So SPK and his one child pay as much as me and my six children because the insurance company does not want to administer more than one premium level?
Healthcare Reform
- Thread starter HALL85
- Start date
Yes, but it's not just insurance companies. To manage/administer that many tiers for the company that contracts with an insurer from what I was told (by my own HR guy) was that it would be a challenge. I'm not saying I agree or disagree with the practice; but why it's done that way. Sucks for SPK....I think the reality too is that for a families healthcare expense, the parents are the biggest consumers and the incremental cost from 1 to 2 or 3 is not that material.
I was thinking the same thing but I looked up the per capita healthcare utilization and it was higher than I expected. For children 0-18, per capita usage was around $3,300 in 2012 compared to $7,500 for working aged adults. That seems like it would be fairly significant to the premiums.
For employee paid plans the employer gets to decide the approach they want to take.
https://thebenefitsguide.com/health-insurance-plans-two-tier-vs-four-tier-plans/
https://thebenefitsguide.com/health-insurance-plans-two-tier-vs-four-tier-plans/
Has nothing to do with the situation I am referring to. Family coverage is still the same whether you have 1 child or 5.
"With a four-tier system, large families share costs only with other large families, driving up those rates."
Yeah, no, not true. Anyone choosing family with a small family size subsidizes the cost of larger family sizes. Totally unfair and mean.
True, for the specific tiers in that article, however, the point of the article is thar the employer designs/selects the plan. There are plans that would have a tiering for family, say 1-2 kids, the 3-4 kids, or just a per kid charge.
When the employer meets with vendors (insurers) they discuss the pros/cons of the different approaches.
SPK145, when you start your own company you can experience the joy of structuring a plan for your employees and then regardless of what you select, having some employees say you are not fair and are mean.
But again, it is the employer who decides the structure of the plan and which insurer they offer.
Try this one: https://www.shrm.org/resourcesandtools/hr-topics/benefits/pages/premiumtiers.aspx
Last edited:
I have my own company (and prior to that was involved in the selection of healthcare plans for 30 years) and I've NEVER seen a tiered plan based on the family size. Would love to see that in actual practice.
Yes, have always been told "That's just the way it is." Remember, small businesses have even less choices.
On a more serious note, it probably isn't just the way it is. Insurance companies would not set it up that way if it wasn't profitable for them. The incremental cost must be relatively small or they would have adjusted it
As a business owner would you be OK if your insurance company offered a family plan that charged (for example) - $1010 for a family of 1 child, $1020 for a family with 2 children, $1030....etc?
Separately, many employees contribute to the cost of health care. At any point in your career did you ever consider charging your family employees different reimbursement rates depending on the size of the family? In the end what stopped you?
I've never seen it presented that way from many. many insurance companies through the years.
Sure provided the delta in family size is fairly priced out (your example is not).
No because we were never charged that way from the insurance companies. Normally you charge your employees a set percentage of what the insurance costs you, (ie, 20% of the total cost or nothing for employee coverage and 50% of the added family coverage, etc.)
Back to a real issue. If you didn't see Rand Paul on FTN yesterday, you should. I respect him for not backing the GOP bill. He gets it.
http://www.cbsnews.com/news/rand-pa...re-republicans-will-realize-its-not-a-repeal/
http://www.cbsnews.com/news/rand-pa...re-republicans-will-realize-its-not-a-repeal/
He gets some of it, but there are some flaws with his plan as well.
I agree with opening up the plans so anyone can have access to a group plan, but does his plan have a mandate? I doubt it does.
The reason employer coverage works is because it's easy to just take that money out of a paycheck and healthy people sign up. Once you are talking about an individual marketplace - you will have a population that is significantly less healthy. Can't see how they wouldn't fail as well.
Paul would also likely prefer to offer plans that provide limited coverage so any healthy people that do sign up would pay in very little leaving a huge burden for the older sicker population.
Paul has no mandate in his plan. Another reason why I agree with him.
Rand Paul believes in personal responsibiity; liberals believe the government should dictate and satisfy all your responsibities.
One thing I can't fathom is how are there 75 million people on Medicaid? There is something wrong there and it's not about health insurance, it's about health care. Government largesse sounds compassionate but it results in distortions in the marketplace, picking winners & losers, and costing all of us in the end.
The BCRA is just more crony capitalism to the insurance companies. Again, you know it sucks when the ones that write the legislation are exempt from it.
One thing I can't fathom is how are there 75 million people on Medicaid? There is something wrong there and it's not about health insurance, it's about health care. Government largesse sounds compassionate but it results in distortions in the marketplace, picking winners & losers, and costing all of us in the end.
