Health Care Premiums

[PTI Anon1640710541]

my oversimplified fix is to only offer catastrophic plans. like, $10k high deductible that pays for nothing. the consumer actually has the power/interest to negotiate and costs become transparent.

if you look at elective procedures NOT covered by insurance (eye surgery, plastic surgery), those have actually become less expensive. more competition, more transparency = lower prices.

 

[kyhusker2]

If I went through my employer's plan, a PPO for family coverage would be $1909.13/month.

I have a high ded. plan/HSA just for myself and pay $156/month with a $3,000 ded. Haven't been informed about the cost for next year yet.

 

[ky8335]

Americans are foolish to have ever thought that a Democrat in office would save them money. However when it comes to free health care it's good that all these illegals will be covered for free.

Health care insurance is the biggest disgrace in America and always has been. A family of 3 paying 1000.00 a month is the future if you don't get these Dem. Out of office.

Pass tort reform like most countries and health insurance will drop like a rock but that requires getting the ABA out of the health care business and American politics.

http://www.statesman.com/news/news/local/new-study-tort-reform-has-not-reduced-health-care-/nRpcp/

http://westvirginia.legalexaminer.c...-health-care-costs-or-improve-patient-safety/

I don't think tort reform is going to lower our costs. It'll just lower what insurance companies pay out. If you think they will pass those savings on to you, you'll be in for a surprise. The people who own insurance companies push for tort reform and want you to push for it too. But it won't save you any money.

Neither will forcing us all to purchase something from a non-competitive marketplace. There just aren't enough options to drive prices down. At least not yet. And until the people who have always gone to emergency rooms start going in to a regular doctor's office for more preventative care the costs won't go down. It's still insurance and a numbers game. We still have to wait and see a change in the actuarial tables.

 

[qwesley]

Tort reform is not a magic cure but it does involve more than insurance premiums. And I not sure insurance companies really care about the issue as they just adjust. The big money saver could be few tests ran as ultra-precautionary cya.

Way down the list on most pressing issues tho for sure.

 

[Big_Blue79]

They have kicked you to . . . you.

Tax law says otherwise. A functioning, healthy insurance market wouldn't have us tied to whatever few options our employers give us. Instead, we should be paid money and purchase health insurance in the market, just as we do for almost every good and service we buy. But because of the tax code and WWII wage freezes, we accidentally fell into a situation with no real competition, few choices, and perverse incentives (tax). ACA just made it worse.

 

[Big_Blue79]

There just aren't enough options to drive prices down. At least not yet.

What if instead of being handcuffed by your employer's choices all working people had to purchase their own healthcare (and receive the tax break and compensation that employers now devote to health insurance for employees)? I feel like that might stimulate competition, with all the attendant benefits.

 

[crazyqx83_rivals88013]

Tax law says otherwise. A functioning, healthy insurance market wouldn't have us tied to whatever few options our employers give us. Instead, we should be paid money and purchase health insurance in the market, just as we do for almost every good and service we buy. But because of the tax code and WWII wage freezes, we accidentally fell into a situation with no real competition, few choices, and perverse incentives (tax). ACA just made it worse.

You sir, are making too much sense.

 

[KopiKat]

Yeah but it's the effing democrats that fight any change to ss. Remember the ad of the republican pushing grandma over a cliff?

I would have loved to be able to opt out of ss and invest that money myself but the dems want no part of that.

And even tho most changes to ss wouldn't affect current retirees, the dems try to use it to scare them into voting for them. And it works.

that is the general message from liberals, democrats, and what they have become in their heart of hearts, socialists: attempt to change any program that WE control and you will perish. Meanwhile, they will also sell you this message: In order to "take care of you" we must be allowed to alter in any way we see fit any private / commercial program that YOU control.

Citizens WILL have less control of their lives, less ability to determine how to care for themselves, poorer overall quality of care, and at greater costs, etc., etc., etc., the more the govt. is allowed to control these things. This is fact. If you support it, then one of three things describes you: (1) you have never achieved or never attempted to achieve to a sufficient level adequate for taking care of yourself, (2) you are in a unique situation that excuses you from the ordinary ranks of expected productive citizen (seems like more than 50% of the population manages to weasel into this category somehow) or (3) you are an inept thinker.

