they're having a go at employer-provided health insurance now

zimv20

macrumors 601
Original poster
Jul 18, 2002
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toronto
link

Health costs facing change

Bush, GOP are pushing a plan to switch more of the burden for insurance premiums to workers.

WASHINGTON - Emboldened by their success at the polls, the Bush administration and Republican leaders in Congress think they have a new opportunity to move the nation away from the system of employer-provided health insurance that has covered most working Americans for the last half-century.

In its place, they want to erect a system in which workers -- instead of looking to employers for health insurance -- would take personal responsibility for protecting themselves and their families: They would buy high-deductible "catastrophic" insurance policies to cover major medical needs, then pay routine costs with money set aside in tax-sheltered health savings accounts.

Elements of that approach have been on the conservative agenda for years, but what has suddenly put it on the fast track is Republicans' confidence that the political balance of power has changed. With Democratic strength reduced, President Bush, Senate Majority Leader Bill Frist, R-Tenn., and House Ways and Means Chairman Bill Thomas, R-Calif., are pushing for action.

Supporters of the new approach, who see it as part of Bush's "ownership society," say workers and their families would become more careful users of health care if they had to pay the bills. Also, they say, the lower premiums on high-deductible plans would make coverage affordable for the uninsured and for small businesses.

"My view is that this is absolutely the next big thing," said former House Speaker Newt Gingrich, whose consulting firm focuses on health care.

Critics say the Republican approach is really an attempt to shift the risks, massive costs and knotty problems of health care from employers to individuals. And they say the Republican Party is moving forward with far less public attention or debate than have surrounded Bush's plans to overhaul Social Security.

Indeed, Bush's health insurance agenda is far more developed than his Social Security plans and is advancing at a rapid clip through a combination of actions by government, insurers, employers and individuals.

Health savings accounts, known as HSAs, have already been approved. They were created as a little-noticed appendage to the 2003 Medicare prescription drug bill.
The combination of HSAs and catastrophic insurance is too new for any definitive data on how consumers are faring.

A study released Thursday by the Commonwealth Fund found that people with high-deductible policies were more likely to have trouble paying medical bills than those in traditional insurance plans. They were also more likely to skip care because of cost.
 

jadam

macrumors 6502a
Jan 23, 2002
699
1
Great... Just Great...

How about we just forget about healthcare all together and make the people pay for their own doctors?

This is supposed to be a government of the people and for the people

not a government of the people and for the political/economic elitists.
 

jadam

macrumors 6502a
Jan 23, 2002
699
1
IJ Reilly said:
You forgot the corporations. Advancing their interests is what this government is all about.

I dunno, but I don't believe for one bit that, that is the government's goal. I believe its more like the government is subtley nudged in that direction, and some times even forced to do what would be directly against the benefits of the american people.
 

IJ Reilly

macrumors P6
Jul 16, 2002
17,915
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Palookaville
jadam said:
I dunno, but I don't believe for one bit that, that is the government's goal. I believe its more like the government is subtley nudged in that direction, and some times even forced to do what would be directly against the benefits of the american people.
Far be it for me to drop the scales from your eyes, but if you look closely (or even distantly) at most of the bills that have passed Congress over the last few years, you'll find benefits larded onto one or more industries. These interests do come first; if anything is left over, we might see it. Just follow the money, my son -- follow the money.
 

Thomas Veil

macrumors 68020
Feb 14, 2004
2,435
5,517
OBJECTIVE reality
"...more careful users of health care..."???

Yeah, I know every time I get a hangnail I expect an ambulance ride and a room in the ICU.

This is yet another government handout to business, another way to regress us back to the 19th-century.

How long are we going to put up with this S**T before we take this country back?? :mad: :mad: :mad:
 

mactastic

macrumors 68040
Apr 24, 2003
3,647
661
Colly-fornia
Didn't you know that most users of health care ask for ambulence rides for splinters? Just like most welfare recipients are professional 'wait-by-the-mailbox' types. :rolleyes:
 

mischief

macrumors 68030
Aug 1, 2001
2,920
0
Santa Cruz Ca
Yup, just this morning ....

I had a headache so I called an ambulance, then requested a full body MRI just to be safe.

