So your parents pre-paid over 50+ years for their actual needs. There are much more efficient ways of dealing with that. There may be no more inefficient way than what has evolved here.
The risk is way overstated when they calculate the premiums. As ed mentioned, they should quit calling it insurance. If the price of your homeowners insurance or life insurance were calculated the way health premiums are, no one would purchase either of them.
Insurance premiums are in line with consumers expectations. Consumers want access to the latest and greatest care. Oh, that new large molecule biologic to treat whatever condition nobody has heard about. Yeah, that's 60k a year. I want that. That new drug that cures hepatitis C. It costs 100k per treatment course. I want that. That complex imaging procedure that gets billed at $2k. I want that, $#@! an xray. Oh yeah, but I only want to pay $100 a month for my premium. And omg a $6000 deductible, oh noes.
The system is $#@!ed, but insurers only play one part of the problem. Consumers, biotech, facilities, and providers all have their role to play in accounting for why insurance costs what it does.
Hell at 25 i didn't have the cash, insurance or not, cover my hospital bill from last year.
One good thing about being a gubment employee with 0 family is I dont pay $#@! other than my $25 copay which covers any and everything that happens during the visit. Blood draws, x-rays, handies from the nurses...
By 2020, 2% of health plan members will account for 50% of total drug spend; right now ~5% account for ~50% of medical spend. Most of us are subsidizing healthcare for the extreme outliers. And it's only getting worse.That is a horrible deal for all but the carriers and a minuscule amount of people with severe medical issues.
I say we start euthanizing people who are over 65 and will never leave the hospital again.
Those that are angry with hospital fees and health insurance, you need to get angry with about 70-80 other industries before you get mad at them. The last thing they are doing, compared to other industries, is printing money.
everyone is all for death panels until it's their friend / relative / pet that needs to go
I get it, as a doctor you hate insurance because the bureaucracy of has made your life miserable. I don't blame you, but stick to what you know. Finance and risk obviously isn't it. I don't love my insurance, its a pain in the ass, but I'm smart enough to realize how much more miserable my life would be if I were un-insured in this country.You have to shop around, and it won't go toward your deductible the way the system is set up, but the discounts are there except for emergency care. I'm done arguing this, if you are happy with your situation good for you.
Last edited by Hellraiser97; 10-30-2015 at 05:16 PM.
Any thoughts on a ppo800 vs fsa that gives $1500 in seed money?
I've told this story before, likely here on the shag, but I'll say it again. According to my micro-econ professor in undergrad, health insurance (the way it is used in America now) is the most economically irrational system in this country.
Here was his simplistic, thought experiment:
Think back to a time before health insurance (i.e. before FDR's confiscatory tax rates on the top income earners drove companies to provide other incentives, like health insurance, to keep or attract top candidates). We had a pool of doctors providing service (supply) and a pool of citizens who would occasional require medical care (demand). Since there was a limit on the supply of doctors, prices were set to a point that would deter the average citizen from seeing a physician for a trivial issue (head cold, broken toe, chicken pox, etc.), but not so high as to prevent people from seeking care for services which require medical attention (broken arm, polio, pneumonia, etc.). Sure, there was a cost to the patients, but it wasn't likely to drive someone to bankruptcy or any other major financial stress. In the rare instances that it was something big (cancer, for instance), communities would pool resources through local fundraisers to offset the burden on the patients (as is often still the case in rural neighborhoods when someone falls on hard times without a safety net). Now, add in health insurance (as used today - i.e. co-pays/cost offsets for all services). Before, a regular visit might have cost a couple dollars (not a lot, but enough to prevent you from visiting the doctor needlessly). After the advent of insurance, people with coverage can go see the doctor, and it might only cost them a $1 co-pay, making it more accessible for even minor conditions. Being good consumers, those with insurance took advantage of their plans and began seeing the doctor more often. This increased the demand for physicians, without increasing the supply of care providers. Thus, to balance the equation, doctors raised their rates, with uninsured visits going up (say $4/visit), and insured paying a slightly higher copay (say $1.25). The supply would re-balance, but the rate of visits increased by the insured (Bobby's got a fever - get in the car; we're off to see the doctor) while decreasing for the uninsured (we'll just set Timmy's broken arm ourselves and put him in a sling). As more and more people started getting insurance, the same process occurred until all of a sudden, people with insurance were paying as much for their copay as they were previous to the widespread access to health insurance and people without insurance faced irrationally high costs for even simple care. This doesn't even take into consideration the ancillary costs of maintaining massive bureaucracies between patients and care providers, or the inherent economic madness that occurs when price is effectively removed from consumer/patient choice. The end result is the bumblefuckery of a system we have, which is about as far away from a free-market solution as could possibly be.
