HIPAA costs ?

[shiny]

The Scandanavian countries seems to have this down pretty well, maybe we should study what works for them.

Also, the point that donheff made seems to apply to most of us who have worked in the private sector - why would we have been paying all along for redundant healthcoverage when we have good coverage through our employers? Once we quit and can no longer stay in that group (past COBRA) then we are at the mercy of the insurance company.

Also, as part of the "freemarket" economy, I want to be able to move to any state that I wish and not have to worry about losing my healthcare coverage. I guess as mkld said some people wouldn't move if it would harm them financially, but it sounds like being held hostage to me.

Also, when people are hurt or sick they (we) are vulnerable and need care. It is not the most opportune time to negotiate healthcare costs.

It could just be my inner liberal-socialist-leftwing radical talking here, but basic healthcare seems more of a basic human need that all societies should strive to provide than a cold-hearted business negotiation.

 

[mykidslovedogs]

I would be curious to see how they (the scandanavians) do it, and also to find out what kind of income taxes are paid by the people to support the nationalized care.

I don't think it makes any sense to tie health insurance to employment. In the old days, when people worked for the same companies for 20 plus years, it made sense, but it just doesn't make any sense anymore. The short amounts of time that people work for one company or another create costly administration for employers (particularly in Cobra administration) and all kinds of problems with portability of coverage.

I don't think people should double cover. Since many employers don't even pay for dependent coverage anymore, why not just waive the employer benefit and purchase an inexpensive HSA plan for the whole family? It might even be less expensive to do that than to pay the dependent premiums on the employer sponsored plan. Maximum out of pocket expenses are oftentimes lower on an HSA anyways, because there isn't any coinsurance or infinite copays to worry about. Coverage is simply 100% after deductible for all medical expenses including prescriptions.

It is sad that there isn't good portability from state to state, but if you purchase a good plan that has a national network (like Golden Rule or Humana One, your coverage just might be portable from one state to the next without re-underwriting. It's always a good idea to check into that option before purchasing a personal health plan anyway. Especially if you think you might be moving in the next few years.

Basic healthcare for everyone is a wonderful ideal, but how fair is it for those who take good care of themselves to have to pay for lipitor, pain killers, high cholesterol medication, and high blood pressure medication for the guy who smokes, drinks, and is way overweight? How fair is it for those who work extra hard to put their kids through private school and plan for early retirement to pay (in the form of exhorbitant tax increases) for "free" emergency care for illegal immigrants and the uninsured? This may seem like a cold-hearted attitude, but when your the one who is working so hard and working long hours and then having half of your money taken away from you by the government, it just doesn't seem right.

 

[shiny]

...when your the one who is working so hard and working long hours and then having half of your money taken away from you by the government, it just doesn't seem right.

I understand, this is how I feel about the war in Iraq.

Like my dad used to say (and still does)... if wishes and buts were candy and nuts we'd all have a Merry Christmas!

 

[Nords]

A couple comments without quoting from the multitudinous paragraphs:
Mykids, what insurance system would you propose if your spouse was diagnosed with liver cancer necessitating hospice care? Or one of your kids with a rare genetic previously-undetected blood disease? I'm not sure that your family's healthy-lifestyle self-insurance high-deductible system would handle the expenses of the maintenance medications & painkillers.

The system you're looking for, with lifestyle incentives and differing tiers of healthcare, sounds a lot like the military medical system I spent over two decades trying to escape from. Our local clinic is wonderful by comparison.

For those enamored of the Scandinavian healthcare system, Ben has complained before of Sweden's excessively high taxes. And he's making medical runs to Bangkok, too...

 

[mykidslovedogs]

Hi Nords,

My healthplan has a $5,000,000 lifetime maximum and pays 100% after deductible for all covered medical expenses including prescriptions. My deductible is $5,150.00 annually, so that is the only annual out of pocket expense I need to worry about. My healthplan has excellent prescription drug coverage. my healthplan costs me about $300.00/month for my family of four. However, MY healthplan would not cover experimental drugs or drugs that are not FDA approved. So, I guess there is always a possibility that a rare condition could cost me more than what I expect. But, at least I have taken measures to protect my assests from the high costs of thousands of other kinds of more common diseases like cancer, high cholesterol, heart disease, stroke, chronic disorders, etc...

Nords, are you from Sweden? What is your local clinic like? What kind of technology does it offer? Are there any waiting lists for high tech procedures like heart and brain surgery? I am curious to find out how it works there....

 

[mykidslovedogs]

And oh by the way, my healthplan DOES cover hospice care too! I forgot to mentione that in my previous message. I do not self-insure. I have already planned and saved enough money to cover my deductible, so if I had to meet the deductible, it would not be a problem. So basically, I have right now, 100% coverage for any medical problem that might arise (except maybe that rare, disease that does not have any FDA approved kind of treatment).

