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Let's see what has happened in the past that might give us a clue as to what might happen in the future.
The gov't started Medicare. Businesses started dropping health care insurance for retirees because the figured why should they foot the bill when the retirees can get get coverage through medicare.
IRA's come onto the scene then 401k's. Hmm. Businesses stopped offering a pension and switched over to 401K's which cost them a lot less.
And you don't think they will pick the option that is best for them this time? Why not?
I agree many haven't and wouldn't pay attention.The deadline for comnaies to adopt the mandates and get alot of flexibilty was last october and many did. The last amnufacturers association actuaries called the cost between paying the tax and contining providing themelves a wash.That was before the higher CBO cost estimates on pool cost for coming years. One also has to consider that they can drop all retiree contributions before and after 65 to retrees.They get out of manging healthcare cost by just paying the tax also.Many that adopted the mandates tiered employees also by thopse covered under present terms of emplyemnt when hired ;number of years worked when retiring and new hires as to what they contribute if anyhtig to retiree coverage before and after medicare;altho they can stay in their plans at full cost. Most cadallac plans offerig more than the mandates alos are likely gone even in contract bargining which the manadtes give heuge bargaining advantage especailly those that end in arbitration.
Good for you, in that you can apply critical thinking, understand the problem, and come up with a real solution that is effective.
That is the first step in "health insurance" (snicker) reform.
So you're saying you don't believe in competition and it won't help to reduce costs and increase insurance options?
Yes that's true.
The data from 2006 shows 62.2% of the population covered by employer-based plans. 6.8% of Americans had private plans, and 17.5% were covered by by Medicaid/Medicare.
That means only 18% without any health coverage, not the 40% that *******s rant about.
I think the statistic you are referring to from 2006 is that 40M did not have health insurance at that time. I believe it is now closer to 50M.
Prior to 1940, only about 9% of Americans had health plan coverage, but note that was generally for catastrophic health care coverage -- it did not cover doctor's office visits, prescription medication, child-birth, pregnancy, emergency room visits or anything else.
Also note that was true, bona fide, genuine, real health insurance, not the stupidity everyone erroneously calls "health insurance" today.
Okay, now comes the Great Depression -- hospitals lose money and so guess what? Hospitals start contracting with local employers to provide hospital care, as a means of getting revenue.
Now, the AHA, Obama's good buddies and major campaign contributor who wrote much of the ACA and are hell-bent on stomping the snot out of Americans, gets into the mess.
They insist that all plans be non-profit -- not smart; but also insist that all doctors and hospitals be included -- good; but the intent was to eliminate competition between hospitals -- very bad for you; and then the AHA also got the States to exclude these plans from regulatory action and over-sight by State insurance commissions, plus be tax exempt -- yes hospitals used to pay taxes.
This AHA committee that sticks its nose into everything becomes the Blue Cross in 1946.
Doctors see this as a threat. They get the AMA into the act to protect doctors and patients from abuses by the AHA and the hospitals. AMA committee that lobbies for doctors ultimately becomes the Blue Shield -- that's why it was quite common to see people with both Blue Cross and Blue Shield. The doctors don't want any interference between them and their patients. Remember we have a good relationship at that time -- and all the up through maybe 1983-1984 before the Great Proliferation, and you paid your doctor whatever you could, whenever you could, without anyone standing over you breathing down your neck. In 1979, I paid the $15 office visit up front, and then paid $10, $12, $15 or $20 a month until I got the $80 sports physical paid off. Once the Great Proliferation started, you could no longer do that. Both doctor and patient were at the mercy of the health plan providers.
So, it's WW II, and you have Wage Inflation, with rapidly rising wages driving up the prices of goods and services. FDR enacts a Wage & Price Freeze, the unions go beserk and threaten to strike, the National War Labor Board is sitting around with its thumb up its ass, placing even more restrictions on employers, and employers come to the rescue with health plan benefits -- and then a little help from the NWLR, who decides that these are non-cash benefits not subject to taxation -- and there you go.
One interesting thing, the cost of health care has always increased -- always, without fail. I would attribute that to two factors, one being the continuous introduction of new medical technology and the other being increasing demand for services.
Saluting...
Mircea
OK, so we get the point in a round about way of how today's employer based health insurance evolved. And we agree that the cost of health care has always increased (just like gasoline, food, clothing and just about everything else.) Also agree that the cost is due to new technology and increasing demand. My aunt used to say that poor people used to just die at home.
If you look at the history of health insurance, you will find it developed during WWII when wage controls were in place. Once employers had this fringe benefit, it was difficult to take it away, especially in unionized companies. It just became a cost of doing business.
