Health Insurance III

[frnash]

Everyone in the pool!

A few points:

"Employer provided (i.e. employer paid) health insurance" is a purely fictional notion.

It is a little like the eternal socialist demand for decreased taxes on individuals and increased taxes on the corporations. Pure fiction. Corporations do not pay taxes, they just pass 'em on to their customers in the form of increased prices for their goods and services.

Likewise, employers really do not pay for their employees' health insurance. They just divert what would otherwise be a significant part of your salary/wages to pay for that insurance!

It's all pure psychological balderdash!

Consider this:

… Additionally, health care costs represent 11% of payroll expense, op 72% since 2001. …

So if you had your 'druthers, would you prefer that your employer pay that "11% of payroll expense" directly to you, or to a health insurance company "on your behalf"? And if it were paid directly to you, what portion of your salary/wages would you be prepared to pay to buy your own health insurance? Eleven percent? Or perhaps more, or more likely, less?

One thing that obtaining health insurance through your employer does is place you and your health "risks" in a pool with your fellow employees.

Pooled risk.

That quite likely results in a lower premium than if you were shopping for health insurance on your own, based on your own unique health risks. Another factor is that to some extent, "employees" tend to be a lesser health "risk" than the "unemployed", if only because the unemployed may be at a greater risk due to their inability to pay for preventive measures. So for the insurance companies, the "pooled risk" of the employed is effectively a form of "cherry picking", of a group at "lesser risk".

One thing about "pooled risk" is that the bigger the pool, the lesser the cost for all of the participants. Spread the risk, spread the cost.

Ergo, how to lower the cost of health insurance for all? Everyone in the pool!

In essence, that is the gist of the mandated insurance aspect of "Obamacare". Get everyone into the pool, including those healthy specimens in the prime of life, who otherwise would not be inclined to pay for insurance … at least until they perceived a need. Ooops, too late!

Bottom line: You are going to pay for health insurance one way or another. Not your employer, not "da gummint". You. Period. End of story.

And please remember, we tend to be compassionate folks. We really don't have the stomach, spine, or heart to refuse health care to those who need it. Thus the requirement that hospitals not refuse treatment for those who can't afford to pay. We just play little fiscal games (like $20.00 Kleenex®) by shifting the cost to those who can. What we need to do is face up to the facts and quit kidding ourselves. Everyone in the pool!

… The young and healthy will be paying for not only their own health insurance but for that of the old and sick. This is a great departure from life as we have come to know it here in the US. The young people will want to buy cars and houses and snowmobiles like their parents before them. … It will not take long for the young to figure this out and we will be back to square one.

And by ignoring their need for lifetime health insurance, or attempting to defer it, they're just deluding themselves, and are going to wind up paying more for it when they finally do need it.

"Pay me now, or pay me later", but you will pay me!

Better to spread the pain over the long term than pay it later with "accumulated interest". The only way you're going to avoid it is to suffer a swift and clearly fatal demise before you ever need any substantive medical care. Is that a desirable outcome?

Everyone in the pool!

 

[G]

Two things the matter with the pool theory. Firstly we have the baby boomers whose numbers are disproportunately large in relation to the current working class whose age was also adjusted to begin at age 26. You can go ahead and cram all of these healthy young folks in the pool and the old and sick will still suck the system dry. There are just too many and we live a lot longer than we used to. Secondly if you tax/fine the working class too severely there is always the possibility they will just up and move away to a different country altogether where you get to keep more of what you earn. Face it, it would not be that hard to improve on the weather we get here in the midwest. Argentina, Australia, Aruba - and those are just the A's!!!!!! And Nash, I know I spelled disproportunately wrong. Sorry.

 

[dcsnomo]

frnash...x2

BTW, and I kinda hate to mention it (well, no, i"m enjoying the **** out of it!) in your "Obamacare paragraph it should be "too late", not "to".

nya nya nya nya nya!

 

[kevisip]

The DEBATE IS OVER.....oh wait, thats a different subject....

 

[frnash]

frnash...x2

BTW, and I kinda hate to mention it (well, no, i"m enjoying the **** out of it!) in your "Obamacare paragraph it should be "too late", not "to".

nya nya nya nya nya!

