My Health Care Rant

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snoqueen
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Re: My Health Care Rant

Postby snoqueen » Sun Jul 26, 2009 3:11 pm

The risk is that someone in your pool will have a very expensive illness or accident, costing more than all the premiums everyone else has paid.

minnow
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Re: My Health Care Rant

Postby minnow » Sun Jul 26, 2009 3:38 pm

White Rabbit - I believe 100% in what you have said As to catastrophic health issues, there may be something in that; however, if that is so in your employer's case, then that is where I'd expect the Government to step in - perhaps. By the way, thanks for the RecallDoyle.com plug - even though you don't agree. :) :) That's why I enjoy being an American. We can disagree and still accept other's ideas and suggestions.

white_rabbit
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Re: My Health Care Rant

Postby white_rabbit » Sun Jul 26, 2009 4:55 pm

snoqueen wrote:The risk is that someone in your pool will have a very expensive illness or accident, costing more than all the premiums everyone else has paid.


There are over 500 employees and the company paying into the "pot" for over 35 years that the company has been in existence. The only money that is drawn out is to pay claims and pay administrative fees. I get an annual statement of benefits that lays out how much money is in the fund. To date, we collect more than what is paid out and have quite a comfortable reserve for when our workforce ages. There is no profit taking insurance company or shareholders to raid the reserves. The money that is in the fund may be invested, preferably in the company, but it is not a zero sum game-plan, it's intent is to grow and mature right along with the average age of the employees of the company.
Last edited by white_rabbit on Mon Jul 27, 2009 8:42 am, edited 1 time in total.

Huckleby
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Re: My Health Care Rant

Postby Huckleby » Sun Jul 26, 2009 5:28 pm

I get my insurance through a "public option" - HIRSP.

This is a health insurance plan that the state of WI runs, and it is used mostly by individuals who can't buy insurance easily. HIRSP is heavily subsided, yet still it is not cheap. There is a high deductible, and policies are still in $400-> $800 per month range, mostly.

The claim that a federal public option will blow away the insurance companies is ridiculous. Any public option is bound to treat people more fairly than a private plan, and therefore it will attract undesirables (such as myself. :) ) Plus it's not like the state or federal treasury has tons of extra money lying around to subsidize a public option, quite the opposite is true. Its likely to be underfunded.

How much has a public option in WI impacted insurance companies here? Not a bit. Same goes for the other state public options around the country. The scare tactics by the Republicans about a big, bad public option are unfounded.

I'm afraid liberals have put too much false hope in transitioning a public option into single payer someday. A public option is unlikely to thrive, especially given the strength of the Insurance lobby and federal budget constraints.

I started out being a "Public Option or death!" guy with the current reform process, but I've come around to seeing the public option as just a limited tool to effect change.

fennel
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Re: My Health Care Rant

Postby fennel » Sun Jul 26, 2009 6:37 pm

Huckleby wrote:The claim that a federal public option will blow away the insurance companies is ridiculous. Any public option is bound to treat people more fairly than a private plan, and therefore it will attract undesirables (such as myself. :) ) Plus it's not like the state or federal treasury has tons of extra money lying around to subsidize a public option, quite the opposite is true. Its likely to be underfunded.
As I understand it, a Public Option will draw "undesirables" only in proportion to what it can offer, since private companies will no longer be allowed to pick and choose. To use a tired cliché, they'll be forced to compete on a level playing field. So both public and private will be working with the same customer pool. The question is, "Which can provide a better quality?"

The record so far seems to show that the private sector has some serious catching up to do.

It's possible the private sector could defy history and come out ahead in terms of delivering the best health care for the least money. But my hunch is that those elements of the private sector who might do so are at the polar opposite of the Interest Spectrum from those currently moaning about "socialized medecine." If nothing else, I think we should give them a voice.

Huckleby
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Re: My Health Care Rant

Postby Huckleby » Sun Jul 26, 2009 7:02 pm

fennel wrote: As I understand it, a Public Option will draw "undesirables" only in proportion to what it can offer, since private companies will no longer be allowed to pick and choose. To use a tired cliché, they'll be forced to compete on a level playing field. So both public and private will be working with the same customer pool. The question is, "Which can provide a better quality?"


