ACA Running Thread

[CHDeac]

I operate a business with soon to be 12 employees. Perhaps the Bar Association has something.

I beleive they have a MEWA. If group is healthy, you could get good rate.

 

[jhmd2000]

I beleive they have a MEWA. If group is healthy, you could get good rate.

Thank you very much.

 

[CHDeac]

Thank you very much.

You’ve seen news reports of individuals and small businesses getting health plan cancellation notices, along with much higher prices for replacement plans. The NC Bar Association Health Benefit Trust is a self-funded plan that is exempt from many of the provisions of health reform that are forcing plan changes and price increases. We already serve over 7,500 lawyers, their staff and families. If your next health renewal is an unpleasant surprise, contact us to compare. Call or email Delores Hunter at Lawyers Insurance for a quote – 800-662-8843, dhunter@lawyersmutualnc.com. Phone: 1-800-662-8843

 

[ChrisL68]

I operate a business with soon to be 12 employees. Perhaps the Bar Association has something.

We have a small business plan that covers 2 employees and their families. Our rates are about the same for both families as the plan for me and my family on the ACA individual plan was last year, and that was before our 2% rate increase this year. Deductibles $2k instead of $7k too.

I would definitely look into small group.

 

[PhDeac]

Which docs are going away? What medical services aren't we covering?

LOL. Stop being obtuse. I'm talking about private insurers.

 

[CHDeac]

LOL. Stop being obtuse. I'm talking about private insurers.

Not being obtuse at all. Im arguing that Medicare for all is an overly simplistic position based on how docs are subsidized today by private insurance. How do we remedy that? Eliminating insurers creates a huge issue. Ask a CEO if they can stay in business at medicare & medicaid rates. Any savings from a single payor will be more than offset by the the fee cuts. What are your thoughts on how to address this?

Lets actually take the next step and look at how Part C might be a better model than traditional Medicare. Part C is very popular with consumers. The model is set up to incent private carriers to deliver Medicare at a lower cost than Medicare when paying docs Medicare rates. When they do, the feds take a piece of the savings while the insurers keep some. There are issues with this program but the concept is pretty sound. Why is that? Could it be private insurers are better at managing care than the feds?

There can certainly be a case for single payer but saying "Medicare for all" isn't one of them. Very flawed and overly simplisitic sound byte. We can debate the role of private insurance but there is a proven track record of managing govt programs better than the govt (e.g. medicare, medicaid, champus, etc). Some insurers can be bad actor for sure but not sure a govt run medicare program leveraging a flawed FFS model is a better solution. But it sure does sound good to many.

 

[PhDeac]

So your argument is that we can't cut out a ton of middle men and deliver health care more efficient.

OK. So why not Part C for All?

 

[dartsndeacs]

I am not sure that is even possible, TBH. My monthly premium for a high deductible plan for a family of five is over $1,200.00 per month. Assuming we use the full deductible, we're at $20,400.00 for the year out of pocket. That's insane, considering nobody is actually even sick.

I operate a business with soon to be 12 employees. Perhaps the Bar Association has something.

I don't know your age but that doesn't sound totally out of line. If you operate the business, it seems you'd be best off going the HRA (partially self-funded) route, so that most all of your family's medical expenses are pre-tax, i.e. deductions of the business. There's some risk there for the other employees if they all come down with swine flu, but I mean for our small business, the numbers are mind blowing, and we can handle the bad luck if it happens. (Usually only companies with 5k+ employees self fund, as they have enough employees to balance out the risk. But on the flip side, if all large companies do it, you know its the best way to go and basically smaller companies are paying extra per employee to hedge against catastrophic risk.)

Basically you can take out 100% of the profit the insurance companies get, and if your employees and yourself are healthier than the average population you really benefit.

 

[CHDeac]

So your argument is that we can't cut out a ton of middle men and deliver health care more efficient.

OK. So why not Part C for All?

My argument has always been that these simplisitic positions ignore the realities of the heath care system and how it works. Why do self insured companies hire the middle man if there is no value being created?

Part C for all wont work because it pays doc Medicare rates. A similar model might work if we changed this but again, why are we building our single payer of a product structure designed for seniors and the disabled?

