Going to the poor house:2015 Inusrance premiums

[DebbieB]

One MAJOR event and you will be glad you have coverage. Our granddaughter had childhood cancer at age 8 and almost died. In and our of the hospital over the course of a year - radiation & chemo. We now call her our million dollar miracle.

One thing good about the ACA is it took away the lifetime cap. Many policies had a $1,000,000 lifetime cap. An illness like you described could max it out.

 

[Dashzap]

So our 2015 benefit guide just came out. I have BCBS PPO. I know working PT and needing a family plan is expensive. I am paying $560/month!!!! I am sure to many this is cheap,but health care reform is here to stay. My family deductible is $3,0000. 80/20 max $9,000. Hopefully we will not need to use it this next year. How about everyone else?

We have a similar policy with BCBS. I pay $1500/month for the four of us.

 

[Dakota731]

Health care cost are rising for some reason at insane rates.

A few years ago, insurance companies tried to pay for everything for everyone (I had one friend who got paid massages for her "stress" and another whose company paid for her jet tub for her "back" issue) and now we are all paying the price. There are people who since they have insurance go to the doctor for every little cough or cold. My daughter who is an ER doctor said people come in all time for ear infections, sore throats, and headaches leaving a fat bill for insurance companies (or taxpayers) to foot. Not to mention people who never exercise or eat right and end up getting all kinds of preventable conditions.

 

[Dakota731]

If enough employees complain, they may opt to do it a different way next year.

Or they will do like many small companies have done and stop offering health care altogether or lay off workers and stick to an all part-time employee base. Businesses have to make money to stay afloat - they are not like the government and can't just take more from the taxpayers. Companies have to pay their suppliers or they go to jail - they can't run huge deficits and debts like our friends in Washington.

 

[Gracie09]

One MAJOR event and you will be glad you have coverage. Our granddaughter had childhood cancer at age 8 and almost died. In and our of the hospital over the course of a year - radiation & chemo. We now call her our million dollar miracle.

I'm glad your grand daughter is recovered! Even pregnancy can take a nasty turn. My pregnancy was going well until week 20 when I suddenly developed pre-eclampsia and HELLP syndrome. That caused multiple expensive hospital trips, specialist care, testing, 3-d ultrasounds to determine when it was safe to take out my dd. And finally a week long nicu and hospital recovery for my dd and myself. All told around a quarter of a million dollars, for a seemingly normal pregnancy. Less than a year later my husband blew out his back and needed back surgery and pt for eight weeks. Another 100k right there. Then my dd ended up in the hospital for a week with RSV. Another tens of thousands there.
Before we hardly ever used our health insurance. DH had twice yearly specialist visits and I had my annual ob/gyn visit. And now that my dd is 5 she also only sees the doctor a couple times a year. This year she's been twice - once for a sty (rule out pink eye for the school) and the next was bronchitis. My other dd has never had a sick day in the 3 years she has lived with us. So now we are back to paying more than we are getting but you can't put a price on peace of mind. I know if something horrible were to happen to someone in my family, we would be covered and wouldn't lose our shirts in the process.

 

[Gracie09]

Or they will do like many small companies have done and stop offering health care altogether or lay off workers and stick to an all part-time employee base. Businesses have to make money to stay afloat - they are not like the government and can't just take more from the taxpayers. Companies have to pay their suppliers or they go to jail - they can't run huge deficits and debts like our friends in Washington.

I don't believe the US allows debtors prisons anymore. You would have to shut down and possibly declare bankruptcy (and if you set up the business correctly the business would be bankrupt not personal bankruptcy)

 

[missbrooke06]

The nurse case manager is NOT part of Obamacare but part of your insurance plan. If you fought it you would probably win as it is potentially a violation of your hippa health care privacy rights as well as potentially a violation of your civil rights to privacy. You have the right to not discuss your health care if you so choose. Obama care does mandate that wellness benefits must be provided but it does not mandate that people must participate in wellness care.

Your insurance company has a right to your medical info. Also, the wellness program is optional (you just have to pay more). There is absolutely zero chance that a claim against a legit wellness program is going to win.

