We need new health insurance

[IUTBAM]

I count my blessings every day that my DH's employer pays for our health insurance coverage almost completely...we pay $6 a month total for the four of us, plus $10 per doctor visit, and $50 for ER for medical....can't recall what we pay if someone is hospitalized, but it's not much. We also have dental and vision included in that, but it's not quite as generous. They consider it part of his compensation package (he works for a mid-size energy company). He's worked in the o&g sector for years, and this is by far the best coverage we've ever had. I told him he can never quit, lol.

 

[scrapquitler]

Here's a chart from an article in today's Wall Street Journal:

Walgreen to Shift Health Plan for 160,000 Workers
Drugstore Chain's Move Underscores Shifting Burden on Insurance

I think that most people with employer subsidized health insurance have absolutely NO IDEA how much their employer contributes to the insurance. At my job (where I don't qualify for the insurance because I don't work full time), my co-workers complained when the price of the family plan rose from $250 a month to $300 a month. My husband is self employed and we pay for the entire policy ourselves, to the tune of $1600 a month for approximately the same plan that my coworkers get for $300 and think the price is outrageous. I do think that people understanding how much health insurance actually costs is one good thing that will come out of all these new changes that we are going to experience in the next few years, because now, people think that the part they pay is all it costs.

 

[mrsklamc]

I count my blessings every day that my DH's employer pays for our health insurance coverage almost completely...we pay $6 a month total for the four of us, plus $10 per doctor visit, and $50 for ER for medical....can't recall what we pay if someone is hospitalized, but it's not much. We also have dental and vision included in that, but it's not quite as generous. They consider it part of his compensation package (he works for a mid-size energy company). He's worked in the o&g sector for years, and this is by far the best coverage we've ever had. I told him he can never quit, lol.

Sadly if the 'Cadillac Plan' tax kicks in in 2018, it is unlikely plans like this will still be offered.

 

[leahjade]

Obamacare exchanges open up in two weeks

Saw on the news last week that it will cost $700-$800 a month for a couple on these plans so not sure how much you are paying now but it may not be a savings.

 

[mrsklamc]

Saw on the news last week that it will cost $700-$800 a month for a couple on these plans so not sure how much you are paying now but it may not be a savings.

I think it depends a lot on what level of coverage, your income, and what state.

 

[Jeff_G]

I think that most people with employer subsidized health insurance have absolutely NO IDEA how much their employer contributes to the insurance.

You are absolutely right! Until January 2013 when we received our W2s and this amount was now listed as required by ACA. My employer and I guess most others did not share this information with its employees even when asked my HR would say they do not give out that information.

So now we can all see just how much our insurance package costs, how much we pay vs how much my employee pays.

Myself and many co workers were shocked when we saw the numbers. My employer paid about 12K for my insurance policy and I paid about 2K in premiums over the year. This is a high deductible plan with an HRA.

I am so grateful my employer is paying into my health care, my co workers are looking at the numbers and wondering its a whole lot cheaper for the company to just drop the coverage and pay the fine.

Or as we are seeing with Walgreen and others giving the employee a stipend and let them go shop the exchange. The question I have are they giving a 12K stipend? Some how I bet not. One company said by having employees use the exchange they are protecting the company from skyrocketing premiums.

Some of that protection is going to be gained by having a larger pool of users in the insurance group, however I suspect the rest will transfer from the company to the employee. As premiums continue to rise the company can pay the same or perhaps a little higher stipend and insulate itself from the increase in cost.

 

[DisneyDizzy]

Honestly, your plan sounds good to me. We pay $1300 a month for family coverage through my husband's employer for Anthem BCBS. We have $3000 individual deductibles, $5000 family. Our insurance pays 80/20. No dental or vision.

Because our income is "high"...so they say, we get no break through the new insurance marketplace. And it looks like we'll still be better off with what we have.

We've never ever paid so much. My husband was in his job for 3 months and they rolled out the new plan so we had no idea what we were in for. He in a high-level engineer and career-wise loves his job. However, we've seriously considered changing companies and taking a step backwards. He'd actually bring home more money with a pay cut.

Guess I just wanted to complain about it so someone! It makes me crazy.

 

[manning]

You are absolutely right! Until January 2013 when we received our W2s and this amount was now listed as required by ACA. My employer and I guess most others did not share this information with its employees even when asked my HR would say they do not give out that information.

So now we can all see just how much our insurance package costs, how much we pay vs how much my employee pays.

Myself and many co workers were shocked when we saw the numbers. My employer paid about 12K for my insurance policy and I paid about 2K in premiums over the year. This is a high deductible plan with an HRA.

I am so grateful my employer is paying into my health care, my co workers are looking at the numbers and wondering its a whole lot cheaper for the company to just drop the coverage and pay the fine.

Or as we are seeing with Walgreen and others giving the employee a stipend and let them go shop the exchange. The question I have are they giving a 12K stipend? Some how I bet not. One company said by having employees use the exchange they are protecting the company from skyrocketing premiums.

