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?

 

[IRstuff]

The only difference between self-insuring and a normal insurance is who gets to hold the money, and who manages claims and risks. For a given coverage, the risk pool is still about the same, less the insurance company profit and skim. The advantage for a large company for self-insurance is that they could potentially still use the money for funding ongoing operations, as opposed to forking over the premiums and letting the insurance company play with the cash.

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[glass99]

Health insurance companies only pay out 80% of premiums in claims, so there is a decent margin to play with in respect to self insurance. If I were an MBA rather than an engineer, I would offer consulting services to big companies to help them administer their in house health insurance. If you take a 10,000 person company who pays $10,000 per year per staff member, they are spending $20MM per year on health insurance OH+P, which could be a consulting fee instead!

 

[TenPenny]

For a company, the advantage to using an insurance company over self insuring for health coverage is that it makes for a 'disinterested' third party who is responsible for denying claims. If you are self insured, any time a claim is denied, the whining and complaining will start, someone with a denied claim will hold a grudge, become a grumpy employee, etc etc. It's 'cleaner' to be able to blame an outside force for any problems.

(I know that the insurance company is not actually disinterested, in fact they have a stake in denying claims, but the point is there.)

 

[glass99]

TenPenny - yes, you are right that there is a significant hassle factor in administering health plans, including having to play the bad guy. This is going to be offset by the elimination of some of the more grating requirements of traditional insurers, like having to go to a general practitioner before you are allowed to see a specialist.

 

[beej67]

The real benefit for a large company self-insuring is that they can narrow the pool of folks sharing the cost by not hiring unhealthy people.

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[JohnRBaker]

"...they can narrow the pool of folks sharing the cost by not hiring unhealthy people."

And here we have ONE MORE REASON for moving to a single-payer health care system not dependent on your employement status.

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[glass99]

If Hillary wins in 2016, are we going to get a single payer system?

 

[JohnRBaker]

By then I'll be on Medicare, but I've got three sons who could benefit from it.

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

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

 

[beej67]

...they can narrow the pool of folks sharing the cost by not hiring unhealthy people."

And here we have ONE MORE REASON for moving to a single-payer health care system not dependent on your employement status.

OR we have one more reason to make people responsible for their own burdens.

Hydrology, Drainage Analysis, Flood Studies, and Complex Stormwater Litigation for Atlanta and the South East -

http://www.campbellcivil.com

 

[IRstuff]

"If Hillary wins in 2016, are we going to get a single payer system"

Not likely, given the relatively even political split in Congress, made worse by the religious-like fervor in branding the opposing political party as "un-American" or worse.

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[glass99]

There are two potent political forces on the landscape right now pushing for single payer - one is senior citizens, the other is women. Both constituencies are on the march right now, both want a single payer system pretty bad. Just look how quick the Republicans dropped their opposition to same sex marriage, basically under pressure from women. It was Blitzkrieg.

 

[JohnRBaker]

OR we have one more reason to make people responsible for their own burdens.

How do you explain that to someone born with a congenital condition, such as Type 1 diabetes? Or someone like my wife, who when she was a child contracted hepatitis through no fault of her own? What about people suffering from the long term effects of a childhood accident or a wounded veterans when they try to move back into the workforce after serving their country?

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

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

 

[swall]

Glass99--Medicare already is single payer. Why would senior citizens be characterized as "pushing for single payer"? I also question the "Women are pushing for it" comment. We have professional women, covered by various employer plans, unionized women workers already covered by plans, poor women already covered by Medicaid and the "Somewhat Affordable Healthcare Act" that the rest would be eligible for.

 

[glass99]

swall: At a minimum senior citizens are protective of the medicare benefits they have, and are always pushing for more. Old folk get quite emotional when you try to take their doctor away. Women have a much greater enthusiasm for going to the doctor than men. For all the husbands out there - how many times have you been to the doctor or dentist only because your wife made you? I will have to dig it up, but I have seen a poll showing a substantial majority (~two-thirds) of women support for single payer healthcare. A senior citizens plus women coalition would be pretty much unassailable by even the most biased media or powerful corporate interest.

The other constituency for single payer are the 50 and 60 something white and blue collar workers who have slightly out of date skills and are worried about getting laid off. How long would your savings pay for COBRA? 20 and 30 somethings either don't care or are more liberal.

The only constituencies really for the current private heavy system are men in their 40's with good jobs because they don't want to get lumped with paying for everything, and doctors who like getting paid $300k/yr.

 

[beej67]

Hey, single payer would be great for small businesses. Wouldn't have to fool with Obamacare. But it would be a pretty big disaster overall once the lobbyists realized they could buy off the government to get unnecessary stuff covered. Costs > infinity.





Hydrology, Drainage Analysis, Flood Studies, and Complex Stormwater Litigation for Atlanta and the South East -

http://www.campbellcivil.com

 

[IRstuff]

"But it would be a pretty big disaster overall once the lobbyists realized they could buy off the government to get unnecessary stuff covered. Costs > infinity."

Amusing, but the costs are already pretty much near infinity. According to:

http://www.forbes.com/sites/danmunro/2014/02/02/annual-u-s-healthcare-spending-hits-3-8-trillion/

we're spending about $13,000 per capita already. That's at least double the annual premiums for a typical single-person insurance package. Given the median household income of about $52,000, we are, on average, as a country, spending more than our yearly salaries, so there's already a truckload of subsidization going on.

Going to single payer might actually drop the costs.

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[davefitz]

An efficient and effective single payer system would likely have an impact on other areas of society- more women would likely prefer to stay at home as opposed to going to work to obtain insurance coverage, and many workers would retire earlier and leave open more employment spots for younger workers that are currently unable to enter the workforce. If the insurance was paid from a national VAT ( also imposed on all imported goods and services) it would also help share the cost of government with overseas mfr's, who currently pay no share of this cost.

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

 

[glass99]

For the current private system to survive the costs are going to have to come down - at some point it becomes irrational to pay double what the rest of the world pays. The only way I can see cost control happening is though technological innovation. Elizabeth Holmes, do you have any other ideas?

 

[KENAT]

glass99 - seriously with the way things work you expect technological innovation to bring down cost in the current US system?

Historically it seems in healthcare technological innovation often increases cost. This is because rather than using technology to do the same thing better & cheaper, it often plays a role in doing things they just couldn't before i.e. conditions where there was once minimal treatment options now have treatments that cost tens or even hundreds of thousands of $ per patient.

A big factor in growing health care costs regardless of how it's payed for or organized is just that the medical condition can do more and more and more then they could a few years ago and that 'more' ends up meaning more $.

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[KENAT]

Make that "the medical condition profession can do more and more and more than they could a few years ago and that 'more' ends up meaning more $

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