 

[MillauFr]

The following costs are also out of control and are driving the cost of medical care:
Medical Malpractice Insurance
Medical Malpractice lawsuits
The cost for a doctor to buy in to a practice
the cost of medical school.
the interest rates doctors are paying on the loans they took out to go to medical school
the consolidation of many hospitals and doctors practices - those buyouts cost money $$$$$$
better medical care technology - they have to pay off that spiffy new MRI machine somehow - a former client was spending over $10,000 per month to pay for the one he bought and that was a 30 year loan.
oh, and let's not forget - insurance fraud. the same former client is in federal jail now for that.

You can also add in insane salaries for the CEOs of some of the these health care companies..

http://www.creators.com/opinion/daily-editorials/health-insurance-ceo-paid-106-million-feel-better.html

$106 million!!!

 

[DVCcurious]

You can also add in insane salaries for the CEOs of some of the these health care companies..

http://www.creators.com/opinion/daily-editorials/health-insurance-ceo-paid-106-million-feel-better.html

$106 million!!!

If ignorance is bliss Americans must be the happiest people on earth.

I worked in healthcare finance for 11 years. I worked for providers and payers. "high CEO salaries" are irrelevant. Malpractice lawsuits are irrelevant. Free birth control is irrelevant.

Let's use your example of "high CEO salaries." 106 million. Wow, that sounds like a lot! But when you divide it by the 300 million people in the US you are basically increasing costs by .30 per person per year. Not exactly a major driver. Malpractice is the same thing, it raises your rates maybe .50 per year, tops.


So what is driving healthcare costs in the US? It's quite simple: End of life care.

My dad got cancer at 60. He died of cancer at 63. During those three years he spent $10 million on healthcare costs.

$10 Million!!!!

His best friend lived in Sweden most his life and has family there. He told my dad that when he was diagnosed had he been in Sweden they would've given him some morphine and sent him to hospice care. Sweden would've saved $10 million.

Almost every person demands every test and every procedure available if there is the slimmest chance they will live one more day. We as a society have decided that one more day of life is worth whatever it costs.

Until we as a society do a cost-benefit analysis (DEATH PANELS!! shout the right wingers) we will continue to have high health care costs.

If you want lower health care costs you're going to have to let people with cancer, heart disease (triple bypass surgeries are not cheap), and other serious ailments die rather than trying to keep them alive for a few years.

Every other medical cost you can think of is insignificant next to a $3 million annual bill to keep my dad around a little bit longer.

http://www.cancer.org/cancer/cancerbasics/cancer-prevalence

according to cancer.org there are 15.5 million people with cancer in the US right now. Let's say they don't all cost $3 million per year like my dad did. Let's say they average $10,000 per year (because some have been cured and don't cost much annually, but they did cost a lot up front for treatment). Well, 15.5 million X $10,000 = $155 BILLION

That puts your "$100 million! CEO Salary" figure into perspective, doesn't it?

So, make the choice: Should those cancer patients get life-saving care, or should they be given morphine and sent to Hospice?

Make your choice and stop whining about "gigantic CEO salaries!" or "evil trial lawyers!" or "free birth control!"

 

[Trixie Belden]

So what is driving healthcare costs in the US? It's quite simple: End of life care.

My dad got cancer at 60. He died of cancer at 63. During those three years he spent $10 million on healthcare costs.

$10 Million!!!!
"

Exactly. And I say this with a mother who has a type of cancer that is incurable. I love my mother very much and will be devastated when she dies, but the fact is, $600k was spent in 3 months alone this year on her health care. I don't want my mother to die, AT ALL, but it's very expensive to treat her.

 

[kydisneyfans]

If ignorance is bliss Americans must be the happiest people on earth.

I worked in healthcare finance for 11 years. I worked for providers and payers. "high CEO salaries" are irrelevant. Malpractice lawsuits are irrelevant. Free birth control is irrelevant.

