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People Lose Their Employer-Sponsored Insurance Constantly

peoplespolicyproject.org

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Re: People Lose Their Employer-Sponsored Insurance Constantly

#151

Post by ppseafield »

ThrustVectoring wrote: post #133
u801e wrote: post #63

Earlier quoted context omitted.

I've always wanted to add a clause to those consent forms stating that my consent is conditional to the provider being in-network for the insurance information I provided the hospital. It is their responsibility to make that determination before they start treatment. If they provide treatment and find that they're not in network, then they forgo the right to bill for that service.

A great alternative strategy is to structure your finances so that it's impossible for creditors to seize your assets - that way, your practical liability is limited to the up-front costs. Which, by being up-front, you can actually reason about and make informed decisions on. This is less difficult than it sounds. Move to Texas, and keep all your assets in retirement accounts, home equity in your primary residence, a…

I wouldn't describe that strategy as great. Having a desired effect, sure, but the tradeoffs are pretty nasty. And doesn't it create potential situations where you require a lawyer? And what if the laws in Texas change, what then?

Wouldn't it be easier instead for healthcare billing not to contain so many gotchas?

Re: People Lose Their Employer-Sponsored Insurance Constantly

#152

Post by pnutjam »

sairahul82 wrote: post #71

The fundamental problem is no body knows the cost of anything beforehand. Neither insurance company not doctors tell the cost of the care. Its really frustrating ! The first step to fix the problem is getting the cost of the care transparently. Without this i am not sure how any of the scheme works whether it is done by govt or private insurance companies !

This also translates to the cost for labor. How much your company is paying for insurance seems to have little correlation to how good your insurance is, so Company A could be paying an extra $5k per employee because they don't have a good HR department.

It also means that every job offer has to be examined not only for salary and culture, which are usually pretty easy to see; but also benefits cost. I've had offers that were an over 20% raise which would have all been eaten by insurance costs. I've looked at my "benefits cost breakdown" at similar companies only to see that one is paying $90k for me and one is only paying $70k, on similar salaries of around $60k.

These insurance costs are not something usually shared outside the company, and they are hard to get until the last stages of your job offer.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#154

Post by henrikschroder »

ThrustVectoring wrote: post #147
henrikschroder wrote: post #142

Earlier quoted context omitted.

> A great alternative strategy is to structure your finances so that it's impossible for creditors to seize your assets It is absolute insanity that this is even a thing to consider. The funniest thing about it is that if you do this, you are effectively socializing your personal losses and letting everyone else insured through your provider bear the cost for your healthcare. If that's not an argument for actually so…

If I could cap my downside risk from medical events through insurance, I would do that instead. And this is not a replacement for insurance, since many medical providers will refuse to provide non-emergency care if they didn't expect that they could bill my insurance for services rendered. But, unfortunately, it's currently impossible to set a maximum price you could wind up owing due to receiving medical care. Any p…

> But, unfortunately, it's currently impossible to set a maximum price you could wind up owing due to receiving medical care.

Of course, because demand for healthcare is infinite, so you could wind up costing the insurance company an infinite amount of money. And if their expenses are uncapped, they're not going to cap how much you can pay them.

And if they cap their expenses on your behalf, it's not really insurance, it's just a shitty payment plan.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#155

Post by ThrustVectoring »

ppseafield wrote: post #151
ThrustVectoring wrote: post #133

Earlier quoted context omitted.

A great alternative strategy is to structure your finances so that it's impossible for creditors to seize your assets - that way, your practical liability is limited to the up-front costs. Which, by being up-front, you can actually reason about and make informed decisions on. This is less difficult than it sounds. Move to Texas, and keep all your assets in retirement accounts, home equity in your primary residence, a…

I wouldn't describe that strategy as great. Having a desired effect, sure, but the tradeoffs are pretty nasty. And doesn't it create potential situations where you require a lawyer? And what if the laws in Texas change, what then? Wouldn't it be easier instead for healthcare billing not to contain so many gotchas?

>And doesn't it create potential situations where you require a lawyer?

Sure, but improving your BATNA helps your negotiations even if you don't need to exercise it. The bill gets handled with opening a dispute and sending a "give me documentation for an implied regulatory complaint" letter. If things devolve into a lawsuit or threat thereof, I tell them my financial situation and what they can expect from a lawsuit and offer to settle for a nominal amount.

>Wouldn't it be easier instead for healthcare billing not to contain so many gotchas?

Well yeah, but I can't change the healthcare billing system, while I can change how my finances are structured.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#156

Post by briffle »

arcticbull wrote: post #86
ummonk wrote: post #57

Earlier quoted context omitted.

That actually sounds like the high deductible plan is functioning as it should though. Causing consumers to price-shop and avoid price-gouging providers.