The BCRA is just more crony capitalism to the insurance companies. Again, you know it sucks when the ones that write the legislation are exempt from it.
Well lucky for all of us, part. those less fortunate than us on here, this disgusting, cruel bill looks to be dead now, and not to be picked up again for some time, if ever. A small victory while this pig and his corrupt conservative pals attempt to fleece as much of they can before 2020, or hopefully just 2018.
Single payer is still at least decade away imo, but this reprehensible repeal would have been another hurdle to get past on the way to what we really need.
Now they will move onto attempting to give the rich the biggest tax cut we've ever seen, and we'll see how many establishment Dems are more than just tough talk and will actually stand up to their similar big money donors. Because the right will not be as divided on that issue like they were here. This form of crony capitalism will be much easier for them to get through. I have much less faith in the Schumers & Pelosi's of the world to stand firm this time.
Single payer is still at least decade away imo, but this reprehensible repeal would have been another hurdle to get past on the way to what we really need.
Now they will move onto attempting to give the rich the biggest tax cut we've ever seen, and we'll see how many establishment Dems are more than just tough talk and will actually stand up to their similar big money donors. Because the right will not be as divided on that issue like they were here. This form of crony capitalism will be much easier for them to get through. I have much less faith in the Schumers & Pelosi's of the world to stand firm this time.
Rand Paul is an honest politician who makes sense and says what he believes. Love the guy even though many liberals try to paint him a different way. The guy stands by the constitution and is also a doctor and understands health care better than most. The Repubs would have been wise to listen to him but too many are in the bag for the insurance companies. This bill was no more than lipstick (BRCA) on a pig (ACA). Glad there isn't even a vote. Neither party has addressed tort reform or many of the issues driving health care costs up. And the ongoing divide continues of personal responsibility vs. socialism. They need to get both parties to the table and have a real discussion but they won't. The party with power wants to appear in power. The party not in power wants to protest everything. Both parties have too many folks in the bag with insurance companies and filled with too many attorneys to address tort reform. Same shit different year. Put Congress and Senate on ACA and see what happens.
Not just in the bag with insurance companies but in the tank with pharma companies as well, a truly bipartisan effort.
And the ADA, and med device, and AHA, and...the ACA was a piece of dog shit; the replacement was an attempt to freeze it. The reality was that it would have thawed and stunk even more.
The republicans are being stupid. They need to work with the democrats. The democrats are being stupid because if they don't work with the republicans their fight to tweak the ACA will not change anything and eventually the ACA is going to hurt a lot of people. Already over 30 counties without an insurer. Almost 1,500 counties with only 1 insurer. We need to put all the politicans in our seat. F them. Don't give them the top of the line healthcare that they have. Put them on what we get. Let them face the heat from their spouse when they can possibly lose their coverage. Their spouses would probably kick their asses if they were risking their own personal coverage. If we have people not willing to do the right thing for their constituents, they will rightfully lose their seat in 2018. As you are taught in kindergarten, EVERYBODY PLAY NICE.
I don't know what you're talking about. Booker just said the other day he's "pressing pause" on accepting pharma donations right now b/c of all the shit he took after voting no on the drugimportation bill. Not refusing to take their $ permanently, but pressing pause for now. I mean, what a gesture! WHAT MORE DO YOU WANT???? 
I hope a true progressive primaries both of our corporatist NJ senators. Menendez gotta go (and might be gone whether he likes it or not this fall once his trial starts), and Booker is still invincible in this state, but I'm convinced a strong primary challenge would bring him way farther to the left where he pretends he is.
I hope a true progressive primaries both of our corporatist NJ senators. Menendez gotta go (and might be gone whether he likes it or not this fall once his trial starts), and Booker is still invincible in this state, but I'm convinced a strong primary challenge would bring him way farther to the left where he pretends he is.
And you believe it? I have to bridge to sell you as well. He has received tons of money from Pharma and his voting record shows it and now all of a sudden he says he won't take ANY MORE money from them?? Give me a F'n break...I don't know what you're talking about. Booker just said the other day he's "pressing pause" on accepting pharma donations right now b/c of all the shit he took after voting no on the drugimportation bill. Not refusing to take their $ permanently, but pressing pause for now. I mean, what a gesture! WHAT MORE DO YOU WANT????
I hope a true progressive primaries both of our corporatist NJ senators. Menendez gotta go (and might be gone whether he likes it or not this fall once his trial starts), and Booker is still invincible in this state, but I'm convinced a strong primary challenge would bring him way farther to the left where he pretends he is.
He was also the worst Mayor Newark has had in years. Think about that statement as well. Not a high bar.