Ya, I know, in theory the public/private will have to play by same rules of admission.
But the privates will still have every incentive to make their operations unattractive to older and sicker customers. The plans themselves may be somewhat similar, but not identical. For instance, the private could offer lower quality joint replacements for their basic insurance plan than the public plan offers. They'll find devious ways to do some cherry pickin. I expect sicker people will gravitate to public option.

BTW, I'm still very much for a public option!
I'm just pointing out that the case against it that it will have infinitely deep pockets and destroy the private market is baloney. And I am not optimistic that it will lead to single payer.

I watched a very insightful interview with president of Mayo Clinic:
http://www.charlierose.com/view/interview/10496

He is very much for Obama's reforms, in the main. He supports a public option, but I have picked up some my own skepticism from him. He points out that there are already 6 different public options: medicair, VA, medicade, etc. and all of them have had trouble controlling costs because of their fee-for-service structure. He mentioned one public option, called "tricare" for the military that he says has done a good job. Adding a new public option will only be helpful if it is done innovatively.

The Mayo Clinic guy is enthusiastic about Dr. Emanuel's ideas, and in fact he suggests that Emanuel is the brains behind the OBama reform strategy. ( Ezekiel Emanuel is Rahm Emanuel's brother.)
http://www.pbs.org/now/news/315.html
http://www.c-spanarchives.org/library/i ... d=283359-1
Last edited by Huckleby on Sun Jul 26, 2009 7:15 pm, edited 1 time in total.

white_rabbit
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Re: My Health Care Rant

Postby white_rabbit » Sun Jul 26, 2009 7:15 pm

Huckleby wrote: There is a high deductible, and policies are still in $400-> $800 per month range, mostly.



That must suck. I don't pay anything more than a $20 copay and most times its much less than that. I put about $600 into my pretax FLEX plan each year to cover those costs and I usually have money left over come January first.

fennel
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Re: My Health Care Rant

Postby fennel » Sun Jul 26, 2009 7:25 pm

Huckleby wrote:But the privates will still have every incentive to make their operations unattractive to older and sicker customers.
Point taken. But if there's a public option in any meaningful way, the services offered need to be demonstrably on par.

Whichever can show that their version is best sets the standard. The competition will be in how to reliably meet that standard.

From a business standpoint this is silly, I know. It's so much easier to compete via "donations."

Huckleby
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Re: My Health Care Rant

Postby Huckleby » Sun Jul 26, 2009 10:21 pm

The public option can do some good, but I fear it won't take us to the promised land of single payer because of political forces. It will be mostly wheel spinning in the mire.

Rather than add a new public option, get rid of all the existing public options, including medicare. Then the government issues a voucher to every citizen to either buy insurance, or perhaps start a health savings account. The vouchers are paid for by a VAT (national sales tax of sorts.) The government would closely regulate the insurance companies, and would mandate certain best practices. The independent review board discussed in current reform proposals would be the model for a qausi-independent regulation body.

Wallah! This is a solution that could actually happen and work.

fennel
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Re: My Health Care Rant

Postby fennel » Sun Jul 26, 2009 10:43 pm

I'm starting to question whether there should there be any private option? Given the record, it might be good to do without private options for a few years, then re-evaluate whether it has any prospect at all.

Huckleby
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Re: My Health Care Rant

Postby Huckleby » Sun Jul 26, 2009 11:00 pm

fennel wrote:I'm starting to question whether there should there be any private option?


OK, lets talk about it in real terms. Lets say the plan is to expand medicare to cover every American. How could you get this through politically? Right now, I would say that proposal might garner the support of 25% of American public. I'm with you, but you have a lot of work to do.

Peacetrain
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Re: My Health Care Rant

Postby Peacetrain » Mon Jul 27, 2009 8:01 am

Peacetrain wrote:
Huckleby wrote:
white_rabbit wrote: What is this "risk" you keep mumbling about?


