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Kandahar's Universal Health Care Plan

What do you think of this Universal Health Care plan?


  • Total voters
    17
The cost of insurance has risen for everyone. The prices may be ridiculous for everyone.

But they are much more ridiculous, significantly so, for small business. Nothing you say will get me believing any different as I personally have the responsibility with dealing with this stuff.

Insurance premiums for small businesses are 18 percent greater than those paid by large companies.

Why Costs Are Higher for Small Businesses. Costs are higher for small-group insurance because states require small-group health policies to cover certain conditions, treatments and providers. Large employers often self-insure. Their plans are governed by federal law rather than state regulations, and federal government mandates fewer benefits. Small group premiums vary widely by state, and the highest premiums are in the most heavily regulated states [see the figure].

Small Business Health Insurance - Brief Analysis #642

Small businesses often pay more for employee health benefits because they don't have the buying power of big employers. As both workers and small employers feel the financial squeeze, fewer are able to afford to offer, or purchase, health insurance coverage.

States and Small Business Health Insurance, 2009

"For our very small businesses, it's probably the most challenging circumstance under which people buy insurance," says Kim Holland, an executive committee member of the National Association of Insurance Commissioners and state insurance commissioner for Oklahoma.

In fact, most of the nation's uninsured are small-business employees or their families, Holland says.

While 99 percent of large companies offer health benefits, the number falls to 49 percent for companies with three to nine employees, according to a 2008 survey by the Kaiser Family Foundation and the Health Research & Educational Trust.

That's no surprise when you look at the numbers. According to the National Federation of Independent Business, health premiums for small business plans have doubled in the last eight years. And for smaller companies, those dollars comprise a larger share of their revenues. On top of that, small businesses pay an average of 20 percent more for their health insurance, says Amanda Austin, senior manager of legislative affairs with the NFIB.

Finding small business health insurance

I could find tons more articles. Not anywhere was I able to find any article stating that costs for small business and large ones are the same. Not one. Nor, could I find anything saying the disparity was insignificant. There may be some variation in how severe the problem is state to state as some states are working hard to find solutions however it is a nation wide problem from cost to cost for small businesses.
 
The cost of insurance has risen for everyone. The prices may be ridiculous for everyone.

But they are much more ridiculous, significantly so, for small business. Nothing you say will get me believing any different as I personally have the responsibility with dealing with this stuff.





Small Business Health*Insurance - Brief Analysis #642



States and Small Business Health Insurance, 2009



Finding small business health insurance

I could find tons more articles. Not anywhere was I able to find any article stating that costs for small business and large ones are the same. Not one. Nor, could I find anything saying the disparity was insignificant. There may be some variation in how severe the problem is state to state as some states are working hard to find solutions however it is a nation wide problem from cost to cost for small businesses.

Of course they aren't the same. Thats not what I said.

If we are looking at reforming healthcare, trying to abandon group health insurance for a single payor system isn't going to benefit anybody, or bring costs down. This is about market prices for health care becoming a burden. You know who has even less purchasing power than small businesses? Individual families. And they don't get to split the cost with somebody else. So if we went to a single payor system like you advise, then alot more people would be unable to afford health insurance. Your own link provides part of the problem as well, when it mentioned the state regulations for group insurance vs. large corps that self insure( and self insure isn't technically insurance anyway, there is no transfer of risk ). We have to look at the rules and laws of how the health insurance market is regulated, vs. blaming group insurance policies for making it harder on small businesses. Its not the insurers fault, they are required by law to provide more services(meaning a rise in premium). Its the state fault. And this is also a prime reason this needs to be a state issue, more than a federal one. If we have overregulation in one state, it sucks for those people, but others remain untouched. If the federal government overregulates, it costs everbody extra.
 
I think we'd be far better off if the tie between employee/employer paid health care was broken for good. Then individuals, families, EVERYONE, would be able to buy their own insurance at a fair market value. The way things are now some folks are basically hostages to their employer for fear of changing anything that might cost them their insurance. There's really no good reason to have your medical coverage tied to your place of work. Especially in a scenario such as the one Kandahar has put forth where the government is offering a plan. Unfortunately his Green Plan sucks Donkey dick as a "basic" plan for the poor. :mrgreen: High deductible plans are only of use when you have money, are capable of saving money, and are disciplined about putting funds in your HSA. Such a plan would never be workable for poor people.
 
