Puck it
Well-known member
Oh go ahead. We want you too.
-
Welcome to AlpineZone, the largest online community of skiers and snowboarders in the Northeast!
You may have to REGISTER before you can post. Registering is FREE, gets rid of the majority of advertisements, and lets you participate in giveaways and other AlpineZone events!
Health insurance rates are way to much money.
- Thread starter ScottySkis
- Start date
Oh go ahead. We want you too.
Didn't realize Health Insurance was only a privilege of the healthy people.
Like I said, I'm patient. It will take time, but I think the more people who end up in the pool both for ACA and private insurance, the more costs will drop.
http://www.pressherald.com/news/nat...lth_care_law_to_cost_less_than_expected_.html
The fact is that ultimately the most affordable system this country could go to is a single payer system. We spend 17.7% of our GDP on Health Care. Almost every other developed country in the world with a single payer system pays FAR less.
Take Canada, they spend 11.2% of their GDP on Healthcare. I've got plenty of friends from over the border. I don't hear from them that their Health Care services suck because it's publicly financed. In fact, most polls show a 70+% approval rating for their care and over 90% favor their system compared with a privatized system like the US has.
Speaking purely from a financial standpoint, I would think fiscal conservatives would be banging the drum the loudest on moving towards a single payer system.
My dad is self employed and actually saved a bunch of money for better coverage thanks to the ACA.
Puck it
Well-known member
I think a lot of people if they take the time to investigate the options find this out. When things first kicked in the insurance companies sent out letters saying your insurance is canceled and here is the really expensive replacement policy. People took that as their only option, when the insurance company was just trying to trick you into paying more.
It sounds like they've met their targets for this go around.
Puck it
Well-known member
Not completely corrected. The number has been adjusted a number times and there is still no real number for those that paid yet.
Warp Daddy
Active member
OK heres my take :
Seems the only ones reaping the benefits so far are the INSURANCE industry . Our hospital albeit one of only 17 % in this state that is profitable with a margin of approx 1.5 will be taking a very deep and substantial HIT on the bottom line over the next decade as as result of Healthcare reform ( reform is CODE language for cuts ) .
Moreover the docs are also sharing the pain as the system adjusts under the push and pull , ying and yang of politicized systemic change . The game has shifted to the point where the industry MUST be able to make margin on the MEDICARE reimbursement rates . Most are unable to do this , ie that is why only very few hospitals make a positive margin . The Insurance companies however will reap a windfall IMHO . Incentives for many to consider becoming physicians are rapidly being affected .
Rural healthcare will remain seriously challenged as the competition for fewer doc and specialists impacts . This COUPLED with the values , work ethic and norms of the New Generation Workforce of Docs (more want to be employed not be independent businesspeople ) with regular hrs and extremely limited callbacks will be a GAMECHANGER .
So imagine greater demand for service ( from all the new enrollees , FEWER service providers i. E. Docs , severely constrained Margin. See previous commentery re making margin on Medicare AND more patient services delivered by mid levels ie PA,s Nurse practironers with huge demand for service . THIS is a daunting challenge .......BUT the insurance industries will continue to pay execs and proffer huge bonuses i would imagine
So saddle up , hold the reins tightly, its gonna be a helluva ride till this thing smoothes out .......IF it does
Seems the only ones reaping the benefits so far are the INSURANCE industry . Our hospital albeit one of only 17 % in this state that is profitable with a margin of approx 1.5 will be taking a very deep and substantial HIT on the bottom line over the next decade as as result of Healthcare reform ( reform is CODE language for cuts ) .
Moreover the docs are also sharing the pain as the system adjusts under the push and pull , ying and yang of politicized systemic change . The game has shifted to the point where the industry MUST be able to make margin on the MEDICARE reimbursement rates . Most are unable to do this , ie that is why only very few hospitals make a positive margin . The Insurance companies however will reap a windfall IMHO . Incentives for many to consider becoming physicians are rapidly being affected .
Rural healthcare will remain seriously challenged as the competition for fewer doc and specialists impacts . This COUPLED with the values , work ethic and norms of the New Generation Workforce of Docs (more want to be employed not be independent businesspeople ) with regular hrs and extremely limited callbacks will be a GAMECHANGER .
