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jank0614
Jank0614  (Level: 67.1 - Posts: 4597)
Wed, 9th Sep '09 11:04 PM

INSURANCE UNRELATED TO EMPLOYMENT

I don't even know when or why health insurance ever had a thing to do with employers. Can anyone tell me how those two entities became entwined?


1. What do you think if health care insurance was pulled totally out of the workplace, and whatever the employer pays toward health insurance for employs now just becomes part of your income? In fact, you'd probably make even more just because of money and time saved by your employer having to deal with health insurance.

2. Then if insurance companies were turned loose to sell their policies anywhere in the country rather than certain companies only being allowed to serve those in certain states, thus enabling them to become more competitive, resulting in lower rates, you could shop all of them to find the company, the policy, and the price you choose.

3. Tort reform - no more huge expenditures for "frivolous lawsuits" (valid lawsuits of course continue)

4. Insurance companies cannot disallow pre-existing conditions

5. Medicaid expanded to make sure the poor have adequate health care and unemployed are covered for a certain amount of time until employed again.

6. These steps should result in provably lower costs and keeps the government from sticking their nose where it's not wanted or needed.

Could you be happy with that?

The more I think of it, the more I don't see why employers should have a doggone thing to do with your health insurance! Take out one more middle man and cut those costs. They cannot be blamed, blackmailed, or responsible for anything to do with health care. It's none of their business!

That actually would prevent your employer from knowing anything about your health conditions - you would no longer have any privacy concerns about your health and your employer. (I have a couple of friends with AIDS who really worry about that)

alvandy
Alvandy  (Level: 229.1 - Posts: 7560)
Wed, 9th Sep '09 11:33 PM

Unions fought for benefits like health care coverage through collective bargaining. With the high union density in the United States- 1950's-1970's [over 37% of workers were union members at its peak]-- more employers provided health care coverage to stay competitive for the most skilled workers.

A little history:

What we recognize as modern medicine began in the 1920s. That's when doctors and hospitals, having only during the previous decade learned enough about disease that they could be reliably helpful in treating sick people, began charging more than most individuals could easily pay. To close this gap, which worsened with the advent of the Great Depression, the administrator of Baylor Hospital in Dallas created a system that caught on elsewhere and eventually evolved into Blue Cross. The Blues were essentially nonprofit health insurers who served local community organizations like the Elks. In exchange for a tax break, Blue Cross organizations kept premiums reasonably low.

The success of the Blues persuaded commercial insurers, who initially considered medicine an unpromising market, to enter the field. Private insurers accelerated these efforts in the 1940s when businesses, seeking ways to get around wartime wage controls, began to compete for labor by offering health insurance. If government regulators had thought to freeze fringe benefits along with wages, we might have avoided making the workplace primarily responsible for supplying health insurance, a role that most people now agree was ill-advised. Instead, the government jumped on the bandwagon by exempting from the income tax company expenses associated with health care. (President Bush's proposal to alter this subsidy so that tax treatment of the self-employed is the same as for people who work for large companies—who currently enjoy an advantage—deserves praise for its progressivity. It would probably accelerate the business world's withdrawal from health insurance, which is inevitable. The trouble is, Bush offers no alternative to the workplace as a supplier of health insurance. Like Bush's plan to overthrow Saddam, it's great on the front end and disastrous on the back end.)

The Blues, in their early days, charged everyone the same premium, regardless of age, sex, or pre-existing conditions. This was partly because the Blues were quasi-philanthropic organizations, Cohn explains, and partly because the Blues were created by hospitals and therefore interested mainly in signing up potential hospital patients. They were sufficiently benevolent that when Harry Truman proposed a national health-care scheme, opponents were able to defeat it by arguing that the nonprofit sector had the problem well in hand. As private insurers entered the market, however, they rejiggered premiums by calculating relative risk, and avoided the riskiest potential customers altogether. To survive, the Blues followed suit; today, they no longer enjoy a tax advantage and are virtually indistinguishable from other health insurers. Meanwhile, large companies, which tend to employ significantly more young people than old people, began to self-insure. The combined result was that people who really needed health care had an increasingly difficult time affording, or even getting, health-care insurance.

As health-insurance costs rose during the 1970s and 1980s—driven both by improving medical technology and by the growing inefficiencies of the health-care system—health maintenance organizations, which had been around since the beginning, began to proliferate, along with other managed-care schemes. Like the Blues, HMOs became victims of their own success. Initially they were mainly nonprofit, but once again businesses spotted an opportunity and for-profit HMOs displaced nonprofit HMOs. (12 percent of the market was served by for-profits in 1981; by 1997, that was more like 65 percent.) With their bottom-line orientation, the for-profit HMOs were necessarily more aggressive about denying treatments.

