Whew, I have health insurance for 2014 !!!!

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Originally Posted By: Donald
The OP is not the typical person the health car act was going after. It was the 7 million Americans who had no insurance and worked at Walmart or McDonalds. They will get a subsidy and finally have health insurance and can go and see a primary care doctor when they are sick vs wait until they are critical and go to the ER.

The full cost of an average health plan if you worked for a major company is around $7500 per year for one adult. Now in most cases the employer pays about 2/3 to 3/4 of that.

If the new health care act was not in place, what would the OP like to see, pay a lot for substandard plans? All the new health care act did for the OP was to not allow him to purchase a substandard health care plan.

I would guess the OP earns about $75K. Health care is expensive, so the full cost of the plans is expensive if you have to pay it all yourself.

I hope in the not too distant future we go to a single payer health care system. We are one of the few democracies in the world without a single payer health care system. And we get worse health care than most countries that do have a single payer health care system.


This is fair and balanced. I would add that we pay far more per person for overall worse healthcare and with a significant number uninsured. We have overuse because cost is hidden which means many insured don't have any motivation for controlling how many visits they make or how expensive the facilities are, and doctors are incentivized to over treat purely to make more money.

I have a HDHP so track my costs. A few years back, my insurance company told me the cost of my annual check up at a local nice facility that was in network was in line with the average. I went there and a week later the bill for a one hour exam and blood tests was over $1000. The average was $250. I had a huge battle with the insurance company over this.

Meanwhile, most people without HDHP go to this facility oblivious to the 4 times increased costs. This opaque system has helped push up everyone's costs and transferred wealth to the medical sector. It's economically inefficient.

Another example was when a sports injury specialist was able to squeeze me in to check out some leg pain. The result? A hurried 10 minute inconclusive diagnosis with a recommendation for physiotherapy sessions. Cost of 10 minute visit was $200 and projected cost of physiotherapy was $1000.

What I did? A 5 minute casual conversation with a friend suggested the possible cause. 5 minutes on the internet confirmed the problem and YouTube videos with simple exercises to alleviate. Later down the line, further research yielded an understanding of the root cause and other changes I've made now manage the issue at a root cause level.

I won't mention the time that a close friend ended up in ER as a result of misdiagnosis and mis prescription of a minor matter and then misdiagnosis before admittance with a warning they might very well be dying.

So I'm sorry but the medical profession is pretty poor and the system has a part to play in that. It has taught me buyer beware, question everything and to be self sufficient. But why as a country should we pay double for that privilege?

Btw, a great way to understand this better is to look at how other countries do healthcare. Switzerland believes in free market principles and introduced healthcare reform in the 70s to much opposition, but now are glad they did. Australia introduced mandatory private healthcare to supplement free universal healthcare. Taiwan researched healthcare around the world before deciding on the best system to introduce from scratch. The bottom line is you have to design a healthcare system holistically, it has to emphasize preventative, efficiency, quality and prevent overuse and abuse. If you want private then you need patient responsibility for cost or price controls. If you want public, you need some copay to prevent misuse by patients and some form of quality control to assure providers are incentivized.
 
Here's another way to look at the situation.

This all comes down to basic liberty. I don't want to be forced into a national insurance plan with all of the misshapen, morbidly-obese, sugar and grease-eating, sit-on-their-butts all day dregs. And I don't want to force these life's-losers to change their lives because of their right to personal liberty as well. They live that way; let them suffer the consequences without my subsidy.

I exercise, lift, and eat healthily because I want to and it makes me feel good. Not to entitle others to succumb ultimately to diabetic amputation and clogged arteries due to their lifestyle. I don't want to pay for the laziness and sloth of so many others.
 
Originally Posted By: [email protected]
Correct me if Im wrong, but is there nobody forcing you to buy the marketplace insurance??

I just went to the Blue Cross insurance and bought my own individual policy (self employed). I priced it out against the state marketplace and the BCBS insurance was cheaper and has a lower deductible.

So why dont people just shop around with private companies and then compare it to the stuff offered by the government? I did and it worked for me.