 

[P.PattersonISwalkingthruthatdoor]

my oversimplified fix is to only offer catastrophic plans. like, $10k high deductible that pays for nothing. the consumer actually has the power/interest to negotiate and costs become transparent..

I'm not sure how effective individual patients will be with negotiating prices; health insurance conglomerates have enough trouble with that as it is. However, I think a "catastrophic plans" strategy is reasonable as long as we divorce some of the most fundamental elements of preventive care from the idea of health insurance itself. After all, "health insurance" itself is a bit of a misnomer since many/most people consistently treat it more like a gym membership than an auto insurance policy.

Things like vaccinations, a few specific cancer screenings, primary prevention of heart attacks/stroke, and a couple other unique birds are needed by almost every single American and have a cost:benefit ratio so skewed that it's a bit ridiculous to tie it to the idea of "insurance". Furthermore, people are unlikely to pay OOP sticker price for some of those things despite it making so much financial sense when you take it to the population level.

 

[jtrue28]

This thread took the most obvious turn that we all knew it would take.

opcorn:

 

[BlueKel_rivals210266]

Insurance premiums were going up, and deductibles/co-pays were increasing many many years before ACA. Healthcare is an expensive business.

It is interesting listen to people ***** about costs. I had a kidney stone a couple years ago (my 7th I believe). For the first time, I had to have surgery. So, there emergency room bills, medicine bills, doctor bills, outpatient surgery, anesthesia bills, etc. I think it all ended up being $11K to $12K. Absent of insurance, agreed upon provider fees, etc, I would have probably been out of pocket $20K+. Instead, I had my High Deductible Plan premiums (let's say $1200 per year), and 20% copays up to an individual out of pocket of $2500 or so.

The insurance is not the problem, at all. It's the crazy cost of healthcare. I'm not sying it is wrong, just that it is expensive. I think PTI noted earlier that the system is set up for a lot of wasted spending. But think about the costs. MRI machines and things are upwards of 7 figures. I think most nurses make $50K+, with some pushing 6 figures. Doctors aren't cheap, nor should they be.

I offer zero solutions, but bitching about health insurance premiums and the ACA is not targeting the right problem. (FYI, I work in insurance, but NOT health insurance at all)

 

[crazyqx83_rivals88013]

Fun when you make 50% more than the median household income in this country but are having to explain to your broker that you can only afford to pay in the range of the bronze ppo or super restrictive silver hmo/hsa.

 

[JDHoss]

My wife and I each have our own coverage (cheaper than the 2 person or family plan that way) through our employer. It's $40 a payday (guess that would be $160 a month for both) with a $1500 deductible and $3000 out of pocket max. We can (and do) contribute to an HSA, and if we meet a few requirements such as getting our screenings and make a few improvements such as weight loss, cholesterol, glucose, etc. we get a $1000 bonus from our employer. A few questions I have about the industry:

* Is advertising to the tune of $4.5 billion necessary for the pharmaceutical industry?

* My FIL got sick while on vacation and had to be admitted to ICU. We drove down to check on him and when we pulled into the parking lot, if hadn't been for the sign as we turned in, I would have sworn we were at a 5 star resort hotel instead of a hospital. Do new(er) facilities really need several million dollars worth of landscaping, fountains, babbling brooks, and a lobby that would rival any upscale hotel? There's also a hospital about 15 miles from me that is an absolute ****ing palace.

* With lobbying from the healthcare industry (pharma/insurance/etc) approaching 9 billion a year, why would anyone in their right mind consider this a lib/con issue when both GD sides are getting their pockets greased?

 

[crazyqx83_rivals88013]

My wife and I each have our own coverage (cheaper than the 2 person or family plan that way) through our employer. It's $40 a payday (guess that would be $160 a month for both) with a $1500 deductible and $3000 out of pocket max. We can (and do) contribute to an HSA, and if we meet a few requirements such as getting our screenings and make a few improvements such as weight loss, cholesterol, glucose, etc. we get a $1000 bonus from our employer. A few questions I have about the industry:

* Is advertising to the tune of $4.5 billion necessary for the pharmaceutical industry?