Let's use your example of "high CEO salaries." 106 million. Wow, that sounds like a lot! But when you divide it by the 300 million people in the US you are basically increasing costs by .30 per person per year. Not exactly a major driver. Malpractice is the same thing, it raises your rates maybe .50 per year, tops.


So what is driving healthcare costs in the US? It's quite simple: End of life care.

My dad got cancer at 60. He died of cancer at 63. During those three years he spent $10 million on healthcare costs.

$10 Million!!!!

His best friend lived in Sweden most his life and has family there. He told my dad that when he was diagnosed had he been in Sweden they would've given him some morphine and sent him to hospice care. Sweden would've saved $10 million.

Almost every person demands every test and every procedure available if there is the slimmest chance they will live one more day. We as a society have decided that one more day of life is worth whatever it costs.

Until we as a society do a cost-benefit analysis (DEATH PANELS!! shout the right wingers) we will continue to have high health care costs.

If you want lower health care costs you're going to have to let people with cancer, heart disease (triple bypass surgeries are not cheap), and other serious ailments die rather than trying to keep them alive for a few years.

Every other medical cost you can think of is insignificant next to a $3 million annual bill to keep my dad around a little bit longer.

http://www.cancer.org/cancer/cancerbasics/cancer-prevalence

according to cancer.org there are 15.5 million people with cancer in the US right now. Let's say they don't all cost $3 million per year like my dad did. Let's say they average $10,000 per year (because some have been cured and don't cost much annually, but they did cost a lot up front for treatment). Well, 15.5 million X $10,000 = $155 BILLION

That puts your "$100 million! CEO Salary" figure into perspective, doesn't it?

So, make the choice: Should those cancer patients get life-saving care, or should they be given morphine and sent to Hospice?

Make your choice and stop whining about "gigantic CEO salaries!" or "evil trial lawyers!" or "free birth control!"

I agree with most of what you say, but my office pays 27% of their income for malpractice insurance, and none of the doctors have ever had a suit against them. A regular visit starts at $165 now. If malpractice was 0, the same visit would be $120.

 

[3boymthr]

If ignorance is bliss Americans must be the happiest people on earth.

I worked in healthcare finance for 11 years. I worked for providers and payers. "high CEO salaries" are irrelevant. Malpractice lawsuits are irrelevant. Free birth control is irrelevant.

Let's use your example of "high CEO salaries." 106 million. Wow, that sounds like a lot! But when you divide it by the 300 million people in the US you are basically increasing costs by .30 per person per year. Not exactly a major driver. Malpractice is the same thing, it raises your rates maybe .50 per year, tops.


So what is driving healthcare costs in the US? It's quite simple: End of life care.

My dad got cancer at 60. He died of cancer at 63. During those three years he spent $10 million on healthcare costs.

$10 Million!!!!

His best friend lived in Sweden most his life and has family there. He told my dad that when he was diagnosed had he been in Sweden they would've given him some morphine and sent him to hospice care. Sweden would've saved $10 million.

Almost every person demands every test and every procedure available if there is the slimmest chance they will live one more day. We as a society have decided that one more day of life is worth whatever it costs.

Until we as a society do a cost-benefit analysis (DEATH PANELS!! shout the right wingers) we will continue to have high health care costs.

If you want lower health care costs you're going to have to let people with cancer, heart disease (triple bypass surgeries are not cheap), and other serious ailments die rather than trying to keep them alive for a few years.

Every other medical cost you can think of is insignificant next to a $3 million annual bill to keep my dad around a little bit longer.

http://www.cancer.org/cancer/cancerbasics/cancer-prevalence

according to cancer.org there are 15.5 million people with cancer in the US right now. Let's say they don't all cost $3 million per year like my dad did. Let's say they average $10,000 per year (because some have been cured and don't cost much annually, but they did cost a lot up front for treatment). Well, 15.5 million X $10,000 = $155 BILLION

That puts your "$100 million! CEO Salary" figure into perspective, doesn't it?

So, make the choice: Should those cancer patients get life-saving care, or should they be given morphine and sent to Hospice?

