<p>Yes, I think doctors and hospitals have been forced to practice both defensive medicine AND defensive business.</p>
<p>Around here all of the major research hospitals have banded together into one monolithic organization. Now, you can get some amazing health care here, really great, but I’m convinced they’ve been forced to do this in order to negotiate with the insurance companies from a position of strength.</p>
<p>Obviously in an emergency, you cannot shop around. But I could shop around for routine non-emergent tests, the way I compare prices for OTC meds.</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>That’s right.</p>
<p>Yes, I do really think it is the paradigm that is the “problem,” so to speak.</p>
<p>When I thought of medicine as an ongoing business concern, I thought the idea of government involvement was horrifying. For me, this was true at the start of the health care debates.</p>
<p>But, as time went by, I began to understand that health care is in the wrong category, right now. Healthcare is like water, air, or, if you want something higher up on maslow’s chart, education. Healthcare is like education. It is something everyone has a right to have access to. Maybe it has become big business for the middlemen, but that doesn’t change the basic fact that humans deserve to be cared for when they are sick.</p>
<p>UCB… I have thought about healthcare stocks…the demographics are good. UNH is near a multi-year high…
But I have this hope that the profits are going to be taken out of this group. I could be wrong. :)</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>
<p>I’m not sure how pricing is going to get better. That is not what I hear from my 2 conversations with employees. I hope I am wrong here.</p>
<p>We have a hdhp, and I do find that I shop around now. I had some elective surgery a year ago and found (ahead of time) that the price variation between the surgical center, hospital A and hospital B was thousands of dollars. I picked the least expensive. (Same surgeon at all three.) Pre-HDHP I would have paid a copay of $500 no matter which I chose.</p>
<p>There was also a very wide spread on MRI costs when I needed one. I drove a bit further, but got my MRI at a much lower cost. </p>
<p>I don’t think that some price sensitivity is a bad thing; one of the many troubling things about our current healthcare system is that for so much of it you don’t learn what the cost is until after you’ve used the services. I wouldn’t take a plane flight, buy a car, or rent an apartment without knowing the price – but somehow in healthcare we’re supposed to get all the relevant info after the fact?</p>
<p>dstark, What my broker told me at the beginning is that, as our group gets older since it’s closed to new subscribers, it will get disproportionately more expensive than similar plans that are still being offered to new subscribers. She said this effect will increase over time. So a year or two down the road now, I should be able to get better coverage for the same amount (or similar coverage for less than I’m now paying). The difference won’t be huge, but maybe enough to keep our insurance for another year.</p>
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<p>You can expect there to be a good deal of political resistance to cost cutting measures. It is not just profits and executive bonues; it is ordinary people’s paychecks as well. The prostate cancer and treatment that has been found to be of questionable value helps pay for the urologists’ paychecks. The questionable value mammograms for normal risk women under age 50 help pay for the radiologists’ paychecks. Other screenings of questionable value help pay for phlebotomists’ and lab workers’ paychecks. Defensive medicine not only adds to physicians’ defenses against lawsuits; it adds to the paychecks of the physicians and others who provide the defensive medicine. And each malpractice lawsuit needs at least two lawyers and associated legal staff.</p>
<p>The settlement…</p>
<p>[url=<a href=“http://www.anthemsanmateosettlement.com/About_this_Settlement/FAQs.aspx]FAQs[/url”>http://www.anthemsanmateosettlement.com/About_this_Settlement/FAQs.aspx]FAQs[/url</a>]</p>
<p>BC trapped those with pre- conditions into existing plans…and the people left in those plans grew older and sicker as nobody new could sign up…BC jacked up the rates. </p>
<p>I wondered why I did not see my plan on the website. Because new people could not get into it. The plan sucks.</p>
<p>So…the way it works…if you are in a grandfathered plan…new mandates can not be added to the plan…so you won’t get cost increases from the mandates. But you will get costs incresses as the people in the plan continue to get older and sicker.</p>
<p>The new plans…will get younger people joining…thereby, keeping costs down…but the new plans may have mandates added which will increase costs…</p>
<p>For me…I think it is a no brainer to switch…cost increases are going to occur no matter what…but at least the new plan starts from a lower cost.</p>
<p>And BC employees did not explain this to me. One employee told me not too switch last year. To wait. </p>
<p>That cost me 6,000, pre-tax…the …</p>
<p>Can I write bit…?</p>
