thoughts on Bernie re: where you start negotiations from

[Merge]

It's also happening again in the mortgage industry thanks to Dodd-Frank that Sanders and others voted for.

Care to expand on that?

 

[Merge]

See now this is the funny thing. The current small business plans have stuff included that you can't use or do not need. My plan (we had a choice of 3 lame plans and we renew in March and I think we will have to change again and only be offered two plans) includes limited dental (pretty much so they can say dental is in there). To use it you have to go to one doctor in Sussex County that noone knows and you can only use a few limited services. No one will ever use that so why is it even in the policy? Same as pregnancy related coverage - you used to be able to opt out and now some of the policies cover it automatically with no option to opt out. ACA is a complete disaster for small businesses in actual practice in NJ.

but if everyone started using the dental, your prices would go up accordingly. Yes, it is there basically to say that they offer it but it is likely priced at the same expectation that no one will really use it... and you are not paying for pregnancy coverage. Your price would be the same if you still had the option to check a box. Your pricing is based on your company's risk pool for filing claims.

What I was referring to in regards to Cadillac plans would be things like massages, gym memberships, aromatherapy etc... Types of offerings that are not for treating an illness and should probably be compensation.

 

[Section112]

but if everyone started using the dental, your prices would go up accordingly. Yes, it is there basically to say that they offer it but it is likely priced at the same expectation that no one will really use it... and you are not paying for pregnancy coverage. Your price would be the same if you still had the option to check a box. Your pricing is based on your company's risk pool for filing claims.

What I was referring to in regards to Cadillac plans would be things like massages, gym memberships, aromatherapy etc... Types of offerings that are not for treating an illness and should probably be compensation.

I understand the Cadillac plan issue and don't disagree.
Before ACA we could opt out of maternity coverage and our premium would decrease. Not an option anymore. And if the dental coverage was not included who is to say the premium would not decrease even a little? It's in there and noone is using it or will use it so what is the purpose? Again just the government forcing us to pay for coverage we don't need so they can pay for others who may need it outside of our members. We do not fit into a large risk pool as a small business so our rates are through the roof and as a result we will look for any relief we can get but we have no options.

 

[HALL85]

Obviously that would need a lot more context of offerings and how much care your employees are consuming... but 5% is very generous from most companies I have seen and worked for. I pay 25% of the cost of my plan which increased 4% this year.

Also, your argument could be stronger if we weren't seeing 12% increases in any company prior to Obama taking office but we were.

Historically, (the past 8-10 years) we have averaged 6-8% increases on average, so this year was an aberration for sure. Our offering is very rich for our employees on the contribution amount (5%) and their overall contribution on deductibles and out-of-pocket. I can't take credit for it; it was done by previous management and has been a good retention tool. The increase is pretty punitive this year so we are evaluating increasing the deductibles rather than their contribution percentage. We are seeing employees taking the highest deductible options and pulling back on their care.

 

[Seton75]

Poor people do not deserve decent healthcare.

 

[HALL85]

Poor people do not deserve decent healthcare.

???

 

[Merge]

We are seeing employees taking the highest deductible options and pulling back on their care.

Out of curiosity, did your rep explain the 12% increase this year?

As I have mentioned previously, I am a fan of he HDHP's with and HSA.
I think the trend of people joining those types of plans is a very good thing. Consumers will be more involved in their cost of care decisions. I worked mine out this year that my HSA balance and contributions will equal my family out of pocket max so while I will not have to worry about unexpected costs of care, I will also be aware of what i am spending the money on so I can roll as much as possible for future use.

I do understand that is a tough sell for your employees since they have only been paying a 5% contribution into the plan.
25% of my PPO vs 25% of my HDHP + HSA contribution was an easy choice.

 

[Seton75]

???

That is the attitude we show whether we like it or not. I am not of that belief. I am sure no one is. But we continue to spend way more than countries who have national healthcare. And the poor get left behind.

I guy I know who cant afford health insurance for him, his wife or their two kids. He and his wife work. He has a health plan at work but he cant afford the weekly payment. But really, who cares if his kids get decent healthcare? I guess we care, but they are not getting good healthcare.

We can continue to pay multiples more than countries with national health plans. We can continue to get less healthy. That seems to be our plan. And we are the greatest!

 

[HALL85]

That is the attitude we show whether we like it or not. I am not of that belief. I am sure no one is. But we continue to spend way more than countries who have national healthcare. And the poor get left behind.

I guy I know who cant afford health insurance for him, his wife or their two kids. He and his wife work. He has a health plan at work but he cant afford the weekly payment. But really, who cares if his kids get decent healthcare? I guess we care, but they are not getting good healthcare.

We can continue to pay multiples more than countries with national health plans. We can continue to get less healthy. That seems to be our plan. And we are the greatest!

Isn't that what Obamacare was designed to do? If you couldn't afford healthcare you get subsidized by the government? No?

There is rationing of healthcare in this country (before and after the ACA). The poor have access to decent care; but we can't afford for everyone to have access to the best care. Not everyone can go to the Mayo Clinic...it would bankrupt the country. And there is even more rationing of healthcare in those other countries as well. The amount of money spent in the U.S. vs. other Industrialized nations is identical up until age 62. Four factors separate the curve after that: Cardiac/Diabetes, Cancer, End of Life and Orthopedics. The first category is primarily self-inflicted....we have the highest incidence of Type 2 Diabetes in the world...amazing for such a civilized country, but processed food, lack of exercise (keep riding that hoverboard...) are the contributors. We spend more on cancer and end of life, because those "national health programs" only pay for first line treatment or minimal geriatric care. Malpractice rates and f-d up reimbursement system also drive up the end of life costs...over test so you don't get sued or pad the bill. Orthopedics is high because we pay for the weekend jock that chooses to have his knee replaced rather than limp. In Europe, you limp.

National healthcare does not solve the problem unless you want to tell the public that we are now going to ration care and treatment. It's not a matter of how it gets paid, but what you choose to pay for. If you want to fix the system, force price transparency, incentivize healthy choices, and ensure there is a safety net of care that the poor are guaranteed good and decent health services.