Wednesday, December 23, 2009
Health Insurance Is a Pain
Posted by John Branston on Wed, Dec 23, 2009 at 11:46 AM
Bad Santa is our insurance representative. He is actually a good guy, but he has a terrible task. He shops for health insurance for our 47 employees and their families. His December visit and his handout with its 8-percent cost increase and $1000 deductibles and ugly numbers brings home the abstractions of national health care in a way the nightly news simply can't.
I once had a summer job at a resort in Michigan where it was possible to have negative earnings after your room and board and withholding tax were taken out. We're not quite there yet but we're working on it.
"I only have one kid," protested a colleague who is the picture of perfect health and still looking at premiums of $7,000 to $10,000 a year.
Been there and done that. My two children are out of college and healthy but fall in the "young invincibles" cross-your-fingers category now that they are off my family plan.
Does it pay to stay healthy? Of course it does, in the sense that nobody wants to have an accident or get sick. But one of the problems with insurance coverage is that there is no payback or financial incentive for taking care of yourself and using as little medical services as possible.
Our agent and my boss looked high and low for the best coverage plans, including the big providers, self-insurance, and reinsurance for deductibles. They are numbers guys. They looked hard. The coverage for employees is very reasonable and excellent. It's families and uninsured spouses that get whacked. We have a "Cadillac" plan and a "Ford" plan. Suffice it to say, you could buy a car for what we pay in premiums and out-of-pockets.
A colleague suggested farming out one's small children to the carnival. Another suggested marrying a federal employee and going on their insurance plan. We're taking it under advisement.
"What about out-of-network?" asked another colleague. The answer: Don't do it.
"Price shopping?" Don't bother. The negotiations have already been done with the in-network providers.
"You have to be a bit of a manager," warned our agent, lest employees ignore their out-of-network specialists with their stealthy charges or the company reimbursement that kicks in after the $1000 deductible.
For the record, he's for national health care legislation. He blames tort lawyers and fraud for much of the cost inflation. And he says if you know a good doctor you better stay on good terms with him or her if you want an appointment on short notice, because business is about to boom.
Comments (15)
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Tort lawyers and fraud are the causes of insurance cost inflation? I guess record insurance company profits and executive compensation didn't have anything to do with it, eh? Please say you didn't let him get away with that bullshit, John.
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Record insurance company profits? Can you please provide accountant certified public numbers showing these record profits? I would like to see what you are talking about.
there are no "record profits" that can bee shown...this is the talking point the socialists use to try to sway the argument. The biggest problem is that we think every thing should be free when we have the sniffles. We need to get back to "major medical" where there is no coverage for simple office visits and then we do not clog the system when all we need is some sudafed.
Shawn, excellent idea. Please convince my doctor to lower the price of his $140 office visits. He actually does lower them, if you have insurance. I could afford to pay what the insurance company pays. What I can't afford to pay is what the insurance company pays plus the part I have to pay plus my premiums.
For those who want tort reform, I say call me when a doctor removes the wrong lung, then we'll talk about whether or not you should be able to sue for every penny you can get for your surviving children.
Accountant certified public numbers? Please. All you need to know is that their stock prices are at record highs right now. So kindly lay off the requirement of proof that cannot be produced. I believe it was the CBO who showed that malpractice has a negligible effect on healthcare prices. And the reality is, malpractice is extremely difficult to prove, therefore few lawyers will even take a case unless there is blatant, undeniable evidence of negligence.
Basic family plan where I work - $13,000 a year.
Luckily my wife works a place offering the same plan for $9,000 a year.
My fear is the Senate bill which Obama supports will do nothing to change this. Until costs are brought under control, nothing will change, and this bill does nothing to control costs.
My favoritest phrase in this debate is reimportation of drugs from Canada. What I don't understand is why we can't just make them sell the drugs here for the same price they sell them in Canada? On what planet does it make sense to call for reimportation of cheaper drugs from Canada, but is politically impossible to just lower the prices of drugs sold in America?
Because that's Soviet style price controlling!
Last time I checked, Canada was still a democracy.
Well, anyway, I'm not too worried. The system can't last much longer before people start burning tires in the streets. When that time comes, I'll hunker down in my bunker of rice bags with my Nintendo and my Berretta and wait for Congress to pass the nationalized healthcare system Medicare For All they should have passed in the first place. That's what will happen one day, dear supporters of health unsurance industry profits.
@shawn - First off, stop with the "socialists." The only member of congress that might not be labeled "socialist" under its current, completely ill-informed usage is Ron Paul and he's insane, so...
Most of the largest, long term health costs come from "diseases of affluence" - heart disease, high blood pressure, type 2 diabetes, obesity and certain forms of cancer, asthma, etc. Meanwhile, our congresspeople are trucking back wads of tax dollars to the pay farmers in their areas to grow (or pay them not to grow anything at all - which is, like, socialism) the corn that becomes the additives in our food and our food's food that cause most of these diseases - and ultimately our exorbitant health care costs. And the food industry uses windfall profits to lobby and keep govt regulations at bay. It's the basically what big tobacco was during the 20th century.
But is curtailing these practices on the table at all? Nope. The opposition is petty much obsessed with tort reform. And what about these monster savings claims? Factcheck.org has debunked them consistently, and puts the savings at close to ONE HALF OF 1% of total health care costs (http://www.factcheck.org/2009/10/malpracti…)
While I personlly don't have a problem with a little bit of tort reform from a gut level, I think we all know why certain congresspeople keep trotting out that tired hobby-horse: their huge corporate backers want to continue to act in bad faith while skirting punitives.
The numbers are all fictional when dealing with healthcare. Refunds, rebates, discounts, and other confusing contractual language completely cloud the actual costs. This is all by design.
Many different variables might push health plans into "Cadillac" territory, including geographic location, plan demographics, and other characteristics of the insured population. More at http://www.healthcaretownhall.com/?tag=cad…
Today's medical professional liability system is too adversarial and too expensive. There are alternatives. More at http://www.healthcaretownhall.com/?p=1779
Speaking of Davis (he of trhe twins and also a member of the committee that discussed this issue), I'd love to have a transcript of what he said in the meeting. Surely a corrective to this bullshit about lawyers being the problem and tort reform being the solution. How about it, Chris? Speaking for the multitudes, I want your take on health insurance. Maybe just a little bit about the mandates in the current bill.
I do enjoy all the varying opinions of what is wrong in health care, capitalism, etc., etc., . When in reality the system is so distorted, dysfunctional, dis dis dis, that it cannot be fixed. It requires a complete rebuild. Nothing else will suffice. If it takes a 2000 page bill to "fix" health care then we should all be very worried.
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