Posted on 10/17/2007 10:34:27 PM PDT by Lorianne
"The U.S. employer-based health-insurance system is failing," declares a new report by the Committee for Economic Development (CED). The CED is a Washington, D.C.-based policy think tank comprised of business and education leaders. And it is right: Employer-based health-insurance is indeed failing.
Between 2000 and 2007, the percentage of firms offering health insurance benefits fell from 69 percent to 60 percent. The percentage of people under age 65 with employer provided insurance dropped by 68 to 63 percent. In absolute numbers, those covered by job-based insurance fell from 179.4 million to 177.2 million.
Employers are jettisoning health insurance because costs are out of control. Since 2001, premiums for family coverage have increased 78 percent, while wages have gone up 19 percent and inflation is up 17 percent. The consequence is that health insurance is the number one domestic policy issue in the 2008 presidential race.
So what is the CED's prescription for our ailing health insurance system? The report promisingly begins by recommending the creation of "a system of market-based universal health insurance." In order to achieve this, the CED would make health insurance mandatory for every American.
The CED proposal envisions the creation of independent regional exchanges that would act as a single point of entry for each individual to choose among competing private health plans. The exchanges would set minimum benefit plans. The exchanges would also cut through the thickets of state health insurance regulations that add substantially to the costs of insurance. Individuals could purchase insurance above and beyond the minimum benefit plans with after tax dollars.
(Excerpt) Read more at reason.com ...
It was a Sunday night. No mistakes were made on this end. I’m a retired nurse, I told my daughter it was apprendicitis, and to get her to the ER. Triage is simple: a fever and pain around the right side of the umbilicus, plus vomiting, is appendicitis unless proven otherwise. The triage nurse (an RN) was too ignorant to assess an abdominal patient in a recumbent position. My SIL was at home with the other kids, my daughter begged them for 2 and 1/2 hours to please reassess my granddaughter, but even though there was ONE OTHER PATIENT, somehow they couldn’t.
She is 12, had the same pediatrician since birth. But then, you know it all, so why am I bothering with you, genius?
The free market system doesn’t always work so well for sick people. Insurance companies compete to sell to healthy people and exclude sick people.
In a real free market system, all customers would be equally desirable if you are selling a product, yes?
Good idea, except they’re 5 minutes from the ER, and it was a stupid RN doing triage, not a clerk. See my post above for further particulars.
The family has good insurance. They’ve had the same pediatrician for all the kids for the past 12+ years. The ER had one other patient who was wheeling in and out of the ER to get sodas and snacks. STILL got freaking lousy care.
The product is not health insurance. Health insurance is one way to pay for the product. The product is healthcare. Healthcare for a chronically ill person will be higher. It is the free-market system which causes insurance for a chronically ill person to be higher than for a relatively healthy person.
The way the insurance business usually works is total claims about equals total premiums paid. Their profits only come from investing the premiums until they have to pay the claims. Many insurance companies are publicly traded so if they truly have unusually good profits you can own a piece of the action. In reality they are not especially great profit generators.
I worked for a pharmaceutical company and in my opinion it was very much like a government job being that they are highly regulated by the FDA. 90% of the work was hoop jumping and overhead. It's one thing to jump through hoops to enforce best practices but what I saw was much wasted effort not focused on doing real work. It's a highly bloated and inefficient government job that only works because of monopoly-sized profits if they make it through all the hoops.
Sure it is. Insurance is a product offered to consumers and in a real free market, everyone is a potential customer to a company willing to take the risk.
The chronically ill carry more risk to an insurer and their premiums, relative to healthy customers, reflect that.
The only reason that the profits are "monopoly-sized" is because we consume so much. Ask a drug rep who sells an ARB or an SRI if they feel like they have a monopoly.
As for the rest of your post, I agree. Big pharma is about jumping through hoops, nothing more or less.