By the way, Im not mad at any system, its designed for people with low incomes who currently have no insurance. I have high income and no insurance, so I went and bought a policy for $96/month. To me, thats a steal considering I have COPD (never smoked a day in my life) and require frequent doctor office visits, inhalers, etc.

FWIW, the marketplace wanted $133 per month.


That's quite impressive. That's about the same as my plan which is heavily subsidized.

What is it about Michigan? I understand they are one of the states that has embraced the reform, but there must be an underlying aspect to the cost structure, perhaps good old fashioned doctors and facilities with reasonable rates and a genuine duty to serve the public rather than treat healthcare as a money making opportunity.

Those states most against the reform perhaps have the strongest lobbies and therefore some people who make a lot of money from the status quo.
 
Originally Posted By: bmod305
Medica Insurance thru work for the last 11 years. Mid 40's non-smoker. We have health saving account with high deductible plan with less than 50 employees. Our plan went up 30% for 2014 and our deductible went from $3500 to $5000. We had a 9% increase in 2013. Our employer isn't paying anything less; he shows us the books. We shopped multiple plans and also MN Sure for small business plans-50% increase with those. Good thing I now get free birth control pills and mammograms-if I was a women.

We have a part time driver at work on MN care/welfare. No deductible, no monthly payments, no prescription costs, free dental, and free eye-care. She also gets subsidized housing and EBT(food stamps) just for having a couple of kids with an un-known baby daddy. She also gets all of her taxes back every year plus about 5K in Earned Income credit to blow on the latest boyfriend. This will go on until her kids turn 18. Since the baby daddy in un-known, no one to go after for child support. What's wrong with this picture?

Just my two cents, and sorry for the rant.

Dave


The welfare recipient is wrong for sure. But its just as bad that businesses keep people in non-benefits status in order to shift the costs of employment from the owner's pocket to the population at large. That's just as treacherous as anything else.

But your employer's issue is the fundamental problem with the insurance industry, its lobby, its regulation, etc. Prime example - amongst the doom and gloom, my HDHP policy did indeed go up in cost. The TOTAL cost (mine and my employer's) is $1040/month, which is a $70 increase over last year. My deductible didnt increase. Now this is just a normal HDHP, nothing different, and because of the risk pool size, the overall costs didnt drive up.

So the stupidity in all of it is that there has never been an allowance to truly let everyone join the same risk pools to bring costs down.

And, BTW, mine covers maternity and perhaps even BC (never looked). But guess what? It is costed in by binning people into groups and averaged over everyone, and it works just fine. Its the stupid regulations that have existed in the past to ensure enormous profits by the insurers while offering subpar care and worse outcomes than many other countries (US isnt even in the top 10) that has been the problem and will be the problem. Exchanges theoretically work because everyone who is an exchange customer can be binned and thus the risk pool can be expanded. That's how its supposed to work. The insurers could make it work cost effectively like they do on many big employers' plans.

THEY choose not to. Its not ACA, its the insurance industry and their mass thievery. That people are so blind to this is amazing. Of course so many are brainwashed that its quite understandable.
 
Originally Posted By: Brule
Here's another way to look at the situation.

This all comes down to basic liberty. I don't want to be forced into a national insurance plan with all of the misshapen, morbidly-obese, sugar and grease-eating, sit-on-their-butts all day dregs. And I don't want to force these life's-losers to change their lives because of their right to personal liberty as well. They live that way; let them suffer the consequences without my subsidy.

I exercise, lift, and eat healthily because I want to and it makes me feel good. Not to entitle others to succumb ultimately to diabetic amputation and clogged arteries due to their lifestyle. I don't want to pay for the laziness and sloth of so many others.


This is beyond laughable. Guess what? You already do!

You pay for it at the worst possible time (end of life) via medicare, and you pay for it when these folks go in and use the ER or go see a doctor and then stiff them for the bill. You think the doctor or health system eats it out of the goodness of their own hearts? Nope. They pass it into your bill. Congratulations for being blind to the reality of things.
 
Originally Posted By: TrevorS
This is fair and balanced. I would add that we pay far more per person for overall worse healthcare and with a significant number uninsured. We have overuse because cost is hidden which means many insured don't have any motivation for controlling how many visits they make or how expensive the facilities are, and doctors are incentivized to over treat purely to make more money.

