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I'd Like to Clarify....

....Something here.

Earlier in this thread, I advocated for employer participation in health care. I think that some are taking that to mean that I want employers to offer "free" insurance to all employees, on a mandatory basis. Nothing could be further from the truth, at least the free part. I do believe that healthcare coverage should be mandatory.

What I envision is a system that takes into account both employers and employees. Employers most definitely have an effect on the health of their employees; occupational hazards and stressors (both physical and emotional) are one of the major sources of health problems.

But other major sources of health problems are lifestyle and genetics, for which employers bear no responsibility. That means people should be picking up part of their own healthcare costs. But how much?

Well, it's my seat-of-the-pants reasoning that since most people spend roughly one-third of their lives in the workplace, subjected to those occupational hazards and stressors over which they have little control (not if they want to keep their jobs, anyway), then employers could reasonably be expected to pick up one-third of the tab, with the other two-thirds being expected of the employee. The employee pays for the proportion of his life where he (or his genetic makeup) calls the shots, and the employer pays for the part where he calls the shots. Simple, at least in theory.

This system would have quite a few advantages for employers. First, a workforce with access to healthcare is a workforce more able and ready to work, with fewer missed days. There would be advantages when unforeseen hazards injured workers; since workers would be covered for their injuries, there would be less justification for lawsuits. And the taxation needed to support public hospitals, with their huge burdens of uncollectible patient debt, should diminish over time.

The system would also have advantages for employees. First, mandatory healthcare coverage legislation would create a huge pool of prospective insureds, creating competition that should lower costs. People should be healthier overall, having earlier access to intervention, and education about the effects of lifestyle on health. That should increase their productivity, and therefore, hopefully, their earnings. They would hopefully pay less in taxes, exactly as employers would, because they too are currently paying for the public health system, which is so wasteful, expensive, and renders such horrendous quality of care.

If some employers have to drive a Lexus 400 instead of a 600 as a result of the cost of their healthcare contributions, that's quite all right with me. And if some employees have to drive a seven-year-old Taurus instead of signing up to buy a shiny new Dodge Ram pickup on time payments, so that they can afford their share of coverage, that's also very acceptable to me. The plain damn truth is that healthcare costs, and if we are to get that cost under control, everyone has to bear a share of the burden. The costs will have to come out of everybody's "fun stuff" budget, most likely. That's never pleasant, but sometimes it's necessary.

We cannot have a mandatory healthcare insurance system without business picking up the tab in some form or another. If we don't ask businesses to contribute directly, then marketplace factors will force them to pay wages and salaries that take the cost of healthcare insurance into account, at least in times of a strong economy.

So, in my humble opinion, we can pick which bullet to bite, but we're going to have to bite one, and soon.

As Linda Richman used to say, "Discuss!"
 
It would be nice to think...

...that business would be forced to pay wages and salaries that take the cost of health insurance into account, but I doubt this would happen.

Look at what happened to defined benefit pensions. Do you think your salary has gone up to cover the cost of providing for your own retirement? Ha! It's easy to say 'average wages in USA are $17 per hour' or whatever they are - but that isn't enough to cover living expenses AND save 15% of it for retirement. (And how much money is 'enough' for retirement anyway?)

Color me cynical, but I just don't believe that any shifting of healthcare burden to individuals and/or the state will result in any wage rises at all. Oh, it'll add more to CEO pay and perqs, but...

Nate
 
I like what Dennis Kucinich proposed - Enhanced Medicare For All. During one of the debates when Hillary and Obama were bickering over "subsideis", Dennis pointed out that with this plan, there would be no bickering like this at all.
 
I was laid off work twice since 2001. Each time I thanked God for COBRA. Although the premiums ran between 325 and 380 per month (rising over time), it gave me coverage that would have been very difficult to get on a individual basis. That is the power of employer related group coverage - they can negotiate a better deal and they spread the cost out over the various age groups and health levels of the employees.

I had one job for a very small company (four people) with basically no medical plan. Well, they had a Blue Cross plan but when I looked at the lousy coverage and all the gotchas, including having to fill out a complete health history, I opted to stay on my COBRA plan. This worked out in my favor as I got into a bad bike accident (hit and run), and the COBRA plan paid for everything except a $100 emergency room fee. We're talking about a $30,000 bill for trauma center and one night in the hospital. Of course the cost was inflated and the insurance company got it reduced, somewhat, to around $23,000, but it would still have been a major hit in my life savings if I'd had no coverage and had to pay for my care out of pocket. If I had been on some individual plan it's quite possible my accident would have only been partially covered, if at all.

