Health insurance costs for 2014 - didn't expect that

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Engineer

Elite Member
Oct 9, 1999
39,234
701
126
And the ones who are working are probably the ones who will get the least benefit out of the new system. I'm not sure how the subsidies work with the ACA but I keep seeing it mentioned. Does one have to be at a certain income level to qualify for assistance? And where do these subsidies come from?

Sorry, I'm not informed on the ACA.

I'm not either. All I know is that you can get a 'level' of subsidy if your income is at or below 4 times the national poverty level. As for where this subsidy comes from, not sure. Fines for not providing insurance for your employees? Really don't know how all this bullshit is supposed to work.
 

ImpulsE69

Lifer
Jan 8, 2010
14,946
1,077
126
The problem is I (and apparently half of the country) have so little confidence in the government that if single payer ever happened costs would skyrocket even more and the US healthcare system would collapse (and probally bankrupt the US Govt, if it isn't already bankrupt)

ftfy
 

JamesV

Platinum Member
Jul 9, 2011
2,002
2
76
The Plain Dealer in Cleveland had an article a few days ago where they found the insurance costs are actually 16% lower than expected - nationwide.

http://www.cleveland.com/open/index.ssf/2013/09/obamacare_health_insurance_exc.html

If your plan is skyrocketing so that top execs can still rake in million dollar bonuses, then I advise you to shop around.

And if you want to harp on the tax credits making the costs actually higher, and you do live in Cleveland, then you should be complaining about the millions going to the Browns stadium to replace perfectly good seats while it's rich owner sit's back laughing at you.
 

Engineer

Elite Member
Oct 9, 1999
39,234
701
126
If your plan is skyrocketing so that top execs can still rake in million dollar bonuses, then I advise you to shop around.

I thought part of the ACA was to limit the % of premiums that could be used for stuff like that to 15%? Of course, like any big pile of crap law, it's hard to wrap your arms around it much less understand it.
 

Jeff7

Lifer
Jan 4, 2001
41,599
19
81
The US healthcare system currently takes 17% of GDP in spending on healthcare. I'm sure if we took that and placed it into single payer, it could be made to work....especially when you consider that nearly every other industrialized country makes a go at it at a much smaller % (around 10 to 12% IIRC) of their GDP (which is smaller than the US by quite a bit) and they cover 100% of their citizens.

Oh I forgot, profits over people every day of the week....what was I thinking? pfftt.
It's into "scam" territory now. (I was thinking "money laundering" also, but I don't think that definition quite fits.)

How do you get people to pay $1 for a single ibuprofen tablet?
1) Make it 400mg or 800mg (OMG, it's so much bigger than the OTC 200mg pills!!)
2) Make it available by prescription only.

Or you could just go buy some generic OTC ibuprofen for a few dollars for a whole bottle.

But you'll pay the inflated price because "Don't worry about it, your insurance pays for it, so it doesn't cost you anything!"
One of my uncles had this sort of discussion with his pharmacist. In his case, it was just this sort of thing, a prescription for a larger dose of an OTC painkiller, which turned out to be at an impressive markup. He asked the pharmacist what they were billing to his insurance for this, and it was like an infinite loop: "What is this going to cost my insurance?"
"You won't pay anything on it. Your insurance is going to cover it."
"I know. What are you going to charge them for it?"
"That doesn't really matter. You won't see any of the cost, they will cover it 100%."

And so on for a few rounds.
It ended up being something like that - about $1 for a tablet of aspirin.
That cost certainly isn't going to affect the margins of the insurance company. They wouldn't let anything like that happen. And if they're applying a profit margin as a percentage of cost, the excessive price of those pills just ends up costing you even more in your premiums.

It's along the same lines as the BS going on with mutual funds, where they charge you money transparently - it comes right out of the returns of the fund, so you never see a bill, therefore it "doesn't exist" as far as many people care to see. You just get ~1-2% automatically shaved off of your returns each year.



This hospital has been in the news a few times, with their attractive pricing. From an article about it, "People began traveling from out town and even from out of state to take advantage of the much lower bills at the Surgery Center — and other hospitals took notice. At least five other Oklahoma City-area medical facilities started posting their own prices online, and some of them are even beginning to lower their bills as their patients push for price-matching.
'Hospitals are having to match our prices because patients are printing their prices and holding that in one hand and holding a ticket to Oklahoma City in the other hand and asking that hospital to step up,' Dr. Smith pointed out."

"For example, a $3,500 breast biopsy at Surgery Center of Oklahoma will cost $16,244 at nearby Mercy Hospital. A hysterectomy jumps from $8,000 at Surgery Center to $37,174 at Integris Baptist Hospital. And the OU Medical Center consistently charges about $15,000 more than what the Surgery Center does for common procedures like open fracture repairs and gall bladder removal."