 

[AMCDeac]

You’ve seen news reports of individuals and small businesses getting health plan cancellation notices, along with much higher prices for replacement plans. The NC Bar Association Health Benefit Trust is a self-funded plan that is exempt from many of the provisions of health reform that are forcing plan changes and price increases. We already serve over 7,500 lawyers, their staff and families. If your next health renewal is an unpleasant surprise, contact us to compare. Call or email Delores Hunter at Lawyers Insurance for a quote – 800-662-8843, dhunter@lawyersmutualnc.com. Phone: 1-800-662-8843

My firm has used the Bar plan for many years. I would recommend looking into it.

 

[PhDeac]

My argument has always been that these simplisitic positions ignore the realities of the heath care system and how it works. Why do self insured companies hire the middle man if there is no value being created?

Part C for all wont work because it pays doc Medicare rates. A similar model might work if we changed this but again, why are we building our single payer of a product structure designed for seniors and the disabled?

The goal is to change the realities of the health care system and how it works. All of your objections have to do with maintaining and sustaining a for-profit health care model to keep the associated costs.

 

[CHDeac]

The goal is to change the realities of the health care system and how it works. All of your objections have to do with maintaining and sustaining a for-profit health care model to keep the associated costs.

Hardly. I'm not objecting at all, I'm merely pointing out the reality of how the system works today how proposed changes impact that reality. Too often people ignore this reality and the results then are predictable. I'm all for figuring this out but object to silly slogans or simplistic analysis. You asked why Medicare for all wont work and I shared my perspective. I haven't heard a thoughtful response yet on that one yet. I've suggested that public / private partnerships may work really well (see Medicare Advantage) but these programs are highly complicated and need to be designed for the broader market.

The reality is we need to change how much care we consume and how much it costs. Simply saying eliminating insurance form the picture doesn't really address this . The reason is people don't want to acknowledge this is that it will mean less health care for patients and/or people getting paid less for it. We are all for paying less for drugs bu are we prepared to pay less to doctors? Less to hospitals? Get less care? Something has to give here.

 

[PhDeac]

Yes. Less bureaucracy. You're setting up "OMG how will docs make a living?" as a straw man.

 

[Gooner]

Back to my earlier point, lots of companies can take a loss on Medicare bc they make a ton on private insurance. If it was all Medicare they wouldn't make any money. Realistically they would have to increase premiums to make more money so that the variety of healthcare businesses that directly or indirectly rely on reimbursement levels could get a larger cut than Medicare as it currently stands would pay out

Just like tax reform, healthcare cannot be fixed until America's corporate structure no longer values maximum profits at the expense of all else. Capitalism does not allow for the 99% to benefit, which is what tax reform and healthcare reform is purported to do (by both parties).

 

[knowell]

Just like tax reform, healthcare cannot be fixed until America's corporate structure no longer values maximum profits at the expense of all else. Capitalism does not allow for the 99% to benefit, which is what tax reform and healthcare reform is purported to do (by both parties).

Venezuela, or do you have a different model in mind?

 

[Gooner]

Venezuela, or do you have a different model in mind?

I was thinking Sweden. Hell, imitating our northern friends would even be a good start.

 

[CHDeac]

Yes. Less bureaucracy. You're setting up "OMG how will docs make a living?" as a straw man.

There is a large system in NC (mission health) that claiming its about to go out of business because they need BCBS to pay them more to cover the $ they lose on Medicare and Medicaid. The real world is harsh sometimes.

 

[dartsndeacs]

Just like tax reform, healthcare cannot be fixed until America's corporate structure no longer values maximum profits at the expense of all else. Capitalism does not allow for the 99% to benefit, which is what tax reform and healthcare reform is purported to do (by both parties).

Americas corporate structure doesn't value maximum profits above all else.

 

[PhDeac]

There is a large system in NC (mission health) that claiming its about to go out of business because they need BCBS to pay them more to cover the $ they lose on Medicare and Medicaid. The real world is harsh sometimes.

Yeah. An efficient system would put a lot of people out of business. Again, your main concern is making sure people make a lot of money. That's the problem with our health care system as is.

 

[myDeaconmyhand]

Yeah. An efficient system would put a lot of people out of business. Again, your main concern is making sure people make a lot of money. That's the problem with our health care system as is.

To be fair to CH, I dont think he is defending the relative morality of the profit driven health care industry, he is just stating that nationalizing such a huge private industry will have enormous economic implications re: lost jobs and investments.