Try this health insurance increase on..

[lendaddy]

I have our company on a PPOM provider (enrolled physicians favored) program. It's I'm sure similar to what most have. Well I just got my rate increase for next year.... 54%!!!!!!

Back to BlueCross BlueShield.

Sweet fancy Moses

[onewhippedpuppy]

Just a mere inflationary increase.........

[MRM]

Health care reform doesn't sound so bad right about now, does it? We all pay for the uninsured anyway, so universal health care would just be a more honest way of doing it. If businesses could count on a certain level of income for all treatment and not have to rack up our fees to pay for the uninsured and deadbeats, the cost should go down for everyone. The problem is that the current system is broken. Free markets don't apply to our health industry now. It is so inneficient that we get the worst of both worlds - high prices and poor service. I can see that someday we will have to go to a single payer system of some kind just to remain competetive in the world economy.

[Scuba Steve]

They've gotta pay off malpractice lawsuits somehow...

I'm afraid lawyers will have a good time going after the deep pockets of the government if they nationalize health insurance.

[lendaddy]

Originally Posted by MRM

Health care reform doesn't sound so bad right about now, does it? We all pay for the uninsured anyway, so universal health care would just be a more honest way of doing it. If businesses could count on a certain level of income for all treatment and not have to rack up our fees to pay for the uninsured and deadbeats, the cost should go down for everyone. The problem is that the current system is broken. Free markets don't apply to our health industry now. It is so inneficient that we get the worst of both worlds - high prices and poor service. I can see that someday we will have to go to a single payer system of some kind just to remain competetive in the world economy.

The answer is to return to a market driven system, not socialize it.

But being realistic I know that we will at some near point have socialized medicine. It's just a matter of when.

[MRM]

I agree with you, Len. I just can't figure out how to return the mess we have back to a real market driven system. That's how I got to start thinking about a single payer system. You can design a single payer system that guarantees a basic level of payment to the provider but still allows all the providers to remain in the marketplace competing for patients.

Single payer is different from socialized medicine, even the Canadian and UK model. In socialized medicine the government takes over the providers, puts them on a salary, and controls the treatment each person receives in exchange for making it free. Under a single payer system the providers remain private but the government acts as the overall insurer. Insurance companies would be free to administer the program, so they and the providers would stay in the marketplace. The main difference is that the risk pool would be all US citizens and the federal healthcare agency wouldbe the single payer, except for optional programs that individuals sign up for and pay on their own. Instead of paying health insurance premiums we would pay some sort of a healthcare tax. The idea is that by creating the largest risk pool and simplifying reimbursement by having only one payer, the system gets more efficient and cheaper, so your health care tax will be far less than your current health insurance premiums plus the taxes you already pay to cover the uninsured.

There are other market-based ideas for fixing our health care system, but this is the basic concept that seems to me to work best, given what we have to work with. I'm certainly open to other, more efficient ideas.

[Tobra]

Originally Posted by Scuba Steve

They've gotta pay off malpractice lawsuits somehow...

I'm afraid lawyers will have a good time going after the deep pockets of the government if they nationalize health insurance.

Really that is a pretty small piece of the pie, the bulk of the money goes to the administrators of the plan, not the physicians anyway. The margin on the HMO plans(vs PPO) is greater for them, so the give you 'incentives' to choose that plan. These are not stupid guys, they see the bright light at the end of the tunnel and know their days are numbered, smart money cashes out as much as possible. You will see (and have seen healthcare premiums climbing steadily. You have not seen (and shall not see) a corresponding increase in physician reimbursement.

[WI wide body]

Originally Posted by lendaddy

The answer is to return to a market driven system, not socialize it.

But being realistic I know that we will at some near point have socialized medicine. It's just a matter of when.

We probably have more of a "market driven" system than a socialized system right now.

I totally understand where you are coming from and the theory is great: let the market determine the costs. But in reality it often just does not work. Problem is that whenever regulations are rmoved all thwe whiz bangs who run the big outfits figure out how to job the system.

If you doubt this, look at nearly everyrhing that has been deregulated over the past 30 years: rail & truck transportation, airlines, banks, S & L's, insurance, gas and electric utility, phones, etc etc and you name one and it probably is worse after letting the big guys use their political and financial clout to write the rules or create monopolies.

[Dueller]

Not to hijack your thread, LenDiddy, but on a related note, What do you guys think is a reasonable amount to pay for health care coverage as a percentage of your income or as a flat amount? Either in premiums+ deductibles or tax rates or whatever system you can think of.

For example, my wife and I have a high deductible, high copay and an HSA. Our plan has a $5000
deductible, pays 70% of approved charges after the deductible. We are allowed to place $3750 per year into the HSA which we can use for medical expenses not covered. $1million lifetime benefits cap. So with our premium of c. 850/month and roughly $325/month going into our HSA we're spending $1125/month for our coverage.

Let's assume I have an accident and run up a $10K bill. We would pay $5K from the HSA, insurance would pay $3750 and we would be responsible for another 1250 the insurance didn't cover. Obviously we are primarily insuring against a catastrophic injury.

I would guess we are fortunate that we can swing this...I cannot see how a couple making less tahn $75-100K/year could.

So what do you guys think is reasonable cost for health care coverage?

