OT. How much does it cost the average American (family) for health care insurance.

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Is that total premium or just what you pay? The OP was discussing total premium, you and employer parts.
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wrote:

What some do not know is that the very large companies do not really pay any insurance. They pay the insurance companies to handle the billing, but they are the ones actually paying the claims. That means you are really giving the company some money back. It would be just as easy for the company to pay for all the medical insurance and cut the wages. It just does not make the dumb employee feel like the company is treating him badly.
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wrote:

a lot of smaller companies self-insure too. it's much more cost efficient to do so. of course, those companies that they pay management fees to have a strong incentive to hold down costs by limiting certain things (new fangled drugs not on a approved list, new types of operations, etc).
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In other words decisions are made financially not medically. While that happens to some extent in all health care systems, medical ones provide better decisions than ones based on 'keeping down the cost', or improving an insuring companies bottom line!
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charlie wrote:

My logic doesn't follow you claim about insurance companies having a strong incentive to hold down costs ... when I worked for self-insured employers, the employer paid estimated medical claims costs plus a percentage. The insurance company benefited only from claims paid; NO incentive to hold down costs. Claims were reviewed closely for accuracy according to contract, and employer went to bat for anyone who had an issue with a claim payment or denial. Both quality companies, IMO.
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Kurt Ullman wrote:

Employer pays equivalent of $7k, plus my $1.8k annual. Employer has 120,000 employees in USA. Employer is "self insured", meaning they pay to have multiple insurance companies manage claims, but claim payments come out of the employer pocket, not the insurance company pocket.
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That depends a little on how the plan is set-up. Many companies may re-insure or essentially lay off part of the risk to another company. Think of it as the company's version of a deductible.
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Steve Stone wrote:

But, the point is that truly large expenditures are covered in significant fraction -- that's where one needs insurance; w/ a decent-paying job and some self-discipline there's no reason not to have the "slush-fund" to handle routine medical costs. Essentially, as noted elsewhere in the subthread, self-insure to a point and underwrite above that.
IMO that switch to the mentality of insurance covering all the minor dings and nicks of ordinary care that has had a major influence in driving up demand/costs since it developed the mindset that "it's paid for, why not?" for every little sniffle or hangnail.
If, otoh, one knows one is responsible up to a reasonable deductible then one will tend to be more judicious in deciding whether it's really necessary to take Johnny/Sally/self every other day.
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Yepper. We essentially have gotten away from health insurance (with insurance defined as taking a large but rare risk and spreading over a number of people) when we got away from the old Major Medical and got into paying for Dr. visits and first dollar RX.
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Kurt Ullman wrote:

And that seems (to have started as a "benefits arms race" when employment rates were high and employers needed advantages to attract/retain better-qualified workers for the professional/skilled exacerbated by the labor unions when employers were flush-enough it was easier to capitulate than fight. Now, chickens have come or are coming home to roost... :(
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Personally, I peg the start of the arms race as the advent of Mcare which served to put a floor under the benefits. But other than that, I would say you were spot on.
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Kurt Ullman wrote:

Hmmm....have to think about that some...certainly M'care inflated costs initially but that it was always for the geriatric crowd I'm not so sure had such an impact on conventional benefits. As noted, I'll have to cogitate some on that as to what role it also played.
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\\ My theory is that the conventional benefits people (specifically the unions, but also others) said something like "If I can't have at LEAST the same benefits as Mcare, then I am striking". That put a floor and each successive round of talks made incremental increases. We are still looking for the ceiling.
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Kurt Ullman wrote:

There should be an option for those who don't want medical care to take a waiver and have their bodies dumped in the landfill when they encounter a serious accident or illness (renal failure, serious burns, ALS, MS, auto accidents, etc.). Them that wants "full coverage" should expect to pay for a plan of full coverage for all.
I'd like to take a survey of everyone who is not self employed, working in a job that has Workers Compensation. How many people do they know who have cheated the system? How many of them have turned in a cheat? They are no different than pickpockets and shoplifters.
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dpb wrote:

ISTR employer-paid health plans gained most of their modern traction as an end-run around WWII wage controls? Since everybody paid the same, and the supply of skilled available workers was choked off by the draft, the only way a company could get more people was by ramping up the bennies?
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Yep. It was away for the government to quiet down some people without violating the wage controls in place. Government expediency coming back to bite us on the ass later on. Who coulda seen that coming. (g). > aem sends...
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Steve Stone wrote:

Mine is $850 w/o kids but age 64/62. Probably lower cost is somewhat related also to location...

Additional thought along lines alluded to in other response--ime, when former employer (also self-insured) looked at changing the administrators/plans in local area, the PPO's that presented all were focussed almost entirely on the individual doctor's office visit for essentially well care. The ability of their plans to deal w/ real illness was abysmal at best--they essentially didn't seem to recognize the problem it appeared in their model.
This was some time ago when they were springing up like mushrooms all over w/ the same false premise we're hearing now that "preventive" medicine will reduce costs significantly. I don't believe there's a single one of those that survived. (BTW, I never personally elected to change own coverage from the base "traditional" insurance provider to a PPO for the above reasons even though premiums were generally higher).
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Are you part of a group? If so, the age of the group affects the cost too. The more younger people, the lower the overall rates.
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Ed Pawlowski wrote:

No...
There's one of the areas that should be addressed imo -- there's no reason self-employed or other individuals shouldn't be allowed to pool w/ others in larger class pools instead of being forced to fight the single-insured battle. Risks/rates should be predicated on overall population bases instead of the current "cherry-picking" of taking the well population and throwing the remainder onto the public dole.
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dpb wrote:

The corollary to the above is, of course, that the previously mentioned young, well population that chooses the irresponsible action of not having any or adequate insurance should have sufficient penalties extracted in some form to persuade them of the wisdom in changing their behaviors. Not sure precisely what that would be, but the tax code or some other method needs to address the issue of having a large fraction opt out simply because it isn't presently on their list of "wish-fors" instead of the new bike/car/trip/whatever...
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