I have a HDHP so track my costs. A few years back, my insurance company told me the cost of my annual check up at a local nice facility that was in network was in line with the average. I went there and a week later the bill for a one hour exam and blood tests was over $1000. The average was $250. I had a huge battle with the insurance company over this.

Meanwhile, most people without HDHP go to this facility oblivious to the 4 times increased costs. This opaque system has helped push up everyone's costs and transferred wealth to the medical sector. It's economically inefficient.

Another example was when a sports injury specialist was able to squeeze me in to check out some leg pain. The result? A hurried 10 minute inconclusive diagnosis with a recommendation for physiotherapy sessions. Cost of 10 minute visit was $200 and projected cost of physiotherapy was $1000.

What I did? A 5 minute casual conversation with a friend suggested the possible cause. 5 minutes on the internet confirmed the problem and YouTube videos with simple exercises to alleviate. Later down the line, further research yielded an understanding of the root cause and other changes I've made now manage the issue at a root cause level.

I won't mention the time that a close friend ended up in ER as a result of misdiagnosis and mis prescription of a minor matter and then misdiagnosis before admittance with a warning they might very well be dying.

So I'm sorry but the medical profession is pretty poor and the system has a part to play in that. It has taught me buyer beware, question everything and to be self sufficient. But why as a country should we pay double for that privilege?



All well said, but a few comments.

First, youre right, the system is opaque... But there is no practical way to have doctors and other providers show their costs. I can do it through my health insurance provider's website, but those numbers have been scrubbed how many times? What is the true cost?

Why doctors and insurance companies have to "negotiate" prices is beyond me. How many times have they billed insurance company x or some service? And how much do they get? The same amount every time? Why this isnt posted as a retail price everywhere is beyond me. People can buy based upon their means and the prices charged. Of course now they dont need to because they have no skin in the game until they start griping about premiums going up. Having more skin in the game and understanding how much of this is indeed a consumer choice would be a good start. But the opacity prevents it.

Regarding going and doing 5 minutes of research on the internet or however you solved your issue... That may be OK for minor things, but imagine if someone with some major illness did this? It could drive them to death much faster (which may be a preferred outcome by some to get them off the rolls). It could make the outcomes much worse, because lack of ability to make the best choices and afford them will prevent them from utilizing a specialist and truly getting to the bottom. Im no fan of doctors or their education as compared to compensation, and I think that much of the physics of most ailments is way glossed over when it comes to medical education. But I know when a specialist is warranted, and regardless of how well I might understand the chemistry, physics or other aspects of the situation, their experience trumps. It would be a sorry thing for people to take too much comfort in their newly obtained info from the net, and avoid getting the right treatment to save a buck.
 
No doubt we need specialists. But in my opinion, the for profit system encourages poor diagnosis (because they can squeeze in another patient to earn $200 in 10 minutes) and over treatment (because it makes them money).

If you have ever received healthcare in another country, you'll see that they are more interested in getting you the right treatment and getting you better sooner.
 
Originally Posted By: Astro14
Originally Posted By: JHZR2


That said, healthcare costs have been rising unsustainably for years. It's nothing new. And for someone who needs a hospital and has bad and lingering issues, they are an insurance liability, do cost society more and should pay more. It's no different than if you have auto insurance with a clean record or one with five speeding tickets and two accidents. The pricing is not the same.

But at least now some coverage is guaranteed, he won't just be dropped for making too many expensive claims should he go into the hospital... And his coverage is assured for many years until Medicare eligibility comes along.


That argument is specious - the rates are not varying because of claim history, they vary because of your income. Further, the new "requirements" for minimum coverage have required many to get coverage that they didn't previously have or need (glad, as a 50 year old man, that I have maternity coverage in my policy now, but not certain it's needed).

So, you get increased rates based on ability to pay and the addition of coverage that was not previously required. It's nothing like auto insurance...nothing at all...


I doubt this is true. The "rates" most likely dont vary at all. The prices paid may vary due to subsidies. However, the OP, earning $50-60k next year, likely qualifies for a big fat one. Not sure how much he makes now, but he may qualify for one even now since he apparently has a family.

