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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

#381

Post by ohyes »

nostrademons wrote: post #353
ohyes wrote: post #351

Earlier quoted context omitted.

This sounds like an ignorant view of getting proper healthcare. There are more things to check because older people have more medical problems, therefore more tests, more treatments, etc. We would have to see what would happen if you gave a 25 year old medicare in this country, I doubt it would be the same experience that an elderly person would have.

There is a very strong correlation between which additional tests are requested and what the hospital can charge under Medicare reimbursement codes. (My mother's boyfriend is a former doctor, and intimately familiar with the health-care system from the other side of the table.) Both of them are also in fairly good health (my mom has no pre-existing conditions, her boyfriend has some issues with his back but nothing u…

25 year olds have fewer health problems that need treatment than 80 year olds.

Re: Employer health plans are getting pricier and skimpier

#382

Post by gniv »

rayiner wrote: post #106
triceratops wrote: post #91

Earlier quoted context omitted.

> whats the alternative to an employer provided health plan? There are a number of alternatives: 1. Government health plan at the state level (i.e. the Canada model) 2. Compulsory private insurance (i.e. the Switzerland model). But employers don't provide it and insurers have to insure everyone who pays. Single, larger, and more diverse risk pool instead of 3 separate pools - one with working age people and children,…

Doesn’t the fact that vastly different systems perform better than the US possibly suggest that our problem is something other than the payor model? What is the theoretical reason why US costs would be higher than Switzerland? Premiums for private insurance should be much lower in the US, given that Medicare takes high cost people out of the private pool.

> What is the theoretical reason why US costs would be higher than Switzerland?

In Switzerland, people actually shop around regularly and change insurance providers. That probably keeps premium costs down.

Re: Employer health plans are getting pricier and skimpier

#383

Post by plughs »

comnetxr wrote: post #360

Imagine if grocery stores forced us to choose one of a few dozen grocery "insurance" memberships to buy groceries, and negotiated directly with the insurers. No prices are labeled in store, they just detect whatever you take and send you a bill at the end of the month. (Differing brands of the same food product are not available in store of course.) Individuals are charged 3-100x more per product than negotiated rate…

Then imagine that there are some people who can't afford the food they need in the grocery store and are going to die.

Alternatives and transparent pricing isn't going to make brain surgery affordable to the average consumer.

Re: Employer health plans are getting pricier and skimpier

#384

Post by erichocean »

throwaway66920 wrote: post #321
kylebyproxy wrote: post #255

Earlier quoted context omitted.

That's all fine in theory, but do some shopping-around and you'll see it's simply untrue. Personal anecdata: 2018, my employer didn't offer insurance. I signed up for a "silver" tier individual plan ($1250 deductible, good coverage) on the ACA marketplace and paid $170-something/mo. (after receiving ~$250/mo. in tax credit). 2019, my employer starts offering insurance, so I'm no longer eligible for the ACA tax credit…

Huh I didn’t know about the tax credit. That sounds like another layer of backwards thinking and another reason to get rid of the whole practice. I’m sorry for your situation.

The "Premium Tax Credit"[0] was a centerpiece of the Affordable Care Act (aka Obamacare), and widely publicized by the media and Obama. ACA exchange premiums are not affordable for most of the people it was trying to help without the tax credit.

[0] https://www.irs.gov/affordable-care-act/individuals-and-fami...

Re: Employer health plans are getting pricier and skimpier

#385

Post by Apes »

comnetxr wrote: post #360

Imagine if grocery stores forced us to choose one of a few dozen grocery "insurance" memberships to buy groceries, and negotiated directly with the insurers. No prices are labeled in store, they just detect whatever you take and send you a bill at the end of the month. (Differing brands of the same food product are not available in store of course.) Individuals are charged 3-100x more per product than negotiated rate…

Consumers using grocery insurance would have no real say or insensitive in what groceries they get - it doesn't matter if all they need is some chicken and a cheap wine. All the grocery store sells are filet mignon and Dom Perignon, and that's what everyone gets.

