<p>geeps, you think it would be better for everyone to save for their own retirement. What would you do about all the people who would be improvident (not bothering to save at all, or save enough) and others who were unlucky in their investments? I’m always incredulous that people like you claim to think that every American adult is capable of doing a good job of managing an investment portfolio, and eager to exercise the self-determination, freedom and independence that would come with that. Yep, I imagine the single parent trying to make ends meet by working two jobs in food service, retail, etc. He or she comes home late at night and after checking that the kids have eaten something and done their homework, he settles down for a quick review of his retirement portfolio, either before or after getting the kids to bed, tackling the laundry, etc.</p>
<p>So, when some of our fellow citizens turn out not to have succeeded at saving adequately for their retirement, what then? You’d step over them as they lie homeless on the sidewalk? I prefer the big hand of government. As a person who grew up in the British Commonwealth, I think of government as “we the people” getting together to do things that we need to do as a community. These notions of government as some kind of evil plot to oppress the people, morass of incompetence, etc., just don’t resonate with me.</p>
<p>Unfortunately, no. The people I work with who have been in the industry a long time are convinced that a system of national heathcare would be a disaster … the rules made so far have increased the administrative burden, cost of coverage, etc … not to mention that our government does not have a track record of keeping costs under control. I look at the cost of coverage and can’t believe how much things cost, and the average cost increase trend is so high. </p>
<p>To be blunt, the fact that we want to live is a big part of the cost issue. We want to overcome all the problems and illnesses we either dealt with or died from in the past. We want our aches and pains to be controlled, we want to survive our cancer or other illnesses, we want to keep our extremely premature babies alive, we want to undergo chemo at 85 … etc., etc. I am NOT passing judgment, simply stating the truth. All of this costs money. Yes, there are other factors, but I suspect wanting to live … and live comfortably … is certainly part of the puzzle.</p>
<p>“extremely premature babies alive, we want to undergo chemo at 85 … etc., etc. I am NOT passing judgment, simply stating the truth. All of this costs money. Yes, there are other factors, but I suspect wanting to live … and live comfortably … is certainly part of the puzzle.”</p>
<p>I am surprised by the elderlys’ will to live when they are in pretty poor shape. I’m not there yet so I don’t know how I am going to think or feel. My dad, who is 84, and is starting to decline, talked the other day about living another 20 years! If he makes it another 5 to 10 years…he is not even going to know who he is. </p>
<p>Then…there was this man I have known for awhile…and he was on his
death bed, and he wanted to get better so he could play tennis. Another guy in his 80’s or 90’s could barely walk…and his goal was to be able to walk up a flight of stairs.</p>
<p>Then…on the other extreme…are the depressed, living their last few years with their heads down.</p>
<p>Auto insurance is probably a poor example, since:</p>
<ul>
<li>It is sold across state lines (unlike health insurance0’</li>
<li>Anyone can purchase a bare bones auto plan; indeed the state pools are all bare bones. In contrast, the Affordable Care Act will require only cadillac plans. (Witness a certain Georgetown Law Student, who pays $70k per year to attend LS, and has become a media darling with a personal call from the Prez, is complaining about a single, non-covered item in her plan (birth control).)</li>
<li>Many go without auto coverage (the free-rider problem does not go away); in SoCal, for example, estimates are that ~30% do not have auto coverage. Thus, those of us that do have to purchase an extra rider to cover those that do not.</li>
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<p>Simple: single payer, and then rationing and price controls. While BC maybe covered for political reasons, other stuff will get dropped, just like in every other country; or lines will get longer. There is no ‘free lunch’ (in contrast to mini’s persuasive arguments). Once we cut out the (big bad) insurers 4.4% profit (or whatever number you prefer) and bonuses, costs will only moderate when demand declines. And it will only decline when the govt slowly start rationing.</p>
<p>weatherga…that would be a state problem. I believe in personal responsibility. Having said that, I’m in favor of a “safety net” for those that truly need it. Do you really think someone making $60k/yr + needs a hand out from the government when they reach retirement age. I don’t.</p>
<p>No, I became an opponent of employer-based health insurance many years ago. But my opinion doesn’t matter; employer-based insurance is a fact of life. </p>
<p>As a employer (I also manage our benefits, so I know the number cold), health insurance is just another cost of doing business, no different than rent, lights and payroll taxes; it is just part of the compensation expense. If rates go up, salaries just increase less.</p>
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<p>Not me. I personally don’t care if they have insurance bcos it’s none of my business. (We offer health coverage to be competitive, not out of some egalitarian mission.) The only ‘insurance’ that I care about is auto, and only for those employees who travel on company business. We require outside Reps to have a minimum of auto coverage so they’ll be covered if involved in an accident while on company business.</p>
<p>Quite frankly, I’m looking forward to California’s state run plan courtesy of the Affordable Care Act in '14. I assume we’ll drop our employer-based coverage, and then give our employees the $ difference in their paycheck so they can join the local health care exchanges.</p>
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<p>Take whatever % you want and call it ‘administrative savings’ from single payer. It will be used up in a year or two. Sure, more people maybe covered, but that will not stop the spiraling costs increases. IMO, the so-called savings is a good talking point, but not statistically relevant.</p>
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<p>Absolutely. (I’ve posted this many times on cc.) Single payer will just result in a different type of rationing.</p>
<p>They are subsidized with tax breaks and work more like an entitlement. The value of the exemption goes up as income goes up so high income earners benefit more than lower income earners. From the Kaiser Foundation - (numbers for 2007 - they are higher now)</p>