Thank you for pointing that out. I fixed it, and a few other typos that you missed as well! (I just gotta get those glasses fixed!)

 

[G]

It will never cash flow

If you took Obamacare to the most lowly entry level banker it would never ever be considered. In its initial form it is a moneysucker for now and forever. One can only hope it will be modified. If you think for one minute that career politicians are smarter than the drug companies and Blue Cross/Blue Shield you are deluded. Politics does not attract the smartest people, just the greediest. Business has historically attracted the most ambitious and the most innovative. Oil the money stamping machinery. It will be working overtime.

 

[frnash]

… the old and sick will still suck the system dry. There are just too many and we live a lot longer than we used to.

Well the nerve of those old fogeys! I guess we'll just have to fire up those "death panels". That'll take care of em, eh?

… Secondly if you tax/fine the working class too severely there is always the possibility they will just up and move away to a different country altogether where you get to keep more of what you earn.

Like China, or India? To follow all the jobs that went there from the good ol' USA?

… And Nash, I know I spelled disproportunately wrong. Sorry.

And I wasn't even going to mention it. I left too many uncorrected typos in my own post!

 

[xsledder]

""Employer provided (i.e. employer paid) health insurance" is a purely fictional notion."

Frnash, you’re WRONG! Based on that signal statement you’ve never owned a business. Let me explain to you how it works from a business owner’s side. The company wants to attract quality employees. How do you entice an employee other than pay? Benefits. So the boss decides to prove some benefits. They can do nothing; sick time; vacation time; flex-time; health insurance; health insurance with vision and dental; 401k; 401k matching; profit sharing; Cafeteria plans (Med 125 (pre-taxed healthcare employee contribution), Day care (pre-taxed deducted from the employee paid by the company)); fitness clubs; flexible spending accounts; etc. or any combination thereof.

So the company gets insurance for its employees. The insurance company has each employee fill out an application giving health information about everyone they plan to put on the coverage. The insurance company takes that information a writes a policy. Everyone in the company is in one pool. Therefore, a small company like mine only has six of its nine employees in the pool.

Based on the number of employees in the pool, their health, the co-pay, the out-of-pocket expense, and the life time benefit; the insurance submits a price to us. For us, it costs $700 per month for a single person up to $1,800 per month for a family. Our monthly insurance bill is $6,500 per month. Now, if the company paid for everything, it would go into the company’s multiplier or into the cost of the product (depending on the type of company). Therefore the cost is passed onto the costumer through the multiplier or cost of the product.

Now, our money to pay for health insurance comes from our customers and not our profits, however, I write the check each month. Don’t tell me I don’t write a check.

To reduce our multiplier or price, we ask each employee to contribute something to the cost of the health insurance. Typically, employee contributions run 22% to 25% of the monthly cost of the health insurance. Our single employee pays $150 per month and a family pays $320 per month. Per month, our employees pay $1,250 out of the $6,500. That means our clients are paying the other $5,250 per month. Since our clients are mostly government agencies, you, the tax payer, are paying $5,250 per month to me to pay for my employee’s health insurance. However, I’m still writing the check!

Now you’re right, a larger pool will reduce the overall cost of health insurance for me, but the government could have done it other ways then forcing everyone into one large socialized pool.

"They just divert what would otherwise be a significant part of your salary/wages to pay for that insurance!"

WRONG again. Salary is take home pay and the health insurance is above that pay. The only part of your pay that is divert to pay for health insurance is what the company sets as the contribution, and that is completely dependent on the boss(es).

DCSNOMO

Are you kidding me? You expect a company to cover someone at a known loss. So you want to be able to pay the company $1,500 a month while they pay out $5,000 an month. Pre-existing conditions are the single aspect of CommyCare that is going to increase our cost exponentially. I can't even begin to explain what is wrong with your logic because it is so absurd. Have you every run a company???

