Want a job? Show me your Health Insuarance Card!

[kelpdiver 2]

Quote

Quote

I
If you're covered under an individual policy and develop a chronic condition that will cost the company too much money, they can drop you like a hot potato.

Not in California, hehe :)

you're not much better off in California. Still very easy to become uninsurable.

[rehmwa 2]

Quote

They are growing by leaps and bounds. Because they don't accpt Medicare or insurance, they are able to offer services at a lower rate because the overhead is substantially lower without the back office staffing requirements.

That'll end as soon as Congress passes a law requiring them to accept Medicare and insurance.

You know it'll happen.

...
Driving is a one dimensional activity - a monkey can do it - being proud of your driving abilities is like being proud of being able to put on pants

[pirana 0]

Quote

It's only been in the last few years that people could not be dropped from group health insurance plans due to their risk factors, and if a person is covered under a group policy and changes jobs, the new company's policy cannot deny them coverage. The same is not true of individual policies. If you're covered under an individual policy and develop a chronic condition that will cost the company too much money, they can drop you like a hot potato.

In my mind, Hillary's thinking here moves us back a bit in terms of universal health care.... but maybe I was too lazy to read it all

linz

Health care is still largely regulated at the state level, and in most states, your assertions are just plain wrong. I work in the biz in MN, which is very typical in its regulation of the biz, maybe slightly more liberal than some in a few areas.

You can not be dropped from any plan, employer sponsored or otherwise, for claims history. The exception is if you have a contract with a dollar maximum (they are typically 1 to 5 million, most are now 2 million or have had the cap removed entirely).

On the changing employers issue, the larger the employer the less chance they will even take a health history questionaire prior to coverage. Most over 500 do not use them at all. Even for Small Group (typically defined as 2 to 49 eligible employees) the transition is away from underwriting individuals. Most states have guaranteed issue products, with incentives for employers to use them instead of health underwritten products. The mid-size pools (50 to 500) are where there is the least consistency and greatest confusion as far as what is happening now and what to do about it.

"The same is not true of individual policies." This is confusing. If you have an individual policy, changes of employer or employment status are irrelevant.

And the last statement is absolutely, positively, unequivocally false. (I was really aching for a chance to use my tryperbolic of the day). At least in most states, you can not be dropped for claims experience (other than the previously mentioned issue of exceeding the lifetime maximum of the contract).

Some of this stuff is true for auto insurance. Health care insurance is regulated from an entirely different mindset. And again, there are still a small number of states that have a few archaic and/or draconian rules hanging on - but they are by far the exception.

FYI - the larger the group, the more say the employer has in every last detail of the plan. Most over 500 are now self-insured. That means the insurance company is not the decision maker, but only administering the plan the employer has designed. Right down to an appeal for a specific denied claim - your employer is actually making the call. Most employers do not want their employees to know this and they hide behind the insurance company. They must figure the admin fees are worth having someone else take the heat, but I find it amusing when they start a legal action against the insurance compnay, only to find out via initial discovery processes that their own HR department made the call.

It is a much more complicated business than it appears on the surface, mostly because of decades of legislative favor-trading and well-intentioned but uninformed regulators. There are some good common-sense ideas, both conceptual and specific, that would go a long way to fixing things (as in improving access and affordability). You can count on our current legislative process to miss the boat entirely on finding them.

But Hillary will change all that, right?

" . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

[pirana 0]

Quote

Insurance companies have already realized that with good preventative care, healthcare overall is cheaper. Is it better to pay for a measles vaccine, or a hospital stay? Cholesterol lowering medications or arterial bypass surgery? How many people could receive a measles vaccine for the cost of tha hospital stay? How many years of pills would equal the cost of that surgery? Its often cheaper to pay for hundreds of people to receive preventative care than for one to end up in the hospital or OR.

Right on the money, BINGO, all all of that.

Any employer worth their salt in understanding health care costs, and certainly the insurance companies, have had this nailed for quite a while. It is why any decent plan now pays 100% for most preventive care, check-ups, vaccinations, certain routine screenings and the like (not subject to any out-of-pocket). Also the trend is toward free or very reduced co-pays for generic drugs (also not subject to OOP).

