<p>I actually think nurses will end up making more, frankly. They will have more responsibility, but they will make more.</p>
<p>Doc’s will make less and this is why I said we need to lower the cost of medical school. There will be all sorts of unintended consequences, and anyone who is trying to tell you that it will be “cheaper AND better” is lying to you. There’s no such thing as cheaper AND better. Likely, it will be more expensive to the taxpayer in the upper brackets, and simply finally available to those without insurance.</p>
<p>It won’t be better.</p>
<p>But, it has to be done, at this point.</p>
<p>And, yes, it will be one stop shopping, one plan, “there you have it.”</p>
<p>And, I’m sure, also, there will be some of us who can get whatever we want because we are willing to pay.</p>
<p>I see it as eventually shaking out to be the same as a public education system vs. a private school. Some public education systems are better than others. It will be like that.</p>
<p>I wonder if that will start to be a real estate draw like a good public school system is. Location, location, location: medical district 5! Must see!</p>
<p>dstark: As somebody who is a diabetic with heart irregularities, I go to all kinds of md’s but pay a $20 copay plus most of my medical tests are free. Needless to say, this is why I haven’t retired yet.</p>
<p>"Doct…Yeah…I could see why you are still working.</p>
<p>Your health issues are under control? What you wrote doesn’t read well. "</p>
<p>better than a year ago but the issues will only get worse with time. A lot of the coverage is through my wife and she has to work another 4 years to qualify for her pension so I may only go another few years.</p>
<p>Employee goodwill is worth a lot. From going the extra mile on projects
to better employee retention in a business where people do jump from
company to company.</p>
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<p>In my building, we have a lot of employees that have been here since
the mid-1980s.</p>
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<p>We have to compete with other companies for labor and providing
day-care for parents next to where they work can make an employee’s
life easier and happier and productive.</p>
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<p>I believe that it does something like this. I get this thing in the
mail every year about that which I keep ignoring.</p>
<p>Mercer and other studies have shown that the majority of employers with >100 employees do not expect to drop healthcare benefits. We deal with employers in this category, and none want to drop it … they see it as a way to retain employees (remember Maslow’s Hierarchy of Needs). I do understand that there are employers who are weighing the costs of this benefit against the potential fines to drop it. There definitely will be some employers who will choose to pay the fines, and I can’t say I blame them. That would get rid of not only the cost, but the associated headaches of the regulations governing healthcare.</p>
<p>I do have a suggestion for those who are paying a ridiculous amount for their healthcare. Investigate managed care options that have health engagement or outcomes based programs. Some may have issues with the qualification requirements, but for those who do not, there is the potential to save a lot of money over traditional health care programs. It’s worth exploring.</p>
<p>I talked to somebody at Anthem Blue Cross for 30 minutes today.</p>
<p>The quotes on the web site are not the real prices. In two months they are going to charge the new prices.</p>
<p>The guy I talked to was really helpful and did want me to have the best plan for my needs at a reasonable cost. The plans he came up with just happened to be the two plans I have saved on my ipad. </p>
<p>There was the Serencsa Class Action which is the reason why I can switch…</p>
<p>Again, I got the grandfather in warning…but I told the guy that I can save 40 to 75% by switching…so I am going to take a chance. </p>
<p>Policy holders should get the updated rates in a few weeks.</p>
<p>I called them today because I saw different rates quoted depending if a person is a sole proprietor…retired…etc… All those quotes are wrong…and low.</p>
<p>As I said before, if I were buying an individual policy, I would buy catastrophic coverage coverage only. If people paid out of pocket for routine medical care, and shopped around, those prices would drop. But under ACA, no one will be able to choose. The government will have taken choice away and decided for us. We will have to buy coverage we may not need or want.</p>
<p>There is no single reason, but there are many contributors:</p>
<ul>
<li><p>Strong incentive for providers to recommend more care, even if less care happens to be better care. Medicare’s practice of low payment amounts but not being picky about what it pays encourages that beyond what normal fee for service practices create incentives for.</p></li>
<li><p>Lack of incentive for patients to check cost effectiveness of care, since most people use third party payment systems (government or private insurance). There is also a strong cultural bias in the US of “more is always better”.</p></li>
<li><p>High provider administrative costs due to each insurance company having different rules, and numerous plans within each insurance company having different rules that providers have to deal with.</p></li>
<li><p>Fear of malpractice lawsuits encouraging the practice of defensive medicine of dubious value other than to be able to say in court that everything was tried. (And malpractice lawsuits are not particularly “accurate” in that many who are harmed by medical error lose, while many who are not harmed by medical error win.)</p></li>
<li><p>General unhealthy habits in the US, such as high rates of obesity and low levels of exercise. Many would rather take expensive drugs instead of exercising and eating healthier to stop high blood pressure, diabetes, etc…</p></li>
<li><p>Limited supply of primary care physicians, because the economics of primary care are much worse than for specialists. With medical school being so expensive that MD graduates are carrying huge amounts of debt, there is strong financial incentive against going into primary care. This has two effects: 1. People have trouble finding primary care physicians (so their easy to solve problems may become expensive problems due to delay). 2. Specialists lobby and market expensive treatments that may end up being overused.</p></li>
<li><p>Direct to consumer advertising for new expensive drugs encourages patients to ask for the new expensive drugs instead of trying the old cheap generic drugs first. Of course, “someone else” is paying for the new expensive drugs.</p></li>
<li><p>Conversion of non-profit hospitals and insurance companies to for-profit companies. However, non-profit companies are not necessarily well-run, and their executives may also try to get larger pay packages than are warranted by their performance. Non-profit companies do need to make non-negative profit to avoid going bankrupt.</p></li>
</ul>
<p>I buy coverage for prostate cancer which, I assure you, I will never need or want.</p>
<p>When people need care, they are generally scared, sick or in pain, or all three. You’re suggesting that they should “shop around” for medical care, as if it were a used car? This market-based mentality is yet another reason why our system is so dysfunctional. Health care is not just another product.</p>
<p>However, that may not be as profitable as one may expect from seeing medical insurance premiums rise so quickly, since much of the added costs in the health care system go to payroll. Health care has been a big job creator in the US, though one can argue that many of the jobs involved are “theoretically unnecessary” to improve health outcomes (some would call this “make work”), such as those handling the immensely complex paperwork in dealing with multiple plans at multiple insurance companies, or all of the medical stuff involved in wasteful or unnecessary care including defensive medicine.</p>
<p>True, but remember that their mission is not to improve health outcomes, or otherwise benefit their subscribers. Their mission is to maximize profit for their shareholders.</p>
<p>Lasma, I want to see the numbers, but I think so. My plan right now is one of the more expensive plans with comprehensive coverage. Yet…it has a high deductible. I don’t really need maternity care. :)</p>
<p>I don’t want to pay 17,000 to 20,000 a year in premiums when in most years…we don’t spend more than a couple of thousand in actual healthcare.</p>
<p>I think I can cut the premiums to 10,000 to 12,000. So…even if anthem starts playing games…anthem will have to raise my cost of coverage a lot for me to be a loser. It could happen.</p>
<p>Have you checked out the web site to see if a different plan than you are on now makes sense?</p>
<p>dstark, We haven’t gotten our increase letter yet, or the packet we always get notifying us that we’re in a “switch” period. I think I’ll call them on Monday. It would be awfuly handy for them if I somehow didn’t get the notice.</p>
<p>We have one of Blue Cross’s worst plans, coverage-wise. So what I’m hoping is that we can keep our premium about the same, while upping our coverage.</p>