What I think is needed, minimally, in this country is a group coverage plan for all citizens. Co-pays and monthly premiums could be indexed to income level. Coverage wouldn't drop when someone is out of a job, but their premiums would get lower until they get back to work. It really is the only sensible way to address the problem of the uninsured and the underinsured. But of course the insurance companies, who make big bucks by ripping off the self-insured, will fight any reform tooth and nail.
 
It's a mess.

Just recently I quit my health insurance. I converted from a COBRA plan. When I started it in the 90's is was about $100/mo no meds. As of January it was $550 still with no meds. For one single person. That is insane.

I've tried to change insurances but I have "pre -exiting" conditions and was refused coverage. I might try again in a few months when I can honestly answer have you seen or been treated for x in the last 12 months. Odds are my health will be worse without treatment but I don't have any options.

What really burned me was I got billed for a few things that happened after my insurance was gone and I was being charged 50-75% MORE than what the insurance company was paying - they had a contracted price and I didn't. What a lot of crap.

I can honestly say I'm sick of how things are going in this country. The ONLY attitude is "Screw everybody, I'm getting mine" and everyone else can go to hell. Over Memorial Day weekend a number of my relatives where talking how they wished there was a national strike or a march on Washington, but no one does anything. I've come to the conclusion we are seeing the results of the 80's and 90's Harvard MBA grads who have managed to take over every company in this country and run it based on the "Greed is Good" mantra from the movie Wall Street.
 
The insurance

laws vary from State to State here to the point it creates complete confusion. The same company can operate under different standards in different States.

I have sarcodial lung disease. As a State employee I have a Blue Cross HMO plan. Recently they notified me they were no longer going to cover some of the medications I need on a daily basis. The medications are not generic and cost more than I make on a monthly basis.

I called the insurance commissioner's office and was told the insurance company had the "right" to make that decision! The "right"?? I paid my premiums and now they decide they are not going to cover me because I have a castitrofic lung disease. Of course they will cover me for other things, like a common cold. But when it comes to the health care I need I am on my own.

I asked the insurance commissioner's office for the information regarding the insurance companies standards and responsibilities for doing business in this State. I was told that information was not available to the public. The insurance company had closed that information to the public.

I have made a plea to the manufacturer of the medications to buy them at an affordable cost.

I pay $180.00 a month for medical insurance that is of little use. Should I leave my job I would not be able to get medical insurance at all. I looked into buying coverage on my own and was turned down by several companies. Finally an insurance agent told me that my lung disease would preclude me from any coverage for medical care for anything related to my lungs. They would cover me for other things but the cost would be incredibly high.

A good blood letting of politicians should be the order of the day in this country. Aas well as corporate leaders. Every politician and corporate executive should be rounded up and executed for Crimes Against Humanity.
 
Insurance laws are confusing and standardizing them on a national level would certainly help provide some peace of mind that these injustices would not happen to those who really need the coverage. Insurance premiums are entirely dictated by profit. Most underwriters will tell you the formula, it's no great secret. In Nebraska, they can figure premiums at 100% profit and expenses (or claims from policyholders) are seen as losses. When the "losses" go up, premiums go up to maintain that profit level. If there were a system of national coverage that could negotiate service rates, drug costs, etc. with providers and the profit margin were fixed (but guaranteed by volume of policyholders) I don't see how this wouldn't benefit everyone. Leave it to our government though, there would be a small handful of people who get wildly rich and millions left with no coverage. Well, just look at Iraq, New Orleans, take your pick. The real truth is, just as George Carlin says: "They don't give a shit about you. They don't give a shit about you. They don't give a shit about you."

Incumbent politicians must be ousted from their offices at the local, state and federal level this November. Get involved with your local campaigns and understand the positions of those running for office and really listen to them. Make those votes count - nearly all of the seats in the House of Representatives are up for grabs or incumbents are fighting for their seats. Make those votes count.
 
Conate:

"It would be nice to think...

...that business would be forced to pay wages and salaries that take the cost of health insurance into account, but I doubt this would happen."


Actually, there is a parallel situation that is so commonplace that we don't even think about it. It's the automobile. Most Americans have to have one if they're to get to work, period.

Wages reflect that reality. If an employer didn't offer enough money for employees to have their transportation to work, then he would have a hard time attracting workers. Employers also pay quite a bit in taxes that help maintain and build the roads workers use. The situation is so widespread that every employer pretty much has to do it; no one employer has the ability to opt out and gain a competitive advantage through not paying wages sufficient to support an automobile.

So, a mandatory plan that had employer contributions built in would quickly become "just the way it is", I think. There are many things in today's workplaces that would have been seen as unacceptable expense back in the day. I'm 55 years old, and I can well remember when employers didn't think they needed to spend the money for air-conditioning- workers weren't worth all that, was the thinking.

Times just change, that's all.
 

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