Is Integris Baptist Hospital going to deliver results that are more than 4x the value of the Surgery Center of Oklahoma? Or is it simply a fat profit margin?
 
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Murloc

Diamond Member
Jun 24, 2008
5,382
65
91
Although I'm surprised since more people are being 'forced' to pay now, that the costs aren't at least steady as more now pay. Was wrong on that completely.
insurances try to make more money, not keep making the same money.

There's no money at current rates for a single payer system. And that's the only way it could happen, nothing changes except who pays!
Don't they teach anything at school these days?


The current system works fine.
what about setting a maximum price of each health service or some similar sort of regulation?
most countries do that.
 

postmortemIA

Diamond Member
Jul 11, 2006
7,721
40
91
High deductible plan is now only option for me - family coverage. Deductible is $5k. Essentially premium is north of $400.
 

raildogg

Lifer
Aug 24, 2004
12,884
569
126
I'm not either. All I know is that you can get a 'level' of subsidy if your income is at or below 4 times the national poverty level. As for where this subsidy comes from, not sure. Fines for not providing insurance for your employees? Really don't know how all this bullshit is supposed to work.

So basically, for a person whose premium went up 3x has to go to a lesser plan or pay up. Of course, many Americans won't notice this or care since they get their insurance from the company/state/federal government. It's just strange how it worked out. It appears that the plans offered in 2013 are completely invalid in 2014 so therefore the insurance companies and their states must increase costs up dramatically.

Apparently, health status does not matter when determining premiums. If one does not utilize the healthcare system, that will not mean that their premiums will be less than someone who does often.

How is this efficient? It's just one size fits all basically.
 
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sixone

Lifer
May 3, 2004
25,162
4
61
The US healthcare system currently takes 17% of GDP in spending on healthcare. I'm sure if we took that and placed it into single payer, it could be made to work....especially when you consider that nearly every other industrialized country makes a go at it at a much smaller % (around 10 to 12% IIRC) of their GDP (which is smaller than the US by quite a bit) and they cover 100% of their citizens.

Oh I forgot, profits over people every day of the week....what was I thinking? pfftt.

We can't take 17% of GDP spending and move it to single-payer. Costs for previously uninsured people will go up astronomically, while the money available to pay for those costs doesn't change.
 

Engineer

Elite Member
Oct 9, 1999
39,234
701
126
It's into "scam" territory now.<SNIP>

Yet the rest of the industrialized world has complete coverage and their people don't feel this way (your examples of how people just say "Oh, I have insurance so who cares what it costs" (paraphrased)) and on top of that, their coverage costs far less than the US per capita and covers EVERYONE!!!
 

Engineer

Elite Member
Oct 9, 1999
39,234
701
126
insurances try to make more money, not keep making the same money.

.

Again, from what I understand, they have to spend 85% (or more) of the premiums on actual health care. They cannot simply give more in wages/etc. to get rid of the money.
 

Engineer

Elite Member
Oct 9, 1999
39,234
701
126
We can't take 17% of GDP spending and move it to single-payer. Costs for previously uninsured people will go up astronomically, while the money available to pay for those costs doesn't change.

The real question is why does it cost 17% of the US GDP to get the crap coverage that we have now vs the much smaller % of the 'smaller GDP's' of other countries that cover 100% of their people? Why is that?

I wonder what % of that 17% ends up in the pockets of big insurance or bill collectors or simple inefficiency of the US medical establishment (i.e. have to have 3 people in a small doctors office just to bill and fight against the insurance companies, etc.)?
 

Slammy1

Platinum Member
Apr 8, 2003
2,112
0
76
My sister works in Washington DC as a lobbyist for the insurance industry. The purpose wasn't to make sure that everyone has coverage, but that hospitals and doctors get paid. So those who can afford it get to foot the bill. Drove me nuts, we're not doing it for the poor that was just more government propaganda.
 

dank69

Lifer
Oct 6, 2009
35,602
29,319
136
3x?
I'll believe that when my shit turns purple and smells like rainbow sherbet.
 

alkemyst

No Lifer
Feb 13, 2001
83,967
19
81
Some companies are looking to dump private coverage and have their employees move to ObamaCare.

So far the ObamaCare numbers look decent especially after tax credits.
 

raildogg

Lifer
Aug 24, 2004
12,884
569
126
It's another form of taking money from one group of people to spend it on another group of people. In the end, you just hurt the economy and make things more complicated. The extra money spent in premiums is the money that can't be spent and thus help the economy.
 