So imagine greater demand for service ( from all the new enrollees , FEWER service providers i. E. Docs , severely constrained Margin. See previous commentery re making margin on Medicare AND more patient services delivered by mid levels ie PA,s Nurse practironers with huge demand for service . THIS is a daunting challenge .......BUT the insurance industries will continue to pay execs and proffer huge bonuses i would imagine
So saddle up , hold the reins tightly, its gonna be a helluva ride till this thing smoothes out .......IF it does
Puck it
Well-known member
OK heres my take :
Seems the only ones reaping the benefits so far are the INSURANCE industry . Our hospital albeit one of only 17 % in this state that is profitable with a margin of approx 1.5 will be taking a very deep and substantial HIT on the bottom line over the next decade as as result of Healthcare reform ( reform is CODE language for cuts ) .
Moreover the docs are also sharing the pain as the system adjusts under the push and pull , ying and yang of politicized systemic change . The game has shifted to the point where the industry MUST be able to make margin on the MEDICARE reimbursement rates . Most are unable to do this , ie that is why only very few hospitals make a positive margin . The Insurance companies however will reap a windfall IMHO . Incentives for many to consider becoming physicians are rapidly being affected .
Rural healthcare will remain seriously challenged as the competition for fewer doc and specialists impacts . This COUPLED with the values , work ethic and norms of the New Generation Workforce of Docs (more want to be employed not be independent businesspeople ) with regular hrs and extremely limited callbacks will be a GAMECHANGER .
So imagine greater demand for service ( from all the new enrollees , FEWER service providers i. E. Docs , severely constrained Margin. See previous commentery re making margin on Medicare AND more patient services delivered by mid levels ie PA,s Nurse practironers with huge demand for service . THIS is a daunting challenge .......BUT the insurance industries will continue to pay execs and proffer huge bonuses i would imagine
So saddle up , hold the reins tightly, its gonna be a helluva ride till this thing smoothes out .......IF it does
Do you think the border hosipitals like Hepburn have seen an increase in Canadian patients since the socialization in Canada? I have heard yes.
Most of the problems with the ACA are related to it being a watered down version of Romneycare. I can tell that you that (in general) people in Massachusetts are very happy with Romneycare. Yes, health insurance rates as a whole spiked, but this was largely related to the expansion of benefits due to the increase in minimum coverage.
In my household there is a dramatic difference between the coverage offered by my job in Massachusetts and my significant others' job in New Hampshire, even though she works as a healthcare provider. Her employer is able to offer her crappier coverage just because she works on one side of the state line. The plan that she is offered meets the ACA requirements but would be illegal in Massachusetts. I think the biggest thing that sets Massachusetts apart is that we have a government option (Mass Health) which provides a baseline minimum coverage and price point.
As for enrollment, the total enrollment numbers are a red herring. It does not matter how many people enroll as long as the mix is good. Health care reform should decrease total costs to society by moving people out of the emergency rooms (where their costs become baked into our fees for services) and into cheaper primary care. The results will be an increase in the burden on men, young people, and the well, in order to pay for the higher usage of the older, women, and chronically ill -- that is just what insurance is.
What we had without universal insurance was not the free market. Did anyone have the ability to compare costs from multiple providers for a given procedure? How did I know what Hospital A and B charged for a MRI? There was no way to know what anything cost until the bill came. Romneycare / Obamacare / the Heritage Foundation plan is the free market solution. You go and buy a product from a number of competing vendors. There is a single location to compare price and coverage so you can make an informed decision.
The biggest gains that I see from health care reform:
- guaranteed minimum coverage that employers must offer
- moves people from the ER to primary care
- individuals have access to group health insurance (pre-existing conditions, reasonable rates, etc)
- direct accounting for the cost of caring for the uninsured (no more baking these costs into everyones rates)
- a way to compare costs between providers
In my household there is a dramatic difference between the coverage offered by my job in Massachusetts and my significant others' job in New Hampshire, even though she works as a healthcare provider. Her employer is able to offer her crappier coverage just because she works on one side of the state line. The plan that she is offered meets the ACA requirements but would be illegal in Massachusetts. I think the biggest thing that sets Massachusetts apart is that we have a government option (Mass Health) which provides a baseline minimum coverage and price point.
As for enrollment, the total enrollment numbers are a red herring. It does not matter how many people enroll as long as the mix is good. Health care reform should decrease total costs to society by moving people out of the emergency rooms (where their costs become baked into our fees for services) and into cheaper primary care. The results will be an increase in the burden on men, young people, and the well, in order to pay for the higher usage of the older, women, and chronically ill -- that is just what insurance is.
