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?

 

[swall]

CEL--I am curious (and want to learn more) about your comment that Canada was "founded by loyalists that fled the American Revolution". My recollection of history is that in what was to become the U.S. , there were folks that did not want to break away from Britain. These people were known as "Tories", if I recall. Some may have moved to Canada, then part of Britain. Canada did not become an independent country until roughly the time of the U.S. War Between the States, aka the Civil War. The time between the signing of the Declaration of Independence and the outbreak of the civil war is roughly 80 years. That seems like a long time for a group of Tories to have finally got around to forming Canada.

 

[CELinOttawa]

Well swall, rather like "Irish" Americans or "Italian" Americans, Loyalists have been a rather peculiar lot... It isn't just the ones who left the USA, but their children who count themselves to be "Loyalists". I have a client who is a Loyalist, and they continue to consider themselves to be "Loyalists" generation through generation.

This page has more information that you'll likely care about:

http://www.uelac.org/

I'll warn you this is an old fashioned way of seeing the world which now seems to be finally waining; They aren't exactly tech savvy, and that page shows it.

You're quite right about the "Tory" bit. Pre-rebellion the folks who were most unhappy with the King and country (as it then stood) were the "Whigs". Roughly speaking, the Tories weren't all that happy either - They just did not support taking up arms, but believed that independence or equal representation in the British Parliament could be obtained through negotiation with the Crown. They, or rather their children, were a very prominent force amongst those who did indeed succeed in obtaining independence from Britain in a peaceful manner some years later.

Note that Tories who moved to Upper Canada (now Ontario), Nova Scotia, New Brunswick, etc, provided badly needed professionals and tradesmen. In many ways Canada was a minor outpost before the Loyalists arrived and the founding of the USA forced the British to refocus efforts. We are, to my view, the bastard child of one group's (fairly reasonable) refusal to pay taxes levied in order to pay for a war with France in absence of the right to vote, and another's placing loyalty to one's King (or, at a minimum, to the oath to the King) above all other concerns. Without both the rebels and the loyalists, we would never have existed at all.

Yes this is all a gross over simplification, but it is as valid as any other generalization.

 

[CELinOttawa]

An excellent, simply, Loyalist summary:

http://www.uelac.org/PDF/loyalist.pdf

 

[ornerynorsk]

rconnor - "Leave it to some white, middle-upper class, libertarian male to declare themselves a “slave” because they have to pay into social welfare programs that support the disenfranchised and most marginalized groups in their society. That’s insulting on so many levels."

WOW, are we going there now?!?! Yes, that is insulting, and you owe the forum an apology.

And Yes, coerced participation in social welfare programs can easily be viewed as a form of slavery. How about we look at the real reasons why healthcare is so grossly out of whack in the US to begin with, and is not affordable.

Google - Davy Crockett not yours to give



It is better to have enough ideas for some of them to be wrong, than to be always right by having no ideas at all.

 

[cranky108]

I do agree that coerced participation in any social welfare programs is wrong, but the health care is just the tip of the iceberg, and part of the reason it is so difficult to get out of social welfare trap.
Social Welfare is not just healthcare, but also food, housing, energy, schools, goods, drugs, etc. and part of the problem is some of those people are just free loaders, and don't want to be productive.
I agree some of those people do need help, but the goverment just dosen't do a good job of removing the free loaders from the list of the needy. Also the black market makes it harder to measure real income.

This is why churches were the vehicle for help of the needy. They have people who can take the time to evaluate the needs of the needy.

But forced paricipation in anything is a form of slavery, and we are all becoming slaves of the goverment masters, in the name of the poor.

And no amount of goverment givaways has reduced the people begging on the streets.

 

[beej67]

Fundamentally, I feel we are pretty close to the same core understanding of the issue but our solutions go in completely different directions. We both see the US as an corporate oligarchy and that this has directly caused the healthcare system to not be in the people’s best interest. Your stance, if I can attempt to paraphrase and correct me if I’m wrong, is because of the corporate corruption of the political system, healthcare shouldn’t be controlled by the government (i.e. universal/socialized). Instead, it should be allowed to operate, as much as possible and as closely as possible, directly between the producer and consumer.

Only for the things we can shop for. Not for the things we can't. We can't shop for emergency services, yet emergency services are the primary reason everyone pays insurance. Emergency services should be single payer, paid out of taxes, just like the police and the firemen. I am arm and arm with you on that one. If you don't know what you're shopping for, you can't shop. I can't even shop for insurance properly not knowing whether I'm going to get in a car wreck or have a stroke or none of the above. You can't shop when you don't know what you're buying.

Our system tries to make us shop for emergency ailments in advance. That's dumb.

Then our system obscures our ability to shop for ailments that we could ordinarily shop for. Like cancer or prescription drugs. Equally dumb.