Point of the matter is, insurance is something you buy with the hope/intent that you never have to use it (say term life insurance, auto collision insurance, etc). Insurance as an economic tool is not sustainable when people purchase it with the intent to use it. This is why there could not be guaranteed coverage for those with pre-existing conditions without the individual mandate. Otherwise people could purposefully avoid buying health insurance while they were healthy until they knew that they were ill and would require medical attention, then run out and buy a plan and immediately make a claim on it. If we truly want to bring down costs and drive efficiencies, we need to scrap our current system, return back to a true disastrous care insurance model (similar to the term life plans offered), and enforce pricing transparency, so that people can shop their care providers for basic services. If great grand-ma has dementia, a failing heart, and is bed-bound, her power of attorney might not be so inclined to spend the $40k necessary to replace her arthritic hip or keep her on life support for weeks after that next stroke. These are not easy decisions, but by purposefully avoiding the economic aspect of such highly emotional situations, the whole system suffers the consequences of un-affordable care for the mostly healthy.
Well leaches were also a lot cheaper then too
I'm looking forward to having to pay income tax on my employer-provided healthcare. That will be fun.
First- why would you pay a middleman to handle claims on regular, predictable expenses? That's like having haircut insurance, or paying for oil changes with your car insurance.
Second- why would you pay more out of pocket? Because of the "discount" you get through the carriers? That's the biggest joke since "student athlete".
Third- I get the value of insuring people fully who can't pay out of pocket for even routine expenses but those people are less common than you think and long term that puts people into a long term pattern of unsound financial behavior.
Insurance is great, when it's insurance. When it's used for routine care and you don't have visibility to the price at the point of sale is where demand distortions happen.
Last edited by bozo_casanova; 10-31-2015 at 05:54 AM.
$#@! Health Insurance and the new laws. Infuriating.
I have a job with great health insurance. Can't stand the job and want to do my own thing.
Checked into insurance the other day and it was $350 for the most basic low-end plan. Same plan is now $450 a month.
Wasn't but a few years ago I paid $40 a month for catastrophic insurance.
I hate paying those medical insurance premiums, co pays, deductibles and bills too. But the problem is the cost of healthcare not the profit of insurance companies. But at the end of the day the insurance costs are going to be as high as they can demand from the public. Healthcare providers and insurance companies will split the money.
Look at the math. There is no way on a individual basis you are likely to come close to spending in 20 years what your premiums plus deductible cost you. In that sense it is absolutely just like life insurance (or should be). It should protect you from large unexpected outlays like cancer or major trauma. But as others have pointed out we use it for everything. It would be like calling Allstate when your gutters need cleaning, or geico when you get your oil changed
Edit and it sure as hell makes it easier to demand higher premiums when people are required by law to purchase your product, you are protected from out of state competition, and federal law prohibits consumers from choosing catastrophic coverage
Last edited by sawbonz; 11-01-2015 at 03:30 PM.
Open enrollment period at work...
Good news is the 2016 plans are the same as the 2015 ones (no price increase).
Anyone have a good calculator to see what's the best deal for us?
