In Kansas, there’s only one provider left this year for Obamacare, and it doesn’t cover some of the major hospitals in the area, so my employer and his family switched over.
They employ the services of an insurance specialist, who is really good at this sort of thing. Basically he found a group, and had the company join the group, so that any employees of the company get that group rate. And then it’s just a matter of making all your family members employees of the company, basically.
So it’s a workaround to get individuals and families the same kind of rate you’d get when you work for a corporation. But it’s complicated, and they wouldn’t know what to do if it weren’t for the insurance specialist.
Funny thing is, they were doing this before Obamacare too, and any time insurance came up, they would ask me, “wasn’t insurance just fine even before Obamacare”? I had to explain that most people don’t sign up their families as employees. That individual coverage used to be horrible, since I went looking for it for me and my wife. And the rates I’m getting now with Obamacare are much better. To be fair, that’s because of government subsidies though. For the Obamacare plan I got this year, without subsidies, I would be paying over $1000 a month for me and my wife. But subsidies pay for over 800/month, so we only pay about $240/month, and it’s about 2500 deductible, I believe, so it’s a good plan. It saves me over $800/year just on my blood pressure medicine, since the plan also includes prescription medicine too.
There’s an industry that popped up and is growing rapidly of faith-based cost sharing companies. I don’t know the ins and outs but my understanding is you tell them you’re of whatever faith (they can’t really prove/disprove) and pay a fairly low fee for… some coverage. In the eyes of the law it’s good enough to not get fined. I’ve never looked too far into it because my employer still provides insurance but might be worth checking out.
Mine is through GoldenRule, and I got it the year before the ACA went into effect, so there was no ACA marketplace when I started. The plan meets the minimum ACA standards, though. I pay about $180 a month, but it’s a high-deductible plan…$5k. I dunno if you could get the same thing now, or if I’m getting a grandfathered deal. This is in West Michigan, not exactly a high-cost-of-living area, so I’m sure that helps.
I was paying $400 with a $6500 deductible until I got the job I’m in now. It’s terrible. You’re paying $4k or $5k a year just in case you get so sick or injured you need more than a doctor’s visit. And then if you’re fortunate enough that whatever malady befell you, you can get back in the workforce quickly so you can then continue to pay the high premium along with paying off the $5000 you now owe a hospital and doctors.
If I was young I’d think of looking for a job in a country with better healthcare and emigrating. I don’t see the US really changing much in the near future. We need fully socialized medicine, which probably means healthcare workers (doctors et al) making less, drug companies making less, hospitals making less, health insurance companies almost disappearing, and taxpayers paying more taxes to fund socialized healthcare. What are the chances of that happening anytime soon?
A friend is independently wealthy in a way that means she doesn’t have to work very much if she’s careful and relatively frugal, though the actual dollar amount is relatively modest, all things considered. It also means her new health care plan is about $800/mo with a $6k deductible attached and shitty provider availability. Huzzah Murica. Especially North Carolina Murica…
My plan went from $670/ month to $970 this year ($1k deductible). In the grand scheme of things, I’m just happy it’s still available. Trump hasn’t managed to kill off the individual market completely.
I pay it thru my company but as an owner it is my money going out the door.
One of the things the ACA did that screws some people is that a “family” plan used to just mean that, your family and everyone in it who qualified was covered. Now each kid is priced out separately so that in the end costs rise. Also, being in our 60’s insurance is just freakin expensive. If I was single I would probably just buy the cheapest thing out there and hope nothing ever happened requiring health insurance.
But I don’t blame the ACA for everything. I have paid insurance premiums for my company for 25+ years and the costs have gone up 5-15% every year. Every year.
Yeah, in the three years before the ACA, my company’s premiums went up 26%, 19% and 33%, respectively. The whole thing is still teetering towards some type of collapse; I’m not sure if the Trump sabotage of O’Care will accelerate it or not.
They bought out Empire BCBS in NY so we’re under them the last few years. My god do I hate Anthem.
They are coasting on past reputation because everyone accepts BCBS, but their admin is horrible. We were self-pay small-group as well. We both pay them for our insurance, and charge them as a provider. They are much worse than they used to be.
I think technically BS and BC are separate here in California. But I do think in some places they are the same. We haven’t had any problems over the years with them. .