What we had without universal insurance was not the free market. Did anyone have the ability to compare costs from multiple providers for a given procedure? How did I know what Hospital A and B charged for a MRI? There was no way to know what anything cost until the bill came. Romneycare / Obamacare / the Heritage Foundation plan is the free market solution. You go and buy a product from a number of competing vendors. There is a single location to compare price and coverage so you can make an informed decision.
The biggest gains that I see from health care reform:
- guaranteed minimum coverage that employers must offer
- moves people from the ER to primary care
- individuals have access to group health insurance (pre-existing conditions, reasonable rates, etc)
- direct accounting for the cost of caring for the uninsured (no more baking these costs into everyones rates)
- a way to compare costs between providers
Warp Daddy
Active member
Puck : we do significant outreach in the capitol region especially thru the US Embassy to garner their employees who have Decent coverage as far as the general Canadian Citizen it peaked several yrs ago . We target marketed toward those who were SELF payers that had the means to pay the freight for elective procedures , surgeries or other procedures that were caught up in a Queuing problem in the Canadian system .
As i said that book of business peaked has pretty much dried up was always very modest but still when margins are tight we look for any and all sustainable revenue streams .The current stream is Embassy employees and their dependents.
Part of my job is employee benefits. For 2014 plan renewals, there was about an average of a 4% increase due to ACA compliance and mandated coverage. This is in the private sector for CT based employers.
I could write a lot about this and have certain opinions. But it boils down to it's far more complicated than it needs to be. They probably could have accomplished just the same by requiring insurance companies to cover pre-existing conditions.
Insurance is the business of financing risk. You need a diverse pool in order for the system to remain viable.
I could write a lot about this and have certain opinions. But it boils down to it's far more complicated than it needs to be. They probably could have accomplished just the same by requiring insurance companies to cover pre-existing conditions.
Insurance is the business of financing risk. You need a diverse pool in order for the system to remain viable.
Puck it
Well-known member
Completely agree. We do not know the make up of the 7 million that signed up. They were hoping for ~17 million to sign up originally from the ~39 million of uninsured.
So who actually makes up this 7 million?
How many have actually paid? Most of the states are reporting from 50% to 70% from data that I have seen.
How many had insurance and were cancelled?
How many had pre exisitng conditions? Which in most states is against the law to deny all ready.
How many are in the healthy demographic 26-35?
How many went back to their parent's plan <26?
How many were unisured before?
I would to see these numbers but there is no central location to get these actual numbers.
That's exactly what he did. He got a notice that his existing insurance at the time was going to go way up. He went to his insurance agent to see what his options were and they were able to get him signed up for a better plan at a rate that was lower than what he had been paying.
I work for a small Connecticut company with 27 employees. We offer health insurance for our employees and pay 80% of the cost, the employee pays the rest. We currently have Blue Cross Blue Shield coverage with a substantial deductible. My company pays over $1500 per month for coverage for my wife and I. Family policies are $1800+/month.
When the states online exchange went active I looked at what was offered. Surprising that I could buy a much better policy with lower copays and lower deductibles from the same Blue Cross Blue Shield on the exchange for less than $1000, it was actually $520 per month cheaper! We are locked into our current contract until the end of the year and we'll be watching what the rates do. If the costs don't equalize next year we may be dropping insurance for employees and let them buy less expensive insurance on the exchange. Possibly give them a stipend towards buying their own.
The current structure sucks. It seems small companies are subsidizing others? Either that or the rates for the ACA were artificially or intentionally set too low the first year?
When the states online exchange went active I looked at what was offered. Surprising that I could buy a much better policy with lower copays and lower deductibles from the same Blue Cross Blue Shield on the exchange for less than $1000, it was actually $520 per month cheaper! We are locked into our current contract until the end of the year and we'll be watching what the rates do. If the costs don't equalize next year we may be dropping insurance for employees and let them buy less expensive insurance on the exchange. Possibly give them a stipend towards buying their own.
The current structure sucks. It seems small companies are subsidizing others? Either that or the rates for the ACA were artificially or intentionally set too low the first year?
hammer
Active member
Could be that your company has a significant claim history...do you have a number of older workers or workers who are getting more medical care?
