Health Care and Employment Solution?

[Trawler]

With the Individual HC insurance today not available for many of us due to prexisting conditions or the those who can get high risk the cost is so high cant afford it. I was wondering how many of us would Retire if we could get affordable coverage today? Thus if we retired we would open up a job. Wonder what the impact of the HC reform could have on unemployemnt due to people retiring because they could get insurance and opening up jobs? People like me with High BP, High Cholesteral and Sleep AP all controlled with drugs and C-pap machine cannot in the state of Ohio get individual healthcare care and you have 6 month naked period for hi risk and would retire if we could get HCI. One thought of a solution is lower the medicare age and collect higher premiums for those who want to buy it that are younger than current medicare age to help offset the high cost of end of life medical needs. Thoughts please.
Thanks

 

[Midpack]

With the Individual HC insurance today not available for many of us due to prexisting conditions or the those who can get high risk the cost is so high cant afford it. I was wondering how many of us would Retire if we could get affordable coverage today? Thus if we retired we would open up a job. Wonder what the impact of the HC reform could have on unemployemnt due to people retiring because they could get insurance and opening up jobs? People like me with High BP, High Cholesteral and Sleep AP all controlled with drugs and C-pap machine cannot in the state of Ohio get individual healthcare care and you have 6 month naked period for hi risk and would retire if we could get HCI. One thought of a solution is lower the medicare age and collect higher premiums for those who want to buy it that are younger than current medicare age to help offset the high cost of end of life medical needs. Thoughts please.
Thanks

I could walk thru this in steps, but ultimately you're proposing younger taxpayers pay significantly more to reduce the Medicare eligibility age so older folks can retire even earlier. Even though I'd benefit, it hardly seems like a fair solution to me...but AARP would agree with you.

 

[Trawler]

I could walk thru this in steps, but ultimately you're proposing younger taxpayers pay significantly more to reduce the Medicare eligibility age so older folks can retire even earlier. Even though I'd benefit, it hardly seems like a fair solution to me...but AARP would agree with you.

Thanks for the resonse to clarify a couple points:
Current medicare eligable age continue to pay the same as today.
People that are younger than Medicare age that would like to purchase medicare for higher premium could ELECT to do so and would only pay if they elected the coverage. Once they reach age 65 premium would drop to todays current rates. Want to give those with PECs an outlet to buy insurance that is not avalable today.

 

[Midpack]

Thanks for the resonse to clarify a couple points:
Current medicare eligable age continue to pay the same as today.
People that are younger than Medicare age that would like to purchase medicare for higher premium could ELECT to do so and would only pay if they elected the coverage. Once they reach age 65 premium would drop to todays current rates. Want to give those with PECs an outlet to buy insurance that is not avalable today.

I think if you do the math, you'll find this doesn't work. Like SS, Medicare is another [-]ponzi scheme[/-] paygo system. In the end, you are adding people to Medicare (folks who want to retire and go on Medicare before age 65), how do you pay for that? You either use the higher premiums from the younger payers who elect the coverage (and that's what will happen, it all gets lost in the "general fund"), or you increase deficit spending on Medicare (though it won't show outright, again thanks to the "general fund"), probably the most fiscally troubled entitlement there is.

And I seriously doubt many younger folks would elect higher premiums knowing (now or eventually realizing) the money is not being set aside for them. At best, you'd probably have people figuring out how to game eligibility by "electing" the higher premium as late (age) as possible.

If it sounds too good to be true, it probably is...

 

[nun]

With the Individual HC insurance today not available for many of us due to prexisting conditions or the those who can get high risk the cost is so high cant afford it. I was wondering how many of us would Retire if we could get affordable coverage today? Thus if we retired we would open up a job. Wonder what the impact of the HC reform could have on unemployemnt due to people retiring because they could get insurance and opening up jobs? People like me with High BP, High Cholesteral and Sleep AP all controlled with drugs and C-pap machine cannot in the state of Ohio get individual healthcare care and you have 6 month naked period for hi risk and would retire if we could get HCI. One thought of a solution is lower the medicare age and collect higher premiums for those who want to buy it that are younger than current medicare age to help offset the high cost of end of life medical needs. Thoughts please.
Thanks

You're describing what we have in MA. Everyone must have insurance. Our premiums are higher than in most of the country because we don't have pre-existing conditions, MA is just an expensive state to live in and we are paying for some of the best hospitals in the world. Still as a 50 year old, single male I'm happy to pay $350 a month to get a $2k deductible and $5k out of pocket max policy as it means someone like me, but with serious illnesses can get the same policy. Actually I'd like to see those deductibles and co-pays disappear, but the way US healthcare is organized that isn't going to happen.