Maybe people don't need healthcare to the degree we need it now. Maybe Congress has to do the right thing and come up with a solution where life saving medicines become cheaper than harmful recreation drugs. Maybe Congress needs to come up with a solution to solve why harmful foods like are so cheap and organic healthy foods are so expensive. Maybe if we come up with solutions that keep people healthy, health insurance won't be such a great need. Yes people will still need it, but that should drive the costs down and allow more people to have it on their own.
I can hear SPK cringing with all of that government intervention, but I agree.
First we need a massive education program for the public to understand that their diets and lifestyle are paramount to reducing healthcare expenditures. We can not expect our healthcare/insurance system to ever be fixed if we can't look ourselves in the mirror and understand we are responsible more than the insurance industry, more than doctors, more than pharma companies with our reliance on fast/processed foods and sedentary lifestyles.
Your overweight family, colleagues, neighbors etc are increasing healthcare costs for everyone. Are we having the discussions we need to be having to have an impact on the those drivers of utilization/cost? There are many who will laugh at that idea and say the government has no place telling people what they can drink and eat or how much exercise they should be getting... but after decades of sitting back and watching us get fatter and fatter... whoever is irrepressible for these conversations is not getting it done.
One of my hopes with Obamacare back in 2010 was that it would help guide us towards recognizing that we are responsible for our health because it was promoting higher deductible types of plans. I don't want healthcare to be "affordable" for people who abused their bodies their entire lives. It should hurt financially to have to pay for maintenance drugs related to 20 years of a poor diet... but of course I wouldn't want to penalize people who have done everything right but got sick anyway so that is a tough balance.
I hope you didn't hurt yourself agreeing with me.
I disagree with the government telling people what to eat and drink. I think the government needs to force companies to inform the American people what they are putting in their body and let the consumer ultimately make their own choice. I think the government should require anyone who sells food to put on display what goes into the food. I read an article the other day about how bad farm raised salmon is for you that it is banned in many countries around the world. I think every product should have a youtube page that goes into detail of what each ingredient in the product is and what it can do to harm your body. We've all read labels that we cannot pronounce half of the ingredients. If you want to run a drug commercial, they list the 25 side effects. Food products should have to do the same.
Yeah I am just talking about education really, but any discussion on healthcare costs should include the fact that healthcare costs would not be close to the problem it is today if everyone just ate a little better and took a 30-45 minute walk every day.
I think it's more than just that. Where do you go for a healthy snack? I have to go see clients in Columbus Circle 2-3 times a month. What they have as far as produce available on the street or places to get fresh made juice is great. In Essex county there might be one place per town like that and 500 places to get a bag of chips, candy bars, and soda. Berries, a perfectly healthy snack cost can cost around $5. You could get a combo of 4 things candy bars, sodas, and chips for $5 at most places. I think the reason people grab the unhealthy food over the healthy food is all cost driven. There are many things that can be done to bring down the cost of healthy foods. However the government gets their money from unhealthy foods, getting people sick, leading to the purchase of medicines and visits to doctors.
You people must lead happy, active and fulfilling lives. If you had my life, you would look past my triple chin and allow me my daily gallon of pepsi and pound of funions. It's cheaper than therapy and recreational drugs.
Fat people are not the problem. They get sick and die. It is all you healthy people that don't die that keep using health insurance. Twenty years of my Metformin and Simvastatin won't equal one year of your end of life treatment so stop worrying and live a little.
Fat people are not the problem. They get sick and die. It is all you healthy people that don't die that keep using health insurance. Twenty years of my Metformin and Simvastatin won't equal one year of your end of life treatment so stop worrying and live a little.
1 What are your ideas for bringing down the cost of healthy foods?
2 I am not prepared to agree the government gets money from people getting sick.... the tax revenue generated gets paid out in other ways. I don't have facts to support myself, but intuitively a 100% healthy population would reduce government expenditures.
1. It's all about supply and demand. You have to increase the supply so price drops. Stop agricultural conservation and allow farmers to grow good crops on that land. Stop farm raising seafood. Do a google search for what those fish are fed.
2. 100% healthy population would have a lot less doctors, medical malpractice would go down killing a source of revenue for insurance companies, much fewer pharmaceutical companies who bring in a lot of tax revenue plus a lot of those people would have to find work in another industry making a lot people unemployed. Now to be fair you'll never see 100% healthy population but these industries will be less than 25% of what they are today if the focus was on preventing being sick, not what to do after being sick.
Organic fruits and vegetables are more expensive because without chemicals, yields and consistency are lower making prices higher. More land may or may not solve the problem, unless you are implying the government should subsidize organic farmers.
You would like to increase the supply of wild seafood? How? It is not an easy fix.