Some of that protection is going to be gained by having a larger pool of users in the insurance group, however I suspect the rest will transfer from the company to the employee. As premiums continue to rise the company can pay the same or perhaps a little higher stipend and insulate itself from the increase in cost.

The sticker shock is about to hit.

And those being shifted to part time get nothing plus reduction in income.

 

[leahjade]

The sticker shock is about to hit.

Especially for middle class families who will get no assistance with the cost. It will be a rude awakening for some.

 

[wendow]

I am comparing this current health insurance to all the other health policies we've had before. We have basic dental which only covers cleanings and fillings. I had to have a root canal 2 weeks ago and had to pay OOP for that. They cover nothing else.
Our medical has a $3000 deductible per person per year for in network. 80 % coverage with maximum $3000 OOP after deductible for approved coverage. Out of network is $6000 per person and 60% coverage after the deductible. I need to call back tomorrow and check on maternity. I'm not sure about vision since we haven't used it yet.
Granted, our insurance could be worse, but it's the worst we've ever had. I will be taking everyone's advice and keep checking around. I think we pay $600 OOP per month. I'm not sure what his employer is paying.

This is similar to the insurance we receive through my dh's work. Except our deductibles are $2500 per person and we pay $800 a month OOP for the cost of the insurance. I think ours is "bad" as it is, by far, the most expensive insurance we've ever had and with the worst coverage. But all health insurances have gotten worse, employers are passing more of the cost on to employees and there are very few options out there if you choose to go out on your own. I did a lot of looking and even contacted a broker last year. There was nothing out there for us. I could find something with a slightly less per month premium but the deductibles were much higher ($7500-$10,000). It just wasn't enough of a savings to take the risk. I have not looked into what will be available with Obamacare either so I'll be doing that as well.

Oh, and we pay $800 a month but dh's employer pays over $900 as their portion. Insurance premiums are just so crazy expensive. We actually never go to the doctor either. My kids do a check-up once a year and dh & I try to also. But we are never sick enough to go to the doctor. But with 4 kids, I wouldn't go without insurance. Also, the amounts I am giving are just for health care...no vision or dental. We pay more for that and the coverage stinks there too.

 

[Jeff_G]

I am almost wondering when no one but the wealthy can afford the insurance plans, will we see medical care start to go back to pre health insurance costs.

Example in 1958 the per capita cost spent on ALL health care was $134, adjusted for inflation this would represent $1,084.41 today.

I believe the invention of the medical insurance industry has caused health care costs to sky rocket.

I will admit we have made some major medical advancements since 1958.

 

[dhardawa]

The problem is the ridiculous cost of medical care these days. As the medical costs skyrocket, the cost of insurance does as well.

 

[manning]

The problem is the ridiculous cost of medical care these days. As the medical costs skyrocket, the cost of insurance does as well.

I read somewhere the biggest cost was malpractice suits.

I can see someone getting compensated for present and future lost wages but someone getting millions for pain and suffering. No.

 

[ruadisneyfan2]

I am almost wondering when no one but the wealthy can afford the insurance plans, will we see medical care start to go back to pre health insurance costs.

Example in 1958 the per capita cost spent on ALL health care was $134, adjusted for inflation this would represent $1,084.41 today.

I believe the invention of the medical insurance industry has caused health care costs to sky rocket.

I will admit we have made some major medical advancements since 1958.

I've worked in a large teaching hospital in downtown Philly for 23 years. According to the hospital it's actually technology that is driving the cost up. (Payroll too.) Our digital mammography equipement is 5 yrs old and our patients gripe that it's still the ol same thing & why haven't we gotten some newer technology.

Maybe because each unit is millions of dollars. We have 6 of them. I ask if they throw away all of their perfectly functioning TVs every time a newer version comes out?

Just like the way my PC is a dinosaur when it's 3-5 years old, anything computerized has a short life span. (Look how often they keep coming out new generations of iPhones.) Our patients want the latest & greatest. The competition is strong so they feel obligated to keep impressing patients, or try to.
I read somewhere at work that the amount of info taught during 4 years of medical school to doctors who are now retiring, now is covered in just 1 year of medical school. That's how much more info they need to know compared to the old days.

I remember many years ago seeing ads in the Sunday paper at Best Buy for $8000 for a plasma TV. As technology ages, the price comes down. Do they even make them anymore? People are probably still paying theirs off.
Remember when VCR's were like $600? and if you wanted a 4-head with HIFI it was closer to $1000.
But who wants old stuff? As dh would say, Cool Ain't Cheap.

We currently have what some here call the 'Cadillac plan'. $25-50 copays depending on whether we go to 'our' hospital/doctors or not. $100 ER visits, waived if admitted. $10-20 Rx plan if we use one of 3 outpatient pharmacies on campus. Delta Dental covers 100% cleanings, 80% fillings, 50% major restorative (root canals, crowns, etc.) $50 pp deductible/yr or $100/family. $2K pp lifetime limit for orthodontics. (Glad we're getting that done now for kids.)
Plus short term & long term disability, life ins, accidental death or dismemberment for self & family, & FSA deductions. For all of this I pay around $420/month pre tax.
Our PT employees pay much more. That's why I continue to work FT; it's not just about the income. I gave up a long time ago being stay home mom. I need security. As I read the Debt Dumping thread about so many posters struggling with multiple medical bills, it only reinforces my belief.