Fair enough. Either your perspective or mine ends up in the same place. In other words, insurance is predicated on risk. If there's no risk to me, I won't buy insurance. If there's no risk to the insurance company, they don't charge me a premium. If I know that I am high-risk, but try to get low-risk premiums, I am gaming the system. If the insurance company charges a low-risk patient a high-risk premium, they are likewise gaming the system. Both of which the market will iron out in the long haul.
Don’t know about everyone else, but in my case, my employer benefits have been getting lesser each year.
Every few months it seems that more former benefit(s) have been discontinued, and the co-pays keep going up.
I didn’t mean offense. I’ve been in ERs where triage was a tough job.
I would be cautious about limiting your judgment to externally visible issues. Last year I was admitted through the ER for elevated ketones (I am diabetic). The discovery of the ketones came later in the evening on a Friday night. On my doctor's advice (via telephone), I went to the ER and subsequently spent the weekend in a hospital bed.
Ketones are not visible, but ketoacidosis can kill you - in a hurry.
I also apologize if I came off as being upset, FRiend. I did not read your post as a humor entry - perhaps a sarcasm tag might have helped those of us with cranial density issues? ;-P
Old people cost more too but charging them more is age discrimination, currently allowed. What I find interesting is women have higher health care costs than men, related to baby making, but sex discrimination is not allowed in health insurance but is allowed in car insurance. Men get taken advantage of but don't complain. I bet as the ranks of old people swell they will vote to push some of their costs onto young people in the name of "fairness".
Forcing healthy people to purchase a policy and pay a monthly premium to transfer their minimal risk to someone else. The only way for a universal coverage to work is to force healthy people to participate.
On the other side of the coin, this proposal-
In order to prevent adverse selection spirals, the exchanges would also do risk-adjustments by transferring some of the premium revenue from insurers that had enrolled more good risks to those who enrolled more poor risks tells the insurance companies that we're going to make you subsidize customers that have already decided you don't want to cover.
This plan is a lose lose for both responsible businesses and consumers.
That's supposed to be how the "republic" was supposed to work right here at home. Many states competing with different ideas, different approaches.
If California got some state healthcare or environmental program right, then people could moe there and enjoy it, or other states could adopt it.
Now we have this centralized predeliction to instantiate a one-size-fits-all policy from DC, the last people to have a clue on how to do anything.
I became aware of this situation as a colleague at work is approaching his 65th birthday. He plans to continue working well beyond age 65, but his medical insurance from the company sponsored plan goes away on his birthday.
Company sponsored medical insurance has been offered as a perk to retain good quality employees. It isn't a right. It certainly isn't a responsibility of employers. If companies decide to withdraw the perk, they will have to either pay the difference or face losing valuable employees to competitors who will pay the difference. Therein lies the issue. It's a matter of paying a valuable employee that extra money to retain them. An employer isn't going to pay perks for commodity labor. All labor is not of equal value. If you question that opinion, ask yourself if you would submit to brain surgery performed by a janitor.
What flavor of socialist KoolAid have you been drinking? Business and insurance companies "want it" because it shifts the responsibility to the taxpayers. Most of the uninsured are also at the bottom of the income scale. They don't have employer sponsored insurance because they never acquired skills valuable enough to warrant the perk. These are the same people who pay less than 6% of the total tax burden and enjoy income from government entitlement programs. It's an expansion of the gravy train. The socialist politicians are buying more votes by stealing money from the productive and giving it away to people who aren't productive...except at the polling place when it comes time to elect socialists to office.
I have employer sponsored health insurance. It costs me $204 every 2 weeks. In addition, I have $1500 per person per year minimum co-pay if I dare to use the coverage. Prescription coverage is a $20 co-pay. Often I tell the pharmacist to just charge me the standard price of the medication...sometimes that is LESS than the co-pay. When I started working for Pacific Telephone in 1980, I had much better coverage and it was 100% covered by the company. How times have changed.
Yes, with more competition, insurance rates will go down ... just like any other commodity or service.
That would be ideal. More competition in between doctors, hospitals and pharm companies would lower prices.
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