 

[REWahoo]

Nords, are you from Sweden?

 

[mykidslovedogs]

REWahoo,

Call me naive, but I didn't understand your last post.

 

[REWahoo]

REWahoo,

Call me naive, but I didn't understand your last post.

Sorry, just my feeble attempt at humor.

If you do a little reading of some of Nord's 8,800+ posts or check out his member profile, you will understand he's a retired US Navy officer and lives in Hawaii.

 

[mykidslovedogs]

Oh, I wonder what kind of "local clinic" he has in Hawaii....

 

[Nords]

Nords, are you from Sweden? What is your local clinic like? What kind of technology does it offer? Are there any waiting lists for high tech procedures like heart and brain surgery? I am curious to find out how it works there....

Nope, but Ben is. I think his actions speak as loud as his posts.

Judging by Google my ancestors appear to be from Finland, but I think some smart Vikings took the first boat outta there.

You've castigated the current healthcare system for forcing healthy people to subsidize the healthcare costs of "less than healthy" people. I'm pointing out that the military healthcare system is the closest thing to the "better" system you've described, where rugged individualists are held accountable for their own health & physical performance, and I'm speculating that you'd like it even less than the nation's current healthcare system. I know I'm much happier being seen by junior civilian residents* than by the staff at Crippler Tripler Army Medical Center.

With apologies to our North American allies, Martha's not trying to turn us all into a nation of socialized nationalized healthcare Canadians. Her point is that the current system needs a safety net. It needn't be much more complex than the way that Social Security provides a retirement safety net without meeting the equivalent of the poverty line, let alone a COLA-adjusted defined-benefits pension. But "Every individual for themselves!" just ain't cutting it for retirement or for healthcare.

One way or another we all end up giving our tax dollars to the people who fall through the nets. A preventive healthcare safety net would be cheaper than the alternative.

Oh, I wonder what kind of "local clinic" he has in Hawaii....

*This one: http://www.wahiawageneral.org/View/PhysicianCenterMililani.html . And the interior decorating is even spiffier...

 

[mykidslovedogs]

I think the biggest problem is for people between the ages of 55 and 65 because they always had employer sponsored benefits, and when they want to retire early, they're put into a tough place if they have pre-existing condtions. I think a safety net could POSSIBLY work for these folks, but I am afraid it would be like the camel's nose under the tent. The next thing you know, EVERYONE would be wanting a safety net, and that's just not right.... And I still think that a safety net for early retirees would cost the taxpayers a fortune....The beneficiaries would have to be willing to have deductibles and agree to pay at least half of the premiums. People have got to learn to take SOME personal responsibility. Look at the Medicare system.....AARP continues to assert that it just isn't enough. Shoot...Part D prescription drug coverage is an INCREDIBLE deal, but all AARP can do is complain about it, yet the premiums are only about $40.00 a month. Heck...Medicare is free (with only a very small deductible) and supplements are guaranteed issue and only cost about $100/mo, yet THAT still isn't good enough. It's just never enough....

I still think people have GOT to learn to take care of their own finances. We can't have the government in everything. If we teach our kids while they are young not to depend on employers and the government to take care of their retirements, we can change the culture of the entitlement mentality. The minute you put in a saftey net, people expect it, and they continue to want more.

 

[mykidslovedogs]

How about this idea...Insurance carriers agree to give guaranteed issue to early retirees who have pre-existing conditions at a certain, goverment defined premium that the INSURED agrees to pay (an amount that is fair to the consumer and yet, will not put the insurance company out of business). As a safety net to the insurance carrier, the government picks up the tab if claims go over a certain, defined amount.

 

[Nords]

The next thing you know, EVERYONE would be wanting a safety net, and that's just not right.... And I still think that a safety net for early retirees would cost the taxpayers a fortune....
The minute you put in a saftey net, people expect it, and they continue to want more.

Well, that's the whole idea of a safety net-- nobody falls through it. What's "not right" about that?

I think one big problem with the healthcare debate is the assumption that a safety net would bankrupt the system and cost even more than doing nothing. IMO we're already paying for "doing nothing", and if those dollars could be deployed in preventive care rather than acute/hospice care then I suspect it'd cost less. But I think it's "not right" to expect people to shoulder the risks and be chained to their jobs/states by pre-existing conditions that aren't their fault.

IIRC the last solution to that problem was "eugenics"...

How about this idea...Insurance carriers agree to give guaranteed issue to early retirees who have pre-existing conditions at a certain, goverment defined premium that the INSURED agrees to pay (an amount that is fair to the consumer and yet, will not put the insurance company out of business). As a safety net to the insurance carrier, the government picks up the tab if claims go over a certain, defined amount.

