Megacorp Reneges on Retiree Health Care

[Jerry1]

I’m in general agreement also. I never understood why, during the ACA debate, it was never a front and center point that people would be freed from their employer if we had something other than employer paid/sponsored health insurance. So many people I know stay in their jobs because of health insurance. Imagine the energy that could be released if people were freed up to work where and for who they wanted if we had a system that supported that.

 

[Midpack]

So perhaps a good first step would be to prohibit employer provided health insurance and make the playing field between employer-provided and individual health insurance level for tax purposes (one way or the other). It may well be that a humongous group will provide the competitive stimulus for positive change if health care costs can also be addressed... if that doesn't work then nationalization may be necessary.

I'm not sure, but every other developed country with some form of universal health care has government oversight. The healthcare industry is well organized, I'm not sure how individuals would counter the status quo if they are not somehow organized, especially where some health care is on an emergency basis (one of many problems). Until "we the people" demand change in very large numbers, for a long time - probably on a scale like the civil rights movement, the US health care status quo wins easily.

But we've had that debate here many times.

Look at the company we keep in terms of health care, while paying the highest cost per capita (double on average that of developed countries) with poorer outcomes.

 

[pb4uski]

I hear you, but just because everyone else does it that way doesn't mean it is the best way to do it.

 

[Jerry1]

I hear you, but just because everyone else does it that way doesn't mean it is the best way to do it.

Can we shoot for better then go for best? My American pride says we should indeed be best, but my blue collar roots tell me we can and should do better.

 

[Omega]

Because they're all the same.

"My" MegaCorp would annually survey the extent to which other MegaCorps in their industry (or outside their industry, if necessary) were screwing their own employees, then use that to justify giving us an "industry-standard" screwing.

Likewise excessive executive compensation, golden parachutes, and all the other evil things that can be done when you have a whole organized crime ring of interlocking boards beholden only to each other.

This is so true!!!!

 

[CRLLS]

I'm not sure, but every other developed country with some form of universal health care has government oversight. The healthcare industry is well organized, I'm not sure how individuals would counter the status quo if they are not somehow organized, especially where some health care is on an emergency basis (one of many problems). Until "we the people" demand change in very large numbers, for a long time - probably on a scale like the civil rights movement, the US health care status quo wins easily.

But we've had that debate here many times.

Look at the company we keep in terms of health care, while paying the highest cost per capita (double on average that of developed countries) with poorer outcomes.

I think we do have Universal Healthcare, at least to some degree. We have the ACA for some. We have Medicaid and for those 65 yrs of age, Medicare. We have choices beyond Medicare (traditional) if we so choose. These are some steps we as a country have taken toward universal healthcare.
It will take some time to get there. I believe that we will eventually.

From my understanding, even those countries with Universal Healthcare, in some ways it may not be as good as our current system. My understanding is that those with means often seek care outside their country's "system".

 

[Caskem]

My MegaCorp allows me to purchase their retiree healthcare--not given anything. But I'm just glad our pensions are extremely well funded.

I hope you're correct, but that can vanish in a second if the corporation is purchased. In Ohio there is no law that keeps corporations from unilaterally changing their pensions/healthcare benefits.

 

[Caskem]

Actually, even if it's considered a contract, in writing and in the employee handbook, they can still unilaterally change it. That's why I never figured out unions. Not sure what you get for your money, but they sure don't protect jobs and pensions.

 

[Chuckanut]

I never understood why the executives of the Mega Corp I worked for needed all sorts of 'extras' to keep them happy and on-board, while the rest of us who were compensated a lot less, were supposed to be 'loyal' because it was the right thing to do.

 

[pb4uski]

Actually, even if it's considered a contract, in writing and in the employee handbook, they can still unilaterally change it. That's why I never figured out unions. Not sure what you get for your money, but they sure don't protect jobs and pensions.

They can do that with retiree health benefits but they can't do it with pension benefits that have already been earned... but they can change future pensions accruals.