And the point about auto insurance was that the risks associated with an insured should be costed into their policy, as they may well cost more or less to the group at large. Auto insurance is a fine example - you can choose multiple levels of coverage, and those with no/minimal coverage cause everyones' rates to increase when uninsured/underinsured funds get used. Everyone ends up paying no matter what... And as individual liabilities increase, the individuals' premiums increase (like they do by age for healthcare), and the premiums will increase for everyone as more and more take part in risky behavior.

The problem is that for auto insurance, for example, people will still go uninsured, and many/most just dont care. Rates go up? Just complain, drop coverage, etc. Revoked DL? No problem. That's why Im waiting for your recommendation of the metrics for the euthanization panel to be proposed
smile.gif
After all, we dont want to pay for them, we dont want to share in the cost of their care, they shouldnt be forced to have insurance... Yet you can be darn sure they will show up at the hospital when they have a heart attack or a stroke or anything else... So how do we decide how to pull the plug to minimize costs? Currently there is an obligation to process and care for these folks, even if not insured and unable to pay. How do you propose to reverse that scenario which exists with ACA or not????
 
Originally Posted By: TrevorS
No doubt we need specialists. But in my opinion, the for profit system encourages poor diagnosis (because they can squeeze in another patient to earn $200 in 10 minutes) and over treatment (because it makes them money).

If you have ever received healthcare in another country, you'll see that they are more interested in getting you the right treatment and getting you better sooner.

Assuming the "other countries" you're referring to are reasonably developed, this is true.

I'll never forget my visit to Bumrungrad Hospital in Bankok, Thailand. The whole place was exceptionally clean, welcoming, and well laid out -- I felt better just walking in the front door. Literally everyone was calm, courteous, attentive, and effective. Even without an appointment, I was in and out in under an hour. It was CHEAP, too -- the entire visit PLUS medication cost me as much as a copay back home.

There definitely are some American hospitals that are just as good. As always, the best in America is up there with the best in the world. It's the AVERAGE in America that's worrisome.
 
We were able to keep our insurance through my wifes employer, which is good because the insurance is good IMO. The rate hikes have been substantial though. Last year, they went up just over $100/month and in 2014 add another @220/month on top of that. Not as bad as others such as volk06, but about 150% increase in two years seems excessive to me.
 
Originally Posted By: TrevorS
Originally Posted By: volk06
I just found out my insurance plan through my employer yesterday.
Single 25yr, my cost is going up 167%.
My deductible is going up 333%.
Going from from a PPO/Copay to a HDHP.

I will not say anymore other wise this thread will most likely get locked.


There's a difference between what you pay and what your company pays.

Are you sure your premium isn't rising because your company is subsidizing you less?

Your deductible is up because of the plan change but usually the premium on a HDHP is lower.

My premiums doubled before the AHA. I switched to a HDHP a while back to keep my premiums as low as possible. HDHP are one way to prevent overuse of healthcare and abuse by the medical profession.


I am paritally involved in benefits, I know all about this. The company is paying the same percentage. The premiums for the PPO plan and the HDHP are basically the same due to the fact that the HDHP has a lower deductible and the PPO has about double the deductible.

You younger single people are seeing the most increase due to the insurance companies having to make up for only being able to charge elderly people 3x the amount instead of the 5x the amount of a single young person, it use to be. So the younger people are getting hit harder to help fill the gap. I believe it is 3x and was 5x, iirc, I'm going off the top of my head.
 
Originally Posted By: volk06
You younger single people are seeing the most increase due to the insurance companies having to make up for only being able to charge elderly people 3x the amount instead of the 5x the amount of a single young person, it use to be. So the younger people are getting hit harder to help fill the gap. I believe it is 3x and was 5x, iirc, I'm going off the top of my head.


Yeah that is the case. Again it is the locust-like boomer population robbing the younger population, as usual. I really hate to think of the bills that my baby will have to pay, for stuff that was enacted and money that was spent (raided) more than once, before I was even allowed to have a say. ACA is nothing compared to the $75-100 trillion in entitlements they expect.

Hopefully all the gripers will not be expecting us to foot the bill for their care, like they gripe about footing the bill for others' care in this exercise.
 