Currently I have:
Blue Shield PPO 500 for $740/month . Covers the whole family (me + wife + kid)
Deductible: $500 individual / $1000 family
Max out of pocket: $3,500 individual / $7,000 family
Office visits: $25 copay
Hospitals/Surgeries/etc: 90% after deductible
Not sure if it's worth it going to a cheaper plan?
Blue Shield PPO 700 for $660/month .
Deductible: $700 individual / $1,400 family
Max out of pocket: $4,000 individual / $8,000 family
Office visits: $30 copay
Hospitals/Surgeries/etc: 80% after deductible
Wife and I seldom need medical care other than preventative stuff which is covered 100% on both plans. However, our baby might get sick as kids tend to do... So I'm thinking the cheaper plan saves us $960/year but we may up ending paying more than that in the event of any sickness... so maybe it's worth sticking with the more expensive plan to guarantee more reimbursement (90% vs 80%) and lower deductibles?
There is also a REALLY cheap PPO, which would save us $1,812 per year but it has triple the deductibles we have now.
Blue Shield PPO 1500 for $589/month .
Deductible: $1,500 individual / $3,000 family
Max out of pocket: $5,500 individual / $11,000 family
Office visits: $35 copay
Hospitals/Surgeries/etc: 75% after deductible
Last edited by LongIslandIceSIP; 11-02-2015 at 05:49 PM.
ALL THREE of those are REALLY CHEAP ppos. i have to believe those prices are after your work's subsidized a portion.
Sip- do you have an HSA on any of those?
Good call- I ask because my HSA is why my High deductible PPO plan makes sense, because the dollars are pre-tax.
Damn Sip! Any and all of those plans gets me hard.
When my job was eliminated last year and I needed non-employer insurance, a family member gave me information on Christian Medical Share plans, which is basically a pool (of over 60,000 households) of church going people that has signed up to help pay for each other's medical expenses. There are 3 of them that has been Obamacare approves, which means it meets the guidelines as "insurance" so you are not penalized at the end of the year on your taxes. I picked the one that best fit our family and I pay $405 each month for our family of 5. I also picked them because my monthly contribution goes directly to the person in need and not to the company for them to distribute as they see fit. Basic medical care is on us, such as doctor's appointments and wellness care but anything over $300 is a reimbursable expense. It's not for everyone as you have to have your church sign off on a form and you have to have "faith" that it will work out if you have a large medical expense. So far, I haven't had any problems with getting a couple of medical items fully paid for. I won't go long here, so if you want more info on the program I picked out just PM me (or Derka). Plus, if you do sign up and say I referred you I get a referral credit on my next month's payment. So I have that going for me, you know.
Ok the right one is BCBS ppo 1500. Youre a healthy bunch. No need to pay up front for healthcare you'll likely not use.
Last edited by BoogityBoy; 11-03-2015 at 05:35 PM.
My plan is through the Texas Bar Member Benefits exchange, but this is exactly what happened to me.GF has BCBS care through the ACA marketplace (she was newly employed with no benefits at the start of the year). She was paying about $300 for a PPO. Just got notice from the gubmint that her plan is no longer being offered and her new plan options were all HMOs, at the same price she was paying for her PPO. She will be getting on her company's plan next year, but was definitely pissed by the bait and switch offered from year to year. No way in hell should an HMO cost the same as a PPO. If you like your insurance...
Looks like the penalty will bite me in the ass enough this year that it will be cheaper to buy insurance.
Which I know is the whole point but still.
Sucks he doesnt have an HDHCP/HSA option. I run a HDHCP for myself only, $6 per paycheck. Kids covered through wives PPO, dont know off top of my head what we are out of pocket for on that. We use my HSA to pay all copays and other expenses. Best of both worlds.
I'm curious about why health care "insurance" is still being bundled into "risk pool" insurances similar to those such as auto insurance, homeowners insurance, flood insurance, et. al. With those, you are banking against a risk.
Football .. OC .. Basketball .. Baseball .. Other Sports .. RC Didn't Offer .. Gamboool
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