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<p>The deductions for small business owners were increased in 2010 in the Affordable Healthcare Act. However, many small businesses are set up as corporations. Mine is a Subchapter S corp. While I can deduct my premiums paid from the business, I have to claim them as wages so I don’t get the payroll tax break that the group plan employees get.</p>
<p>I completely agree with this, particularly in the most expensive area of medical costs, end of life care and “extreme” measures to keep alive those who are already dead.</p>
<p>I also think Kelsmom is sooo right. We seem to want to live forever.</p>
<p>Perhaps, too, with the advent of rationing at the end of the life, we might finally get some compassionate assisted exit strategies, as well.</p>
<p>geeps I guess you didn’t see the tea partiers during the healthcare debate with their signs, “Keep your government hands off my Medicare!” Too funny.</p>
<p>Well, forget what I said about my insurance company considering a spouse as an employee. Just the other day we got a notice that they now require a payroll as proof of your employees which totally screws a small business where one spouse runs the business (think consultant) with no employees (but who are we kidding - of course the spouse helps out!) </p>
<p>I’m so angry I can hardly speak. As if we aren’t sending them enough money for a product that we rarely ever use!!!</p>
<p>So let’s say a 16 year old tears his/her ACL, MCL, and meniscus in the knee. How long are they looking at waiting to have reconstructive surgery? How long are they going to get to go to rehabilitation?</p>
<p>Re what bluebayou said: I am afraid H’s employer will drop the health insurance under the cover of the ACA. While some employers may pay in salary what they paid for health insurance, will that cover what the health insurance will cost under the exchanges? And will most people get an increase in salary in these hard times? I doubt it. </p>
<p>Employers will drop coverage and point to the exchanges. Employees will compare the cost of the insurance versus the cost of the fine and many will go the uninsured route. Then if they get sick, they will buy the insurance, with no pre-existing condition problem. So the risk pool will shrink and the number of sick in the risk pool will rise. </p>
<p>Of course all of this could be academic come June with the Supreme Court ruling.</p>
<p>My workplace changed to an À la carte model a few years ago so it goes
by person and spouse, DP or child.</p>
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<p>Health Insurance isn’t taxable income. I don’t recall whether they are
taxable if their plans’ value exceeds a certain amount.</p>
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<p>Sounds a lot like my mother. Except we didn’t always have food and she
didn’t check our homework. She owns her own home, pays her taxes and
is self-sufficient in her 90s. And she’s a big believer in dividend
stocks.</p>
<p>Yes, health insurance isn’t taxable income so the increase in salary to match losing health insurance would have to be MORE than the cost of health insurance to make up the difference. </p>
<p>That will never happen. </p>
<p>Like most people I am happy with my health insurance. It has changed many times with changes in jobs, but I have never had a problem. I have had several surgeries for different things, and no problem.</p>
<p>Life expectancy is going up, despite a good chunk of the country
not taking particularly good care of itself. But there are a lot of
people that are taking good care of themselves and I can see large
numbers living well into their 90s. Easily.</p>
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<p>I wonder if people would stop driving like complete morons if they
had to pay the costs of their accidents out of pocket instead of
having the big risk pool pick up their costs.</p>
<p>We had snow two days ago (very rare in the Northeast this winter).
The highway was 80% bare and there were accidents all over the
place. I guess that it was technically the first storm of the
season and people weren’t used to it but this is the New England!
Don’t drive 70 when there’s snow and ice on the ground!</p>
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<p>You either pay your employees more or provide them with healthcare.
Where I work, healthcare isn’t a huge percentage of pay (which is to
say that we’re paid quite well).</p>
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<p>The theoretical benefit is that the company can provide coverage more
efficiently than the employee can. We hire lots of younger people and
they are generally healthier. The older folks generally take better
care of themselves compared to the overall population (which isn’t
necessarily saying much). In my building, which isn’t particularly
large, we have a gym (weight machines, free weights, lots of cardio
equipment), a large fitness classroom (big open space, video, audio
equipment, balls, all kinds of weights, special cushioned surface,
mirrors), and a table-tennis room. One of our larger facilities has a
fitness center the size of our entire building including a swimming
pool, day-care, etc. We clearly believe in the benefits of exercise.</p>
<p>We also have options for legal insurance, various options for life
insurance, options for disability insurance and a few others. Life
insurance and disability insurance are required - I guess we want to
be sure that dependents are taken care of should the employee die. I
also think that the company feels that they can provide these benefits
more efficiently than employees can.</p>
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<p>I had to use a doctor in Singapore many years ago when my son was
sick. I went to the clinic, the doctor saw my son, and I paid a fee of
something like $15. Zero paperwork. I did call my insurance company to
verify coverage before-hand and they told me that it was fine but I
didn’t bother getting a reimbursement.</p>
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<p>I’m a bit surprised by this. Our company has programs in place to
promote healthy employees, provide support for family or other
problems and take care of things so that employees don’t have to worry
about them so that employees can focus and spend a lot of effort at
work.</p>
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<p>Could you rephrase that? I have some trouble understanding what you’re
trying to say.</p>
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<p>That’s true for unemployment insurance too.</p>
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<p>I think that depeneds on your marketability. But it would probably push
down the price of medical care if folks got to see what it really costs.</p>