 

[Trawler]

I think if you do the math, you'll find this doesn't work. Like SS, Medicare is another [-]ponzi scheme[/-] paygo system. In the end, you are adding people to Medicare (folks who want to retire and go on Medicare before age 65), how do you pay for that? You either use the higher premiums from the younger payers who elect the coverage (and that's what will happen, it all gets lost in the "general fund"), or you increase deficit spending on Medicare (though it won't show outright, again thanks to the "general fund"), probably the most fiscally troubled entitlement there is.

And I seriously doubt many younger folks would elect higher premiums knowing (now or eventually realizing) the money is not being set aside for them. At best, you'd probably have people figuring out how to game eligibility by "electing" the higher premium as late (age) as possible.

If it sounds too good to be true, it probably is...

Good points but the underlying question is how many people would retire early that cannot today. If they had an outlet to buy insurance in this case Medicare they would retire today pay more than they are today into the system but could retire and then a current unemployed person would take there place in the work force and be an additional person paying taxes ? Would this reduce the deficit ? There has to be some kind of solution to this.

 

[Texas Proud]

It is a problem.... and insurance is a paygo system also... you and others pay into the system... somebody needs services... they pay for those services...


Young people do not like paying for the medical expenses of the old... I deal with the insurance for a small company and one of the younger guys was giving me an earful of the costs of our high deductible plan... he wanted a cheaper option... his main comment 'why should I be paying for all the medical expenses of the old folks'....

He does not understand (and I can not tell him) that a lot of the cost are actually some of the kids that people have.... some have medical conditions, some are accident prone... some young lady (the wife of an employee) got a brain tumor... sure, right now he and his family are not using the services that cost him $700 per month.... but they might...

 

[nun]

Thanks for the resonse to clarify a couple points:
Current medicare eligable age continue to pay the same as today.
People that are younger than Medicare age that would like to purchase medicare for higher premium could ELECT to do so and would only pay if they elected the coverage. Once they reach age 65 premium would drop to todays current rates. Want to give those with PECs an outlet to buy insurance that is not avalable today.

The private health care industry would lobby against this as an expansion of Medicare takes patients away form them. The US healthcare system needs serious reform as it delivers some of the world's worst outcomes at the highest per capita cost. There are plenty of good solutions in other countries, but because of the current trend for fear of any regulation and vested interests I don't see change coming soon. If Market principals rather than public health principals continue to dominate the delivery of healthcare people with pre-existing conditions will also continue to die earlier in the US than they would in other countries.

 

[Trawler]

It is a problem.... and insurance is a paygo system also... you and others pay into the system... somebody needs services... they pay for those services...


Young people do not like paying for the medical expenses of the old... I deal with the insurance for a small company and one of the younger guys was giving me an earful of the costs of our high deductible plan... he wanted a cheaper option... his main comment 'why should I be paying for all the medical expenses of the old folks'....

He does not understand (and I can not tell him) that a lot of the cost are actually some of the kids that people have.... some have medical conditions, some are accident prone... some young lady (the wife of an employee) got a brain tumor... sure, right now he and his family are not using the services that cost him $700 per month.... but they might...

Thanks for the comments. To add I think there are many people who are willing to pay premiums but cannot get underwritten for individual health care insurance due PECs thus are chained to a job in order to be on a group plan. If they could buy IHCI they would retire thus creating a job and an additional tax payer. Medicare needs more revenue so if sell these folks who want to retire early a "Medicare Individual Health Insurance Policy" would there be enough offset from the premiums of this policy and payroll tax from the person who went from unemployed and on the dole to a taxpayer to be overal revenue nuetral or even positive??

 

[pimpmyretirement]

It is a problem.... and insurance is a paygo system also... you and others pay into the system... somebody needs services... they pay for those services...


