Intrusive healthcare ins. questionares

[kb01]

Originally Posted By: Shannow


Reason for community ranking was that modelling showed that if the market was left to pick and choose, retirees would never be able to afford insurance, despite having paid through their healthy years.


That's pretty much how it works in the USA. The difference is that only non-group insurance is based on community ratings and even then, premiums are adjusted for pre-existing conditions, sex, and age. With Bluecross in my state, only 4% of those who apply for insurance get the quoted, baseline premium rate.

Most people get insurance through work, with employers subsidizing part of the premiums. Premiums are based on the overall health, age, and sex of the group. If you work with too many older people, too many women, or just have unhealthy coworkers, you will have exceedingly high premiums.

The system works OK for most people but completely falls apart if you're older and lose your job and aren't old enough to qualify for Medicare. It also doesn't work well if your unhealthy coworkers result in you getting stuck with $1,200/month insurance bills.

 

[JHZR2]

Originally Posted By: kb01
Originally Posted By: JHZR2
I just dont get it.

If you go here:

http://www.opm.gov/insure/health/rates/index.asp

You can see what the federal government gets as a "deal" on insurance.

Though there is a misconception that every fed gets a "cadillac" plan, it is a choice. And some of the plans are VERY expensive to the employee, and the gov't does NOT pay the majority of the cost.



I'm looking at the non-postal rates and it appears that the federal government subsidizes 75% of premiums.

For the first plan listed "Alabama Aetna HealthFund". The total monthly cost (family) is $824.53, with the government paying $618.40 and the employee chipping in $206.13. I think a 75% subsidy is fairly normal for individual policies but few, if any, private companies in my state subsidize family plans at that rate. I'd kill for access to a family plan for $206/month. Even a family plan for $824.00/month that came with maternity, prescriptions, and a $5,000 deductible would be absolutely amazing.

Originally Posted By: JHZR2


Im looking at the non-postal HMO plan, full monthly costs. There are a TON that are FAR less than $10k/yr for premiums.

And if the companies were loosing money on these, they wouldnt be in the business.

So I fail to see how so many get such poor rates. And I also fail to see how if the rates provided under a deal like this were extended to a greater amount of the population, how they would be much worse.

Just because I show govt data doesnt make my comments here political, but I think this is a good nationwide evaluation of costs of healthcare when a sizeable population is included.

If only non-feds could "qualify" for these rates...


The federal rates are so good because the federal government is the largest purchaser of insurance in the world. The bigger and more diverse the group, the lower the risk for the insurer because high claim recipients are balanced out by the healthy and the young.

For a small business buying insurance for 20 people, the insurer needs to jack up premiums to deal with expensive members of the group. If the average premium is $7,000/year per employee, that only brings in $140,000/year, 20% of which goes to insurance overhead, leaving $112,000 for paying claims. If one coworker is diagnosed with cancer or has a high risk pregnancy, that's enough to make the group unprofitable and possibly uninsurable.

Those in small groups, especially with a disproportionate number of women, or coworkers over 40, are completely reamed when it comes to buying insurance.


But, see, that's why I don't get it. Why lump just by a small group? If one hundred million people are buying insurance, then that is the pooling of risk, not ten people here and fifty there.

You hit my point exactly, the govt is the biggest buyer of insurance (and you're right, overall it is like a 60-75% benefit payment). Some of the cadilac high option plans are paid less than 50% by the govt. but the split of premium is irrelevant, we see the entire monthly charge. Now, given the number of govt employees, we have a pretty good cross section of the working public to at least 55-60yo, including all the cancer cases, high risk pregnancies, etc. The rates come to what they are.

So at least by state, you can see what the tough population risk pool is profitably costed at. So forget obamacare or any of those politically charged things, heck, forget cross-state buying of insurance and pooling of risk. Just look at what the bulk population should be costed at. Seems a lot less than what I'm hearing from individuals on this thread.

So the question is why can't individuals and groups of small business pool risk to get pricing aligned to roughly what we can see from the Feds. Seems like profit mongering on part of insurance companies and nothing more (profit mongering by medical "professionals" aside).

After all the insurance industry is the one industry where it is absolutely legal and accepted to discriminate on most every metric that has been made illegal in every other aspect of life.

 

[Win]

The quarterly premium for our family plan comes due on the first of next month. It's $891 every quarter. The provider is Blue Cross Blue Shield. The premium was less before the passage of certain legislation promoted as lowering the premium cost of health insurance.

Of course it is a high deductible plan. Health insurance is, and always has been, available at very reasonable cost on the open market. Too many people confuse health "insurance" with what are really prepaid medical expense plans - of course it is staggeringly expensive to prepay for all kinds of medical costs that a person will likely never incur. It never made sense to me to do this.

The point of insurance is to provide coverage for unlikely and catstrophic events that would be ruinous without a distributed risk, not to create a "free" trip to the doctor everytime someone's kid has a runny nose.

The only out of the mainstream question I recall being asked was if I piloted or was a crew member on non commercial aircraft. Or maybe that was on the life insurance policy.

 

[PZR2874]

Originally Posted By: Win
The point of insurance is to provide coverage for unlikely and catstrophic events that would be ruinous without a distributed risk, not to create a "free" trip to the doctor everytime someone's kid has a runny nose.


^Exactly

 

[Shannow]

Agree there.

And that's what annoys me about the Oz Health Insurance industry...we were just informed that hip replacements are no longer covered, but I can get two pairs of running shoes, and a massage...and premiums are going up 7%, but you can save by paying up to a year in advance.

 

[PZR2874]

Not covering hip replacements means the older you are, the quicker you die.

Immobility kills older folk.

Quicker you die, the less bills accumulate.

 

[andyd]

off topic but, my house insurer acts like a darn Home owners association. They sent some cube rat with a camera out to my casa and He shot pictures of the aluminum card flashing I had tucked under some buckled shingles. The roof is old, granted, but it working fine and suffered no damage from hurricane Irene. I re-roofed one section and simply removed the visible card flashing from the other. Problem was I was on the hook for 6 months until they graciously renewed my policy

 

[i812]

Here in FL Seneate is trying to pass a bill regarding privacy of Firearm Owners; Provides that a licensed medical care practitioner or health care facility may not record information regarding firearm ownership in a patient's medical record.

http://www.flsenate.gov/Session/Bill/2011/432