My stance is that the “producers” in this case will, as they always will in a capitalist economy, put profits before creating an equitable healthcare system. That same corrupting influence on our government is now directly, and with less regulation, in charge of the healthcare system.

Only because we're not allowed to shop around. The consumer can vote with his dollars if he knows what he's shopping for. Corrupt and Evil corporations go the way of the Dodo Bird once people are given the choice to spend their money elsewhere. General Motors makes crappy cars, therefore they fail and Toyota grows.

Right now, we don't have any real choice in the matter. And Obamacare is even worse, because those of us who chose not to pay into the pot are now FORCED to buy the flawed, screwed up product, by the very government you want to put in charge of everything.

Even though the government is far from perfect, it is much more accountable to the people than a for-profit hospital or big pharma company.

No it's not. It's not it's not it's not. I can choose not to give a company my money. I cannot choose to not give government my money. And now, with Obamacare, the government is forcing me to give money to the very company you seem to hate so much. I remind you...

Your position, and the position of the whole industry to date, suffers from the two fundamental flaws of nanny state progressivism:

1) People can't be trusted to do what's right for themselves
2) The government can't be bought

Your progressive government is bought. The people you voted for are bought. The head of the FDA is a Montsanto lobbyist. The head of the FCC is a Comcast lobbyist. Obamacare was written by lobbyists. The fundamental underpinnings of progressive nannystateism don't work if the government is bought.

There is no vote I can cast on election day that is for someone who isn't bought.

Now to your two objections to my ideology:
1) I think that people, in mass, will naturally do what’s right for themselves but not what’s right for society. That’s my point.

And government will, in mass, naturally do what's right for the people who bought it, not what's right for society. That's my point. It's been that way since the Sumerians, and it has never changed. You have been duped into thinking that the people you vote for are doing what's right for society, when actually they're just jockeying for insider trading positions.

http://www.npr.org/blogs/itsallpoli...ss-quietly-overhauled-its-insider-trading-law

...and funneling money to the people who donate to their reelection campaigns...

https://www.opensecrets.org/lobby/issuesum.php?id=HCR

...and cutting deals with those same corporations to find fat, high paying lobbyist jobs for themselves when they quit politics...

http://www.opensecrets.org/revolving/

2) I touched on this already but I absolutely agree that government can be bought. However, I still have much more say in how the government works than I do how corporations work.

You do not. You have an infinite amount of say in what a corporation does with your money because you can choose not to give them your money. You have no say in what the government does with your money, because when you go to the ballot box, you are choosing between two bought candidates with different colored shirts on, each of which is going to do the same thing once he gets to Washington, which is take money from lobbyists and then invite the lobbyist to write the laws. You have no say in that.

You have no say in state government either. You have some say in local government, because you can talk to your local representative, and your vote means something to them. Our modern system at a national level simply turns money into votes via marketing tricks. We're a cashocracy. Sweden isn't. That's why you can't do Sweden's system here.

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

http://www.campbellcivil.com

 

[IRstuff]

"The consumer can vote with his dollars if he knows what he's shopping for. Corrupt and Evil corporations go the way of the Dodo Bird once people are given the choice to spend their money elsewhere. "

That's assuming there's no patent protection on the drugs. Up until recently Lipitor was still protected, and you paid whatever the drug company wanted.

"You have an infinite amount of say in what a corporation does with your money because you can choose not to give them your money. "

Not by your lonesome. Unless there's an en masse exodus, the corporations are only beholden to the stockholders. This is well-known and documented. Moreover, corporations rely on the typical consumer being totally lazy, otherwise, 7-11s would go out of business. But, they don't because people are lazy enough to go there and pay double or triple what it costs in a grocery store, because of the "convenience."

Likewise, people shop for doctors by convenience, and they would probably pay a premium for that. This is what makes ERs more attractive than most urgent care facilities; although, there are now more urgent cares that are open 24/7, and they generally have shorter waits.

TTFN
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[rconnor]

beej67, I really enjoyed and agreed with a lot of your post.

Firstly, you still seem to be trying to convince me that corporate money has corrupted politics. You don’t need to convince me (I’ve referenced it before, but I believe Lawrence Lessig’s “Republic, Lost” does a great job explaining the situation. I feel you’d enjoy it beej). However, where we differ is you want to scrap the whole system, I just want to remove the poison. You are using Sweden as an example that is unreachable (I disagree but it matters little) but the UK is much closer to the US in terms of corporate influence in government. While I agree, drastic changes in the American political system are required (speaking of Lessig, see the MayDay campaign), I feel it’s a stretch to say that it is forever doomed.

The consumer can vote with his dollars if he knows what he's shopping for. Corrupt and Evil corporations go the way of the Dodo Bird once people are given the choice to spend their money elsewhere.

