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MrJoshua
MrJoshua PowerDork
11/18/14 12:19 p.m.
Swank Force One wrote: That wasn't really the point. Yes, insurance is just one more thing to get involved. No, i don't want to go without insurance. Why not? Because CARE costs are out of control. Health CARE reform didn't address anything related to health CARE costs.

I agree health CARE reform didn't address health CARE costs, but I disagree with your notion that health insurance is an innocent bystander not driving prices up. It is major contributor to cost.

aircooled
aircooled UltimaDork
11/18/14 12:20 p.m.

I think the point Swank is trying to make here is that the insurance companies are not making unreasonable profits. There are still likely a LOT of COSTS (overhead, admin etc), but that is not the fault of the insurance companies. It's certainly in the interest of the insurance companies to keep costs down.

SVreX
SVreX MegaDork
11/18/14 12:29 p.m.

In reply to Swank Force One:

Yep.

I seem to recall somebody who used to race a Yugo arguing (long before we got into this mess) that we needed to address health COSTS, before we could consider offering health INSURANCE.

Oh well...

SyntheticBlinkerFluid
SyntheticBlinkerFluid PowerDork
11/18/14 12:29 p.m.

I've been looking at health insurance, and it's damn expensive.

Truth is, I can't afford it, but I can't afford not to have it. Don't want a penalty for not having it either.

I don't know what to do.

Xceler8x
Xceler8x GRM+ Memberand UberDork
11/18/14 12:46 p.m.
Datsun1500 wrote: All I hear in this thread is how important it is to have. If it's so important, then sacrifice something to pay for it. Is it more important than a car? Car insurance? Vacations? Etc. People find a way to afford those things, they can find a way to afford insurance. Do I want to pay $14,000 in insurance premiums every year, not really, but I'm not willing to risk not having it. If everyone was buying it at an early age instead of depending on someone else to handle it, premiums would be much, much, cheaper. As pointed out a few times here, a lot of the cost is to make up for the people that are not paying.

Because everyone can afford a car and vacations. <- sarcasm.

If you're using this as a stand in for various luxuries I can say that "Yes, Virginia. Some folks live without luxuries and still can't afford health insurance or care."

If you buy insurance at an early age it will be cheaper. Not cheap, but cheaper. Check the numbers I submitted earlier in the thread. Its when you're older and sicker that it becomes burdensome for various reasons.

Some of the cost is to make up for people who can't afford to pay or work the system so they don't have to. The rich and middle class do this as well. The rest of the cost is due to various factors such as inflated prices for service, inflated prices for medical products, inefficient use of resources, etc. The high cost of medical insurance and care is not due to one cause as stated in your post.

SVreX wrote: I seem to recall somebody who used to race a Yugo arguing (long before we got into this mess) that we needed to address health COSTS, before we could consider offering health INSURANCE. Oh well...

I agree with this completely. Until we control the costs we'll never see true health care reform. It would seem the big argument is how to do that. Control costs? That would most likely require gov't intervention. Control profits? See my previous statement. Single payer plan wherein the gov't negotiates for it's citizenry? It would seem a vocal portion of the population is against this. Use market forces to drive down the cost of care? To do that we'd have to have transparent pricing. The ACA was a small step down the road of adjusting all of this.

All while we have one the least effective and most costly medical care in the industrialized world.

Swank Force One
Swank Force One MegaDork
11/18/14 1:15 p.m.
MrJoshua wrote:
Swank Force One wrote: That wasn't really the point. Yes, insurance is just one more thing to get involved. No, i don't want to go without insurance. Why not? Because CARE costs are out of control. Health CARE reform didn't address anything related to health CARE costs.
I agree health CARE reform didn't address health CARE costs, but I disagree with your notion that health insurance is an innocent bystander not driving prices up. It is major contributor to cost.

I haven't really made the point that insurance is an innocent bystander, but until something is done about costs and/or there's much better regulatory measures concerning providers, insurance is 100% necessary. There's no way around it.

There's mandates that tell insurance companies that xx pennies on the dollar have to go directly towards paying claims. Yes, you could make the argument that the remainder is unecessary and is what's driving costs up. However, that's pretty short-sighted, as the remainder (which is $0.10-0.15 depending on policy) is what pays my salary. Pays for our buildings. That remainder is what runs the business. What's left out of that is profit.

These mandates have already had a huge effect on the companies. Many of my friends have lost their jobs. I haven't worked less than an average of 55 hours in almost 5 years, and it's getting even worse. Our workload is increasing due to other things caused by ACA, and we can't afford to hire more bodies.

There's a change coming 1/1/2015 from ACA that is increasing costs of my department (Small. Less than 20 people.) ALONE by over $300k.

