HealthCare Opinions (2 Viewers)

[bergs]

It's that of year again (Open Enrollment in the US for employer-provided healthcare).

Anyone seeing any new or interesting trends?

We've been asked to provide biometrics (results of a full physical) to the insurer or get assessed a $50 per month penalty. They say that they want to use these to better refine their offerings, but the rumor is that they're going to use these to provide something like healthcare coupons in a couple of years and will vary the amount of the coupon based on your biometrics, and then you can go out to the Exchange and get your own healthcare.

Since the inception of Obamacare I've thought that employer provided HMO/PPO programs were going to be an executive-only perk in 5 years and it sadly seems that we're on that timetable. There are some great provisions in Obamacare (e.g. nobody should have to go confirmed busto because they get sick) but I'm not thrilled about what I've seen thus far outside of those far reaching provisions.

 

[grandgnu]

It's just another way for our government to find ways to tax us. I'm going to get socked with the penalty on my taxes this time around and it goes up again next year I believe. Le sigh

 

[Tommy]

I just did my mine the other day. The only thing that changed is ER visits went from $50 to $75 copay. (both are waived if omitted). Our union actually kept our rates decent. I pay $208 per month for the family. (includes dental and vision)

 

[links_slayer]

Medical (employee + 1) went up ~$10/paycheck with no changes to coverage
Dental: No change
Vision: No change

To avoid a $50/person/paycheck increase we needed to certify that each person covered is a non-tobacco user or was going to enroll in a cessation program by the end of 2015.

 

[abby99]

Wellness programs and biometrics were adopted by employers well before the passing of the Affordable Care Act in an attempt to control employer-sponsored health insurance premiums (15 years ago?). Although there are concerns that some "voluntary" wellness programs (participate or pay a higher premium) might be in violation of the Americans with Disabilities Act, they definitely seem to be gaining in popularity among employers and insurers.

My sense is that, at least in the short run, many/most large employers will continue to provide subsidized health care as a benefit in order to remain competitive in the job market, but smaller employers might provide subsidies for insurance obtained through exchanges. I'm particularly galled by those who want to repeal the ACA without offering a reasonable alternative.

The trend I see is that more and more Americans feel entitled to receive marquis health care that is paid for by someone else.

 

[Nickawompus]

It's that of year again (Open Enrollment in the US for employer-provided healthcare).

.....................

Since the inception of Obamacare I've thought that employer provided HMO/PPO programs were going to be an executive-only perk.....................

Pretty sure that employers are not allowed to discriminate by employee designation. One for all and all the same.

 

[ssanel54]

We've been asked to provide biometrics (results of a full physical) to the insurer or get assessed a $50 per month penalty.

Take the penalty

 

[Milo013]

It continues to baffle me how the US Government so magnificently BOTCHED the transition to a National Healthcare system. Could they not have just looked at Canada (or ANY Euro nation) and said, "That looks good, lets copy THAT". They could even have gone the public/private hybrid that places like England and Germany (among others) use.

Nope . . . has to be MADE IN AMERICA. Genius.


And I would take the $50.00 hit. No way I want to turn over any more information than is ABSOLUTELY necessary to ANY third party.

 

[ellased]

i wouldn't say the canadian health care system is great though.
it's expensive for everybody (through taxes) and is continously run on a deficit.
there is no magic solution for the aging of the population. it just costs money plain and simple.

 

[Milo013]

i wouldn't say the canadian health care system is great though.
it's expensive for everybody (through taxes) and is continously run on a deficit.
there is no magic solution for the aging of the population. it just costs money plain and simple.

Oh, don't get me wrong, our system has it's flaws, chief among them wait times for noncritical procedures. But the US had a slew of options to choose from for a NAtional Healthcare system, and they seem to have ended up making NO ONE satisfied.

 

[JoseRijo]

Blaming Obamacare for rising health care costs is like blaming your children for your gray hair (or lack of hair). "Hey, I had a full head of black hair 10 years ago before I had kids, it must be their fault I now look like Old Man Winter."

 

[bergs]

Blaming Obamacare for rising health care costs is like blaming your children for your gray hair (or lack of hair). "Hey, I had a full head of black hair 10 years ago before I had kids, it must be their fault I now look like Old Man Winter."

I don't mind higher costs relative to what I perceive to be a "normal" increase. I'm not thrilled with the idea of having to spend hours shopping at a web-based Exchange and having to provide a lot of significant biometric information to a third party that is under no obligation to keep it private (the individual insurers that I would provide this too with my current organization's healthcare have indemnity up the ass from what I understand). I've grown accustomed to my employer providing a sufficient healthcare offering but given the ACA provisions, this may not make financial sense for them for very long. Simple market logic at work here.

On the flip side, I do like the provisions that prevent me from going confirmed busto if I get sick and need expensive treatments, and preventing insurers from declining people due to pre-existing conditions.