 

[mrsrunningbear]

If you took Obamacare to the most lowly entry level banker it would never ever be considered. In its initial form it is a moneysucker for now and forever. One can only hope it will be modified. If you think for one minute that career politicians are smarter than the drug companies and Blue Cross/Blue Shield you are deluded. Politics does not attract the smartest people, just the greediest. Business has historically attracted the most ambitious and the most innovative. Oil the money stamping machinery. It will be working overtime.

this word is getting used way to much its gonna get pulled should maybe remove it...just my.02

trying to keep this around its good and healthy

 

[thunderstruck88]

i would love to have a woman in the white house running this country A regular housewife to with a budget she has to stick with week in week out and no room for error We need to fix up our country first before we can do anything else Take care of our own first

 

[mrsrunningbear]

i would love to have a woman in the white house running this country A regular housewife to with a budget she has to stick with week in week out and no room for error We need to fix up our country first before we can do anything else Take care of our own first

X2

 

[frnash]

The insurance company has each employee fill out an application giving health information about everyone they plan to put on the coverage. The insurance company takes that information a writes a policy.

and

Based on the number of employees in the pool, their health, the co-pay, the out-of-pocket expense, and the life time benefit; the insurance submits a price to us.

Not necessarily so! I certainly have seen that in small companies, even to the extent of an employee being laid off solely due to a particularly large health "risk" posed by that employee! I have also seen employees simply and automatically enrolled in the corporate health plan with no such examination and "risk assessment" of their individual health status, this in some of the largest companies, such as "Generous Electric". Perhaps they're self insured?

Everyone in the company is in one pool. Therefore, a small company like mine only has six of its nine employees in the pool.

"Everyone in the company is in one pool.", but only six of your nine employees are in the pool? That doesn't compute! Which is it?

Now, our money to pay for health insurance comes from our customers and not our profits, however, I write the check each month. Don’t tell me I don’t write a check.

Six of one vs. a half dozen of the other. What difference (other than the cost of one check each month) between you paying the insurance company vs. just including the corresponding amount in each paycheck and letting each employee cut their own deal on health insurance? You stlll write the check(s), and the total dollar amount is the same. I will acknowledge that such "sleight of hand" does yield certain (apparent?) tax advantages to both the employer and employee.

WRONG again. Salary is take home pay and the health insurance is above that pay.

Six of one vs. a half dozen of the other again. Just fiscal legerdemain (trickery). You could simply choose to get out of all the hassle with the health insurance game and give it all to the employee, letting them deal with the insurance issues. Much the same argument could be made for other "benefits" as well, like a "super cafeteria plan": "Here's your total salary, you choose which items you want from the 'menu', if any, and pay the listed price for each." If an employee wants to take the full salary and "go naked" with respect to benefits, that's his/her choice.

All the rest is just psychological gamesmanship.

Are/were you an auto dealer?

No offense, and I certainly don't deny that you have had to deal with such administrivia, but much of your argument(s) sound very much like the ridiculous games auto dealers engage in in effort to sell an automobile, such as:

"Buy a car today and we'll give you $4000 cash back!"

Yeah, right, I'm going to get an auto loan for the purchase price of the car, then you're going to give me "cash back"? So in effect you're giving me back a part of the money I just borrowed? Such a deal, eh? No smoke and mirrors, please, just give me the bottom line price!

Ditto for health insurance. Let's not play the "shell game", just give me the bottom line price.

 

[xsledder]

Not necessarily so! I certainly have seen that in small companies, even to the extent of an employee being laid off solely due to a particularly large health "risk" posed by that employee! I have also seen employees simply and automatically enrolled in the corporate health plan with no such examination and "risk assessment" of their individual health status, this in some of the largest companies, such as "Generous Electric". Perhaps they're self insured?

Perhaps their self insured, however, they are filling out a questionnaire when their involved with an insurance company; health examination no, but there is a questionnaire.

"Everyone in the company is in one pool.", but only six of your nine employees are in the pool? That doesn't compute! Which is it?

I shouldn’t have to respond to this one. If you need an explanation of my true intention of what the statement was, well, heaven help you.

Six of one vs. a half dozen of the other. What difference (other than the cost of one check each month) between you paying the insurance company vs. just including the corresponding amount in each paycheck and letting each employee cut their own deal on health insurance? You stlll write the check(s), and the total dollar amount is the same. I will acknowledge that such "sleight of hand" does yield certain (apparent?) tax advantages to both the employer and employee.