I believe this, too. Because it’s not just the individual market. It’s everyone. It’s just a bit more severe and a lot more visible for people whose employers are not absorbing the cost. We have seen charts of slow wage growth over the past decades, and I wonder how closely that correlates with increasing healthcare costs.
This can’t be sustainable. I only hope that, the next time the Dems have control of Congress and try to fix it, the GOP has become a sufficiently responsible party to participate in that process.
I’ll say that my employer-subsidized health care is a generic “family” plan, despite being just a single father. Here, I pay as much as someone with ten kids. Not saying you don’t have a valid concern, but just highlighting there’s another side of the coin.
I agree, but I do not think ACA does much regarding health care cost increases. It’s about increasing coverage which is a laudable goal as it increases human capital at the cost of monetary resources. I have heard disagreements on this - people often claim the uninsured drive costs because they use ERs etc etc. They push for community health plan coverage because of this. My local hospital lobbied under that. I don’t believe them.
I used to download the healthcare reports for patients coming in - those with good insurances get the full workup. The ones with medicaid merely get an EKG and get discharged as stable.
It is a very strange alliance of people that actually want to increase efficiency of healthcare. One, commercial insurers because they pocket the costs. They do this with hated HMOs and preauthorizations and whatever. Two, GOP members who would use “efficiency” as code for slashing benefits. I do not believe any of them will be honestly trying to increase efficiency.
We have a systemic issue of overusing expensive healthcare. A well-regarded British journal, the Lancet, put out a study comparing outcomes for patients given a stent and some who purposefully were given a fake procedure. This is apparently not allowed in USA ethics rules. Anyway, the TLDR is that stents don’t actually seem to help much of the time even thought it’s standard of care. They cost 20k-50k. There is big money in stents. Many drug reps I know moved to device sales.
There’s an older study from the 90s about cardiac caths in the New England Journal of Medicine regarding caths/angiograms. In Canada they don’t use them as often, and outcomes are similar to the USA.
The thing is when YOU are the patient and your insurance covers it, you’re gonna get the standard treatment. It’s your life. The doctors will do it too because that’s what they do, hammer, nail. I’m not saying they are practicing fraud and applying treatments without the indications (although some people get caught doing that)
Another big part is probably end-of-life care. Palliative medicine claims to be cheaper and delivers similar outcomes (well the person’s gonna die in the same time period right?). Their argument is that having the patient do all these tests and procedures makes them more uncomfortable and gives the family false hope. This sounds very … cruel? But it’s not. It’s about letting them be more comfortable, give them painkillers, treat the complications (pneumonia, infections, etc).
But who’s gonna make the argument that grandma shouldn’t get cancer drugs?
We have a tiered plan where I work. It helps keep the cost for those who make the least in the company by having those make more pay more for their health insurance. Even through a company plan, for a family, it can actually get pretty high but the deducible is manageable, and there are HMO options. For the PPO it’s basically 80/20 which can still cost a lot.
I had a conversation with my PCP during a regular checkup last week. He works for the largest healthcare provider in STL, and he was complaining about how much time their new electronic records system takes to use. I asked him whether his management knew this wastes at least an hour a day, representing an opportunity cost in patients not seen.
His reponse was, “They don’t care, as long as I order enough tests.”
The technocrats want it is so they start implementing some ‘pay for performance’ crap in the future. This has some serious issues - one, we’ll see the same cheating as teachers do. two, cherry picking of patients will mean nobody will want to see the sicker patients.* Since immigrants as a group tend to have worse health outcomes because of lack of English, higher smoking (I think in NYC Asians are the highest % group that still smokes), and just plain lower income. The criteria has to be implemented very, very well and I believe it has limited uses. For example, make everyone screen for XXX condition if they have YYY condition. Okay, that’s good. But what’s more likely to happen is it becomes a bullshit checklist that you have to prove or you lose 4% of income.
I recently learned my EMR software charges $15 / month for 100 MB of data. I did the math and that’s $36,000 a year for 30 GB. Amazon S3 would charge … $400 / year or something for that same amount. Highway robbery. Note we have ONE provider.
I am downloading all the crap off, printing it back to paper, and gonna do some sort of local google search thingy so we can find them electronically if we want.
*Note that as of last month or so they finally published sane criteria. Now you only need to report one point out of ten to avoid the 4% penalty. Before it was 10/10 and they were really hard to meet IMO (although 80%-90% of doctors claimed they did…)