[CurtEgerer]

Len - I just saved $20,000 per year on my health ins. costs. It's the same Blue Cross coverage I've had for my employees but I switched to a different deductible plan (can't recall the name of it right now ...). Originally, each employee had a $500 deductible for major procedures. I upped that to $2000 but agreed to pay the $1500 increase out of my pocket if they use it. If everyone remains healthy, I save $20K per year. Worst case scenario and everyone on the plan maxes out their deductible, I still save something like $5000.

[onewhippedpuppy]

How about we secure our borders, then actually ENFORCE the laws on the books? No illegal aliens = very few that don't pay their medical bills.

I'm amazed that there hasn't been a company that steps up and fills the void in our health care system. Right now we have many high-cost insurance carriers, who are making money hand over fist. They raise rates but not reimbursements, therefore increasing profit margins. More of a high cost, low volume strategy, because I assume that each price increase drives off customers. I'm honestly suprised there isn't a low cost, high volume health care provider.

Even at the current reimbursement levels, you could simply have a smaller profit margin than the existing companies and make up for it based on volume. God knows people would be knocking down your door money in hand, if you were able to offer reasonably priced health insurance.

[lendaddy]

Regulations prevent or discourage any truly unique solutions.

[Dueller]

Originally Posted by Scuba Steve

They've gotta pay off malpractice lawsuits somehow...

I'm afraid lawyers will have a good time going after the deep pockets of the government if they nationalize health insurance.

If that's the case, please explain why the average claim paid per doctor is around $12K/year and the average premium per doctor is about $35K/year.

[Superman]

Originally Posted by lendaddy

Regulations prevent or discourage any truly unique solutions.

This is dishonest. I would be surprised if you were this poorly informed. Part of the problem, Len, as you know, is that our money pays for everybody's health care. There is already universal health care, and it is being managed by the health care industry. You are paying, and they are making the pricing decisions. Aspirins cost a thousand dollars apiece, and then insurance companies and Medicare cut "special" deals that are not really special, except that they reduce the $1000 cost of aspirins.

The other problem IS competition. Everybody has to have a CAT scan. I don't know of any economist that buys into the mythology that the free market meets all needs and resolves all problems. In fact, it is undeniable that markets must be regulated. At least in the sense that competition must be preserved. Monopolies are not efficient. In order to be able to make use of the supply/demand mechanisms in capitalism, there needs to be competition. And there is competition in most industries including this one. But that competitive behavior is not automatically, always, reliably, good for the consumer. Look at the pharmaceutical companies, Len.

This "regulation is the problem" crap is grasping at straws. And far from true. Radical right-wing vision is at least as twisted as radical left-wing barf.

[Porsche-O-Phile]

Originally Posted by onewhippedpuppy

How about we secure our borders, then actually ENFORCE the laws on the books? No illegal aliens = very few that don't pay their medical bills.

Such "politically incorrect" statements are verboten in the new NannyState America. Back to "sensitivity training" for you. It's "undocumented", not "illegal", you know!

[Moses]

I buy health insurance for all my employees. I pay 100%. I am getting KILLED. Hospitals, pharmaceutical companies and medical technology/diagnostic companies are making record profits.

My malpractice rates continue to climb despite never having been sued. My employees still expect yearly raises/bonuses. My office rent is now up to $6,500/month. Medical supplies have quadrupled in price over the last 10 years.

My contracted rates of reimbursement are less now than they were 15 years ago. I work longer hours and earn less every year.

Private practice is dying.

[onewhippedpuppy]

Originally Posted by Porsche-O-Phile

Such "politically incorrect" statements are verboten in the new NannyState America. Back to "sensitivity training" for you. It's "undocumented", not "illegal", you know!

So what you're saying is that we should all learn Spanish, then pay them to become citizens?

[Dueller]

Somehow I don't think Tylenol costs $13 each in the e/r because of undocumented or illegal aliens. That is unless they're executives for a pharmaceutical company or HMO.

[Moses]

Originally Posted by Dueller

Somehow I don't think Tylenol costs $13 each in the e/r because of undocumented or illegal aliens. That is unless they're executives for a pharmaceutical company or HMO.

Illegal aliens have very little impact on the price we pay for health insurance as they are generally uninsured. The cost of their care is borne by county, state and federal funds. Ultimately, they have an impact on your tax rates, but not your health insurance rates.

[Dueller]

Originally Posted by Moses

Illegal aliens have very little impact on the price we pay for health insurance as they are generally uninsured. The cost of their care is borne by county, state and federal funds. Ultimately, they have an impact on your tax rates, but not your health insurance rates.

That was my point, Doc.

Can you answer this? I have an HSA and essentiaally catastrophic coverage. We have never met our deductible (fortunately). On the rare occasions my wife or I do go to a provider, we indicate we will be paying upfront ourselves. As a result we get charged the super retail amount; i.e., not the discounted amounts an insurance company would pay. I've been fortunate to have one of my wife's physicians to charge the resuced amounts. Where it is most painful to the pocket is with pharmacies. Since we are paying from our HSA we still get charged much more than what an insurance company would pay for the same meds.

We've esssentially agreed to self insure up to $10K or so. Doesn't seem fair.