* My FIL got sick while on vacation and had to be admitted to ICU. We drove down to check on him and when we pulled into the parking lot, if hadn't been for the sign as we turned in, I would have sworn we were at a 5 star resort hotel instead of a hospital. Do new(er) facilities really need several million dollars worth of landscaping, fountains, babbling brooks, and a lobby that would rival any upscale hotel? There's also a hospital about 15 miles from me that is an absolute ****ing palace.

* With lobbying from the healthcare industry (pharma/insurance/etc) approaching 9 billion a year, why would anyone in their right mind consider this a lib/con issue when both GD sides are getting their pockets greased?

More great questions.

 

[Btothe4th_rivals376930]

It's not going to get better. As the ACA rules fully kick in you guys with your "cadillac" policies are one bad claims year away as a group from seeing huge increases in premium.

Its becoming more and more apparent that moving forward your elected supplemental coverages will play a much bigger role. The days of getting dental and vision being important are behind us, you had best be signing up for critical illness or the out of pocket maximum will eat you.

 

[CatDaddy4daWin]

Yeah but it's the effing democrats that fight any change to ss. Remember the ad of the republican pushing grandma over a cliff?

I would have loved to be able to opt out of ss and invest that money myself but the dems want no part of that.

And even tho most changes to ss wouldn't affect current retirees, the dems try to use it to scare them into voting for them. And it works.

Oh you mean like this one from Democrats...err Republicans

 

[P.PattersonISwalkingthruthatdoor]

* Is advertising to the tune of $4.5 billion necessary for the pharmaceutical industry?

* My FIL got sick while on vacation and had to be admitted to ICU. We drove down to check on him and when we pulled into the parking lot, if hadn't been for the sign as we turned in, I would have sworn we were at a 5 star resort hotel instead of a hospital. Do new(er) facilities really need several million dollars worth of landscaping, fountains, babbling brooks, and a lobby that would rival any upscale hotel? There's also a hospital about 15 miles from me that is an absolute ****ing palace.

* With lobbying from the healthcare industry (pharma/insurance/etc) approaching 9 billion a year, why would anyone in their right mind consider this a lib/con issue when both GD sides are getting their pockets greased?

 

[mdlUK.1]

Oh you mean like this one from Democrats...err Republicans

Never saw that one,. Not saying it didn't play on TV but I never saw it. Maybe an Internet ad? Sure saw the lib/dim version first and often! And if you're trying to say the dims don't try to scare old people all the time, you're nuts.

 

[Big_Blue79]

My wife and I each have our own coverage (cheaper than the 2 person or family plan that way) through our employer.

* My FIL got sick while on vacation and had to be admitted to ICU. We drove down to check on him and when we pulled into the parking lot, if hadn't been for the sign as we turned in, I would have sworn we were at a 5 star resort hotel instead of a hospital. Do new(er) facilities really need several million dollars worth of landscaping, fountains, babbling brooks, and a lobby that would rival any upscale hotel? There's also a hospital about 15 miles from me that is an absolute ****ing palace.

Good post. My wife and I keep separate coverage - it would cost about ~$200/month more to put her on my better plan. Not worth it. Again, your tax laws at work. I bundle home and auto (well, when I had a car, and a house) for savings, but I can't bundle my wife and I together because there are no competitive, non-employer sponsored plans. Hope you like what your employer offers.

My wife had shoulder surgery a couple of years ago at the Hospital for Special Surgery in NYC. Despite some incompetence on their end (doctor in network, hospital in network, anesthesiologist in network, but they assigned an out of network surgical assistant leading to months of haggling over the bill), the hospital made out all right - they got paid. They're getting by just fine; it's a well appointed hospital. But they're starting to rival my law school on the frequency of their money begging. Happy Thanksgiving card, on nice stock, and oh by the way did you see this handy form for donating to HSS? Won't you consider being an angel and donating? You got great care at HSS, donate today so others can do the same. F. Off.

 

[P.PattersonISwalkingthruthatdoor]

(doctor in network, hospital in network, anesthesiologist in network, but they assigned an out of network surgical assistant leading to months of haggling over the bill)

that is spectacular.

filed away for future reference.