This nicely summarizes our second fundamental difference. While I agree this works to control product quality and cost, it does nothing to control the means of production (fair wages, local employment, treatment of workers, environmental impacts, usage of profits, etc.). As I stated:

Mass boycotting of companies on ethically grounds (which is the only “voice” you have in an idealized free-market) is difficult for the average person, especially if the companies costs are lower than competitors (i.e. the Walmart example or why 99% of clothes coming from sweat shops, etc.). People respond to the product, not the means of producing the product. Therefore, while, in theory, an idealized free market should promote cheap, quality products, it has no control (nor does it care to control) the ethical and ecological means of production. This is a problem for me.

I just cannot understand how a producer in an idealized free-market is not the same as a producer in a capitalist economy.

But beyond this, and addressing the third difference, equity is none existent in this picture. All we are talking about is the “efficiency” of the system, not the equity of it. As a producer, if enough rich folk buy my product, I have absolutely no incentive to support the lower class. Quality becomes more and more a premium for those that can afford it. This may be fine for tee-shirts but it is not acceptable for a healthcare system. As a consumer, if I can afford quality, I have absolutely no incentive to support those that can’t. As a few posters have made abundantly clear, they have absolutely no issues with this scenario. I do. I hope that you, beej67, do as well. How does a free market solution, predicated on individual gains, create an equitable system?

So, we share a lot of ground but differ on these three areas:
[ul][li]The government is inherently self-serving, you can fix corporations to be more “for the people”/Corporations are inherently self-serving, you can fix the government to be more “for the people”[/li]
[li]Given choice, consumers will force producers to act efficiently and ethically/Consumers will response to the product but ignore the means of production, Producers will aim to maximize profits over acting in societies best interest[/li]
[li]The free-market will create a more efficient healthcare system/The free-market does nothing to create an equitable healthcare system, in fact it could exacerbate issues of inequality[/li][/ul]

 

[beej67]

"The consumer can vote with his dollars if he knows what he's shopping for. Corrupt and Evil corporations go the way of the Dodo Bird once people are given the choice to spend their money elsewhere. "

That's assuming there's no patent protection on the drugs. Up until recently Lipitor was still protected, and you paid whatever the drug company wanted.

Patents are one of the many ways that government obscures and interferes with the free marketplace. Patents need an overhaul. Five years tops. See above.

"You have an infinite amount of say in what a corporation does with your money because you can choose not to give them your money. "

Not by your lonesome. Unless there's an en masse exodus, the corporations are only beholden to the stockholders. This is well-known and documented.

GM can make cars that explode, but if there's a marketplace (there is) then I can choose to buy a Ford. They make their choice, I make mine, and none of my money goes to the corporation that makes the exploding cars. Simple. That's the free market. If enough people decide they don't want exploding cars, GM goes away. (unless their lobbyists buy the government and in so doing buy themselves a bailout)

I cannot choose to stop paying taxes to the government, even when that government uses them to build bombs that explode, and I cannot influence in any way their choice to go bomb brown people in Iraq even though it didn't do us any good the last three times we tried it. Similarly, I cannot choose what government decides to cover with Medicare, and now under Obamacare I can't even choose not to buy insurance from a private, for-profit company.

Moreover, corporations rely on the typical consumer being totally lazy, otherwise, 7-11s would go out of business. But, they don't because people are lazy enough to go there and pay double or triple what it costs in a grocery store, because of the "convenience."

Likewise, people shop for doctors by convenience, and they would probably pay a premium for that. This is what makes ERs more attractive than most urgent care facilities; although, there are now more urgent cares that are open 24/7, and they generally have shorter waits.

So? Convenience is an aspect of quality. I fail to see the problem with 7-11s, nor with Urgent Care facilities.



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

http://www.campbellcivil.com

 

[beej67]

Firstly, you still seem to be trying to convince me that corporate money has corrupted politics. You don’t need to convince me (I’ve referenced it before, but I believe Lawrence Lessig’s “Republic, Lost” does a great job explaining the situation. I feel you’d enjoy it beej). However, where we differ is you want to scrap the whole system, I just want to remove the poison. You are using Sweden as an example that is unreachable (I disagree but it matters little) but the UK is much closer to the US in terms of corporate influence in government. While I agree, drastic changes in the American political system are required (speaking of Lessig, see the MayDay campaign), I feel it’s a stretch to say that it is forever doomed.

Would you at least agree that big-government progressive policies such as universal single payer healthcare can't work until the prior poison of money-in-politics is fixed?

Growing a broken government before fixing that government just entrenches the brokenness of the government.