I'll be sure to let the ambulance driver know after a car accident they should shop around :\ Maybe an Ayn Rand medicalert bracelet would help. Allergy: Socialism.

In our area, its becoming popular for the hospital (the only one in our area) to be in network, but the doctors who work in that hospital are NOT in our network.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#157

Post by arcticbull »

krapht wrote: post #116
arcticbull wrote: post #90

Earlier quoted context omitted.

IMO the biggest problem is that you're not really qualified to judge medical practitioners. How am I supposed to know if what they're recommending is actually necessary? The market price of an MRI? How do I know they're not skipping care I should have to offer a lower price? Or if they're offering unnecessary procedures? The reality is you need an M.D. to make a reasonable evaluation. This is why at an HMO we have pr…

Same way you evaluate developers. Say you are a manager at a company who needs to hire somebody to develop an application for you. You aren't technical. You have no idea if you need the thing the consultant is saying you need. So you check completed works, existing client testimonials, educational history, recommendations from coworkers or friends, etc.

Just wait until you get a reference request on your last colonoscopy :P

Seriously though in general managers have worked in and around technical people before, and their role in the process is to evaluate qualitatively. Are they a good communicator? Do they seem like awful people? They use feedback from the engineers to estimate if they're good engineers. I don't have a deep bench of M.D.s to lean on to figure this stuff out.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#158

Post by nybble41 »

coldtea wrote: post #94
helen___keller wrote: post #37

The point of health insurance is to pay into a risk pool as a collective so that the small percentage of people who end up needing the largest percentage of health care, nobody dies or goes into monumental debt. This can be done via taxes but insurance is a private market solution which should in theory make it more efficient for the sake of maximizing profit. So then if it's supposedly more efficient, why do I waste…

> This can be done via taxes but insurance is a private market solution which should in theory make it more efficient for the sake of maximizing profit. Imagine there's a single, private, insurance company, A. Wouldn't the natural interest of A be to maximize health costs (i.e. make paying for health coverage expensive, as thus their insurance more desirable and more expensive in return)? And if there were more small…

> Imagine there's a single, private, insurance company, A. ... Wouldn't the natural interest of A be to maximize health costs ... ?

Sure, but as an insurer they don't have any control over health care costs. They could bid prices up, I suppose, but that eats into their profits; such a strategy would cost them more than they could possibly gain.

> And if there were more smaller insurance companies competing with A, wouldn't it make sense for A to just eat them up to eliminate competition ... ?

The smaller companies would have to agree to that. Some of them could be co-ops or other organizations structured to represent their members and not interested in being bought out by a company which doesn't share the same principles.

> ... wouldn't it make sense for them to collude and keep prices and profits high?

Cartels are notoriously unstable. Every member has an incentive to cheat on the cartel to gain market share. And then you have the aforementioned co-ops and others who wouldn't be interested in joining the cartel.

> ... isn't it their natural interest to spend on buying politicians ... ?

And here we come to the real issue. Not that companies are interested in buying politicians—that's only to be expected, under the circumstances—but rather that (a) there exist politicians with the power to forcibly interfere in the market without being branded as criminals, and that (b) these politicians are willing to be bought and to support laws actively harmful to their nominal constituents.

In order to have a private market for either health care or health insurance you must first get the politicians out of the market.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#159

Post by jmcqk6 »

praneshp wrote: post #95
arcticbull wrote: post #86

Earlier quoted context omitted.

I'll be sure to let the ambulance driver know after a car accident they should shop around :\ Maybe an Ayn Rand medicalert bracelet would help. Allergy: Socialism.

That's why the out of pocket maximum exists. (I think?)

The out of pocket maximum can be a lie, too. I have an 'out of pocket maximum' on my ACA insurance plan, but there are medical services that are exempt.

Last year, I paid $4000 more than my $6500 out of pocket maximum, because I had a heart procedure and the heart rehab following the procedure was an exception to the out of pocket maximum, a fact I discovered only after incurring the costs. You see, if you clearly follow the asterisk and the footnote references in the policy, then it's very clear that these expenses would not have been covered.

Re: People Lose Their Employer-Sponsored Insurance Constantly

#160

Post by sorokod »

ummonk wrote: post #57
jvagner wrote: post #44

Earlier quoted context omitted.

We have a high-deductible health plan and live in Reno. When my gf recently had the need for a CAT scan, the first choice was here in Reno, and it was priced at over $800. She cancelled her appointment, called over in Carson City (20 minutes south of Reno), and got one done, by someone in our network, for $400. The doctor's office who referred her said, "$800? Really!?" The Reno specialist made her a follow-up appoin…

That actually sounds like the high deductible plan is functioning as it should though. Causing consumers to price-shop and avoid price-gouging providers.

People in poor health are not consumers and getting medical help is not shopping.
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