I think we'd be far better off if the tie between employee/employer paid health care was broken for good. Then individuals, families, EVERYONE, would be able to buy their own insurance at a fair market value. The way things are now some folks are basically hostages to their employer for fear of changing anything that might cost them their insurance. There's really no good reason to have your medical coverage tied to your place of work. Especially in a scenario such as the one Kandahar has put forth where the government is offering a plan. Unfortunately his Green Plan sucks Donkey dick as a "basic" plan for the poor. :mrgreen: High deductible plans are only of use when you have money, are capable of saving money, and are disciplined about putting funds in your HSA. Such a plan would never be workable for poor people.

I think you are underestimating just what the fair market cost of individual health care plans would be, if we abolished the group health plans. You think it would lower costs, I think it would at best, keep them where they are(for individual plans, which are too expensive anyway) but realistically would drive the prices up.

I am thinking of offering up a counter proposal to Kandahars at some point. I like some of his ideas, just not all of it.
 
I think you are underestimating just what the fair market cost of individual health care plans would be, if we abolished the group health plans. You think it would lower costs, I think it would at best, keep them where they are(for individual plans, which are too expensive anyway) but realistically would drive the prices up.

I am thinking of offering up a counter proposal to Kandahars at some point. I like some of his ideas, just not all of it.

Well the one thing you have to remember is these large corporate plans for massive groups of employees turn around and wheel and deal with drs. They come to agreements on what they will pay for a particular procedure code. Drs. are often suckered into accepting these agreements because so many people are employed by the large corporation in a given area that to turn down the agreement would cost them a large percentage of their patient base.

So a drs. fee for a service might be $150. An employee of a large corporation might have an insurance with whom the dr. has agreed to accept $60 for the service. The employee has a $5 copay. So the dr. bills $150. The ins. company agrees to their contractual agreement of $60. Then they send a check for $55 and the patient pays $5.

Some poor slob with a high ridiculous deductible and an insurance plan that didn't have the same "power" in reaching contractual agreements as the one above walks into the dr and gets charged $150. His plan maybe has worked out an agreement with the docs that they pay $110. He hasn't met his deductible yet so he pays $110.

Then the really poor slob who has no insurance but isn't poor walks in to the drs. office and that asshole pays the entire $150. Eventually when the dr. decides he isn't making enough he will up that procedure code to $200. Person A & B above pay the same as the dr. is stuck in a contractual agreement with their insurance providers. The no insurance guy now pays $200 to make up for the cost of the many guys who now only pay $60.

All that riot needs to be done away with.
 
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Well what if you don't work? Wages can not be garnished in such cases yet person still automatically gets the Green Plan. We're clearly not going to jail folks for not carrying medical insurance so what's to stop all non-working folks from just refusing to pay for any medical plan with the knowledge that they'll automatically be enrolled in one anyway???

If the person doesn't work at all and has zero income, their Health Voucher would cover the cost of the Green Plan anyway...and would go a long way toward covering the cost of the Blue Plan.

talloulou said:
Absolutely not. I foresee huge issues with this and stipulating that it is illegal for foreigners to travel here to use the Green Plan will do nothing to resolve the issues this would cause.

This is more an issue of practicality...As it stands now, many foreigners who spend a week in New York on business have to buy a temporary health insurance policy, because their own governments do not cover it. That's quite a big hassle just for a short business trip, and obviously that's a drag on our economy and our foreign trade. The EU countries basically stipulate that they'll cover the costs of treatment of any EU citizen who visits their country. If the United States were to implement universal health care for our own citizens and join some kind of similar pact with the other UHC nations, then we wouldn't have as much of a need for this provision.

talloulou said:
and according to above any foreigners....

Not ANY foreigners. Only US citizens and permanent residents are eligible for the whole range of plans. Foreigners who are temporarily working, visiting, or studying in the United States would only be eligible for the lowest plan.

talloulou said:
This is incredibly close to my current plan that's combined with an HSA account. You don't mention HSA accounts anywhere. You should, they're a fantastic idea. Since the Green plan is the "automatic enrollment" plan and the one that is most likely going to be used to cover poor folks, foreigners, non-working peoples, etc the plan is virtually akin to having no insurance. With a $2000 ind and $4000 family deductible the plan will almost never be used. My family currently has a $3000 yearly deductible. We've never met it. Unless someone in the family is chronically ill or there is a catastrophe the people under the Green plan are going to be expected to just flat out cover most of their medical expenses out of pocket on top of paying their monthly premiums. Unless the government is going to reset dr. fees to make them incredibly low this ins. plan is akin to a poor person having NO insurance but being required by law to pay a monthly premium with forced enrollment.

