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Employer health plans are getting pricier and skimpier

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Re: Employer health plans are getting pricier and skimpier

#51

Post by mywittyname »

throwaway_law wrote: post #14
badrequest wrote: post #5

The sooner we can completely divorce healthcare from employment, the better.

I hear this statement all the time...but what does it mean? If employers didn't provide health insurance to employees wouldn't we just wind up with 40% of the insured uninsured? Its not like Corporate America is going to make up the difference and start paying cash to compensate for the lost benefit, at least thats what happened as pensions got stripped away from the workplace. Even if the employer's did make up the…

Having a critical mass of uninsured people is the foundation we need to resolve the healthcare crisis in America. Those uninsured people still need healthcare. If enough people start calling up small clinics asking for pricing, a cottage industry of small health providers will pop up to service these people with transparent pricing.

The insurance industry has perverted our healthcare system. The major reason doctors moved from private practice to being associated with hospitals is to simplify billing because health insurance companies look for any reason to refuse payment. To reverse this trend, we need more people willing to bypass insurance and buy healthcare directly.

Health insurance is a failed experiment. People should pay for their healthcare directly, and the government should provide for those who require serious, expensive treatments (after a payment that is some percentage of their income).

Re: Employer health plans are getting pricier and skimpier

#52

Post by pg_bot »

Ididntdothis wrote: post #27
throwawaysea wrote: post #19

The entire health insurance industry makes ~$25B in profits a year, correct? That doesn't seem overly large considering it is the entire insurance industry.

It’s not only profit. They also cause a lot of administrative overhead. For example if doctors had to deal only with one insurer or at least one coding system they wouldn’t need four billing assistants as I have seen. In essence insurance companies do a lot of unnecessary stuff. Their profit is only a small part of that cost.

There are two coding systems (ICD - for diseases, and CPT for procedures) that are mandated to use by medicare/medicaid and all the insurance companies use them as well. Most of them even accept the same forms. They need those billing assistants for other reasons.

Re: Employer health plans are getting pricier and skimpier

#53

Post by cascom »

Pfhreak wrote: post #39
badrequest wrote: post #5

The sooner we can completely divorce healthcare from employment, the better.

Do you think that companies would give you a raise equivalent to what they were paying on your behalf for healthcare? I suspect not. I mean, it's one thing if we moved to a single payer system, which would be great, but just moving out of the employer's hands and into the general public seems like a disaster. (Also, I am not a fan of the employer healthcare model.)

that's a fair point, but which is easier for an employee to compare, wages between two companies or job offers when they buy their own insurance and know the cost, or to compare wages AND benefits of two different jobs/offers

Re: Employer health plans are getting pricier and skimpier

#54

Post by alkonaut »

Pfhreak wrote: post #39
badrequest wrote: post #5

The sooner we can completely divorce healthcare from employment, the better.

Do you think that companies would give you a raise equivalent to what they were paying on your behalf for healthcare? I suspect not. I mean, it's one thing if we moved to a single payer system, which would be great, but just moving out of the employer's hands and into the general public seems like a disaster. (Also, I am not a fan of the employer healthcare model.)

If you add a payroll tax equal to the average cost of insurance, then it’s neutral for employers as a group.

The payroll tax could be used either to fund a single payer system or to fund deductions for employees helping them buy insurance.

Re: Employer health plans are getting pricier and skimpier

#56

Post by ceejayoz »

abstractbarista wrote: post #55

Is it possible that it is due to more people becoming insured that are burdensome on the system? I thought it was pretty expected that as you get more of the unhealthy parts of the population into healthcare, costs will rise for everyone else.

Part of the goal of the individual mandate in Obamacare was to force healthy people to obtain meaningful levels of health insurance to offset that.

Re: Employer health plans are getting pricier and skimpier

#57

Post by war1025 »

cascom wrote: post #47
throwaway_law wrote: post #14

Earlier quoted context omitted.

I hear this statement all the time...but what does it mean? If employers didn't provide health insurance to employees wouldn't we just wind up with 40% of the insured uninsured? Its not like Corporate America is going to make up the difference and start paying cash to compensate for the lost benefit, at least thats what happened as pensions got stripped away from the workplace. Even if the employer's did make up the…

1 - If my company buys health insurance for me, its tax deductible(pre-tax), if I buy it myself it is after-tax . Now companies are can just gross-up pay, and don't have to compete on healthcare... 2) Pooling remains an issue, but as it stands now, consumers have little to no choice, one would imagine that once a 125m households start shopping for insurance there is going to be competition on price... in most circums…

I believe the pre-tax post-tax thing is actually wrong. The difference is that you pay for the plan with post-tax money until tax season rolls around, when if I remember correctly (from having an individual plan for several years) you get to deduct those costs.

So really, it's just the typical American thing of people being terrible at understanding tax codes and adjusting their withholdings correctly.

Re: Employer health plans are getting pricier and skimpier

#58

Post by rukittenme »

taurath wrote: post #32
throwawaysea wrote: post #19

The entire health insurance industry makes ~$25B in profits a year, correct? That doesn't seem overly large considering it is the entire insurance industry.

You can pay execs $100mm a year and have that not be profit. This is why they lobby so hard.

Yes because shareholders love paying executives tons of money so they don't have to collect it themselves... /s

Re: Employer health plans are getting pricier and skimpier

#59

Post by mieseratte »

tempsy wrote: post #49

I think another thing about employer-based healthcare that few think about is that if you work for a large company then it is almost certainly self-insured, meaning that you or your employer is paying premiums into a fund that it is managing itself. How crazy is it to think that not only does Apple or Ford or Trader Joe's need to manage it's own business but that it is also hiring actuaries/insurance specialists/cons…

> I'm not sure many people that work at large companies realize that their employer knows every diagnosis, procedure, and prescription you've ever picked up, and actively trying to incentivize you to use as little healthcare as possible.

I work for such a company, and it's great. I pay about $30 per month for a plan with a tiny deductible ($2,500), and they offer great wellness perks like weekly classes (yoga, kick-boxing) in-office, partner with a local CSA that does a bi-weekly produce truck out in the parking lot. They do encourage folks to get yearly wellness screenings, and basic dental cleanings by increasing your plan by about $2 per week if you don't.

This is a single, no dependents rate. I believe the comprehensive plan, with families runs about $70 per month.

As it were, the plan is employer funded but we have some type of partnership with a major provider for administration so the employer itself isn't hiring actuaries / specialists / consultants. Perhaps your personal experiences differ here?

Re: Employer health plans are getting pricier and skimpier

#60

Post by bryanlarsen »

mywittyname wrote: post #51
throwaway_law wrote: post #14

Earlier quoted context omitted.

I hear this statement all the time...but what does it mean? If employers didn't provide health insurance to employees wouldn't we just wind up with 40% of the insured uninsured? Its not like Corporate America is going to make up the difference and start paying cash to compensate for the lost benefit, at least thats what happened as pensions got stripped away from the workplace. Even if the employer's did make up the…

Having a critical mass of uninsured people is the foundation we need to resolve the healthcare crisis in America. Those uninsured people still need healthcare. If enough people start calling up small clinics asking for pricing, a cottage industry of small health providers will pop up to service these people with transparent pricing. The insurance industry has perverted our healthcare system. The major reason doctors…

> People should pay for their healthcare directly, and the government should provide for those who require serious, expensive treatments (after a payment that is some percentage of their income).

It's cheaper for the government to pay for everything. If you incentivize skipping check-ups and minor treatments they turn into large expensive care.

The rest of the western world has had universal health care for ~50 years now and it works better in every other western country than it does in the US. The US should just choose a country and copy it.

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