 

[Midpack]

I think we do have Universal Healthcare, at least to some degree. We have the ACA for some. We have Medicaid and for those 65 yrs of age, Medicare. We have choices beyond Medicare (traditional) if we so choose. These are some steps we as a country have taken toward universal healthcare.
It will take some time to get there. I believe that we will eventually.

From my understanding, even those countries with Universal Healthcare, in some ways it may not be as good as our current system. My understanding is that those with means often seek care outside their country's "system".

It’s true Medicare and Medicaid are forms of universal healthcare for just over 1/3rd of Americans (and growing?). And while ACA is somewhat, it is relatively expensive and relies on cost shifting. It ACA was indeed universal and every American was enrolled, it would be way more expensive than any other country, double on average - with poorer outcomes. ACA is only a very small portion of those covered, was about 6%.

And it’s easy enough to look up medical tourism stats. Turns out more Americans seek healthcare outside our borders because it’s too expensive in the US, than foreigners coming in to the US for various reasons.

However, dozens of countries have better care judging by outcomes. The US has better health care at the cutting edge of treatment, often at premier health care facilities, but generally not the best for routine care or preventive care by any means.

I hope we get closer to universal healthcare, but there is nothing happening right now or on the radar that I know of heading is that direction - yet.

In 2013, around 900,000 Americans traveled overseas for treatment, according to Patients Beyond Borders, a provider of medical travel information.

However, health tourism is not the preserve of Americans — around 8 million patients from across the world seek overseas treatment each year, contributing to a global industry worth $24-$40 billion, says Patients Beyond Borders.

Reasons other than cost to travel overseas for health care include better treatment, as well as avoiding long waiting lists and dodging questions from colleagues and family.

Despite the high price of treatment, between 600,000 and 800,000 foreign patients opted for U.S.-based treatment last year, according to Patients Beyond Borders.

Renowned clinics that attract international patients include the Cleveland Clinic in Ohio, Johns Hopkins Hospital in Baltimore, Maryland and Mayo Clinic, which has branches across Arizona, Florida and Minnesota.

https://www.cnbc.com/2014/03/12/top-destinations-for-health-tourism.html

 

[CRLLS]

Midpack, I know that some stats show the US lagging in the results of healthcare provided. I was mostly referring to the waiting period some residents of those Universal Healthcare countries need to endure before they can see s specialist or have procedures done. I don't know the data but have heard anecdotal stories about the very long waits.

It would be interesting to know what the type of medical treatment Americans go out for and what treatments the foreigners come here for. Also interesting to find out if those foreigners who come here for treatment have universal healthcare in their home country.

Canada has "universal healthcare" but according to this USNews report, It may not be as rosy as we Americans might think.

Crossing the Border for Care
Frustrated by long waits, some Canadians are heading to the U.S. for medical treatment.

Contrary to popular belief among Americans, health care is not entirely free for Canadians. Dental, ambulance and many other services as well as prescription medications must be paid for out of pocket or they're covered through a combination of public programs and private health insurance. About two-thirds of Canadians have such insurance.

 

[Midpack]

Midpack, I know that some stats show the US lagging in the results of healthcare provided. I was mostly referring to the waiting period some residents of those Universal Healthcare countries need to endure before they can see s specialist or have procedures done. I don't know the data but have heard anecdotal stories about the very long waits.

It would be interesting to know what the type of medical treatment Americans go out for and what treatments the foreigners come here for. Also interesting to find out if those foreigners who come here for treatment have universal healthcare in their home country.

Canada has "universal healthcare" but according to this USNews report, It may not be as rosy as we Americans might think.

Crossing the Border for Care
Frustrated by long waits, some Canadians are heading to the U.S. for medical treatment.

Again, the bottom line is more Americans seek treatment offshore than foreigners seek treatment in the US.

And looking at any one attribute from one country doesn’t tell us much. You’ve chosen one country (Canada) and one attribute (wait times) - why? Even then, from the source you linked.

The Commonwealth Fund, a U.S. think tank, released a report two years ago ranking Canada 10th out of 11 wealthy nations in terms of health care. Only the United States fared worse. The report, based largely on satisfaction surveys by patients and health-care providers, placed Canada last in timeliness of care. The United Kingdom was ranked No. 1.