 

[mrhotdice]

Tort reform is not a magic cure but it does involve more than insurance premiums. And I not sure insurance companies really care about the issue as they just adjust. The big money saver could be few tests ran as ultra-precautionary cya.

Way down the list on most pressing issues tho for sure.

This is not debatable if you just look at the health care cost in every country which has limits put on the amount that the consumer can get in court. I saw the other day the cost of not just health insurance but the cost of malpractice is so much lower. If I remember, the example they give was two surgeons, one in Miami and the other in Canada.
U.S. Doctor was paying almost 300,000 a year while the Canadian doctor was between 10,000 and 25,000 depending on which province they lived.

Americans have been hoodwinked into accepting what they are told by the AMA, aBA, and the drug industry. Here in Taiwan were I live, the cost of my insurance is 75.00 a month and 5 U.S. Dollars a visit. Cost of drugs is zero. Now many say that the cost of social medicine has to many limitations and from my experience here, that is total BS. Most doctors here are American trained, but they do not practice the way the U.S. Doctors operate. One, they just have normal offices, no leather couches, the point is they see patients, 50-100 a day. If you need a spec, they send you to one usually at a government hospital that is usually when you tell them you can go or if needed, the next day. I see no one here in Taiwan who doesn't have health care.

Another thing is how old age is treated here. Basically their is no rest homes here. When you get old, you stay in your home and your family will hire a health professional to take care of you like a health maid. Here, a registered nurse from the Philippines cost 600.00 dollars a month, that 24 hours with your parents.

You see, health care is not important in USA, only profits where in most countries health care is considered part of being their citizen.

A family paying as much as some on here say might as well just be robbed.

 

[WayneDougan_rivals170043]

Here, a registered nurse from the Philippines cost 600.00 dollars a month, that 24 hours with your parents.

$600 a month? We call that slavery in America, son. Keep your third world indentured servant ideas out of here.

 

[WayneDougan_rivals170043]

Here's a thought on malpractice. The consumer should purchase it and it should be blind to the doctor. I came up with this when thinking about the Three's Company guy (John Ritter) who died of a heart issue. His wife sued the hospital for like $14M partly because that represents his income stream. I guarantee the cost of his procedure was the same as mine, yet the malpractice I could possibly receive is much lower than his, so I am in a sense subsidizing the wealthy's insurance settlement.

Further, and more importantly, you should be able to waive your right to malpractice in order to cut costs.

 

[mrhotdice]

$600 a month? We call that slavery in America, son. Keep your third world indentured servant ideas out of here.

I'm not your son and you are just foolish. Only a foolish person would call Taiwan a third world country. Maybe you need to travel a little. And since you know nothing about the Philippines, a Reg. nurse their makes 250.00 a month. Maybe that is why their are so many philippinos work all over the world in health especially in UAE, Dubai, Singapore, Hong Kong, and all over Europe. I guess these are third world countries as well.

Wake up USA.

 

[WayneDougan_rivals170043]

I'm not your son and you are just foolish. Only a foolish person would call Taiwan a third world country. Maybe you need to travel a little. And since you know nothing about the Philippines, a Reg. nurse their makes 250.00 a month. Maybe that is why their are so many philippinos work all over the world in health especially in UAE, Dubai, Singapore, Hong Kong, and all over Europe. I guess these are third world countries as well.

Wake up USA.

Listen here, son. First, I was referring to the Phillipines when I said third world. Second, you are advocating bringing in people to the US to work for sub-minimum wage wages. Not only would this displace domestic workers, but it also establishes a true second class of people in America. What the hell is the matter with you? Dollars to donuts you are a baby boomer.

 

[UKserialkiller]

I like calling my doctor "Michael". ~Sacrasm

Pay $$$$ for a PA. "You got a head cold"

 

[Chuckinden]

that is spectacular.

filed away for future reference.

Similar thing happened to me. I had to go to the ER, second time in my life, hospital in my network, but the ER doctor was "filling in" and wasn't in the network. Got a bill for over $1600. After fighting it to no avail, I read my policy and found that any emergency is paid for in or out of network. They told me to forget it that it would taken care of.