Make your choice and stop whining about "gigantic CEO salaries!" or "evil trial lawyers!" or "free birth control!"

Actually, no. That's not true. I worked in insurance for over 17 years for the evil insurance company as the person who set the insurance rates. End of life care is not driving the cost of insurance because those costs are excluded from the average every day insurance premium increase. Every policy when it is rated, unless it is an individual policy which is community rated, has a set number of factors which goes into the calculation of the preimum, general experience, industry rating (SIC code factor), age factor (I can even calculate the age factor of any given company for you right now if you asked and had the company's demographics), historical experience, group size overall. From this they then exclude all claims over a certain loss level, generally speaking unless your group is HUGE, the loss level tends to be about $100,000 maybe more, maybe less. For claims the size you speak of, the health insurance companies have a separate stop loss policy added in to their costs that is spread across all their groups. It is factored into the administration costs of the plan. Plus, since many many many people who have the extreme end of life costs you are discussing are older many many of them have medicare or partial medicare which offsets the expenses to the insurance company, yes there is balance billing, but there are offsets.

If your group has overall bad experience on an average level, in otherwords, 4 or 5 claims where the patients approach the large loss cap but don't exceed it and if your group ages significantly or if your group increases in size and passes a certain size threshold that allows them to vary the rating you will see a rate increase often significant.

OH and and yes, the obama care mandated plan changes are having a HUGE effect. The big factors are those I listed, because those costs drive what the insurance companies are being charged by the providers at a base every day level. Your average office visit cost in the last twenty years has climbed from about $45 to $145. The same could be said for routine exams and many routine rx costs and there is your be cost driver in insurance premium increases - NOT large claims. Since routine care is now mandated every plan has to now accommodate for the increase in claims for the average every day claim.

 

[Dakota731]

I don't believe the US allows debtors prisons anymore

Not true,though it's rare you can go to jail for not paying taxes in the U.S.

Let's use your example of "high CEO salaries." 106 million.

How come no one complains when the CEO of Apple makes $74 million in salary and stock options?? Contrary to popular belief, not anyone can run a billion dollar company and do it well. There are only a select few who are qualified and can do it well so they are paid accordingly. Just like football or basketball players.

 

[Gracie09]

Not true,though it's rare you can go to jail for not paying taxes in the U.S. How come no one complains when the CEO of Apple makes $74 million in salary and stock options?? Contrary to popular belief, not anyone can run a billion dollar company and do it well. There are only a select few who are qualified and can do it well so they are paid accordingly. Just like football or basketball players.

We're not talking taxes we are talking civil debts. And debtors prison for civil debts was outlawed in the us over 200 years ago. So no the pp will not go to jail if she doesn't pay her business debts. Her business will go bankrupt. It happens all over the country all the time and people aren't going to jail over it.

 

[DVCcurious]

For claims the size you speak of, the health insurance companies have a separate stop loss policy added in to their costs that is spread across all their groups.

And that reinsurance costs money. So what I'm saying is true: massive end of life claims are driving our healthcare cost increases. Whether it's a direct cost or a cost through "reinsurance" doesn't change the fact that we (the consumer) are paying for it one way or another. And if reinsurance is used those reinsurers need to make a profit, so reinsurance actually increases the end consumers cost. Because now we're not only paying for that $3 million cancer patient, we're paying for reinsurer company profits.

Plus, since many many many people who have the extreme end of life costs you are discussing are older many many of them have medicare or partial medicare which offsets the expenses to the insurance company, yes there is balance billing, but there are offsets.

Where does that money Medicare uses to pay the bill come from? Oh, right, our paychecks. So we, the consumers, are paying for that cancer patient's $3 million bill. "Medicare" isn't an entity that has it's own money. It is an entity that takes money from the consumer and uses that money to pay for older people's medical care. The money still comes from the consumer regardless how it's "categorized" as Medicare, Insurance, Reinsurance, whatever.

I worked for a hospital chain as a financial analyst doing the budget/long range financial forecasts. If you go to this hospital and couldn't afford to pay we'd still treat you and you'd get "free" medical care. But when we design our pricing structure we KNEW that there would be this "charity care" so we jacked up the price of our services so that the consumers who could afford to pay would pay for their own services as well as pay a part of the services of those who couldn't pay.