Young people do not like paying for the medical expenses of the old... I deal with the insurance for a small company and one of the younger guys was giving me an earful of the costs of our high deductible plan... he wanted a cheaper option... his main comment 'why should I be paying for all the medical expenses of the old folks'....

He does not understand (and I can not tell him) that a lot of the cost are actually some of the kids that people have.... some have medical conditions, some are accident prone... some young lady (the wife of an employee) got a brain tumor... sure, right now he and his family are not using the services that cost him $700 per month.... but they might...

Young guy like that should price an individual policy and opt out of group insurance, if he's paying $700 per month for health insurance.

 

[nun]

Good points but the underlying question is how many people would retire early that cannot today. If they had an outlet to buy insurance in this case Medicare they would retire today pay more than they are today into the system but could retire and then a current unemployed person would take there place in the work force and be an additional person paying taxes ? Would this reduce the deficit ? There has to be some kind of solution to this.

I think you would see more people ERing if they could get reasonable health care, particularly if they have pre-existing conditions. My ER decision doesn't depend much on health insurance as I'm guaranteed it at a reasonable cost if I leave work just by living in MA. My monthly costs would go up from $100 to $350, but that's within my budget and won't change if I get ill.

 

[chinaco]

All insurance type systems are pay as you go systems... they may have a reserve pool. Without current premium flow they would fail quickly.

Medicare is more like a pay before you go system. You are really paying now for coverage later.

The problem is the way our system is setup. It promotes anti-selection because of a patch quilt health care system and because of certain laws, regulations and social concerns.


Probably the biggest hole in a voluntary system is this:

People can opt-out and still get coverage. They can later opt in when the probability raises that they need care (even for young people... start a family.... I want it now). I mean if you really wanted to be completely nit picky about it, one could say that single people subsidize families.


The system forgives anti-selection.

People only choose to opt-out because they think they will be forgiven (financially) if a catastrophe happens and can enter a system when they may need coverage.


In fact, that is what happens.


But our formal system is setup where one can participate in it all of their life and lose their coverage through no fault of their own and be black listed.

 

[ziggy29]

But our formal system is setup where one can participate in it all of their life and lose their coverage through no fault of their own and be black listed.

Well, "the system" itself doesn't allow folks to lose coverage just because they get sick or develop a condition. But if someone loses their job and can't afford COBRA, yes, then a preexisting condition can screw them royally. Seriously, the linkage between health insurance and full-time employment needs to be severed. I think that one change would free many people from needing to work, and free others from corporate shackles.

 

[chinaco]

Well, "the system" itself doesn't allow folks to lose coverage just because they get sick or develop a condition. But if someone loses their job and can't afford COBRA, yes, then a preexisting condition can screw them royally. Seriously, the linkage between health insurance and full-time employment needs to be severed. I think that one change would free many people from needing to work, and free others from corporate shackles.

There are way to fall through the cracks after the COBRA ends if one has a problem.


I agree with severing health insurance from the job. There are quite a number of employers that do not offer coverage.

 

[ziggy29]

There are way to fall through the cracks after the COBRA ends if one has a problem.

Yes, if you don't properly jump through all the hoops that HIPAA requires. If you do use all your COBRA and don't allow a lapse in coverage for 63 days or more, you won't have to deal with pre-existing condition exclusions (even if costly and even if in a state risk pool). The cost may make a practical barrier to continued coverage, but not a legal one.

I agree with severing health insurance from the job. There are quite a number of employers that do not offer coverage.

There are also plenty of people who would retire or accept part-time w*rk if full-time employment wasn't required to keep health insurance. That would improve their quality of life and perhaps create a few job openings for those who still need to w*rk.

 

[Blackwoodt]

I was wondering how many of us would Retire if we could get affordable coverage today?

I would be retired today if I had health coverage, however I am lucky enough to work for a company that offers retiree health insurance.

My plans are to stay until after my 55th birthday next September to have health coverage for myself and DH.

 

[Texas Proud]

Young guy like that should price an individual policy and opt out of group insurance, if he's paying $700 per month for health insurance.

That is what I told him... opt out... but then he wanted to get his salary increase for what the company pays... I said 'you can choose to have insurance or not, but can not get more pay'... we pay 100% of the cost of insurance for our employees... they only pay for the family part...