Health insurance is a benefit above and beyond an employee’s salary/pay rate. No one has ever asked me how much the health insurance cost during an interview, or how much additional income their earning with the health insurance. They only ask what the amount of their contribution is. An employee who is a single insured is earning an additional $550 per month on top of their salary (at my company). That’s an additional $6,600 per year I’m paying for them. Remember, I don’t have to provide health insurance. Well, at least I didn’t until a few weeks ago. Insurance is not reported as income on their paycheck, and with MED 125 their deduction can be taken out pre-tax. Of course, I don’t have to do MED 125. If you actually worked with corporate books, large or small, you would understand this. There is no “sleight of hand”.

Six of one vs. a half dozen of the other again. Just fiscal legerdemain (trickery). You could simply choose to get out of all the hassle with the health insurance game and give it all to the employee, letting them deal with the insurance issues. Much the same argument could be made for other "benefits" as well, like a "super cafeteria plan": "Here's your total salary, you choose which items you want from the 'menu', if any, and pay the listed price for each." If an employee wants to take the full salary and "go naked" with respect to benefits, that's his/her choice.

Again, benefits aren’t income and are not guaranteed. No one says I have to give you them. Well, that was until a few weeks ago. Salary is salary, benefits are benefits, I can stop give benefits tomorrow and you as an employee should not expect an increase in pay; again, no fiscal legerdemain. Also, you don’t understand what a Cafeteria Plan is. A Cafeteria Plan is where I take money out of your check pre-taxed, for example, $100 per check for daycare. Then your daycare provider sends me the bill directly. Then I write a check to the daycare provider. You never see the money, nor do you ever get the money. Now, there are limits to how much you can take from your check pre-taxed. That amount is determined yearly by the Feds.

All the rest is just psychological gamesmanship.

Are/were you an auto dealer?

No offense, and I certainly don't deny that you have had to deal with such administrivia, but much of your argument(s) sound very much like the ridiculous games auto dealers engage in in effort to sell an automobile, such as:

Yeah, right, I'm going to get an auto loan for the purchase price of the car, then you're going to give me "cash back"? So in effect you're giving me back a part of the money I just borrowed? Such a deal, eh? No smoke and mirrors, please, just give me the bottom line price!

Ditto for health insurance. Let's not play the "shell game", just give me the bottom line price.

If you ever ran a company you would understand this, because it is not psychological gamesmanship. I run an engineering company. I deal with this stuff on a daily basis. There is a lot more to this then I have time or space to tell you on this board. All I can say is this; the dismissals (“shell game”) I’m getting from you are the same dismissals I get from everyone who is ignorant about running a company. If everyone was a boss at some point in their live and had to worry about where the next payroll was coming from, this would be a different and better Country

 

[russholio]

Interesting reading both points of view. Obviously I can't speak for all places of employment, but I do know that where I work, if you opt not to take health insurance, you do get a check (not sure how much, since it never applied to me). Some people do exercise this option if their spouse's plan is better than theirs. I'd be willing to bet though, said check is not the same amount as what the premium would be.

 

[dcsnomo]

""Employer provided (i.e. employer paid) health insurance" is a purely fictional notion."


DCSNOMO

Are you kidding me? You expect a company to cover someone at a known loss. So you want to be able to pay the company $1,500 a month while they pay out $5,000 an month. Pre-existing conditions are the single aspect of CommyCare that is going to increase our cost exponentially. I can't even begin to explain what is wrong with your logic because it is so absurd. Have you every run a company???

Umm yeah, in fact I own two companies now. The error in your logic is that you are putting profit over HEALTH. This is about HEALTH, and the insurance companies up charging and dropping those that need that care is not about HEALTH. In America, those that need HEALTH care are continually and systematically removed from the system that pays for it. Insurance companies make a profit not by providing health care, but by not providing it. You can get all the health care you want in America for reasonable prices unless you get sick.

Yes, pre-exisiting conditions will increase costs. Why? Because finally these people will be able to get HEALTH care. This is HEALTH, not auto, not fire, not liability. It's about HEALTH, and sooner or later you will get sick, or you will get old and you will understand.

People who don't need health care can afford it, people who need health care cannot. And my logic is absurd????