Someone always has to pay, this hospital chain wasn't going to take the hit. The consumer took the hit.

The insurance companies don't pay those costs, Medicare doesn't pay those costs, reinsurance doesn't pay those costs. WE pay those costs. In one case the hospital sends the bill to Medicare and medicare pays it with money they take out of our paycheck. In another case the hospital sends the bill to the reinsurer and the reinsurer pays it with money they got from billing the insurer, who pays that reinsurance bill with money they got from the consumer's premiums. In another case the hospital bills the insurer and the insurer pays it with money they got from the consumer's premiums. It doesn't matter how the bill moves through the pipes. We're still the ones who have to pay it.

If we let people with serious end of life diseases just simply die all of our costs would be lower.

 

[eliza61]

And that reinsurance costs money. So what I'm saying is true: massive end of life claims are driving our healthcare cost increases. Whether it's a direct cost or a cost through "reinsurance" doesn't change the fact that we (the consumer) are paying for it one way or another. And if reinsurance is used those reinsurers need to make a profit, so reinsurance actually increases the end consumers cost. Because now we're not only paying for that $3 million cancer patient, we're paying for reinsurer company profits.



Where does that money Medicare uses to pay the bill come from? Oh, right, our paychecks. So we, the consumers, are paying for that cancer patient's $3 million bill. "Medicare" isn't an entity that has it's own money. It is an entity that takes money from the consumer and uses that money to pay for older people's medical care. The money still comes from the consumer regardless how it's "categorized" as Medicare, Insurance, Reinsurance, whatever.

I worked for a hospital chain as a financial analyst doing the budget/long range financial forecasts. If you go to this hospital and couldn't afford to pay we'd still treat you and you'd get "free" medical care. But when we design our pricing structure we KNEW that there would be this "charity care" so we jacked up the price of our services so that the consumers who could afford to pay would pay for their own services as well as pay a part of the services of those who couldn't pay.

Someone always has to pay, this hospital chain wasn't going to take the hit. The consumer took the hit.

The insurance companies don't pay those costs, Medicare doesn't pay those costs, reinsurance doesn't pay those costs. WE pay those costs. In one case the hospital sends the bill to Medicare and medicare pays it with money they take out of our paycheck. In another case the hospital sends the bill to the reinsurer and the reinsurer pays it with money they got from billing the insurer, who pays that reinsurance bill with money they got from the consumer's premiums. In another case the hospital bills the insurer and the insurer pays it with money they got from the consumer's premiums. It doesn't matter how the bill moves through the pipes. We're still the ones who have to pay it.

If we let people with serious end of life diseases just simply die all of our costs would be lower.

LOL,
Yes it's very easy to be dismissive and smug until it's your love one dying.

I for one am very glad we are not a county that simply lets people die (and it's never "simple")

If we did a lot of things, our cost would go down. Military, international aide, etc etc.
You live in a society, you chip in for the cost.

 

[OceanAnnie]

LOL,
Yes it's very easy to be dismissive and smug until it's your love one dying.

I for one am very glad we are not a county that simply lets people die (and it's never "simple")

If we did a lot of things, our cost would go down. Military, international aide, etc etc.
You live in a society, you chip in for the cost.

Our insurance went up 41% and we are losing prescription coverage. We are paying more for less coverage.

Not happy.

 

[DVCcurious]

LOL,
Yes it's very easy to be dismissive and smug until it's your love one dying..

I'm not "smug and dismissive"; I'm honest about why our health care costs are so expensive in the US. In case you missed it, it was MY DAD who was dying of cancer. So, yes it was my loved one.

And I'm thrilled you all chipped in to pay his $10 million medical bill from November 2008-April 9, 2011. If it wasn't for you guys he would've died in February 2009.