Now I contend that power corrupts, and the more power you give government the more likely it's going to be to become corrupted. The more money you push through Washington DC, the higher the ROI is on trying to manipulate government to your own ends. And the higher that ROI climbs, the more lobbyists will descend on DC to try and squeeze more money for themselves or their companies from the public largess. It is inevitable, and the only way to stop it is to starve the beast. You may disagree with that, and I will respect your opinion.

But we should be able to build upon the common ground we do have, that we both realize that government is currently bought. Until it gets un-bought, how can we put it in charge of health care?

This nicely summarizes our second fundamental difference. While I agree this works to control product quality and cost, it does nothing to control the means of production (fair wages, local employment, treatment of workers, environmental impacts, usage of profits, etc.).

I agree. But it's great to control cost, and the problem with our healthcare system is the cost. That's why they oh so ironically named Obamacare the "Affordable Care Act." And that brings us to this:

All we are talking about is the “efficiency” of the system, not the equity of it. As a producer, if enough rich folk buy my product, I have absolutely no incentive to support the lower class. Quality becomes more and more a premium for those that can afford it.

I'm an engineer. When I see a problem, I identify the problem, and I develop a solution to that problem. When a politician sees a problem, they seek within that problem a way to grow government and kick more money back to whoever donated to their campaign.

The problem with health care was rising costs. Costs. Nobody complained about healthcare back when it was cheap because pretty much everybody could afford it, and the ones who couldn't could rely on public safety nets that didn't have to bear such a huge burden. Cost is what broke everything. Cost.

So what happens when the problem, Cost, gets put in the hands of politicians? We get a bill that does nothing to address cost, and does everything to expand coverage. Obamacare wasn't a cost bill, it was a coverage expansion bill. Their solution to the cost problem was to make everything more expensive and then force everyone to buy it.

Seriously.

Think about it.


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

http://www.campbellcivil.com

 

[cranky108]

Isen't it strange that we have all of these mandated safety measures in cars to reduce injury, yet the cost of the (assumed) fewer injury's is higher?
Did the mandates some how expose the problem is too many hospitals? Or that hospitals can't control costs in the face of (assumed) reduced number of injurys?

Just maybe we have too much health care?

 

[IRstuff]

"Isen't it strange that we have all of these mandated safety measures in cars to reduce injury, yet the cost of the (assumed) fewer injury's is higher"

The simple answer is that people are surviving the more severe collisions that would have killed them outright 20 years ago, both because the cars are more robust, and the emergency services do a better job of keeping victims alive in the "golden hour." This is corroborated by the fact that US soldiers fighting the last 3 wars are returning with more severe injuries that would previously have resulted in a combat death. That's one reason why VAs are swamped with more disabled vets than ever. Traumatic brain injuries (TBIs) are now survivable because of the better helmets, but the result is life-long mental and medical care costs.

So, not strange at all. It's essentially an unintended consequence of raising the threshold for causing a fatality.

TTFN
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[cranky108]

The disabled care I would think is mostly out patient, which can happen in less expencive facilities (assuming they don't need MRI's, and rooms etc.). So while the cost in the long run should be higher, the cost of the additional services should be in a more competive facility.

So that's what is driving the long-term disability insurance rates, and the fact that people don't want, or can't take of there parrents.

Just think that all this has led to more demand, so adding more demand on top of this is just going to increase costs. However, this is not the same as the hospital issue, as hospital stay rates seem to be on a downward trend.

 

[IRstuff]

Hospital stay rates tend to be driven by insurance companies; a pregnancy with no complications only allows for one night of stay after delivery. The hospital will push you out because they won't get reimbursed by the insurance.

There are a lot of things that drive the short term costs through the roof. A single premature baby can generate both increased delivery and NICU costs as well as long-term disability costs.

TTFN
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[glass99]

Its not clear to me why places like the NICU are as expensive as they are. Yes they have a bunch of fancy equipment, but my conspiracy theory is that the really big expense of hospitals is are the administrators, and that overhead gets lumped into the NICU. The fancy equipment just creates the appearance of value.

 

[beej67]

glass99 -

https://www.youtube.com/watch?v=NcHdF1eHhgc

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

http://www.campbellcivil.com

 

[glass99]

beej67: Brilliant! Its like the Monty Python guys had a crystal ball.

 

[Tunalover]

When I got laid off in 2007 my COBRA coverage was $1650/mo for the family. It was nearly as high as our mortgage! Does this seem high even seven years later, for BCBS coverage? Excellent Monty Python spoof on healthcare BTW beej67!



Tunalover

 

[glass99]

tunalover: $1650/mo for a family plan is about right in 2014 (its what I pay), but high for 2007 which should be more around $1200 for an HMO. Its even a little bit more appalling than what the cost should have been.

 

[Tunalover]

glass99 of course there never is a way to confirm that COBRA recipients are REALLY paying only the cost of the plan.

Tunalover