“Canadians often think that the long wait times and bureaucratic roadblocks we experience are simply the price we pay to have a system that is fair and free… but the world tells us otherwise," journalist Michael Bolen wrote in The Huffington Post. He noted that in the Commonwealth Fund report, European countries with universal health care systems that use a hybrid of private and public models have shorter wait times and are ranked higher overall.

 

[CRLLS]

The answer to your "Why" is because Canada is one country from which I have personally heard reports from individuals. And it is fairly easy and inexpensive for a Canadian to come to the USA for treatment.

I do not agree that your blanket statement of "the bottom line is more Americans seek treatment offshore than foreigners seek treatment in the US." is a fair assessment of universal healthcare vs our current system without knowing the reasons behind the data. For instance, how many who seek treatment outside are for cheaper dental work or are seeking miracle cures after receiving every benefit US medicine can provide? Totally at different ends of the spectrum, may or may not be in that "data. I don't know these answers

We are not at odds here. I believe that UHC is needed in the US and at some point in the not too near future, will become law of the land. Our whole system is broke and has been for some time IMO. But government-run UHC will not solve all the issues. Look for examples with those who are on traditional Medicare for example. A pretty good system from what I can see. But it still has its problems with costs and coverage and in some cases, denial of coverage.

 

[indiajust]

canada briefly

The canadian HC system is the same for all. So the CEO's sit in the same waiting rooms with the sick kids.


Their basic care is delivered cost effectively, better cheaper faster than US.


But just like UK, they have rationing of surgical procedures. Cancer patients wait and wait. No way to cut in line. So they can die in the queue. It is literally first come first served.



They have problems with technology too. Medtech is rationed for cost reasons.


This is why you see canadian patients down here. They don't want to wait and risk dying and are willing and able to pay extra for quicker service. Quicker is illegal unless you leave, and it costs more, but it is preferable to death.


Insurance can shift costs, but fundamentally it raises prices and reduces price transparency and competition... things that would eventually pull prices down for all.


US is getting worse and worse for basic care, but at the high end we have some of the best new procedures and technology. The bottom line... our outcomes are twice as expensive and half as good.


I suspect that a real market in health care (not insurance, thats a financial product) would be different than anything out there today.

 

[Jerry1]

When the line in Canada gets too long, the government will buy services in the US. They use to send many cardiac patients to one of our premier heart specialist hospitals. Then they ultimately filled the gap with in country specialists and facilities.

 

[indiajust]

I really like the Chilean (australia, swiss, ...) retirement system structure. Instead of having a plan per employer, there is a national plan and account system.


Their version of FICA is contributed directly to your account. As are employer and personal contributions. No rollovers, you have some flexibility in where you hold your account.
It is just one account. Most have provisions for the truly poor (contributions made on their behalf). But it really is just one retirement account for life. And it is inheritable. Just try that with FICA.

 

[brett]

Our experience with the Canadian health system has been excellent. Like any public health system there are issues. Urgent care, in our families experience over three Provinces, is addressed in a timely fashion. My spouse recently underwent neurosurgery. Little wait time for any of her 3 specialists or for the operation which was extremely time sensitive.

Most of us view the provision of medical services in the same manner as we view public safety, clean water, etc. It seems strange to us to have our system characterized as socialized medicine. We do not refer to the police, fire, emergency and water systems as being 'socialized'. It is simply a basic service that everyone should be, and is, entitled to. Talk now is in moving to, at some stage, Pharmacare in order to provide the requisite drugs.

We pay for it through taxes, with some provinces levying a small premium, some do it via income tax returns, others as part of the general tax burden. It is not free and constitutes the largest part of a provinces budget. Our province does not charge or collect premiums. The neighbouring province of BC currently has a family rate of $150 month which is being reduced to $75. per month on Jan 1. Other provinces may have higher monthly premiums. People/families with income less than $42K will pay less. The individual rate is half of the family rate. Many employers pay the premium as part of the employee benefit package.

