<p>I’m pretty sure the poster meant the insurance co. is going to need to see W2’s, W3’s, and quarterly payroll returns to prove a spouse is a bona-fide employee, not just a bogus one being used for insurance purposes. Payroll is a p-a-i-n to set up and deal with on a weekly basis. This requirement will put a definite squash on the people with spouse “employees”, especially if the spouse is the only employee.</p>
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<p>Could you rephrase that? I have some trouble understanding what you’re
trying to say.</p>
<p>Yes, I will try.
In the past, our insurance company considered the spouse to be an employee. They did not require verification like payroll information. They were very clear on this point (we didn’t not want to risk insurance fraud!). My husband is a consultant. I help in him at times, but I am not on the payroll and it would not make sense to put me on the payroll (due to the increased taxes). </p>
<p>So, they are now changing their policy and requiring payroll info to verify employees. We are looking into how they are going to handle spouses. We shall see if they will keep the spouse exemption. In this medical insurance climate, I am not encouraged about a positive outcome.</p>
<p>Exactly srystress. </p>
<p>But please don’t use the term bona-fide and bogus.
A spouse is (often) naturally involved. At the very least, we make an excellent sounding board. In a company, you go to a colleague and ask for feedback. Or get advice. In a sole proprietor situation, the spouse often does this. Or handles the paperwork or the errands or any of a long list of misc jobs that need to get done.</p>
<p>You know bluebayou…</p>
<p>I have been arguing with you for awhile about this…</p>
<p>But…I think you are right.</p>
<p>It is not going to be enough to get rid of the insurance companies. We are going to have to change the cost curve…not just lower it by getting rid of the insurance companies.</p>
<p>Bummer.</p>
<p>On the plus side…I guess my daughter’s career is safe. :)</p>
<p>If I take 1 trillion dollars…which is approximately half of what the US
spends on healthcare…the government is the other half…if I remember
right…</p>
<p>And compound that out over 50 years…at 6%…</p>
<p>In 50 years the cost of that portion of healthcare is going to be
approximately…18.4 trillion a year.</p>
<p>If we cut out administrative costs and the profit of healthcare companies by 20%… which is a large number…</p>
<p>Healthcare costs go from 800 billion a year to 14.746 trillion a year.</p>
<p>Actually…if we could really cut 20%… it is worth it.</p>
<p>Actually…even if we can just cut health care costs 10%… it is worth it.</p>
<p>Nevermind…we should get rid of the insurance companies. :)</p>
<p>But bluebayou is right…if we can reduce the rate of growth in health care
every year…</p>
<p>We can get a much larger bang for the buck.</p>
<p>If we start at 1 trillion and healthcare costs go up 4% a year…we end up with $7 trillion in health care costs 50 years from now…</p>
<p>If we start at 1 trillion and healthcare costs go up 6% a year…we end up with $18.42 trillion in healthcare costs 50 years from now…</p>
<p>If we start at 1 trillion and healthcare costs go up 8% a year…we end
up with 46.9 trillion in healthcare costs 50 years from now…</p>
<p>A few of us might be alive 50 years from now…and when we read
projections about how much healthcare is going to cost in the future…it
depends on how much healthcare costs increase over time. </p>
<p>If you want to scare people…use a higher rate of increase.</p>
<p>By the way…if the economy grows 6% a year…50 years from now…the GDP of the USA will be approximately…$276 trillion…</p>
<p>What am i going to invest in to keep my lifestyle going 50 years from now? 
It is going to be tough to get 6% to 8% compounded returns.</p>
<p>Doct…if you don’t mind…</p>
<p>What are you paying and how did you get those low rates? Employer?</p>
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<p>My mother picked US blue chips a long time ago and they’re still working for her today.</p>
<p>BCEagle91, my grandmother did too.</p>
<p>And it may work again…I don’t know.</p>
<p>sryrstress, I do the payroll for DH and me, and it’s not a pain at all. I pay us just once a month, but it wouldn’t be any harder to do weekly. We have QuickBooks Pro, and I just click on a couple of buttons and print out checks. I go online once a month to pay the withholding taxes. If I ever have questions (which I rarely do after 14 years), I can email our accountant and get an answer quickly.</p>
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<p>Nothing wrong with spending money on health promotion, but there is essentially zero actuarial $ benefit to the company (besides employee goodwill). All health promotion programs only work very long-term, but most employees will be long gone by the time that any benefits kick in. Again, from a statistical standpoint.</p>
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<p>Nice perks, but of no value in containing the company’s health care costs. Now, perhaps they might make a dent in Medicare many years out…</p>
<p>OTOH, if your company offers retiree medical benefits, then health promotion can work to benefit the bottom line.</p>
<p>dstark: another way to look at it…if health care costs are increasing 15% per year, and we whack ten % across the board in 2014, by September of 2015 we’ll have eaten up all the whacked savings… and the costs will continue to increase because demand will increase.</p>
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<p>This is the most bogus of all arguments. Why wouldn’t they drop coverage when there were no fines? To say that employers are going to wake up one morning and realize they can drop coverage makes no sense at all. They could always have done this. Many states already offered health insurance programs. The employers in those states have not dropped their coverage and told their employees to go to the state. All the reasons that employers offer health insurance will still exist.</p>
<p>Bluebayou, That’s true…but…you still benefit by making the cut…</p>
<p>Your costs will still increase over time. But they will increase less and your overall costs will be less.</p>
<p>If I cut…1 trillion in costs to 800 billion the first year…and then…healthcare costs go up 25 percent the next year… I am right back to 1 trillion a year.
