New health insurance

[Mike Henderson]

You make some good points, Joe. I've thought a lot about whether the "market" could be used to reduce the cost of medical care. There are places where it will work but there are places where it's difficult.

The first requirement is that the consumer needs to be paying for the services. But medical costs can blow up so fast when you have an accident or a serious illness - that's why we buy insurance. So maybe insurance should only cut in after the consumer pays some initial costs.

The second requirement is that the price for services have to be available to the consumers. For some things, like a CT scan, that's easy. But some services are so esoteric that the consumer would not understand what to even look for.

And then the issue of whether the consumer has time to shop. If you have an accident, you need treatment. You can't take the time to determine what services you need and shop those at different emergency rooms. Or you're diagnosed with a serious illness and need surgery. Same problem.

I just don't know if market mechanisms can be fully applied to medical care. They'll work in some cases but not all.

Mike

[Rod Sheridan]

Being a small business owner, I have to pay for my family's health insurance out of pocket.

A $2500 deductible and $5000 insurance premiums is my plan.

I wish all people had to pay for their own health insurance, it would force shopping around for the best medical value. Ex: when we had a last kid back in 2000, two hospitals were $1500 different in their respective ob costs. We chose the cheaper of the two hospitals. My wife doesn't do epiderals, but the hosp brought it into the room and they charged us. Anna called the hospital and said she didn't use it so take it off the bill. Had we had baby insurance, we would not have checked how to save money.

also, her Dr, reduced his fee by $1800 if we prepayed him for his services. we saved over $4000 by paying cash and being diligent and reviewing the itemized expenses.

if the above statement sounds too political, mods, please remove. I was attempting to interject economics into this thread.

joe

Thanks for the information, as a Canadian I'm always on the learning end of the equation regarding health care in the US.

Regards, Rod.

[Greg Peterson]

My brother works for a large, international shipping company. He recently injured himself, off the job, however it was a re-injury of an on the job injury several years ago (lower back). His job is very physical and his injuries are common in the environment there.

He will be unable to work for a while until his back is 100% (as per managements orders). In order to receive his medical benefits he must work a minimum of 80 hours per month. Being a full time employee and having over twelve years at the same job, this has never been a problem.

But now that he is on company disability (they paid him all of his sick time up front in one lump sum - that's the companies idea of disability pay), and he can't work for who knows how long, he will be losing his medical insurance until he can come back to work and put in 80 hours in a month. Of course his wife was unable to join the plan in the first place so she isn't affected.

Now that he really needs the coverage, he is without. No income, no medical coverage. Good luck picking up a private plan that won't exclude his existing condition. Good luck being able to afford any plan with no income.

It is a relatively rare exception when one can shop for medical care. But I suppose we can have EMT's carry a price list with them and let the patient choose which hospital and services they want. Or in my brothers case, he can shop around and see which doctors and physical therapists will allow him to make payments. That ought to be easy enough.

Yeah, health insurance, what a wonderful business.

[Paul Ryan]

UPS is union. It's hard to believe the union would agree to such a contract change.

Mike

That is quite common practice around here for employers to only cover parts of the employees insurance then the employee is responsible for the rest of their coverage along with the entire amount for the rest of their family. My wife is a full time union nurse and we pay a huge amount every month that goes for our family heath care. It increases every year and everytime they sign a new contract. It would be a happy happy day around here if they paid for 100% of heath care for family.

[Mike Henderson]

That is quite common practice around here for employers to only cover parts of the employees insurance then the employee is responsible for the rest of their coverage along with the entire amount for the rest of their family. My wife is a full time union nurse and we pay a huge amount every month that goes for our family heath care. It increases every year and everytime they sign a new contract. It would be a happy happy day around here if they paid for 100% of heath care for family.

What I was trying to say was that health care is a contract issue. The company can't make changes to the coverage unless they negotiate a contract change, and the union is unlikely to agree to that change in the middle of a contract period especially with a company making money.