(Ack!... Ack!!.. Ack!!! -Ad Infinitum-)
 

jadam

macrumors 6502a
Jan 23, 2002
699
1
I say, start writing your representives in the house! Especially the republican ones. Barrage them with letters telling them they or the republican party will not get your vote next year if they pass these bills through.
 

atszyman

macrumors 68020
Sep 16, 2003
2,442
1
The Dallas 'burbs
I wouldn't mind this for myself if my company would give the money saved on insurance to the me in my paychecks. Of course I almost never get sick and see a doctor once every 3-4 years, and once implemented i know I would all of a sudden become very sickly.

As a plan applied across everyone this is horrible. Increase everyone's personal expenses by adding medical fees on top of all of their other financial obligations and make them less likely to see a doctor before illnesses/injuries become serious. I would think that productivity losses due to employees long term illnesses (everyone who puts off a cold until it becomes pneumonia because it's too expensive) would almost offset any gain that corporations would see. Does anyone think people would keep up with preventative healthcare if they had to pay full price every time they see a doctor?
 

blackfox

macrumors 65816
Feb 18, 2003
1,208
4,026
PDX
<sarcasm>interesting plan...it is not enough to remove major sources of Democratic funding through tort-reform and Union regulation changes, but now the GOP can just kill or seriously marginalize (with ilness/destitution) many key demographics of the Democratic base.<sarcasm>

Ultimately, this will never work, at least not for an extended period of time. The underlying contributers to the skyrocketing costs of Health care have not been adequately addressed, and indeed exarcerbated as the last Medicare Reform bill has shown. As our the baby-boomers continue to age, they will be an important voting block, as will the generation below them who will find themselves unable to afford health care for themselves of their families. Once the problem affects enough people to gain critical mass, like during another recession (which is inevitable), any policies such as this will be scrapped and the leadership associated with them removed. You may very well see the Revenge of the Democrats and the ascension of FDR 2 and the New, New Deal.

Like much greed-based policy decisions, in Government and in Business, this will be unsustainable over even the medium-term, and while the benefactors of such a scheme may never be held accountable, the policies will, and will be changed.
 

Thomas Veil

macrumors 68020
Feb 14, 2004
2,435
5,517
OBJECTIVE reality
atszyman said:
I wouldn't mind this for myself if my company would give the money saved on insurance to...me in my paychecks.
I'd say you've got the same chance of this as you have of an accident at work suddenly endowing you with super-powers.

In all seriousness, it wouldn't be the same. As much as your employer pays for you, they are usually getting a large group rate. You probably couldn't touch a personal health plan for the same amount of money...and that's if they decided not to exclude you for any prior medical history.
 

mactastic

macrumors 68040
Apr 24, 2003
3,647
661
Colly-fornia
blackfox said:
<sarcasm>interesting plan...it is not enough to remove major sources of Democratic funding through tort-reform and Union regulation changes, but now the GOP can just kill or seriously marginalize (with ilness/destitution) many key demographics of the Democratic base.<sarcasm>
And you thought you were only kidding?
Link
As the nation's trial lawyers again funneled tens of millions of dollars to Democrats and their causes in the last election, Republicans were crafting a strategy to choke off that money for future campaigns.

President Bush's agenda for the next four years, much of which he will highlight in his State of the Union address tonight, includes many proposals that would not only change public policy but, the GOP hopes, achieve an ambitious political goal: Stripping money and voters from the Democratic Party and cementing Republican dominance for years after he leaves office.

One of the clearest examples is an effort to limit jury awards in lawsuits against doctors and businesses. The caps might not only discourage "frivolous" lawsuits, as Bush argues, but also deprive trial lawyers of income from damage awards that they could then give to Democrats.

"If we could succeed in getting some form of tort reform passed — medical malpractice reform or any of part of that — it would go a long ways toward … taking away the muscle, the financial muscle that they have," said Sen. John Thune (R-S.D.), who ousted Senate Democratic leader Tom Daschle last fall despite a heavy flood of trial lawyer money backing the Democrat.
"Are we doing it because it creates more Republicans? Or are we doing it because it's the right thing to do, and by the way, it also happens to create more Republicans?" asked Grover Norquist, head of Americans for Tax Reform and a frequent advisor to Karl Rove, Bush's chief political advisor. "It's both."