The idea of the Green Plan is to cover catastrophic events only. I disagree that only poor people will use it, as the vouchers I'm suggesting would more than cover the cost of the Green Plan. Most poor people would probably be better off with the Blue Plan.

The Green Plan is more geared toward people who just don't WANT much coverage, and are willing to take their chances for all but the most terrible problems. It might be ideal for healthy, single twenty-somethings who don't want to spend much on premiums they probably aren't going to use anyway, or it might be ideal for very wealthy people who are willing to self-insure for minor health problems. It would probably NOT be ideal for the average poor family with someone unemployed.

talloulou said:
I'm not sure if I'm comfortable with a national database with all my medical info on it. Personally, right now, I view it as a non-issue for myself because I have no diseases or issues that I'd like to keep private. But what if I did? There's no way such databases would remain private. Especially in the cases of celebs, public figures, etc. You can only punish the person who released such info if you can find them. Imagine trying to figure out who leaked that Angelina Jolie is HIV + when all doctors have access to such a system.

The privacy aspect of this is indeed a huge concern with this. However, I think there are some ways to limit it. Rather than just an open-source medical record that anyone with a medical license could see, the patient would need to sign privacy releases every time they transferred to a new doctor, in order for the information to be posted in the database.

For example, when I visit my doctor, I could authorize him to add all of my medical files to the database. Then when I visit a new doctor and authorize him to do the same, I would also be authorizing him to access all of my OLD medical files. This would limit the access of doctors who have nothing to do with the patient at all, so that curious doctors don't start snooping around the files of famous people.

Obviously it isn't a foolproof system, but unfortunately I think that as technology progresses, privacy will become more and more difficult to maintain. We can implement some safeguards like these, to ensure that it's as secure as possible.

talloulou said:
I think the employer/employee/health coverage link should be broken. I'm in favor of no employer being allowed to offer health care plans. I don't insure my car through work, nor my house, why should my health ins be tied to my
workplace? The practice of large insurance companies offering cheap plans to huge corporations with 1000's of employees while completely refusing to offer anything even slightly decent and affordable to small businesses needs to stop, the sooner the better.

I completely agree.
 
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Well the one thing you have to remember is these large corporate plans for massive groups of employees turn around and wheel and deal with drs. They come to agreements on what they will pay for a particular procedure code. Drs. are often suckered into accepting these agreements because so many people are employed by the large corporation in a given area that to turn down the agreement would cost them a large percentage of their patient base.

So a drs. fee for a service might be $150. An employee of a large corporation might have an insurance with whom the dr. has agreed to accept $60 for the service. The employee has a $5 copay. So the dr. bills $150. The ins. company agrees to their contractual agreement of $60. Then they send a check for $55 and the patient pays $5.

Some poor slob with a high ridiculous deductible and an insurance plan that didn't have the same "power" in reaching contractual agreements as the one above walks into the dr and gets charged $150. His plan maybe has worked out an agreement with the docs that they pay $110. He hasn't met his deductible yet so he pays $110.

Then the really poor slob who has no insurance but isn't poor walks in to the drs. office and that asshole pays the entire $150. Eventually when the dr. decides he isn't making enough he will up that procedure code to $200. Person A & B above pay the same as the dr. is stuck in a contractual agreement with their insurance providers. The no insurance guy now pays $200 to make up for the cost of the many guys who now only pay $60.

All that riot needs to be done away with.

Well every time I have argued with people about healthcare reform, I have always said that the place we need to look is the relationship between the insurer and healthcare provider. What you and I have been arguing over before is the relationship between insurer and insured, and I don't see anyway to really effectively cut costs there.

One of the things I would put forth in my version of a plan, would be to get rid of the preferred provider networks. Unless you go out of country, your insurance should follow you wherever and the policy deductibles should remain the same no matter what hospital network you use.
 
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