<p>Ok Lasma…I just read your last post…does that square with what I just wrote?</p>
<p>UCB…i agree.</p>
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<p>Our company works with a physician who is known for adjusting on the fly in the OR. He may start surgery with the intention of fixing problem A, but while he is in there discovers that problem B needs to be addressed. How exactly would you like for him to give you a price if he really doesn’t know what he’s going to do once he’s in there? </p>
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<p>Outpatient facilities are almost always going to be cheaper than doing the same thing at a hospital. Outpatient facilities have to pay for those specific facilities; at the hospital that facility may also have to pick up some of the tab of the ER, etc because those utilizing the ER can’t pay the bill…</p>
<p>Arabrab…think about it…</p>
<p>My dad was just in the hospital for 2 weeks…he was bedridden…what was he really going to do…tell them …not to give him a particular treatment until he had time to shop for a better price…</p>
<p>Come on…</p>
<p>One of the treatments caused my dad to lose reality…</p>
<p>Come on…</p>
<p>The whole floor my dad was on was full of 80 and 90 year olds…they can’t pea or poop…they are demented…their loved ones are worried sick…really…the loved ones are under lots of stress…and these people are going to comparison shop for lower prices?</p>
<p>Yes dstark, it squares. </p>
<p>Is there a way of knowing how much is added to the grandfathered plan due to the aging of the subscribers, versus how much is added to the new plans due to mandates? </p>
<p>I agree completely with this:</p>
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<p>… so we are definitely going to make the switch, it’s just a question of whether it’s this year or next year.</p>
<p>I think we get to switch whenever they decrease benefits, as well as whenever they increase rates. As you noted upthread, they are now doing that in the fall, hoping we won’t notice that they are charging us a lot more for a lot less.</p>
<p>I am going to switch. Almost every plan is cheaper than the one I have now. A year ago…did you see any plans worth switching to?</p>
<p>“Is there a way of knowing how much is added to the grandfathered plan due to the aging of the subscribers, versus how much is added to the new plans due to mandates?”</p>
<p>No.</p>
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<p>Kelsmom: I have no doubt that is the response today, for the simple reason that they know nothing on which they can make a comparison. Companies know what they offer today. They know what their benefit plan looks like today. What they don’t know is what the exchange will look like, nor what the fee/tax/penalty to be if they opt out.</p>
<p>It may turn out that the exchange offers a better package than what the company is offering today, for example. If so, switching to the exchange almost becomes a no-brainer. But absent coverage information, pricing, etc, today no business person can make a decision based on his/her crystal ball on the ACA exchanges.</p>
<p>Moreover, there is a more practical matter. Most 100+ employee companies started out small, really small. When a company is only a 5-10 person company, the exchange will look mighty fine. When it becomes a 20+ person company, the exchange will still look great. Ditto at 50 ee’s…the point is that a company may just stay in as it grows.</p>
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<p>No, we saw a couple that were marginally better than what we have, but nothing that really said we should jump in then, rather than waiting. I haven’t checked rates yet this year. </p>
<p>What’s the deadline for this cycle?</p>
<p>ETA – I just took a quick look, and the quotes are SIGNIFICANTLY lower than what we’re paying now, for much better coverage!</p>
<p>The best investment that you can make for your own future with respect to the health care system is to take care of your own health. Exercise, eat healthy foods, don’t get fat, and don’t smoke or otherwise use recreational drugs (legal or illegal). Get [preventive</a> care which has good evidence of effectiveness for your situation](<a href=“http://www.uspreventiveservicestaskforce.org/recommendations.htm]preventive”>http://www.uspreventiveservicestaskforce.org/recommendations.htm).</p>
<p>The healthier you are, the less likely you will be at the mercy of an expensive dysfunctional medical care system (regardless of where it ends up politically). Yes, you may lose the genetic lottery and have some medical problem that cannot be avoided, but there are still good reasons to do your best to prevent any avoidable medical problems.</p>
<p>I agree with ucbalumnus. I just wish our family hadn’t lost the genetic lottery in multiple ways!</p>
<p>Yep. Although no one can argue against taking good care of ourselves, there are plenty of people who have expensive medical conditions through no fault of their own. That doesn’t stop the health insurance industry from heavily penalizing them, though.</p>
<p>“ETA – I just took a quick look, and the quotes are SIGNIFICANTLY lower than what we’re paying now, for much better coverage!”</p>
<p>Good…</p>