Jeff7

Lifer
Jan 4, 2001
41,599
19
81
...
what about setting a maximum price of each health service or some similar sort of regulation?
most countries do that.
In the US, you'd probably have protests about socialism-this-and-that.
(Even though that's pretty much what insurance is - everyone pays a little bit so that a catastrophic event doesn't utterly destroy the few people it affects.)



Yet the rest of the industrialized world has complete coverage and their people don't feel this way (your examples of how people just say "Oh, I have insurance so who cares what it costs" (paraphrased)) and on top of that, their coverage costs far less than the US per capita and covers EVERYONE!!!
Well sure, but the US is the greatest country in the world in absolutely every respect, so of course those shithole industrialized nations can afford their filthy, dehumanizing health care systems.






Brb, got to go buy some more F-35 fighter jets.
 

sixone

Lifer
May 3, 2004
25,162
4
61
The real question is why does it cost 17% of the US GDP to get the crap coverage that we have now vs the much smaller % of the 'smaller GDP's' of other countries that cover 100% of their people? Why is that?

I wonder what % of that 17% ends up in the pockets of big insurance or bill collectors or simple inefficiency of the US medical establishment (i.e. have to have 3 people in a small doctors office just to bill and fight against the insurance companies, etc.)?

Having someone to deal with insurance companies is not an "inefficiency". It's a cost of doing business - just like having someone to ensure compliance with government interference like HIPPA and now Obamacare.
 

Engineer

Elite Member
Oct 9, 1999
39,234
701
126
3x?
I'll believe that when my shit turns purple and smells like rainbow sherbet.

Well, get a spoon and start eating your shit as my wife's premiums have more than tripled and the deductible went from $600 to $1,750 per person. Now her premiums were very low to begin with so it's not a 'huge' amount of money but it more than tripled nonetheless.
 

Meghan54

Lifer
Oct 18, 2009
11,573
5,096
136
We keep going with our current health care for profit system and we surely will bankrupt the country.

And if we sent to a single payer system, those that cite taxes going bananas and no room left in the budget and where would the $$ come from, the answer is the premiums your employers pay and the premiums you pay for ins. would essentially convert into the "taxes" for health care. Imagine if every penny that is paid into health premiums was used to really fund universal health care...

That said, as long as pharma. and health ins. co's. have such big clout with Congress, we're stuck with what we have, a broken system destined to fail. Why else do drug companies scream when forced into competitive situations for their drugs, or why drug companies charge U.S. residents multiple times the cost of the same drug sold in Canada, for instance.

And despite all the health ins. companies crying about their product not being very profitable, I call BS on that. If what they're doing doesn't give them much profit, why are they fighting so hard to keep the system the way it is? Here's a hint....most insurance companies don't profit much off their product in a direct way but instead ins. co's. are one of the largest, if not the largest, institutional investors in the stock market, and the profits from that aspect, rarely talked about, is where a huge amount of their profits are derived. Make no mistake, health care is profitable if done right, and the health industry in the U.S. does it quite right for profits.

It seems as if we, as a country, are willing to tolerate what is sub-standard health care while spending more as a country than any other on earth with the absolute worst health outcomes from all that spending (for instance---rates of infant mortality currently places the U.S. right behind Cuba, at around 34th in the world; the U.S. life span is also behind many 2nd world countries and down around, again, Cuba), sure, keep what we have. But it's going to reach a breaking point.

Add in the vast numbers of bankruptcies from health care costs, even when having great ins. coverage (some estimate almost 2/3 of bankruptcies are attributable to the end cost of a serious accident or illness) and you have an unsustainable system in place.


But we place very little value in the U.S. as a whole on having a healthy population, a healthy population which would be much more productive (see Germany, et al) and not in fear of gaving to go see an MD.

C'est la vie. Such is the U.S. Everything is for profit, common sense be damned.
 

Jeff7

Lifer
Jan 4, 2001
41,599
19
81
...
And despite all the health ins. companies crying about their product not being very profitable, I call BS on that. If what they're doing doesn't give them much profit, why are they fighting so hard to keep the system the way it is? Here's a hint....most insurance companies don't profit much off their product in a direct way but instead ins. co's. are one of the largest, if not the largest, institutional investors in the stock market, and the profits from that aspect, rarely talked about, is where a huge amount of their profits are derived. Make no mistake, health care is profitable if done right, and the health industry in the U.S. does it quite right for profits.
They can sure pay their sales staff an impressive amount of money. One of my dad's friends worked in pharmaceutical sales. Six-digit annual salary, somewhere beyond $150k.