But what seems to unmentioned in this debate is this was al nice and good until employers found themselves in competition with foreign businesses in nations that either have public insurance , state owned and operated healthcare or none at all. Then they were like a runner with a big lead weight strapped to them trying to race others not so encombered! For example , the cost of employee and even worse retiree healthcare became the largest single budget line in GMs budget and was nearly 1/3 of the cost of building a GM car before the company went bankrupt in 2009. Companies like Toyota did not have this handicap and simply motored ahead of GM. One could argue this drove GM and Chrystler too into bankruptcy and the subsequent reorganization which saw a transfer of the responsibility for retiree and worker health retirement benefits to the unions which were where a lot of the federal refinancing of these companies then went . The unions were given ownership of 30 % of GM and Chrystler. Simple economic and the Global market is what is dooming employeer financed health insurance, the choice is either end the companies operations in the USA and simply maintain a sales and service operation in the USA going forward or operating with the burden of healthcare financing shifted to the employees just like they did for what used to be called retirement benefits or a pension. Remember what it was like before we had to rely on IRAs, 401(k)s and that crap called Profit Sharing!
But what seems to unmentioned in this debate is this was al nice and good until employers found themselves in competition with foreign businesses in nations that either have public insurance , state owned and operated healthcare or none at all. Then they were like a runner with a big lead weight strapped to them trying to race others not so encombered! For example , the cost of employee and even worse retiree healthcare became the largest single budget line in GMs budget and was nearly 1/3 of the cost of building a GM car before the company went bankrupt in 2009. Companies like Toyota did not have this handicap and simply motored ahead of GM. One could argue this drove GM and Chrystler too into bankruptcy and the subsequent reorganization which saw a transfer of the responsibility for retiree and worker health retirement benefits to the unions which were where a lot of the federal refinancing of these companies then went . The unions were given ownership of 30 % of GM and Chrystler. Simple economic and the Global market is what is dooming employeer financed health insurance, the choice is either end the companies operations in the USA and simply maintain a sales and service operation in the USA going forward or operating with the burden of healthcare financing shifted to the employees just like they did for what used to be called retirement benefits or a pension. Remember what it was like before we had to rely on IRAs, 401(k)s and that crap called Profit Sharing!
I agree with you completely. Keep in mind that I was only explaining how we got to this point. I don't think, however, that the alternative is simply "operating with the burden of healthcare financing shifted to the employees." Organizations have been doing this for a couple decades. That merely shifts the costs around. What we need is to get as much out of competition as possible to drive costs down. We don't have to go to a single payor system to reduce costs. By having insurance companies market directly to individuals and getting employers out of the middle, the market will drive down costs.
The other part of this solution is to move to a true health insurance system and not a prepaid health expense plan. Only large expenses should be covered by health insurance. There should be incentives for maintaining a healthy lifestyle and shopping for low cost alternatives for elective procedures. How many people today ask what a knee or hip replacement, or an MRI is going to cost?
Nobody can anticipate if a $400,000 medical bill is lurking. Paying out-of-pocket isn't going to cut it for this type of expense, unless you are in the "Romney rich" category of wealth. One of the victims of the Colorado Movie shooting is looking at the possibility of $2 million in future health care based on his injuries. He has no insurance. He was young and healthy a few days ago. Now he is badly injured and in a coma. His family has raised $70k so far for his bills.
As far as buying our own health insurance. Pre-Obama care...they can turn you down if you have pre-existing conditions if you were on an "individual plan" aka not provided via your job. And for those that were lucky to get by the pre-existing rules... insurance companies were able to accept your premium for many years, then cancel your coverage and deny your claim (after care took place) if you had a large claim due to accident or illness. So purchasing your own coverage was "iffy" pre-Obamacare. Maybe you thought you had insuance because you paid your bill each month. But then when you return home from a hospital visit, you find out your carrier denied the claim and cancelled your coverage. I know someone that this occurred to. It was a small business owner that paid for health insurance for several years. Then an illness occurred and the insurnace weasled out of the entire bill which was almost $100,000.
Obamacare has fixed this.
Romney wants to repeal it. Amazing.
But a heck of a lot of conservatives feel that abolishing health care and continuing on with health care through bankruptcy is far preferable.
Since when has it not been cheaper for an employer to withhold offering HI to their employees? It always has been cheaper, nothing has changed.
Maybe that's because you don't understand how things really work.