Yes, some of you are getting hosed. Many of you are getting hosed. I'm getting hosed. That's how insurance of any kind has always worked. Everyone hates it until they need it.

And let me tell you... with how much services cost, you need it.

We aren't the bad guys. We're just working with what we're given.

madmallard
madmallard HalfDork
11/18/14 1:36 p.m.
SyntheticBlinkerFluid wrote: I've been looking at health insurance, and it's damn expensive. Truth is, I can't afford it, but I can't afford not to have it. Don't want a penalty for not having it either. I don't know what to do.

sadly, the choice to choose at all has been wrested from you.

at the individual level, your options are only to pay for terrible coverage, or pay slightly less for no coverage in what basically amounts to a "life tax." there is literally no other choice.

at the political level in long term solutions, your job is to make sure if you have any democrat in your representation of the federal government that voted for this legislation know that you are unhappy and that you vote.

racerdave600
racerdave600 SuperDork
11/18/14 4:58 p.m.

I work in a small company, and except for payroll, health insurance is the single biggest cost that we have. The owner is set on always offering it, but the costs have more than doubled in the past 3 years. It is getting more difficult, even with the amount charged to employees.

But we still haven't touched on several reasons prices are so high. There are many, but I will focus on two, as they are big ones in the price drivers. First and foremost is the cost of doing business in our current state, and that is mainly due to lawsuits. The number of tests run have much to do with covering your butt, and the price of malpractice insurance is downright staggering. My wife's employer pays close to $1 million a year for his office. Let that sink in for a minute and then determine how many patients it takes to pay for that. I know in our state, many insurance companies refuse to do business here because of the amount of awards from juries. It really is out of control.

Second, we basically fund the medical advances for the world. As the rest of the world caps what can be charged for devices and medical coverage, the world's companies use the US to fund R&D, etc. Don't discount this as cost driver.

There are so many ways to reduce cost in this industry, but they aren't vote getters.

racerdave600
racerdave600 SuperDork
11/18/14 5:00 p.m.

As for profit margins, those are tiny, tiny figures. Most companies couldn't survive on those.

RX Reven'
RX Reven' GRM+ Memberand Dork
11/18/14 6:23 p.m.
racerdave600 wrote: First and foremost is the cost of doing business in our current state, and that is mainly due to lawsuits. The number of tests run have much to do with covering your butt, and the price of malpractice insurance is downright staggering.

Hi Racerdave600,

As I pointed out back on page four, 15% to 18% of the total cost of running our health care system is attributed to defensive medicine IE: tests, procedures, meds., & devices that aren’t indicated but rather are purely proscribed to protect against litigation.

This isn’t a left Vs right thing…both sides have conducted multiple studies over multiple years and have consistently come to the same tight range of estimates.

All we need is a tiny piece of tort reform to exclude punitive damages and that 15% to 18% would be cut in half overnight. We could then redirect this surplus of resources to provide medical care to everyone in the nation that doesn’t currently have medical insurance without imposing any additional burden on the system.

It’s not too good to be true, do the math yourself, it works. Simply stated…don’t waste resources doing an MRI that isn’t needed just to keep from getting sued, do the MRI on the poor guy that just fell off a roof.

At the end of the day, you’ve got the exact same number of doctors, nurses, hospital beds, MRI machines, etc. all working at the same pace. The only thing that has changed is that you’re now better allocating resources because you no longer live in fear of massive settlements.

The icing on the cake is that you’re also no longer paying out massive settlements but don’t forget, the huge, huge, huge win is that you’re allocating resources optimally.

Unfortunately, the ACA wasn’t crafted by process engineers with years of REAL experience in the medical field with millions of dollars of REAL savings to their credit such as myself, it was crafted by people that are short on knowledge and long on agenda.

RX Reven'
RX Reven' GRM+ Memberand HalfDork
11/18/14 7:19 p.m.
MattGent wrote: Data as of 2011 (prior to ACA). The problem was never health insurance company profit margins, but the "fix" was applied there as it was the only thing they could pass.

Yep, pharma averages 15.4% net profits and had no special tax imposed, devices average 12.6% and had a 2.3% special tax imposed.

In case anyone has made the mistake of listening to the politicians behind the ACA, the 2.3% is on gross sales not net profits….somehow they always manage to leave that small detail out.

That works out to a whopping 18.25% of net profits taken on top of the standard 35% corporate tax.

I can’t begin to tell you how infuriating it has been to see politician after politician get in front of the camera and ridicule device makers saying “it’s not that big of deal, it’s only 2.3%”.

We’ve cut our shifts in half and built a huge factory in Malaysia to survive.

Folks, we’ve really screwed ourselves with the ACA.

Marjorie Suddard
Marjorie Suddard General Manager
11/18/14 7:39 p.m.
Swank Force One wrote: That wasn't really the point. Yes, insurance is just one more thing to get involved. No, i don't want to go without insurance. Why not? Because CARE costs are out of control. Health CARE reform didn't address anything related to health CARE costs.