 

[dcsnomo]

i would love to have a woman in the white house running this country A regular housewife to with a budget she has to stick with week in week out and no room for error We need to fix up our country first before we can do anything else Take care of our own first

X2

 

[dcsnomo]

dcsnomo - OK. We currently have 40 million people that do not have health insurance. Many of these are the very people you speak of. Old or sick. It is going to be a very expensive endeavor. The early funding proposals are heavily weighted on the young and healthy. The young and healthy will be paying for not only their own health insurance but for that of the old and sick. This is a great departure from life as we have come to know it here in the US. The young people will want to buy cars and houses and snowmobiles like their parents before them. How long before the young and healthy tire of this system and opt out of their coverage and pay the minimal fine for coverage. (About $4000 per year as I read it.) What if 30 million young people decide that they would rather pay the non-compliance fee and use their money for other things. What the heck - they still have health insurance - right? There is no money coming in to fund the health needs of the old and/or sick. The whole plan is screwed. It will not take long for the young to figure this out and we will be back to square one.

True, but it is not just about 40 million without health insurance. Another 20 million buy their own insurance and are forced to reduced coverage because of cost. Employer provided insurance has now declined to 53% of the population, and is a declining benefit. Employers have seen costs increase 72% over the last 9 years. And the government insured population has now increased to nearly 20%.
So, fewer employers are covering employees, costs are increasing, and people are going without insurance or landing on a government plan.

 

[dcsnomo]

If you took Obamacare to the most lowly entry level banker it would never ever be considered. In its initial form it is a moneysucker for now and forever. One can only hope it will be modified. If you think for one minute that career politicians are smarter than the drug companies and Blue Cross/Blue Shield you are deluded. Politics does not attract the smartest people, just the greediest. Business has historically attracted the most ambitious and the most innovative. Oil the money stamping machinery. It will be working overtime.

Government is not a profit generating business, it taxes its citizens to provide essential services. You may disagree with the service, or how it is implemented, or the cost, but any low level banker would not consider:
The Army
Navy
Air Force
Marines
Coast Guard
Interstate Highway system
Education funding
Social security
Amtrack
NASA

You are correct about politicians not being the smartest, just the greediest. Would you want that job? Not me!

 

[dcsnomo]

Look guys, this is a fun discussion, I appreciate you all taking the time to participate, and it is very civil. My brain hurts remembering all these figures, however, and I am beginning to tire a bit, but I am enjoying it!

Here's what I think the issue is:

If you are employed at a company that has health insurance, you are younger, your family is healthy, you are very satisfied with America's health care system.
If you are on a government program, you are relatively satisfied.
If you own a self-employed you have to buy your own insurance, and if you have no health issues or are young you're ok with that

If you are self-employed and are older or have any health issues you cannot afford quality health care
If you lose your job you cannot afford health care, and your next employer will not cover your health issues
If you have no insurance and you are young and healthy you are a gambler
If you have no insurance and need health care you are 1 step from bankruptcy.

But this is about health, my ability to live and enjoy my family. Whether I am old or young, this is about the basic right to live. This is America. I do not expect you to give me this for free. I work. I pay taxes. Why is my ability to get health care based on me not needing it?

When I was 35 and working for a large corporation I had great health insurance. And, I would be willing to pay the same rates as these people. But my costs are not sustainable! My friend, who is healthy and 60 years old pays $2700 a month, and it will go up 25-35% per year!! That means by the time he gets to Medicaire he will be paying at least $8500 per month, assuming neither he nor his wife get sick. If they do, they will most likely be dropped. Do you really think he will have insurance when it costs him over $100,000 a year? And what is his big offense? He is self-employed and 60 years old.

Stop the madness! Allow me to pay my fair share in return for my health!

Everyone in the pool!

 

[ezra]

you listed just a small tip of the ice berg of fed jobs and none of the real gems that wast our money and have no place in fed Gov. with fed now employing 2,700,000 people who pretend to work hard except every holiday. with the average pay for a fed job is now at $79,179 and with Benny's is at $119,982 why would you want to work for the privet sector with with the average pay at just $59,900.ps I think I saw team Obama cheerleader pom poms and skirts on sale at the mall this week.