Another tidbit: Managing chronic conditions has moved much nearer to the forefront. Even properly managed, a chronic but lesser condition like asthma can cost more than an organ transplant, over the life of the patient. Unmanaged, the more serious chronic conditions almost always cost more than many of the things we typically think of as the most expensive. Required enrollment in programs to manage chronic conditions as an incentive towards reducing premiums is growing and will eventually become an industry of it's own. Never mind that people should do it just as a matter of good health - but price pressures are going to force the issue.

" . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

[pirana 0]

Quote

Pre-1965 the expensive options were far fewer and farther between than they are now.

Heart bypass, transplant surgery, operations to fix fractures, a lot of vascular surgery -- it just didn't exist.

We aren't going back there. Even if it would be better for the gene pool. Of course, Medicare, which was what started in 1965, doesn't do much about the gene pool; it's about helping older people find affordable insurance.

The medical world isn't the same as it was in 1965.

Wendy W.

Those things are actuallly not big issues. They contribute very little to the rising cost of care. The big hitters these days are more like:

<> Expensive drugs
<> Extraordinary measures, especially at the end of life
<> Utilization (frequency of care)
<> Unmanaged chronic conditions

" . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

[pirana 0]

Quote

Quote

Not to change the subject but health care costs are not ruining Ford and GM. That would be mainly due to the unions

MANAGEMENT is responsible for running companies. Blaming unions is a cop-out excuse for poor management.

The issues are interwoven. The auto unions have for decades squeezed an incredibly expensive and totally unreasonable benefit set out of the automakers. They got away with it only because it is so extremely expensive to move a centrally located heavy industry.

But of course as the automakers were eventually able to respond, and manage their business based on the market pressures, then the very same unions bitched about the companies moving and the loss of jobs. The unions have been slowly working for decades towards pricing their membership right out of jobs and did not have the vision to see it coming.

" . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

[lawrocket 3]

Quote

The problem with health as opposed to gas is that if you don't see a doctor, your health problem can get much worse. You can go from a case of strep throat to a cardiac infection, or from a cut finger to necrotizing fascitis (how the heck do you spell that?). If you skip the doc visit because you can't afford it, then the taxpayers (and everybody else who visits the hospital) end up picking up your medical bills if you end up in the hospital

It's more like a winidshield wiper. If you dont' get new windshield wipers your vehicle problem can get much worse. You can go from a case of bad windshield wiper to collision that causes potential deaths and destruction. If you skip the windshield wiper because you can't afford it, the public (and everybody else who goes upon roads and sidewalks both public and private) may end up facing the consequences, as well as you.

It's an interesting thought, isn't it? Which is more of a public danger? A cut finger or a busted windshield wiper?

My wife is hotter than your wife.

[Nightingale 0]

The wiper is more of a danger than a cut finger... but, what's more dangerous to the public: a broken wiper or a case of measles in an unvaccinated population?

[georgerussia 0]

Quote

That'll end as soon as Congress passes a law requiring them to accept Medicare and insurance.

But if you have PPO insurance, wouldn't you be able to get the service there, pay in cash, and then file a claim yourself? After all, it is just a non-participating provider, and my insurance would pay 50% of the costs.

* Don't pray for me if you wanna help - just send me a check. *

[georgerussia 0]

Quote

you're not much better off in California. Still very easy to become uninsurable.

Well, it is a little better anyway. But the risk to be denied access to free/cheap healthcare system if you get really expensive disease is the same everywhere. For example in the countries with government healthcare they just tell you: "well, you know, we do not have enough money, but we put you in the list, your number is 988, please call us in 6 months".

* Don't pray for me if you wanna help - just send me a check. *

[Rookie120 0]

Quote

"well, you know, we do not have enough money, but we put you in the list, your number is 988, please call us in 6 months".

Is that what happens in Canada now?

If you find yourself in a fair fight, your tactics suck!

[georgerussia 0]

Quote

Is that what happens in Canada now?

Maybe.
It also happens in some rich parts of Russia now. The rest of Russia, which is poor, do not even have lists - they'd tell you plain and simple that there are no money in the system to treat this disease, and it has been like that for last ten years, so there is nothing we can help you with, so go away.

* Don't pray for me if you wanna help - just send me a check. *