Medical insurance, with the exception of out of country medical, was never a consideration when we approached early retirement in our late fifties. We cannot envisage a system that is tied to the employer. We knew that it would be there when we needed it. My daughter lives in a remote location. They system pays for helicopter evac for her child to a large city hospital when/as required.

 

[jim584672]

My former Megacorp has retiree Medigap at $150 a month, but they never adjust it for inflation. So in effect,over time it is being phased out. I never qualified since I left prior to 55.

 

[Chuckanut]

I have yet to meet a Canadian or a Brit who would trade their health system for the American one.

 

[ERD50]

I have yet to meet a Canadian or a Brit who would trade their health system for the American one.

That does not mean they don't exist:

https://www.usnews.com/news/best-co...dians-increasingly-come-to-us-for-health-care

-ERD50

 

[brett]

It is certainly not perfect. It can be improved. However, every survey that I have seem over the past twenty years shows and 80 percent plus percentage in favour of the system that we currently have. Politicians who try to tinker with it or suggest additional 'user fees' are quickly dispatched by either the voters or their own party to the dustbin of has beens or also rans.

Currently the drug companies are very nervous. They are very concerned about pharmacare. Even now, provinces are joining together in larger buying groups and going out to tender for drugs-especially generics. One recent study showed that the one Province was paying 20X the amount that New Zealand was for the same generic drug. The message....lower the price or we will source it from New Zealand. This is still in the early stages of playing out. The goal is to lower the cost of drugs to the health care system-at least down to the level a British or European pricing matrix I am told.

 

[Scuba]

Interesting thread. One thing I wonder about is cause and effect. When people say the US healthcare system doesn’t have good outcomes, longevity is one of the key metrics I’ve seen used to substantiate “poor outcomes.” The US has very high rates of obesity and obesity-related illnesses and deaths. But is that because of the healthcare system?

I think it’s more related to US culture vs foreign cultures with regard to physical fitness, portion sizes and fast food. In the US, kids and adults ride in cars, while in many countries people walk and/or bike as a part of daily life. Very few Americans commute to work on a bike, but lots of people in Amsterdam do, as one example. Anyone who’s traveled abroad knows the portion sizes in the US are HUGE. When we were in Greece for 6 weeks, we saw almost no fast food chains. If the countries with socialized medicine had the same cultural factors as the US - ie drive everywhere vs walk or bike and eat huge portions of unhealthy fast food - would their care really deliver better results? And is the reason these other countries don’t behave like the US driven by their preventative healthcare systems? Maybe partly, but it seems to me it’s more culturally driven.

While it may be true that more Americans go elsewhere for medical procedures than foreigners come here, I think it’s also true that Americans go abroad to try to save money, not get better quality. People who can afford it come to the US from other countries, not to save money but to get the best possible quality of care on demand, with no wait. To me, there is a big difference in the motivation.

 

[Midpack]

I do not agree that your blanket statement of "the bottom line is more Americans seek treatment offshore than foreigners seek treatment in the US." is a fair assessment of universal healthcare vs our current system without knowing the reasons behind the data. For instance, how many who seek treatment outside are for cheaper dental work or are seeking miracle cures after receiving every benefit US medicine can provide? Totally at different ends of the spectrum, may or may not be in that "data. I don't know these answers.

I offered what data I could, wasn't hard but it took some effort on my part. If you're going to disagree, why not offer up data to support your opposing POV. I would be more than happy to dig further, if you would too.

I'd contend that others relying on hearsay is part of the problem.

But we are on the same page re: what ends we'd like to see.

 

[Chuckanut]

That does not mean they don't exist:

https://www.usnews.com/news/best-co...dians-increasingly-come-to-us-for-health-care

-ERD50

I guess it depends on how one defines 'trade'. I was thinking of a trade that involves totally abandoning the British/Canadian system and going 100% to the American system (or visa-versa) for the rest of one's life. No doubt, if that is the only way to get treatment for a life threatening disease, one would do that.