 

[atomiktoaster]

Milo, the one group that's happy with the new system is insurance companies with new mandatory customers. And Jose, if there's anything that's accelerating the aging process for my friends around 30, kids are definitely it. Your point still stands though

 

[jbutler]

no change for me in either cost or services. i have spousal medical/dental.

It continues to baffle me how the US Government so magnificently BOTCHED the transition to a National Healthcare system. Could they not have just looked at Canada (or ANY Euro nation) and said, "That looks good, lets copy THAT". They could even have gone the public/private hybrid that places like England and Germany (among others) use.

Nope . . . has to be MADE IN AMERICA. Genius.

frankly if it had been anything other than a clusterfuck i'd have been floored. nothing but the best in the usa. or at least the best you can get the bulk of a rotating group of 535 idiots to agree on. relative to the system as it was, obamacare is a big step up. relative to the system we should have in this country - single payer - it is a fucking catastrophe.

anyway, all this talk might turn out to have been for naught if King v. Burwell goes as some believe it will. like everything else in this country, i expect the healthcare economy to get a lot worse before it gets better.

 

[bergs]

Milo, the one group that's happy with the new system is insurance companies with new mandatory customers.

I'm not sure what everyone thought was going to happen. You had a national healthcare system created by legislators that were had significant healthcare lobby PAC funding. If there were two groups I wouldn't want involved in determining what program best serves the public welfare for healthcare it's the healthcare lobby (read: insurers) and representatives of the United States Congress.

 

[Schmendr1ck]

Several years ago, my forward-thinking employer saw the writing on the wall (and insurance premiums on our cadillac plan that were increasing 20-25% per year), so we switched to a High Deductible Health Plan (HDHP) in 2009. The company contributes to each employee's HSA to help offset the higher deductible, but still saves a substantial amount over the old PPO. I contribute the maximum to my HSA as well. In a bad year (where I hit the $4k deductible), my total out-of-pocket cost including premiums is cheaper than what I would have spent on the old PPO. In a good year, my costs are significantly lower. Additionally, a big chunk of the money I'm "spending" is actually sitting in my HSA and still belongs to me, rather than simply disappearing into the pockets of the insurance company.

Two years ago, my employer took it one step further and began self-funding our HDHP. Our company is part of a collective with a few other small businesses, and each contributes X dollars per employee to a pool which is used to pay all small and mid-sized claims. We still have an insurance policy for large claims, and our program is administered by a major health insurance provider. This saves us the hassle of doing it ourselves, and also gets us the same contracted rates from in-network providers that regular insurance customers receive.

In 2009, we started voluntary annual "wellness screenings." Basic blood work, fill out a questionnaire, get $50. When self-funding began, these became a little less voluntary. Yes, you can still opt out, but your insurance premiums will be $50 per pay period higher if you do. Also, in 2015 we're getting hit with a 15% premium increase, but this is primarily due to a high number of 2014 claims. In previous years, our premium increases were 3-6%.

What I like most about this plan is that we have been forced to become educated consumers of health care. It's not "30 bucks" to go see the doctor anymore (even though that was never really true on the cadillac plan) - we see the true costs, and we pay them out of our own money. Yet we save money over the old PPO plan, and we still have the safety net of an annual out-of-pocket cap for bad years and catastrophic events.

 

[grandgnu]

Here's something interesting that I came across regarding penalties, hadn't been aware of this. Might be a way out for me in paying their stupid tax, since I generally wind up owing a little because I have less taxes taken out of my weekly pay (because why would I want to give the government an interest free loan?)



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http://money.cnn.com/2013/08/13/news/economy/obamacare-penalty/

Among those exempted include: undocumented immigrants, Native Americans and those who earn too little to file tax returns. Also, people who would have to pay more than 8% of their income for health insurance and poor adults who live in states that are not expanding Medicaid also aren't subject to the penalty. The uninsured can also file for hardship exemptions.

So how will the penalty be collected? Through your tax return. But if some folks want to remain uninsured, it could be tough for the Internal Revenue Service to get the penalty. That's because Congress did not give the agency the authority to prosecute those who don't pay, a power it does wield over those who don't pay their income taxes, said Jay Angoff, a partner at Mehri & Skalet law firm who worked on health reform in the Obama administration.

Those who are owed money could see their refunds docked by the penalty amount. Others, however, will likely just get nasty letters.
"The penalties have little teeth," Angoff said. "Congress didn't give the IRS too much power."

 

[Milo013]

Under the ORIGINAL iteration of the Ontario Health Insurance Plan (OHIP), people would receive a yearly statement of what their usage of the system cost. Not what they were billed (because no one used to receive a "bill"). This allowed the taxpayer to SEE what the costs to the system were when, for example, they went to the ER with flu symptoms, or if they broke their arm.