"Every one of the ideas for the most part has merits on its own, so … they're defensible," said Stephen Moore, a conservative activist who plans to raise $10 million this year to advertise on behalf of Bush's Social Security plans. "But I think, altogether, this was devised as a Karl Rove grand plan to cement in place a Republican governing coalition that could last for a generation or more."
 

pseudobrit

macrumors 68040
Jul 23, 2002
3,418
4
Jobs' Spare Liver Jar
Another reason I'm moving to Canada.

This type of plan works well for healthy people. I have a chronic disease that requires constant medication.

I cannot afford to live in the New America.
 

mactastic

macrumors 68040
Apr 24, 2003
3,647
661
Colly-fornia
Timely article...
About half of all bankruptcy filings in the United States occur because of health-related expenses — and that share is growing, a study released today has found.

While the number of overall bankruptcies more than tripled from 1980 to 2001, when almost 1.5 million individuals and couples sought protection from their creditors, health-related bankruptcies increased 23-fold over the same period, the study found — suggesting that rising medical bills were a significant factor in the increasing number of court filings.

Most of those who sought bankruptcy for medical reasons were middle-class homeowners who had health insurance when their health problems began, researchers found.

The study, which its authors said was the first to examine specific medical reasons for bankruptcy, was published in the health policy journal Health Affairs. Conducted by investigators from Harvard University's law and medical schools and Ohio University, the study examined filings from 2001 in five federal bankruptcy courts, including the Central District of California, and interviewed those who cited medical reasons as the main cause of their bankruptcy filing.

Those cases involved injury or illness, uncovered medical bills of more than $1,000 in the two years before filing, loss of at least two weeks of work because of illness or injury, or mortgaging a home to pay medical bills.

"These are hard-working, 'play by the rules' people who have health insurance and have discovered that they were just one bad diagnosis away from financial catastrophe," Elizabeth Warren, a professor at Harvard Law School and one of the study's authors, said in an interview Tuesday. "I think that's the real heart of the story. This is about people who thought they were all safe."

Even with health insurance, people often pay large out-of-pocket sums for healthcare. In addition, the study found, employment-based coverage does not fully protect families because illness can lead to job loss and loss of coverage.

"Families are hit with a one-two punch when someone gets sick," Warren said. "They both lose income and get hit with new expenses, and the combination turns them upside down financially."

When his medical expenses for cancer treatment became overwhelming, even with insurance, Steven Choi of Rowland Heights filed for bankruptcy, his son said Tuesday. That allowed Medi-Cal to cover the costs of his treatment before his death last year.

"The medical condition caused us to do things we never thought we'd have to do," said Tom Choi, 35, of Buena Park. "My dad was a pretty proud guy. And we told him [declaring bankruptcy] is the only option you have.

"We could support our parents if we had to, but we couldn't support a million-dollar hospital bill," he said.

Unlike others who filed for bankruptcy, medical debtors were more likely to have had a lapse in health coverage, either because they could no longer afford to pay for insurance or they changed plans and, because of their preexisting ailments, lost coverage.

Three-quarters of the study's interviewees had medical coverage when they first got sick, but later lost it.

The study, which will follow up with interviewees to see how the bankruptcy affects their lives, found that one-third of medical debtors continued to have problems paying bills, particularly mortgages, rent and utilities.

"A person may recover physically from a medical problem, but they never recover financially," Warren said.
 

pseudobrit

macrumors 68040
Jul 23, 2002
3,418
4
Jobs' Spare Liver Jar
How many people have lost their homes due to a severe illness?

You know, this is the kind of crap that makes me eager to leave.

What kind of "greatest nation in the world" or "superpower" doesn't have the right to seek good health built into it?
 

mactastic

macrumors 68040
Apr 24, 2003
3,647
661
Colly-fornia
It's all a part of the 'ownership society'. The rich get to own your **** when you get sick or injured, or need to sue and can't.
 