If you wind-up needing a kidney transplant, and the bill comes to $200K, who gets fucked in the ass?

I'm guessing $200K doesn't come directly from your employer's bank account.

.


White rabbit- you still havent answered the above question. Who covers costs beyond the basics.

you said your employer pays in 2x what you do, why do want our employer involved in our health care? thought we trying to move away from that?

Also if our goal is to take proits out of health care, shouldnt that go for providers as well?


W.R. - If i understand correctly, you will never pay more than your premium and a small co-pay($20 or less) per visit and in return you get full coverage?

You also say its because they take the profit aspect out.
Why then arent other non-profits(or government) able to duplicate these results?

I love what your plan seems to offer but its hard to believe there isnt a catch somewhere, but you keep claiming theres not so maybe im not missing something.

white_rabbit
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Re: My Health Care Rant

Postby white_rabbit » Mon Jul 27, 2009 10:19 am

Peacetrain wrote:

W.R. - If i understand correctly, you will never pay more than your premium and a small co-pay($20 or less) per visit and in return you get full coverage?



Office visit copays are $15. Certain tests have a copay, I had high cholesterol so my quarterly blood tests have a $15 copay. Annual physicals and dental check ups are covered 100%. I have two prescriptions, one for cholesterol which I will hopefully soon not need to take, that is $20 copay, it's actual cost is about $120 if I had to pay full price, the other is for high blood pressure which I have also got under control and will hopefully stop that as well, which is $4.50 copay for a month worth of prescription, retail price is around $25.

Our health care premiums are tied to costs, not profit. In 2008 we effectively contained costs so we had zero increase in our premiums going into the 2009 plan year. The company if focused on keeping a healthy workforce, we have an on site fitness center at work that is free to employees, family and partners and our on site deli tries to focus on providing healthy and nutritious food. Of course there are life time limits written into the plan, but I think it's something like $5million in benefits. We are also a younger, but aging workforce and the company has very low turnover and longevity of employee service. Obviously as we age there will be increases in costs but as it is now the biggest costs to the system are new births and if I'm correct we end each year with more money in the system than the previous. Luckily we have had very few, if any, catastrophic illnesses for those in the plan but it's bound to happen. I don't know if the company has secondary insurance to cover such instances, but I will ask HR. I do know that we carry separate long and short term disability insurance. Our dental insurance is through Delta Dental and we also have a vision plan which I opted out because I put my vision dollars in the FLEX plan, but for the health care we are self insured. I was talking with a coworkers wife recently who works for Dean and she told me they pay less through my employer for insurance than if they elected to pay for DeanCare through her employer. Even that had me scratching my head saying, "how does that work?".

Keep in mind, the $35.25 per pay period that I pay is for a single man, the rates are obviously higher for those with families and/or partners. The thing I like most about our system is the portability. My doctor is at Dean, but he recently mentioned to me that he is thinking of retiring in the upcoming years. I'm not locked into Dean, when he does retire I can shop around for a new doctor at any of the Alliance participating groups, which is basically all of them with the exception of GHC.

Huckleby
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Re: My Health Care Rant

Postby Huckleby » Mon Jul 27, 2009 11:19 am

white_rabbit, I guess your employer is contributing a lot more to your health plan costs than you realize. Either that or your coworkers are androids who never get sick.

white_rabbit
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Re: My Health Care Rant

Postby white_rabbit » Mon Jul 27, 2009 11:51 am

No, I get a plan summary every year. We pay more into our system than what is taken out in claims. Yes, the employer contribution is generous, twice than what we contribute. But we have cut out the profit taking insurance companies and pay a plan administrator instead for a fraction of the cost. An expectation is that we be wise and informed health care consumers and take care of ourselves. The company hosts health and safety fairs each year and we are encouraged to be fit and healthy to help contain costs. We are also discouraged from running up costs as well. Mammograms and colonoscopys are covered 100% but a visit to the ER is a $50 deductible, while urgent care is a $15 copay. I'm now curious about your plan considering how skeptical you are that health care can be done well while containing costs.


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