Re: Employer health plans are getting pricier and skimpier

#386

Post by kbutler »

plughs wrote: post #383
comnetxr wrote: post #360

Imagine if grocery stores forced us to choose one of a few dozen grocery "insurance" memberships to buy groceries, and negotiated directly with the insurers. No prices are labeled in store, they just detect whatever you take and send you a bill at the end of the month. (Differing brands of the same food product are not available in store of course.) Individuals are charged 3-100x more per product than negotiated rate…

Then imagine that there are some people who can't afford the food they need in the grocery store and are going to die. Alternatives and transparent pricing isn't going to make brain surgery affordable to the average consumer.

There are people who can't afford groceries now - we don't fund that by having the government pay for all groceries for everyone.

Re: Employer health plans are getting pricier and skimpier

#387

Post by pdonis »

tempsy wrote: post #284
pdonis wrote: post #253

Earlier quoted context omitted.

The government negotiating rates on behalf of all citizens is not the same as the government paying 100% of all citizens' costs. "Medicare for All" is the latter; but all we really need is the former. Basically the government could do on behalf of all citizens what it already does on behalf of government employees and elected officials: negotiate with providers to come up with a menu of plans, and then let each perso…

"Medicare for all" does not mean free healthcare. It's paid for by taxes. You taxes become your "premium" under that system. The concept of "private health insurance" outside of supplemental insurance would not exist under that system.

> "Medicare for all" does not mean free healthcare. It's paid for by taxes.

I didn't say "free healthcare". I said "government pays 100% of costs". Yes, that means ultimately we all pay them through taxes.

> The concept of "private health insurance" outside of supplemental insurance would not exist under that system.

Under Medicare, "government pays 100% of costs" also means "government is the only provider of health insurance". But my whole point is that you don't need to do that in order for the government to use its negotiating leverage to negotiate better rates; the government can do that even if the rates it's negotiating are with private insurance providers. That's basically what the government does now for Federal employees and elected officials; they aren't on Medicare, they have a selection of private insurance plans that have negotiated rates with the government. My suggestion is to simply extend this to all citizens, so the government can negotiate even better rates since they now have a much larger pool of people to negotiate for.

Re: Employer health plans are getting pricier and skimpier

#388

Post by pravda »

adamredwoods wrote: post #307
eric_b wrote: post #148

The problem is that there is not a single reason that healthcare is so expensive. Even if you list the top 15 reasons, you still have to apply the "5 whys" to each of them to find root causes and possible solutions. - Doctor's are paid too much... why? - Well they need to be paid a lot because medical school debt is 250k or more... why? - Medical schools/the AMA are artificially limiting the number of students and re…

There is a WHY (or at least a general why): Obfuscation. - lack of clarity on competitive pricing - obfuscation by adding multiple layers in buying process (broker - insurance - claims adjuster - hospital) - obfuscation through too-many-options syndrome (Obamacare versus Medicare versus state-driven healthcare versus emergency-only healthcare) - lack of clarity when being billed (getting several bills from several di…

>This is the result of "free market" idealists at work.

Huh? I can't think of anything less free market then the American medical system!

Ok, maybe defense contracting is less free market. But at least that is paid for out of federal tax money.

Re: Employer health plans are getting pricier and skimpier

#389

Post by sabujp »

kbutler wrote: post #386
plughs wrote: post #383

Earlier quoted context omitted.

Then imagine that there are some people who can't afford the food they need in the grocery store and are going to die. Alternatives and transparent pricing isn't going to make brain surgery affordable to the average consumer.

There are people who can't afford groceries now - we don't fund that by having the government pay for all groceries for everyone.

universal healthcare is sort of the equivalent of free food. What if your medical condition is malnourishment?

Re: Employer health plans are getting pricier and skimpier

#390

Post by bluedino »

Where I work (in the USA), we have an employer-paid plan. There are no weekly premiums paid by the employees. There's a minimal deductible, around $500-1500 maximum per year.

The employer gets the bills, they pay them. They belong to a cooperative and get negotiated rates, they have a provider network and everything.

Why isn't this more common?

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