Scrappy Jack

iTrader: (2)

I believe one of the primary alternatives was to allow inter-state insurance competition which was pitched as reducing costs to the companies by expanding economies of scale and reducing state-by-state regulations and beauracracy. For example, rather than dictate all insurance policies in State X must cover accupuncture and massage therapy, you could have "bare bones" policies and the consumer would add their own "extras" as needed.

This was also suggested to be combined with eliminating the tax favorability of employer-paid health insurance and having more individuals pay for their own policies directly.

This would theoretically increase competition and reduce prices to the consumer while improving portability and eliminating the direct risk of losing your health insurance because you lost your job.

In addition, improvements to price discovery have been suggested (such as hospitals and doctors having to post prices for common procedures online) as well as increases in the availability of things like HSAs (health savings accounts).

fooger03

iTrader: (2)

alternative: accident insurance - to cover health related expenses related to non-recurring injuries. Car accident? Badly sprained ankle? it's covered. pre-existing condition? chronic illness? not covered under base insurance. This protects people from bankruptcy in the event of a significant unexpected event. I propose that the threat of bankruptcy is the #1 reason that HSAs haven't caught on in this country like wildfire.

You want to be insured for those other things? That's where you start adding (and paying for) additional options to your plan.

If HSAs become a popular method for paying for health related expenses, price information will naturally become more perfect, as doctors begin to post prices for common procedures in order to show how much money you can save by going to doctor A vs. doctor B. If that happens, "fraudulent prices" (where a doctor will charge 2,000 for a procedure, but the insurance company determines he's only going to get 400) will go away, and doctors will begin by charging 400 for the procedure instead of 2000. Soon, docs will be charging 375, and 350, and 325 just to try to get more patients...

...lastly, when people start paying for their own routine health expenses, the demand for doctors will fall sharply - I'm certainly not going to go see a doctor for the common cold - or an ankle sprain... as the demand falls for doctors, we'll have another sharp decrease in pricing. Too many doctors with too few patients, and they're going to start marginalizing their own profits just to stay in business. You'll probably have doctors offices issuing out their own loyalty cards - "visit us 3 times, and the 4th visit is free!" - or providing incentives - "free cholesterol checkup with any doctor visit!"

IMO, modern day doctors should be vilified based on how much profit a decently sized practice can make. They're on about the same level as teacher's unions and homeowner's associations as far as I'm concerned.

Braineack

iTrader: (62)

6-3 bros. maybe she gave the justices a wavior?

rleete

iTrader: (21)

She's lying, like every other statement she makes.

Braineack

iTrader: (62)

"In the end, however, it is the duty of the people to protect the Constitution from the court. Social progress cannot be held hostage by five unelected men."

-David R. Dow, columnist for the Daily Beast


oh yeah, and author of "

America's Prophets: How Judicial Activism Makes America Great

America's Prophets: How Judicial Activism Makes America Great

"

Opti

Anyone know whatg happened with this
?

Braineack

iTrader: (62)

they are trying to persuade each other to vote a certain way, instead of just reviewing the law independently and determining if it's Consitutional or not.

expect a decision in June.

hustler

iTrader: (6)

Coming from a guy who's using his health insurance a lot over the last few days, paying $250/month for coverage is a totally reasonable expense and I'll continue to pay for it and be happy about it.

Special note:
I can afford this insurance because I don't have an Escalade or a bunch of other ---- that I don't need.

Scrappy Jack

iTrader: (2)

Good grief. $250/month for individual coverage? I am assuming you do not have employer-based group insurance?

I do. YTD, I have paid only about 16.6% of the total insurance premiums (balance picked up as employer-paid benefit). That's just for health, not counting dental or vision (or life or disability insurance).

That really is something most people take for granted and goes back to health care being an area most consumers have no idea what they pay or what things cost.

mgeoffriau

iTrader: (7)

I'm surprised it's that low, if that's the total premium cost.

I know my Blue Cross/Blue Shield policy costs my employer roughly $350 a month, because that's how much he offered to add to my paycheck before taxes if I sourced health insurance outside of work and wanted to opt out of the employee group plan.

rleete

iTrader: (21)

About 10 years ago, I was a contract worker. I got laid off, and was between jobs. Wife came down with apendicitis, and we had just refused COBRA, as we figured it was too expensive - over $800 a month. Bad timing.

Bill came due, and there was a charge on the bill for $768.47 listed as a "NYS surcharge". When I asked about it, the hospital said that it was usually paid by insurance, and most people never even saw it. No option, I had to pay it. I paid, and left.

My mother runs the AARP volunteer tax centers in our area. She did my taxes that year. Because she was curious, she figured the taxes both ways - with my deduction for the surgery (over 11 grand) and without - to see the difference. Anyone care to guess what the difference was? Yup, $768.47; same amount to the penny. NYS has you screwed no matter if you have insurance or self pay.

Scrappy Jack

iTrader: (2)

Actually, you are absolutely right. I was looking at one pay period. My total (employer + employee) premium is closer to $450. I pay a little less than $80 of that.


I don't know what the answer is, but rleete's story is exactly why I think severing the employer-as-insurance provider link could be a cornerstone to improving the US healthcare system.

Something comparable to Mark's employer's proposal, possibly through taxation. That is, instead of the current system in which (I believe) the employer-paid benefits are tax deductible to the employer (and premiums are before-tax deductions to the employee), the entire amount of health insurance premiums could be made tax deductible to the individual if bought in the private market.

If nothing else, this would seem to prevent the type of scenario where you have people either "tied to an employer" for insurance coverage (particularly with pre-existing conditions) or where they have health issues between employers/coverage.

hustler

iTrader: (6)

I have that ultra-badass federal employee insurance that everyone talks about. Its not cheap, but the coverage is awesome. I have a $350 annual deductible too.

The problem is that America thinks healthcare should be free. It shouldn't be free, it should cost a fortune to save your life and I want a doctor so badass that he can charge whatever he wants and drives a Maserati. I don't want some beta-bottom working on my today, i want the best money can buy.

Scrappy Jack

iTrader: (2)

So is your employee portion $250/month or is that total cost (employer + employee)?

BTW - Good luck with your eh-nus.

Braineack

iTrader: (62)

dude, having federal employee insurance is wickedly stellar.

chpmnsws6

iTrader: (12)

^^^ This. If they cut what the physicians make, only the bottom feeders will be willing to work. I'd rather have a hunter cut and gut me then a bottom feeder. At least then death will be sudden.

Working for a hospital as a non smoker, coverage for myself is only 35 a paycheck for basic coverage. Typical ER visits are 200-300 dollars, and a surgery to remove 6 large kidney stones was 1200, including the 4 day stay. While none of these were for me, they were the girlfriends bills. Sheets cheap in the grand scheme of things, even for near minimum wagers like us. We just drive a Miata, XJ, and Caliber, plus live cheaply and work OT to make up for it.

hustler

iTrader: (6)

My cost.

Braineack

iTrader: (62)

is the admin even allowed to do that? they had their day in court. the job of the scotus is to rule on constituionality, the legislative branch gave its argument. that's it, the end. now to pull this political stunt?

mgeoffriau

iTrader: (7)

Irrelevant.

Braineack

iTrader: (62)

just like the constitution?


but how come the $500 billion obamacare sucks of out medicare not cause a disruption? or did he not read that part after the bill was passed?