The costs will continue to increase but they wil increase at lesser amonts and the overall costs will be less.</p>
<p>You still save money because if you did not make the cut…your costs
would start at 1 trillion instead of 800 billion and after the year of a 25% increase…you would be paying 1.25 trillion…</p>
<p>And you would save more and more every year going forward.</p>
<p>So for example…800 billion…then 1 trillion…then 1.25 trillion. = 3.05 trillion with the initial cut. (3 years).</p>
<p>No initial cut. 1 trillion then 1.25 trillion…then 1.5625 = 3.8125 trillion…
(3 years).</p>
<p>The savings are 762.5 billion after 3 years…</p>
<p>Obviously the savings won’t be that high…we are not going to see healthcare costs go up 25% a year for 3 years…well…mine might. I am
just using 25% because it was easy.</p>
<p>The savings will be less with smaller rates of increase…but they are real and will increase over time.</p>
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</p>
<p>Some insurances will provide discounts for participation in health and wellness programs. Also, there are insurance companies that will pay for your fitness membership…</p>
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</p>
<p>The exchanges will offer a much different perspective than an individual insurance plan, at least that is offered in California. The exchanges will:</p>
<ul>
<li>Not preclude pre-existing conditions</li>
<li>Offer a standard benefits package, including birth control pills</li>
<li>Not be age-rated (well, there are two age bands)</li>
<li>Have rates that won’t increase 20%/year (the politicians won’t let that happen)</li>
<li>Be a one-stop shop</li>
</ul>
<p>Essentially, exchanges are ‘no fuss-no muss’ by design. Win-Win. And if it works properly, eventually it will morph us all into single payer.</p>
<p>dstark:</p>
<p>I don’t doubt there are ‘savings’ to be had in the system, but there are plenty of ways to achieve savings. Just one example: allow importation of Rx from Canada and Mexico.</p>
<p>btw: don’t forget that insurance companies are tax payers too. Thus, for all the millions & millions of profits that Aetna & Wellpoint are earning, they are giving ~40% of that to the US and State governments.</p>
<p>"Doct…if you don’t mind…</p>
<p>What are you paying and how did you get those low rates? Employer? "</p>
<p>between my employer and my wife’s, we pay $3200 per year.</p>
<p>That’s true…</p>
<p>There is going to be more unemployment…less taxes received from insurance companies…</p>
<p>People will have more discretionary income or at least be more likely to afford healthcare…</p>
<p>So maybe others will pick up the slack from the losses in the insurance industry…</p>
<p>There will be winners and losers.</p>
<p>You mentioned single payer yourself…what would you like to see done </p>
<p>besides or instead of single payer?</p>
<p>EDIT…Ok…I see your edit…</p>
<p>Then the drug companies make less…somebody is going to have to
make less…</p>
<p>Doct…are you kidding me? </p>
<p>Medicare might be bad for you…your costs may go up. :)</p>
<p>That is very low…</p>
<p>If I paid that…It is very doubtful that I would have started this thread. ;)</p>
<p>Bluebayou, Do Aetna and Wellpoint really pay that much in taxes?
Not too many large corporations do pay those rates.</p>
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<p>Everybody is going to have to make less. Why should healthcare be the only ones to have to make less? People seem to be in favor of healthcare employees making less money, but there is a domino effect that has to take place. If a nurse makes 15% less pay, then how are they going to make it if everything else continues to go up?</p>
<p>That’s combined dental and health. The dental part isn’t so great in that there is a deductible.</p>
<p>Doct…omg…dental too… Lol…</p>
<p>If I could get my rates that low…I could probably quit what I am doing…I may be out anyway and still be stuck with these healtcare costs. </p>
<p>My increases last year are about what you pay…</p>
<p><a href=“http://ycharts.com/companies/AET/effective_tax_rate[/url]”>http://ycharts.com/companies/AET/effective_tax_rate</a></p>
<p>i have no idea how accurate this is but it does look like aetna pays a pretty high tax rate.</p>
<p>Like bluebayou’s company, I’ve read that 30% or more of employers may drop health insurance once the exchanges come into effect. </p>
<p>There will be a one-size-fits-all program, take it or leave it and pay a fine. And when the benefits you want aren’t offered, there will be no where else to go.</p>