The rates set up on the exchanges are likely based on a complete mix of insured where with an employer the mix is smaller and known based on past history. Just a guess...I'm not in the field but I did have a decent breakfast this morning.
That is a pretty high rate, think the total premiums for family coverage where I work is around $1100/month (of which I'm also fortunate enough to pay just 20% of).
Geoff
Well-known member
This is the whole problem with corporate group health plans. If you work for a company with mostly older workers mixed with childbearing-age women, the premiums are nuts. My company outsources the HR function so I work for a co-employer based in Florida. My W-2, ADP payroll stuff, and all my benefits come from the co-employer. We happen to be with a co-employer group that is mostly young male high tech workers. My gold-plated Aetna PPO plan with $500 deductible, small co-pays, and 100% coverage for anything after that is about $7,000 as long as I stay in-network. If I worked for a small company with a bunch of old geezers, it could easily be twice that. In addition, my employer pays 88% of the premium so my pre-tax contribution is just about invisible in my paycheck.
Personally, I think the biggest problem with Obamacare is that they didn't rescind the "Emergency Rooms have to accept uninsured people" law. Hospitals are still choking on people who don't pay their bills. If you're gaming the system or you're an illegal, it shouldn't be everybody else's problem when you get injured or sick.
If you're looking at changing jobs, the questions about how health insurance works are now critical because it's all over the map.
Not Sure
Well-known member
OK heres my take :
Seems the only ones reaping the benefits so far are the INSURANCE industry . Our hospital albeit one of only 17 % in this state that is profitable with a margin of approx 1.5 will be taking a very deep and substantial HIT on the bottom line over the next decade as as result of Healthcare reform ( reform is CODE language for cuts ) .
Moreover the docs are also sharing the pain as the system adjusts under the push and pull , ying and yang of politicized systemic change . The game has shifted to the point where the industry MUST be able to make margin on the MEDICARE reimbursement rates . Most are unable to do this , ie that is why only very few hospitals make a positive margin . The Insurance companies however will reap a windfall IMHO . Incentives for many to consider becoming physicians are rapidly being affected .
Rural healthcare will remain seriously challenged as the competition for fewer doc and specialists impacts . This COUPLED with the values , work ethic and norms of the New Generation Workforce of Docs (more want to be employed not be independent businesspeople ) with regular hrs and extremely limited callbacks will be a GAMECHANGER .
So imagine greater demand for service ( from all the new enrollees , FEWER service providers i. E. Docs , severely constrained Margin. See previous commentery re making margin on Medicare AND more patient services delivered by mid levels ie PA,s Nurse practironers with huge demand for service . THIS is a daunting challenge .......BUT the insurance industries will continue to pay execs and proffer huge bonuses i would imagine
So saddle up , hold the reins tightly, its gonna be a helluva ride till this thing smoothes out .......IF it does
ACA limits the amount Ins co's can make , 80% must be spent on healthcare 20% on overhead ect.
My Wife works in the feild...Hospitals have seen a major drop off in elective surgerys , speculation is due to raising deductables.
There are contiuing layoffs, One of my wifes coworkers just got laid off , They have 3 kids, her husband is laid off and recently diagnosed with Cancer and going through Chemo....How ironic ,
ACA has nothing to do with healthcare and everything do do with Politics, It was designed to fail from the start, O wants single payer and said so before the first election.
Geoff
Well-known member
I think that the correct solution wold have been to scale back Medicaid to be about 80% as good as good private health insurance instead of 95% as good as private health insurance, let anyone who is denied coverage by private insurance pay a means-tested Medicaid monthly premium, and allow private health insurance to continue being "insurance" based on risk instead of "benefits administration". In addition, I'd get rid of the requirement that emergency rooms and hospitals that take Federal money (Medicare, Medicaid, etc) can't turn away the uninsured. If you're an illegal, you pay cash or you go home. If you game the system and opt out of buying health insurance, nobody should be obligated to treat you.
On employer sponsored plans, between 1% and 5% of your employee population will drive you overall claim experience. If you have a small population, there isn't a lot of room to make up for a few large claims. In larger populations, you usually(but not always) have enough lives to help spread out the expenses.
Never happen and really couldn't. If you spent some time working in the ER you'd understand its not always easy to differentiate between the payers and non-payers. And treatment for trauma can begin way before figuring any of that stuff out.
Similar threads