As you point out, however, when the contract comes up for renewal, everything is on the table, including health care coverage.

Mike

[Joe Mioux]

You make some good points, Joe. I've thought a lot about whether the "market" could be used to reduce the cost of medical care. There are places where it will work but there are places where it's difficult.

The first requirement is that the consumer needs to be paying for the services. But medical costs can blow up so fast when you have an accident or a serious illness - that's why we buy insurance. So maybe insurance should only cut in after the consumer pays some initial costs.

The second requirement is that the price for services have to be available to the consumers. For some things, like a CT scan, that's easy. But some services are so esoteric that the consumer would not understand what to even look for.

And then the issue of whether the consumer has time to shop. If you have an accident, you need treatment. You can't take the time to determine what services you need and shop those at different emergency rooms. Or you're diagnosed with a serious illness and need surgery. Same problem.

I just don't know if market mechanisms can be fully applied to medical care. They'll work in some cases but not all.

Mike

thanks Mike,

re: bold type. This is how small businesses must operate. We have insurance for the big ticket health expenses, but pay out of pocket for the small everyday medical maladies.

Also, I have had a Medical Savings Account for years. I don't use that money for every day medical expenses. It is in a bank account if I need it for a family medical emergency.

I really need to bump it up to around $10K, currently it is around $7k

there are ways around and ways to negotiate reduced medical expenses - sometimes. Other times, no,

[Greg Peterson]

UPS is union. It's hard to believe the union would agree to such a contract change.

Mike

UPS union isn't all it's cracked up to be these days.

[Frank Hagan]

He will be unable to work for a while until his back is 100% (as per managements orders). In order to receive his medical benefits he must work a minimum of 80 hours per month. Being a full time employee and having over twelve years at the same job, this has never been a problem.

If he is in the US he is eligible for COBRA at no more than 102% of the cost of his prior health plan. The problem with this is that he's not working, and as a union member his health insurance cost is likely to be $13,000+ per year. But, continuing the COBRA coverage may help him avoid running into a "pre-existing condition" exclusion when he does go back to work.

[Butch Edwards]

my wife and I pay about $7200 in premiums a year... our deductables are at $3200 out of pocket,meaning, we lay out over 10 thousand dollars a year before the 80/20 ratio kicks in. personally, I'd been better off over the past 30 or so years, to put that premium $$ in a seperate account @ my bank, and paid what medical bills we had from there... I guarantee I'd be money ahead. her insurance is raising the premiums AND the deductable next year, and my ins thru the Gov't has been reducing covereage over the past few years. we're told which Drs we can see IF we want our insuranace companies to pay anything... that goes for labs/ dentists/etc....I realizt that the insurance companies are being raped by lawsuits, the non-covered insured being served at medical facilities(they DO pass the cost along), etc... but it's getting to the point where medical treatment outside of emergencies, is becoming a luxury, not a basic affordable benefit.

[Doug Mason]

I have read some articles that predict that in 10-15 yrs, health insurance provided by employers will be a thing of the past--just as happened with pensions. We are in a global economy--and our employer-paid-health policy is a competitive disadvantage for US companies. Remember, in the US system, capital flows to where the means of production is cheapest (globally)--and most foreign governments provide health insurance (via taxes).

I agree w/this assesment--that employers will drop such insurance. I think it will happen sooner than later. In the big picture, for the 40% of the highly skilled in the US population, it won't matter; but for the other 60% (those less-skilled who are competeing for wages with workers in other countries), the cost will be transfered (directly/indirectly) to the government (and paid by taxes).

[Jeffrey Makiel]

I wish all people had to pay for their own health insurance...

Group plans are definately the enemy of independent plans. Not only do independent plans cost significantly more, the claims are also challenged more.

In New Jersey, 65% of the plans are independent. This is a big issue. And, there are only a couple of providers of independent plans.

IMHO, there is no free market for insurance consumers. And, there is no free market for patients.

-Jeff