This. We really need to stop taking the bait and refuse to follow our political process like it's a sporting event (complete with convenient red and blue team colors) and start going after the root causes of most of our problems: corporate lobbies that get away with murder AND robbery while we chase the rabbits they hired to run.

Margie

wbjones
wbjones UltimaDork
11/18/14 9:14 p.m.

what she said

Swank Force One
Swank Force One MegaDork
12/3/14 12:07 p.m.

Just to bring this back to the surface.

Today i learned that our health plan costs more than what SWMBO makes at her job.

mtn
mtn UltimaDork
12/3/14 12:15 p.m.

The whole thing is insane. Why is it that 2 married young people cost more to insure on one policy than those same 2 people on separate policies? There is literally no difference in the coverage. (It is a family plan, but still utterly stupid)

mtn
mtn UltimaDork
12/3/14 12:15 p.m.
Swank Force One wrote: Just to bring this back to the surface. Today i learned that our health plan costs more than what SWMBO makes at her job.

Swank Force One
Swank Force One MegaDork
12/3/14 12:23 p.m.

To be clear, it doesn't cost US more. But someone is paying it.

Nick_Comstock
Nick_Comstock PowerDork
12/3/14 12:32 p.m.

In reply to Swank Force One:

Before we left TN, SWMBO had $40 left every month after paying insurance for her and our son.

Swank Force One
Swank Force One MegaDork
12/3/14 12:37 p.m.

madmallard
madmallard HalfDork
12/3/14 2:26 p.m.

In reply to mtn:

probably the 2 biggest problems right now as far as cost are actually the employer mandate, and the tossing out of what the government considers 'junk plans.'

""they"" made it so insurance plans are now required to cover all sorts of things that they may not have had to at levels they didn't before. Basically; if a company offered a stripped down plan, a regular plan, and a max coverage plan:

the stripped down plan was made illegal. the regular plan was forced to add things they didn't cover before. the max coverage plan had a new 'cadillac' tax added to it for being too good.

so even if you wanted to do business with an insurance company that only covered a few things that you worried about, you cant find that kind of coverage anymore. (like if you're snipped or tied, getting insurance that doesnt cover pre-natal to save money.)

and even if you -had- good coverage before the ACA, because of new taxes, you're paying more for the same coverage.

Flight Service
Flight Service MegaDork
12/3/14 2:39 p.m.
RX Reven' wrote: Unfortunately, the ACA wasn’t crafted by process engineers with years of REAL experience in the medical field with millions of dollars of REAL savings to their credit such as myself, it was crafted by people that are short on knowledge and long on agenda.

That is the only thing on this whole thread I agree with, but hell it has been floating around Washington since the mid-90's when Gingrich tried to pass it...

racerdave600
racerdave600 SuperDork
12/3/14 5:10 p.m.

Like most things, when politics are involved, things get expensive and crappy.

failboat
failboat UltraDork
12/3/14 7:32 p.m.
mtn wrote: The whole thing is insane. Why is it that 2 married young people cost more to insure on one policy than those same 2 people on separate policies? There is literally no difference in the coverage. (It is a family plan, but still utterly stupid)

I dont understand this either. We just had our meeting today to review our healthcare changes for the upcoming year...

All by myself = $117 per paycheck keeping my current plan. Up $17 from last year (well there goes a nice chunk of my measly raise...)
Me and the wife = $295. Oh wait, her employer offers a healtcare plan? Thats an additional $100 surcharge to have her on my plan. So yeah, nearly $400 per paycheck. (not including dental, vision, optional life insurance stuff, FSA..)

berkeley that. every man for themselves!

N Sperlo
N Sperlo MegaDork
12/3/14 8:13 p.m.

I have my own insurance. My coverage is ok. I have some bills, but I take my time paying them. My meds through my company will run me around $300/mo. My wife has me on her insurance, but it doesn't cover until mine runs out except for medicine. Medicine runs me approx 50/mo. Soon my wife will change jobs. Hello 300/mo meds. I have no idea how this E36 M3 works.

slefain
slefain UberDork
12/3/14 8:47 p.m.

Self-employed here, single income, family of four. Our insurance is going up $120 per month for 2015 (through the exchange). Screw that. I'm trying to pick from one of the "gold" plans but the cheapest is $540 a month. What I hate is trying to find a plan that covers what we need. If they have good prescription drug coverage, they don't have pregnancy coverage (we want one more kid eventually). If they have pregnancy coverage, they don't cover my son's occupational therapy. If they cover occupational therapy, they have lousy prescription drug coverage. If they cover everything we need then I accidentally scrolled too far and got into plans we can't afford.

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