IJ Reilly

macrumors P6
Jul 16, 2002
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Now, here's the real kicker: As anyone who's worked for themselves can attest, an individual in the health insurance market is basically roadkill from word go. They have zero bargaining power. Rules regulating the industry vary from state to state, but given an outstanding health issue, you could easily find yourself being either (1) uninsurable, or (2) not insurable at an affordable price. Pushing millions more Americans into this miasma is an insurance industry executive's wet dream come true. No longer would they be compelled to provide coverage for millions of non-affluent or unhealthy Americans. Those people will be left to beg at the public trough -- IOW, a perfect solution from an industry standpoint.
 

mactastic

macrumors 68040
Apr 24, 2003
3,647
661
Colly-fornia
Exactly. Any beancounter worth his or her salt realizes that if you insure the right people, ie those who will file as few claims for as little money as possible, aka healthy people, that their profits will increase dramtically over a scenario wherein they cannot cherrypick their customers. But healthy people are the ones who need coverage the least. A sick person needs the coverage, but will they get it? Hell no, not if the number crunchers have their say.
 

blackfox

macrumors 65816
Feb 18, 2003
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IJ Reilly said:
Now, here's the real kicker: As anyone who's worked for themselves can attest, an individual in the health insurance market is basically roadkill from word go. They have zero bargaining power. Rules regulating the industry vary from state to state, but given an outstanding health issue, you could easily find yourself being either (1) uninsurable, or (2) not insurable at an affordable price. Pushing millions more Americans into this miasma is an insurance industry executive's wet dream come true. No longer would they be compelled to provide coverage for millions of non-affluent or unhealthy Americans. Those people will be left to beg at the public trough -- IOW, a perfect solution from an industry standpoint.
Right you are, and that is kinda the (hopeful) point of my above post. That the logic behind this, in political terms, is not sustainable. If the ranks of the uninsured hit critical mass, it is likely that the Government will step in with anything from Federal subsidies to complete overhaul, even Nationalization of Health Care. This would spell relative doom to the Insurance Industry, although a wealthy % of the population would probably still opt for private care/insurance.

Of course, in the intervening years between now and that moment, the Insurance Industry would make a killing (a not funny pun) and most likely not be held accountable as Individual companies, let alone individuals.

Nevertheless, this strategy moves so far towards one poll ( ahem...pole)and the effects will be so profound, as to necessitate an eventual swing to the other side, even extreme.

oh...I'm still wearing my foil hat...sorry.
 

IJ Reilly

macrumors P6
Jul 16, 2002
17,915
1,466
Palookaville
I've given up trying to figure out what's politically sustainable. I should have thought that 45 million uninsured would have been a critical mass, but I'd have thought wrong. Imagine if all these people had voted their economic interests last November? All I can say for certain is that Congress and the President will over the next four years do their utmost to comfort the comfortable, and sell it to everybody else as being in their interest. It's a house of cards for sure, but when it will come crashing down is anybody's guess.
 

atszyman

macrumors 68020
Sep 16, 2003
2,442
1
The Dallas 'burbs
Thomas Veil said:
atszyman said:
I wouldn't mind this for myself if my company would give the money saved on insurance to...me in my paychecks.
I'd say you've got the same chance of this as you have of an accident at work suddenly endowing you with super-powers.
And therein lies the problem with just about every healthcare solution, and why this one will be more popular with people at first.

Government provided healthcare is not popular enough due to the fact that people will have to pay higher taxes without an increase in income. This one will win over more people due to the "Tax exempt" healthcare account. People will see that as being able to get free money despite the fact that they will now be paying through the nose for their healthcare.

How long will it be before someone comes up with an insurance plan to fill the new gap for individuals paying their own healthcare expenses? So at that point we have your catastrophic illness insurance, the "new" health insurance which is almost exactly like what we have now, and all of it at the expense of the individual.

My God its brilliant! Corporations save lots of money. People get screwed and another insurance industry is born. Who is our government working for again?
 

IJ Reilly

macrumors P6
Jul 16, 2002
17,915
1,466
Palookaville
I'd buy into Medicare, if I could. My out-of-pocket costs would be lower and my benefits better (not to mention, more secure), and I suspect even my doctor would approve. But this isn't going to happen, because it would force the insurance industry to compete directly with a government program, and that would put the lie to the argument that industry is inherently more efficient than the government.
 

chanoc

macrumors 6502
May 20, 2003
339
0
Anchorage, Alaska USA
I basically told my employer they could take their HMO health plan and non-matching 401k and stick it up their arse. It is cheaper for me to go to the Anchorage Neighborhood Health Center and make sliding-scale payments, as I made scant for money last year - 80% off services.

For anything serious though, either medicare or go bankrupt. Hell I do not need car loans, Apple Store loans (a rip-off 20% interest), credit cards, or any of that snizzle. :)