 

[Midpack]

Good points but the underlying question is how many people would retire early that cannot today. If they had an outlet to buy insurance in this case Medicare they would retire today pay more than they are today into the system but could retire and then a current unemployed person would take there place in the work force and be an additional person paying taxes ? Would this reduce the deficit ? There has to be some kind of solution to this.

I'm not going to do the math for you, but you seem to be forgetting that Medicare is heavily subsidized by general revenue. The Medicare premiums are far less than the cost of the underlying health care, so adding people at a big discount (what Medicare does) just adds to the deficit. If early retirees would be willing to pay Medicare premiums that reflected the real costs of health care it would probably be about $1,000/month - about the same as private insurance, or Obamacare.

If the math was workable, it would have been done long ago.

Your generational job swap proposition just confuses the issue, the underlying Medicare revenues/spending proposition just doesn't work.

We'll probably have universal care in my lifetime, but it will ultimately cost a lot more than today. Public health care is subsidized by general revenue (income taxes) and private insurance by employers. It's sad that people think their Medicare or employer health care premiums/contributions cover the costs - not even close. I'm afraid that misconception underlies your premise.

I'll excuse myself from this thread...

 

[nun]

I would be retired today if I had health coverage, however I am lucky enough to work for a company that offers retiree health insurance.

My plans are to stay until after my 55th birthday next September to have health coverage for myself and DH.

I'm 50 and if I stay with my employer until 55 I'll be able to retire on their plan and pay exactly the same premium as I pay now which is $100 a month. However, as I can get a good "Bronze" plan for $350 through the Massacusetts Connector I could easily retire before 55. My employer's plan is more generous and obviously costs me less as they cover 75% of the cost, but the availability of reasonable health insurance irrespective of pre-existing conditions by state law means than it isn't a big driver in my retirement date planning. Also it means that 98% of MA residents have health insurance.

 

[pimpmyretirement]

That is what I told him... opt out... but then he wanted to get his salary increase for what the company pays... I said 'you can choose to have insurance or not, but can not get more pay'... we pay 100% of the cost of insurance for our employees... they only pay for the family part...

100% coverage for the employee cost is pretty sweet. You'd think the obvious answer would be to get his insurance through the company and then buy his family health insurance on the individual market.

My wife and I bounce between insurance co's, depending on which of our employers have the better offering. Open enrollment and qualifying life events are good things to get familiar with, if someone is trying to maximize their insurance benefits. A few sick people at a small company can really put their insurance costs out of line with the market.

 

[M Paquette]

I say we simply encourage our youth to exercise their right to ride motorcycles without helmets, and then harvest their [-]rich, delicious[/-] healthy organs for our benefit.

 

[GregLee]

I say we simply encourage our youth to exercise their right to ride motorcycles without helmets, and then harvest their [-]rich, delicious[/-] healthy organs for our benefit.

That reminded me of Larry Niven, for some reason, and I looked at his Wikipedia entry, mainly to see if he was still alive. I happened there upon this interesting suggestion of his "that hospitals stem financial losses by spreading rumors in Spanish within the Latino community that emergency rooms are killing patients in order to harvest their organs for transplants, in order to reduce illegal immigrants' use of emergency rooms."
Larry Niven - Wikipedia, the free encyclopedia

 

[Alan]

I would be retired today if I had health coverage, however I am lucky enough to work for a company that offers retiree health insurance.

My plans are to stay until after my 55th birthday next September to have health coverage for myself and DH.

This is exactly what I did, held on until age 55. I'm so glad I did, having a good HI plan is a big weight off my mind.

 

[palomalou]

Wouldn't the "Obamacare" (IF it stays in place) give basically the same result that Trawler is seeking? (I don't mean the name to be a criticism; I am a supporter and think it should have gone further, to national health care.)

 

[Animorph]

This is exactly what I did, held on until age 55. I'm so glad I did, having a good HI plan is a big weight off my mind.

I thought many employers have been cancelling this kind of arrangement, even after you've retired. It's only a promise, not a guaranteed benefit. Not sure I would count on it, but it would have been nice. DW needed 1/2 year more service to qualify (without a subsidy) for her employer's health plan after retirement when her employer decided to stop doing that.

I'm hoping ObamaCare survives and DW will keep working until 2014...