 

[3 fan_rivals214492]

Pass tort reform like most countries and health insurance will drop like a rock but that requires getting the ABA out of the health care business and American politics.

I realized you were a fool when you argued for tort reform. Tort reform may be the dumbest idea since NAFTA

 

[AlbanyWildCat]

NO changes to my health care coverage from my (great) employer ...

High Deductible Family Plan

• $84 twice a month
• $3000 deductible, $6000 max OOP
• Employer contributes $1000 to my HSA; I contribute $2500;
• Close to $10K in the HSA and will stop my contribution after this year.
• Kids go to the doctor when sick, wife and I not so much; also leverage tele-doc type services when a prescription is needed to help control costs.

 

[crazyqx83_rivals88013]

NO changes to my health care coverage from my (great) employer ...

High Deductible Family Plan

• $84 twice a month
• $3000 deductible, $6000 max OOP
• Employer contributes $1000 to my HSA; I contribute $2500;
• Close to $10K in the HSA and will stop my contribution after this year.
• Kids go to the doctor when sick, wife and I not so much; also leverage tele-doc type services when a prescription is needed to help control costs.

I think we've established that corporations provide great health coverage since me and other taxpayers are subsidizing it through tax breaks to you and your employer. A similar plan is nearly 3x as much for me. Why don't you meet me in the middle (as it should be)...

 

[AlbanyWildCat]

I think we've established that corporations provide great health coverage since me and other taxpayers are subsidizing it through tax breaks to you and your employer. A similar plan is nearly 3x as much for me. Why don't you meet me in the middle (as it should be)...

Was only responding to the OP...yes, my company does provide great benefits, but the marketplace is very competitive for employees.

Healthcare has been a mess forever and will continue to be. I'll leave it at that.

 

[PTI Anon1640710541]

I think we've established that corporations provide great health coverage since me and other taxpayers are subsidizing it through tax breaks to you and your employer. A similar plan is nearly 3x as much for me. Why don't you meet me in the middle (as it should be)...

3x as much? How do you figure???

I just looked on healthcare.gov, and the price was about $230 for a 37 year old. At 57, it's about $450.

Albany is paying $170, and gets another $83 tax free via HSA. I don't think your math, or your common sense, is adding up.

 

[crazyqx83_rivals88013]

3x as much? How do you figure???

I just looked on healthcare.gov, and the price was about $230 for a 37 year old. At 57, it's about $450.

Albany is paying $170, and gets another $83 tax free via HSA. I don't think your math, or your common sense, is adding up.

He said it was a family plan. (Learn to) read again.

 

[WayneDougan_rivals170043]

Tort reform would be a good thing. Bonk your head and go to the ER, you will be getting a CAT scan because they are scared to death about getting sued.

 

[BlueRaider22]

We've had a few foreign Dr's and PT's that come to our practice for wks to learn how we provide healthcare. We often discuss healthcare from their home countries. A lot of them are just atrocious. One that sounded interesting was Argentina.

In Argentina there is a gov't supplied coverage plan. It's a crap plan, but it does enable coverage to almost all citizens. It's not uber expensive to the gov't because it's such a poor coverage and most opt out of the plan. The majority of citizens are free to shop around for their own plans. Employers rarely provide health plans.....as it is up to the individual to get their own. Because it is in the hands of the individual to shop around, coverage plans are far cheaper. They mention that their healthcare plans are usually a similar price to their car insurance.

 

[Lexie's Dad]

PTI is right - demand needs to be dampened.

However, I haven't seen anyone address supply (apologies if I missed it). It needs to be increased - keep provider standards high, but eliminate barriers to entry with more schools and tort reform. Supply and demand is simple, but it works.

 

[P.PattersonISwalkingthruthatdoor]

PTI is right - demand needs to be dampened.

However, I haven't seen anyone address supply (apologies if I missed it). It needs to be increased - keep provider standards high, but eliminate barriers to entry with more schools and tort reform. Supply and demand is simple, but it works.

there's been a huge push in the ARNP and PA arenas over the past decade or so. A lot of primary and urgent care is provided by those two types of mid-levels, as is nocturnal cross-coverage.