutiny of costs and a tendency for people to question why we need every single test done.
    Employer paid health insurance was a benefit that came about because of wage and price controls of WW2. Wages were frozen to prevent employees from jumping from one firm to another, possibly disrupting war production. Employers did what they have always done when the government interferes with their business, they find a way around the new regulation. The work around was fringe benefits, of which health insurance was one. "I can't pay you more, but I can give you 2 weeks vacation and health insurance for your family." At that time health insurance was cheap. Medical technology was largely limited to antibiotics. Prescribe a dose and either the patient gets well or they die.

    Just another example of unintended consequences of regulation.

    The health insurance for my company was renewed in July. It is a grandfathered plan, mostly for hospitalization. Employee and spouse, about $400/month, Family about $600/month. This was about a 14% increase, about half and half between rising medical costs and increased age of participants.

    The most valuable part of the health insurance so far is if the procedure is covered, the insurer gets tremendous discounts vs. the hospital billed amount. These discounts are applied to both the deductible and copay amounts. The billed amounts are typically 50% to 100% higher than the amount the insurance company actually pays.

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    Quote Originally Posted by Gordon B. Clarke View Post

    Care to name a few of those countries? Maybe the reason you don't have "people dying in the hospital hallways" in the USA is that they don't get admitted unles they have insurance? Name a few countries that "lets you die" and I'll apologize for that remark.
    Two patients die from starvation or thirst each day in UK hospitals and care homes, say statistics | The Independent

    2 patients die from starvation or dehydration due to neglect in the UK every day

    And no one is refused life-saving/preserving service of any type in US hospitals, regardless of their insurance status or income. We also don't refuse service or reduce the urgency of service to smokers, addicts, morbidly obese, or any other self-imposed condition (like the UK does.)

    Weirdly, the UK is 10 spots higher on the list you cited than the US.

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    It would be interesting to see how much of what is paid for a procedure in the hospital is actually going toward the net cost of it. As one who ran two departments in a hospital during the mid 70's the ratio at that time was near 50/50. The administration, insurance, and forced government oversight. Charging $15.00 for a $1.25 item which was to pay for something else that was under paid because of regulations and insurance limits on a $15.00 item/process cost with a reimbursement of only $1.25! Hence the $15.00 Aspirin charge.

    I’m sure this is still happening and the burdens forced on the hospitals and doctors is enormous. They have no other options but to work the system as best they can legally if they are going to survive.

    Sole source government controlled health insurance is not the answer. Reduction of, dare I say , liberal intervention by the government and the slews of unrealistic regulations is. Freedom to compete with borderless insurance from multiple insurance companies is, in my opinion, is a step in the right track. Elimination of health tax penalties is another "You pay for our system or we take your money anyway" is just not defenable. A government controlled insurance health care system to me appears to be a step toward a form of government and control we don't want.

    It’s not working... and I believe with the government regulations and political control as ingrained as it currently is… it’s going to be extremely hard to stop this upward spiral of cost.
    Last edited by scadvice; 11-16-2017 at 04:47 PM. Reason: fixed (hopefully) end of para one's sentence

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    Quote Originally Posted by gbent View Post
    Employer paid health insurance was a benefit that came about because of wage and price controls of WW2. Wages were frozen to prevent employees from jumping from one firm to another, possibly disrupting war production. Employers did what they have always done when the government interferes with their business, they find a way around the new regulation. The work around was fringe benefits, of which health insurance was one. "I can't pay you more, but I can give you 2 weeks vacation and health insurance for your family." At that time health insurance was cheap. Medical technology was largely limited to antibiotics. Prescribe a dose and either the patient gets well or they die
    But the change Ziggy is talking about happened much later, eighties or nineties. When I had a young family in the seventies, I had was covered by an employer's health plan which came with a packet of claim forms. I paid the bills for most things, then submitted a claim, and was eventually reimbursed for about 80% of what I paid. Those big bills were scary (I still remember the hospital bill for the birth of my first daughter was $5,000.) Submitted that one quick so the reimbursement check was in hand before the bill was due. Used to really see exactly what everyone was billing, all while wondering just how much the insurance would cover.

    After the kids grew older, I didn't have much exposure to the insurance plans of various employers for other than doctors visits and the like. Then I had a heart attack ten years ago, and everything is different. Everybody bills the insurance directly; weeks later you get a statement that says everybody paid, and you still owe $500. You look at the numbers on the statement and see a $75,000 hospital bill satisfied by a $16.000 insurance payment, but you still want ME to pay $500? How about I give you 20% of that like the insurance company did? Problem is, don't work that way. Impossible to figure out the charges.

    Dennis


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