I go to the dentist, and they recommend Listerine brand mouthwash, offer a coupon for it, and I'm sent home with a bag of Colgate brand supplies. Colgate-branded stationery.
Doctor's office: The clock on the wall has GlaxoSmithKline's logo on it. So do the post-it notes they use, and the sign-in sheet.
What portion of our money is used to fund their sales and marketing teams? And their lobbyists? (A variety of derogatory adjectives come to mind when I use that word.)


(Mutual fund companies, again: Some of the post-it notes at work have the 401k provider's logo on them. The various fees the plan participants pay are what buys us those things. It's fun paying for advertising that's telling us to buy the costly funds we're already buying!)



It seems as if we, as a country, are willing to tolerate what is sub-standard health care while spending more as a country than any other on earth with the absolute worst health outcomes from all that spending (for instance---rates of infant mortality currently places the U.S. right behind Cuba, at around 34th in the world; the U.S. life span is also behind many 2nd world countries and down around, again, Cuba), sure, keep what we have. But it's going to reach a breaking point.
<fingers in ears>
"LALALA NO, GREATEST COUNTRY IN THE WORLD!!!! Evil lies from the media! Of course you love Cuba, it's communist, just like you!"
And it usually continues like that.





Add in the vast numbers of bankruptcies from health care costs, even when having great ins. coverage (some estimate almost 2/3 of bankruptcies are attributable to the end cost of a serious accident or illness) and you have an unsustainable system in place.

But we place very little value in the U.S. as a whole on having a healthy population, a healthy population which would be much more productive (see Germany, et al) and not in fear of gaving to go see an MD.

C'est la vie. Such is the U.S. Everything is for profit, common sense be damned.
A healthy population is a long-term investment, and it's not easy to quantify directly.
We need something that shows up on a quarterly financial statement. You can do that by dropping people from plans, avoiding taking on risky investments (do blood and health screenings on prospective revenue sources), weaseling out of covering medical procedures, and applying insane markups to everything. That's how you can help the disadvantaged classes of top-level management, so they can get the lavish paychecks and stock options that they so richly deserve.
 
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alkemyst

No Lifer
Feb 13, 2001
83,967
19
81
We keep going with our current health care for profit system and we surely will bankrupt the country.

And if we sent to a single payer system, those that cite taxes going bananas and no room left in the budget and where would the $$ come from, the answer is the premiums your employers pay and the premiums you pay for ins. would essentially convert into the "taxes" for health care. Imagine if every penny that is paid into health premiums was used to really fund universal health care...

That said, as long as pharma. and health ins. co's. have such big clout with Congress, we're stuck with what we have, a broken system destined to fail. Why else do drug companies scream when forced into competitive situations for their drugs, or why drug companies charge U.S. residents multiple times the cost of the same drug sold in Canada, for instance.

And despite all the health ins. companies crying about their product not being very profitable, I call BS on that. If what they're doing doesn't give them much profit, why are they fighting so hard to keep the system the way it is? Here's a hint....most insurance companies don't profit much off their product in a direct way but instead ins. co's. are one of the largest, if not the largest, institutional investors in the stock market, and the profits from that aspect, rarely talked about, is where a huge amount of their profits are derived. Make no mistake, health care is profitable if done right, and the health industry in the U.S. does it quite right for profits.

It seems as if we, as a country, are willing to tolerate what is sub-standard health care while spending more as a country than any other on earth with the absolute worst health outcomes from all that spending (for instance---rates of infant mortality currently places the U.S. right behind Cuba, at around 34th in the world; the U.S. life span is also behind many 2nd world countries and down around, again, Cuba), sure, keep what we have. But it's going to reach a breaking point.

Add in the vast numbers of bankruptcies from health care costs, even when having great ins. coverage (some estimate almost 2/3 of bankruptcies are attributable to the end cost of a serious accident or illness) and you have an unsustainable system in place.


But we place very little value in the U.S. as a whole on having a healthy population, a healthy population which would be much more productive (see Germany, et al) and not in fear of gaving to go see an MD.

C'est la vie. Such is the U.S. Everything is for profit, common sense be damned.

I believe in for-profit. I had a workmans comp injury recently, they did nothing to care for my injury except push it out to where surgery is not a viable option now.

Since this is no-fault (which obamacare most certainly will be), you can't sue for damages.
 

mugs

Lifer
Apr 29, 2003
48,924
45
91
Nothing in the Affordable Care Act would have caused your premiums to triple. What could very easily have caused your premiums to triple is your employer reducing the amount they subsidize. Employers have been doing that a lot since 2008. You're fortunate that yours waited so long. Isn't it great that your healthcare is a gift from your employer that can be taken away whenever they want? It's an awesome system we have here.

tl;dr your premiums didn't triple, your employee contribution did.
 
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