Originally Posted By: JHZR2


Why doctors and insurance companies have to "negotiate" prices is beyond me. How many times have they billed insurance company x or some service? And how much do they get? The same amount every time? Why this isnt posted as a retail price everywhere is beyond me. People can buy based upon their means and the prices charged.


That's basically how it works for providers in Ontario. If somebody goes to their doctor, the doctor bills OHIP/submits to OHIP for that visit and the type of visit has a code associated with it that carries a set price. There is no negotiation. If the doctor then sends the patient down to a private clinic for an X-ray or ultrasound, each procedure has a specific billing code associated with it that the clinic then submits to OHIP and are paid for those procedures. The rates are standardized as OHIP is the single payer and dictates the rates.

What this also means is that if somebody who doesn't have coverage in Canada were to need to visit a clinic for something, they would just be out of pocket the OHIP rate for the procedure, which is quite reasonable.
 
Originally Posted By: JHZR2


Yeah that is the case. Again it is the locust-like boomer population robbing the younger population, as usual. I really hate to think of the bills that my baby will have to pay, for stuff that was enacted and money that was spent (raided) more than once, before I was even allowed to have a say. ACA is nothing compared to the $75-100 trillion in entitlements they expect.

Hopefully all the gripers will not be expecting us to foot the bill for their care, like they gripe about footing the bill for others' care in this exercise.


Your generation just got a big break through the precedent setting legal abrogation of the Detroit pension contracts. Are you more thankful for the reduced generational debt implications, or worried about the social, legal and financial implications of declaring contracts void when they are financially and politically inconvenient?
 
Originally Posted By: volk06
I am paritally involved in benefits, I know all about this. The company is paying the same percentage. The premiums for the PPO plan and the HDHP are basically the same due to the fact that the HDHP has a lower deductible and the PPO has about double the deductible.

You younger single people are seeing the most increase due to the insurance companies having to make up for only being able to charge elderly people 3x the amount instead of the 5x the amount of a single young person, it use to be. So the younger people are getting hit harder to help fill the gap. I believe it is 3x and was 5x, iirc, I'm going off the top of my head.


Does that rule apply to your contribution within a company plan? My company seems to have a flat rate for the employee contribution.
 
Part of the problem is that folks are typically "paying" with Other Peoples Money. Almost anytime OPM is part of a system, the prices are distorted.

The ACA just adds more OPM to a system most agree is broken. How is that going to fix the system?

Seems like the real big winners will be insurance companies and medical service providers who now have a larger pool of OPM from which to bill.
 
Healthcare and retirement planning. They should really have taught this stuff at school.

And there needs to be an end to the programs and plans where people are promised that future taxpayer will pay for benefits defined up front.
 
Some really good observations in this thread. Whether ACA gets us there, it is in everyone's best interest to have healthy Americans and have them have the ability to recognize illness early, so more costly procedures or diability benefits are not needed. x million people without coverage doesn't make their healthcare needs disappear, it aggravates the situation, moving cost onto those who do have coverage (fairness anyone?)

For those who don't like subsidizing others care, kindly remove your children from public school; I don't have kids and dislike subsidizing the raising of kids I did not choose to have, and apparently you can't afford to educate.... j/k, sort of. Point is society benefits from having healthy (and educated) people.
 
Wouldn't it be interesting if we let one state in the union opt out of any requirement for any education or health provision. All those people who are against putting money into a central pool to spend on everyone could move there. They could also opt out of the interstate and FAA and border and immigration and Social Security programs.

How many people would come, how many would leave and where would they be in 5, 10, 20 years?
 
Originally Posted By: TrevorS
Wouldn't it be interesting if we let one state in the union opt out of any requirement for any education or health provision. All those people who are against putting money into a central pool to spend on everyone could move there. They could also opt out of the interstate and FAA and border and immigration and Social Security programs.

How many people would come, how many would leave and where would they be in 5, 10, 20 years?

Pretty sure some states (Texas, Mississippi, etc.) are performing small versions of this experiment as we speak, while other states (Massachussetts, Vermont, etc.) are doing the opposite. AFAIK, it's going rather well for the latter, and not so well for the former.
 
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