If your employer doesn't cover your health plan, then you'd receive that money as taxable wages, which would probably be just enough to push a lot of people into the dreaded AMT Tax Range. And then of course, since you're receiving wages in lieu of health-care benefits, you would pay more in FICA and SECA, and so would your employer.
That would also mean your employer would pay more in taxes for SUTA, and FUTA and worker's compensation insurance/fees (in addition to paying more in FICA and SECA), plus any other idiotic regulatory costs.
So if dropping health plan coverage and paying wages -- including all the strings that are attached to wages --- is cheaper than paying the fine for Obamacare, or cheaper than paying the higher costs of health plan coverage -- and still to this day not one person has any idea exactly how much one employee will cost, since H&HS is still cranking out regulations, then the best business decision for an employer would be to drop health plan coverage.
Watch what happens...
Mircea
Quote:
Originally Posted by villageidiot1
OK, so we get the point in a round about way of how today's employer based health insurance evolved. And we agree that the cost of health care has always increased (just like gasoline, food, clothing and just about everything else.) Also agree that the cost is due to new technology and increasing demand. My aunt used to say that poor people used to just die at home.
So besides that, what are you trying to say?
It's fee-for-service.
That benefits health plan providers, but not patients, and neither plan providers nor patients have an incentive to reduce costs or use services effectively --- which also drives up the cost of health care.
That is the reason Medicare and Medicaid are failures, and it is the reason why the government keeps trying to levy cost controls, which is the right idea, but wrong execution, because that has done nothing but increase costs overall.
If you look at the period 1988-1996, that was the slowest growth in health care costs, but then that was also the hey-day of managed care.
The tax subsidies I mentioned, we call that "dead-weight." That's an actual economic term.
You as a society will experience a net-loss, once you reach a point where the "winners" can no longer compensate the "losers" (and that creates inefficiency and the likelihood of slow to no economic growth or a contraction of the economy).
That's related to "diminishing returns." The health care sector of your economy is not like any other economic sector. You always have inputs and outputs. Generally speaking, you gain an economic advantage when you increase the number of inputs, but only so long as marginal benefit is greater than marginal cost.
For health care, you always have one of two outcomes when you increase inputs and that is either no increase in marginal benefit or a decrease in marginal benefit.
In other words, health care spending is a money pit.
For some sectors of the economy, when you reach a point were marginal benefit = marginal cost, increasing the inputs will increase the benefit, but not in health care. When you reach that point in health care you curve goes flat; costs increases but no one derives any benefit from the increased costs.
That brings us back again to the tax subsidies, because they hide the true costs, and that's why you have a lot of stupid spending in health care where money is actually thrown away.
Health Care Spending, Quality, and Outcomes: More Isn’t Always Better
Go there, and you'll see that there is no relationship between medical spending and outcomes.
The same is true for education. Spending more does not produce smarter students. Spending more in health care does not decrease the need for health care services, nor does it save lives, reduce illnesses or anything else. The only thing that happens is that health care spending begets health care spending.
And why?
One reason is because ZERO Americans have "health insurance" because it does not exist in the US. What you have have is a big commie share-fest money-pool that steals money from single people to subsidize everyone else, and because it's all fee-service-based, it's a big spend-fest.
So get rid of employer-sponsored health care, repeal Obamacare or at least repeal Section 6001 written by the AHA that bans clinics, then go back to the old days when hospitals were taxed, and tax the snot out of hospitals to force hospitals to close and adopt the Clinic Model, you know, like Europe (which liberals rave about). Then you'll have true competition operating at the highest efficiency, which will force the creation of real health insurance.
When you have real, true, genuine, bona fide health insurance, you'll know, because you can use any doctor or any medical facility anywhere at any time without being penalized with "Out-of-Network" fees, and you'll be able to purchase your coverage a la carte, just like you do for your home or car. So if you don't want coverge for doctor's office visits, then you tell your insurance agent that, and you pay less than people who want doctor's office visits covered.
Right! I had hip surgery in December. The hospital bill alone was $76K. I just happened to have that tucked inside my mattress. People that say this have zero idea of how much health care costs. And don't give me this crap about how it will all go down if we don't have ins. If costs go down, so will quality.
LOL! The first 4 are all repeats of the same report in the OP. Not a one has cited a company that did drop its benefits; they all have these "plans" to.
#5 states similar, with slightly different numbers. It also says that most emplyoees expect increased compensation if their insurance is dropped.
How's that for you, bub?
Obviously companies have not dropped benefits yet....Health care reform has yet to take effect...
How about responding to the content of the articles? Or do you have nothing substantial to say?
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