For the past 15 or so years the hospital has given us an individualized, annual statement listing all of our benefits: sick time, vacation time, insurance, etc.
We'd laugh about it but really it shows what hiring me costs them. IIRC bennies were around $20K/year more than my 'compensation' as they call it.

So far the downturn in the economy hasn't affected us much. Our numbers are up and we are busy, busy, busy. One year, maybe 2009, we got a 1 time bonus instead of a raise but other years we still get 2-3% and every 5-10 years they compare our pay to other similar size hospitals in the area so we are not top paying but still competitive. They're doing research now & estimate by 2014 we should hear about that.

We'll soon see how Obama Care affects what the hospital offers.

Dh's work offers similar health insurance choices but lousy dental plan. Basically go to a specific dentist whom I don't know. Since dh can get around $500/month back in his paycheck if he waives insurance, we stick with mine. My employer gives us nothing if we waive ours.

 

[Jeff_G]

Maybe because each unit is millions of dollars. We have 6 of them.

But why is the machine millions of dollars? Does it really have millions of dollars in materials, labor and some profit for the company? No of course not. Sure we are paying back the research for that machine plus funding new research.

But also perhaps its multi millions because they know the hospital will pay it. The hospital pays it because they know they can bill insurance $5,000 every time they use it.

Somewhere here the free market has gotten interrupted and we have gone off another path.

 

[ruadisneyfan2]

But why is the machine millions of dollars? Does it really have millions of dollars in materials, labor and some profit for the company? No of course not. Sure we are paying back the research for that machine plus funding new research.

But also perhaps its multi millions because they know the hospital will pay it. The hospital pays it because they know they can bill insurance $5,000 every time they use it.
Somewhere here the free market has gotten interrupted and we have gone off another path.

Not really. I think BC pays around $300 for a mammogram.

 

[crisi]

I am almost wondering when no one but the wealthy can afford the insurance plans, will we see medical care start to go back to pre health insurance costs.

Example in 1958 the per capita cost spent on ALL health care was $134, adjusted for inflation this would represent $1,084.41 today.

I believe the invention of the medical insurance industry has caused health care costs to sky rocket.

I will admit we have made some major medical advancements since 1958.

In 1958 when my great aunt had cancer, she died. They gave her what is now considered comfort care and did a radical mascetomy. No chemo, no radiation. When she was in the hospital, which wasn't often, she was in a 20 bed ward - one room, 20 beds, no privacy.

In 2009 when my sister had cancer, she had eight rounds of chemo at $12k a shot - the latest medicine which was still under patent. She had a mascetomy and reconstruction, plus targeted radiation. When she was in the hospital, she had a private room.

Without insurance, they wouldn't have been able to afford to save her life. With my great aunt, there really wasn't that much to pay for - and they did have insurance.

They didn't save my brother in laws life - but treatment for the two years from his diagnosis was millions of dollars, including eight weeks of ICU care at the end of his life. It would have been a lot cheaper to put him into hospice and let him die, but that wasn't his choice - and while his choice (and the choices of people like him) are what helps drive up the cost of health insurance, not enabling people to make that choice gets us into the realm of "death panels." (for the record, I would not have made that choice).

Insurance is paying for care for my friend's severely disabled daughter - a little girl who wouldn't have survived her birth in 1958 (or 1988). The improvement in medical technology means that there is a long term cost involved sometimes.

By the way, the taxpayer paid for my brother in law since the only insurance he had or could get was a state program within Minnesota. We pay now, we just pay in different ways.

 

[timmac]

If we go back to the OP, I think the real statement isn't so much "I need better insurance" as much as "I wish medical care didn't cost so much", as a few others have already kind of pointed out.

Something a lot of people don't realize--at least until they've really thought about it-- is that having insurance isn't generally about saving money at all. In fact, about the only time insurance represents any kind of savings is if there's a catastrophic event (think heart attack) that would otherwise cost tens or hundreds of thousands of dollars. In order for any insurance company to stay in business, that implies that almost everyone else is paying more for insurance than the cost of the care they receive any given year; thus, the total spent for insurance by all participants remains less than the total the insurance company pays out. Once you consider the cost of the company running itself, it's easy to see it's often actually a pretty wide gulf between the two, in fact.

So, the reality is that, for the overwhelming majority of people, the overwhelming majority of the time, having insurance is actually a losing financial proposition. Most of us nonetheless maintain it, among other reasons, for peace of mind to protect against the possibility of the catastrophic scenario mentioned above. So, unless the issue is that a particular insurance company is difficult to deal with or something like that, changing insurance isn't likely to be a win. In most typical situations, no insurance is ever going to represent a "good deal", per se.

 

[crisi]

You don't WANT health insurance to be a good deal. When health insurance is a good deal, its because you are sick or injured beyond what is normal.

 

[timmac]

You don't WANT health insurance to be a good deal. When health insurance is a good deal, its because you are sick or injured beyond what is normal.

Exactly!