I was born with a very bad and rare disease.

http://americanpregnancy.org/pregnancy-complications/group-b-strep-infection/

I spent the first 3 weeks of my life (July 1976) in the NICU (intensive care for newborns). The cost was $800,000 in 1976 dollars. Everyone who paid insurance premiums in 1976 paid for me to be alive today.

Am I "dismissive and smug" when I'm talking about my own life? If our society didn't believe in spending "whatever it takes" to save a life then I wouldn't be here right now.

I'm not writing to make any sort of value judgment on how much is OK to spend on end of life care. I'm writing to inform you guys that ALMOST OUR ENTIRE medical expense gap between the US and European countries is a result of End of Life Care.

"High CEO Salaries" have nothing to do with it, "Malpractice lawsuits" have nothing to do with it. Massively expensive end of life care has everything to do with our high costs.

If you're complaining about high insurance costs you need to realize you are really complaining about spending money to keep cancer patients alive longer, or you're complaining about the money we're spending on the NICU. You are not complaining about "high CEO salaries" or "free birth control" because those costs are irrelevant next to the cost of end of life care.

 

[3boymthr]

And that reinsurance costs money. So what I'm saying is true: massive end of life claims are driving our healthcare cost increases. Whether it's a direct cost or a cost through "reinsurance" doesn't change the fact that we (the consumer) are paying for it one way or another. And if reinsurance is used those reinsurers need to make a profit, so reinsurance actually increases the end consumers cost. Because now we're not only paying for that $3 million cancer patient, we're paying for reinsurer company profits.



Where does that money Medicare uses to pay the bill come from? Oh, right, our paychecks. So we, the consumers, are paying for that cancer patient's $3 million bill. "Medicare" isn't an entity that has it's own money. It is an entity that takes money from the consumer and uses that money to pay for older people's medical care. The money still comes from the consumer regardless how it's "categorized" as Medicare, Insurance, Reinsurance, whatever.

I worked for a hospital chain as a financial analyst doing the budget/long range financial forecasts. If you go to this hospital and couldn't afford to pay we'd still treat you and you'd get "free" medical care. But when we design our pricing structure we KNEW that there would be this "charity care" so we jacked up the price of our services so that the consumers who could afford to pay would pay for their own services as well as pay a part of the services of those who couldn't pay.

Someone always has to pay, this hospital chain wasn't going to take the hit. The consumer took the hit.

The insurance companies don't pay those costs, Medicare doesn't pay those costs, reinsurance doesn't pay those costs. WE pay those costs. In one case the hospital sends the bill to Medicare and medicare pays it with money they take out of our paycheck. In another case the hospital sends the bill to the reinsurer and the reinsurer pays it with money they got from billing the insurer, who pays that reinsurance bill with money they got from the consumer's premiums. In another case the hospital bills the insurer and the insurer pays it with money they got from the consumer's premiums. It doesn't matter how the bill moves through the pipes. We're still the ones who have to pay it.

If we let people with serious end of life diseases just simply die all of our costs would be lower.

Yes, end of life care is expensive and it IS draining our society, especially those who have to declare bankruptcy to get out from under the burden of medical costs incurred during end of life care but AGAIN they are not driving the increases in insurance premiums. The two are NOT the same.

I was speaking of the overall increases to insurance premiums. Yes, we supplement the costs of medicare through our own contributions to FICA and MED but those costs are not impacting the increased cost of insurance premiums, they are impacting your net take home pay NOT the same.

The reinsurance cost is sooooo small because it's spread across such a HUGE base for all providers, that it's negligible as compared to the overall cost increases that employees are seeing. Probably 1/10 of 1% of the increases that are occurring. Imagine if you will that the insurance company is paying $10,000,000 in reinsurance premiums per annum. They take that cost, split it across the 100,000 members in their plan. That works out to $100 per member per YEAR that's less than $10/month. Then imagine that premium goes up 10%. So the premium increases $1 per month. It's peanuts in the scheme of $1,500 to $2,000 premiums.

 

[Dakota731]

I for one am very glad we are not a county that simply lets people die

We sure do - at last count 1.03 million unborn babies each and every year in the US (even though birth control is now FREE)