Isn't that pretty much another definition of a safety net? Somewhere in the last six pages of this thread I'd picked up the possibly mistaken impression that you were against that...

 

[mykidslovedogs]

I'm really not for safety nets, but if costs less than the current system, I'm all for it. HOWEVER, whenever safety nets are put into place, people start to expect more, so you have to be careful about the effect of the camel's nose under the tent.

Take for example, Medicare. The elderly still do not think it is enough. They don't want to have deductibles, and they don't want to help out with the premiums. They want it to be FREE. Everyone wants it to be FREE. We can't have a safety nets for everyone. It's much too expensive.

Perhaps, a safety net could be put into place TEMPORARILY to help those that got stuck into the system of workplace benefits, but we have got to ultimately change the mentality. We've got to teach people to get their own coverage while they are young and healthy, and then keep it for life.

I am certainly not rich, but there IS an affordable way for me to protect myself in the event of a catastrophic illness. A high deductible health plan is not that big of a deal to pay for. Even if I didn't have a savings to pay for my deductible, a loan for $2000 would not financially devastate me. It's better to have a high deductible health plan than nothing at all. Plus, it encourages me to manage my health and to shop for better prices when it comes to my health.

For example - a few years ago, my daughter had to have an ultrasound and I was recommended to go the hospital to have it done. The bill would have been $1000.00. I shopped around and found out that she could have her ultrasound done in a doctor's office for only $200.00. If I would have been getting my benefits for free from the government, I would have just gone to closest, most convenient location and spent $1000.00. Because I had to take responsibility for some of the cost, I found a better price elsewhere. This is the nature of the free market and keeping competition in the marketplace. Perhaps, ultimately, HSAs will help drive down the costs of healthcare, because people won't just buy the most expensive drugs and they won't just get bunches of unneccessary tests. People will be more proactive about their health and the costs accociated with their care.

I consistently hear people saying that high deductible major medical plans are only for the wealthy. I have one, and I am certainly not wealthy. I am middle class. Yes, I do give up certain things in order to plan for my retirement..I don't live in a big fancy house, I don't drive fancy cars, and I don't go on expensive vacations. Ultimately, I WILL be able to retire early though, because I have saved and planned and I will not be dependent on either the government or my employers for my well-being.

 

[Nords]

Take for example, Medicare. The elderly still do not think it is enough. They don't want to have deductibles, and they don't want to help out with the premiums. They want it to be FREE. Everyone wants it to be FREE. We can't have a safety nets for everyone. It's much too expensive.

I think you have a very cynical view of the world that "they" live in, unfettered by documentation to actual studies or other links.

That tends to make the healthcare debate pretty difficult too.

 

[mykidslovedogs]

OK, I know that sounded kinda callous, but AARP never gives up on their criticism of the system, so I guess it's AARP that sort of creates the stereotype. Each time legislation is created to help, all they seem to do is complain that it's not enough.

 

[golfnut]

MYKIDSLOVEDOGS,

In earlier post you mentioned what you are paying per month for a HSA medical plan. Just curious, is this a indivudual plan you purchased on behalf of you and your family?? If so, would you mind divulging who your carrier is?? Reason I am asking is I am trying to get a handle on medical costs if I decided to do something crazy like ER.

Right now, I am purchasing thru my employer a HSA plan with a $4,000 (family)deductible for $50 per month.

 

[mykidslovedogs]

MYKIDSLOVEDOGS,

In earlier post you mentioned what you are paying per month for a HSA medical plan. Just curious, is this a indivudual plan you purchased on behalf of you and your family?? If so, would you mind divulging who your carrier is?? Reason I am asking is I am trying to get a handle on medical costs if I decided to do something crazy like ER.

Right now, I am purchasing thru my employer a HSA plan with a $4,000 (family)deductible for $50 per month.

Mine is a Humana One Individual HSA (not empoyer-sponsored). I purchased it for my whole family. My family deductbile is $5150. Rates vary from State to State. I live in Colorado, and my family rate is a little over $300.00/mo. for this plan. My husband and I are in our late 30's, and we have two kids. I've had the HSA since it came out a little over two years ago. We started with a $4000.00 ded. plan, and then raised the deductible to $5150.00. Since then, we have been able to save approx $10,000 into our HSA Bank account which is now earning a 3.25% interest rate on a tax-free basis.

You're probably not going to find an individual plan that is a "cheap" as your portion of the premiums on your plan that you have with your employer. The tradeoff is that if you develop a pre-existing condition while you are employed and then, for some reason, become unable to work, it will be difficult for you to find affordable coverage later on. That is a great benefit you are getting from your employer. If you are planning to work for your employer for many many years, you might be able to save enough in your HSA account to compensate for higher health insurance costs later on in life, so you'll really have to think it through, whether it's worth it or not to stay on your employer's plan.