The Government scrapped that program. With the rise in costs for healthcare, and the increasing use of ERs for basic medical visits, it might be time to bring that program BACK.

 

[noelsarchs]

It continues to baffle me how the US Government so magnificently BOTCHED the transition to a National Healthcare system. Could they not have just looked at Canada (or ANY Euro nation) and said, "That looks good, lets copy THAT". They could even have gone the public/private hybrid that places like England and Germany (among others) use.

Nope . . . has to be MADE IN AMERICA. Genius.




And I would take the $50.00 hit. No way I want to turn over any more information than is ABSOLUTELY necessary to ANY third party.

I lived in the UK national healthcare system from 2007-2009 and could have died under that fucked up system if I had not gone out and paid for a private doctor, not once, not twice, but three times. My coworker who lived there before me working in our office almost lost his sister who was left to die under that system. It's going to be survival of the

fittest plain and simple, both financially and medically.

So the genius of made in America has it's predecessor in the famous UK / Euro / Canadian systems. Good luck to us all.

 

[Milo013]

Correct me if I am wrong, but the NHS guarantees a basic level of healthcare for all, and people are free to supplement that with private insurance, correct?

 

[noelsarchs]

Correct me if I am wrong, but the NHS guarantees a basic level of healthcare for all, and people are free to supplement that with private insurance, correct?

Only when you can get an appointment which could take over 3-4 months, then after your 5 minutes (literally) with the doctor, a further appointment with the next doctor a few months later. Been there, done that. You go in to see a doctor only to tell them what's wrong and you have about 5 minutes until they send you on your way with a recommendation to see another one. It's the worst experience I have ever been through. The USA system where you can get an appointment now if you need one is vastly more desirable.

 

[abby99]

The USA system where you can get an appointment now if you need one is vastly more desirable.

Of course it is, unless you can't afford it. Then you wait until your problem is serious enough to warrant a visit to the ER and let those who have insurance pay for your treatment, which is the least cost-effective way of treating people. One way or another, the "haves" are going to pay for the care of the "have-nots." We just need to find the most efficient way to do it, and we need to come to terms with the fact the wellness care is more cost-effective than waiting until medical situations become critical. Or we could just let the poor die off -- that should solve the problem.

 

[jbutler]

Only when you can get an appointment which could take over 3-4 months, then after your 5 minutes (literally) with the doctor, a further appointment with the next doctor a few months later. Been there, done that. You go in to see a doctor only to tell them what's wrong and you have about 5 minutes until they send you on your way with a recommendation to see another one. It's the worst experience I have ever been through. The USA system where you can get an appointment now if you need one is vastly more desirable.

I guess we should just disregard the fact that study after study after study shows that UK consumers are far more satisfied with the NHS than Americans are with our piss poor excuse for a system.

 

[Nickawompus]

Here's something interesting that I came across regarding penalties, hadn't been aware of this. Might be a way out for me in paying their stupid tax, since I generally wind up owing a little because I have less taxes taken out of my weekly pay (because why would I want to give the government an interest free loan?)
"

Not being snarky just trying to understand here, you are employed without insurance? Sorry if I missed something here.

 

[grandgnu]

Not being snarky just trying to understand here, you are employed without insurance? Sorry if I missed something here.

Yes, my employer used to have health insurance but dropped it a few years ago (before Obamacare) so I am working full-time but no health benefits. It's a small, one-owner company. We had lost an account that was 40% of our business. Fortunately since then we've brought on new business and stayed afloat, and even looking to expand now. But the health beni's have not returned

 

[abby99]

Yes, my employer used to have health insurance but dropped it a few years ago (before Obamacare) so I am working full-time but no health benefits. It's a small, one-owner company. We had lost an account that was 40% of our business. Fortunately since then we've brought on new business and stayed afloat, and even looking to expand now. But the health beni's have not returned

Sorry to hear about this, gnu. IMO this is one of the major reasons why the USA needs to move away from a primarily employer-based healthcare plan.

 

[Nickawompus]

I guess we should just disregard the fact that study after study after study shows that UK consumers are far more satisfied with the NHS than Americans are with our piss poor excuse for a system.

Yes indeed but poll after poll after poll also shows Americans are dis-satisfied with the color orange so I'm pretty sure Gruber was not far off base and I blame Faux news.

[edit] Polls and studies are taken with far too many generalities to be of much worth IMHO.

 

[Mr. Cheese]

I'm self employed and my plan went from 175 a month to 275 .

 

[Milo013]

Then you need to have a chat with your boss . . .

 

[CdnBeerLover]

Blaming Obamacare for rising health care costs is like blaming your children for your gray hair (or lack of hair). "Hey, I had a full head of black hair 10 years ago before I had kids, it must be their fault I now look like Old Man Winter."

It's not their fault?!? Don't tell them...