There needs to be a solution!


sandracam
Sandracam  (Level: 149.3 - Posts: 4190)
Thu, 10th Sep '09 12:01 AM

Thanks Alvandy, very informative!

smokydevil
Smokydevil  (Level: 163.0 - Posts: 5381)
Thu, 10th Sep '09 1:11 AM

I like it! Except.....I don't see how the very poor would get health insurance. Leave it up to the states? People who make minimum wage can't even generally afford the basics very well without help. Do the math. I might think some of these other plans were a good idea, including the one above, if Medicaid was expanded to cover poor individuals within a certain range even if they don't have children. Some of these "other" solutions that I've seen out there don't solve or deal with coverage for the poor at all. They gloss over it with talk of "personal responsibilty", whether that's actually a possibility for some people or not. But that's just me.

caramel1
Caramel1  (Level: 128.2 - Posts: 21596)
Thu, 10th Sep '09 5:02 AM

Medicaid falls on the states and in case you hadn'y noticed most states are broke. Providing help to those who cannot afford, buying acroos state lines like one can with auto insurance (Axelrod would not answe O'reilly as to why not) and alsio there is not major tort reform but think we all know the answer to that one. Unions certainly did negotite greart health care when times were good, but the resuly was FM and Chryler went belly up because of legacy costs when foreign cars came here.

pepperdoc
Pepperdoc  (Level: 152.5 - Posts: 4286)
Thu, 10th Sep '09 8:14 AM

That's a fascinating history post, Alvandy. I'm currently covered by Blue Cross/Blue Shield and had no idea their role in this. I just knew they had been around a long time.

Does anyone know anything about caps on insurance profit? Since they cap benefits, perhaps their profits should be capped. My doctor used to post an article in one of his exam rooms about the huge salaries some of the executives of health insurance companies make. He also added hand-written opinions to the photo-copied article. I think he was trying to create a little patient rebellion against high insurance costs.

bigmama60
Bigmama60  (Level: 95.2 - Posts: 6648)
Thu, 10th Sep '09 8:33 AM


If it wasn't for the unions your teachers' union would not have been able to negotiate your benefits.
Tort reform? Republicans say Democratics have trial lawyers Republicans have insurance companies and some doctors who have now become entrepreneurs.

Maybe Axelrod would not answer Bill O' because Axelrod was trying to keep from laughing. Maybe it sounded so pathetic Axelrod didn't want to embarrass Bill O' s lack of intelligence. How can you equate a car to the most precious commodity on earth; a life?

bigmama60
Bigmama60  (Level: 95.2 - Posts: 6648)
Thu, 10th Sep '09 8:38 AM

I know the insurance companies make huge profits and allow people to die in favor making a profit. Only because they hire people to look for pre-existing conditions to cancel and deny insurance.

smokydevil
Smokydevil  (Level: 163.0 - Posts: 5381)
Thu, 10th Sep '09 9:12 AM

"Medicaid falls on the states and in case you hadn'y noticed most states are broke. Providing help to those who cannot afford, buying acroos state lines like one can with auto insurance (Axelrod would not answe O'reilly as to why not) and alsio there is not major tort reform but think we all know the answer to that one."

Medicaid is paid for by the states and the federal government.

I know the constitutional issue bothers you. Curious, how is medicare or medicaid alright if this kind of insurance would be unconstitutional? Should we cancel it then?? I'm personally not worried about that issue......was the constitution made for man or man for the constitution?

Tort reform- I know what it is, I know how it would apply to the health care issue, I don't know what your going on about in that last sentence. I don't know that I've heard your thoughts on this issue Linda, you'll have to spell out what "think we all know the answer to that one" means.

caramel1
Caramel1  (Level: 128.2 - Posts: 21596)
Thu, 10th Sep '09 12:16 PM

Tort reform would cut way down or eliminate frivoulous law suits . Many doctors test and retest for fear of being sued. Beverly, I am well aware that my health care package was negotiated by a union. That health care was among the primary resons I taugt in extremlty difficult circumstance for many many years. if it has been my only reason, would not have been worth staying there. That same union and tenure protected teachers who did not even attempt to teach on an equal basis for those of us who did . There is something very flawed in an entity which views people as a group and not on an individual basis.

bobolicios
Bobolicios  (Level: 117.7 - Posts: 1745)
Thu, 10th Sep '09 12:31 PM

I like the President's plan I just heard his speech and signed the letter on line in support of his plan. At least for myself and others like me, there will be a prayer of getting insurance in his term. I think you are wrong Jan you work for a school district where no doubt you have insurance. Companies should provide some form of low cost insurance for workers as part of their salary. Why is it their responsiblity because when companies that have many employees bargain for insurance they can get much better prices and coverage than individuals can. It is also a way to attract the better skilled employees, and did anyone consider would also result in healthier employees, thus saving them money. In the long term which many don't see it will save everyone money. No one that argues on these boards against Obamas plan seem to care about what we are talking about you can't put a value on human life, and health. It is a basic necessity, like shelter and food, protection and education. Did any of you hear his speech? He was NOT talking about a government takeover of health care. What is wrong with some of you people.
I think it is just crazy that the state of Alabama only has one insurance company. No competition whatsoever, with the health care reform plan a public non-profit choice would be made available to compete with existing insurance companies. They don't need to make more money than they already do.


caramel1
Caramel1  (Level: 128.2 - Posts: 21596)
Thu, 10th Sep '09 12:38 PM

That is why the argument is out there for people being able to purchase health insurance acrooss state lines like they can auto insurance-haven't quite figurred ut whuy but Obama isn't going for it. if your employer is required to provvide ypu wih health insure look forward to lower wages and the distinct posibility of no job. Fewer jobs=less expense

bobolicios
Bobolicios  (Level: 117.7 - Posts: 1745)
Thu, 10th Sep '09 12:46 PM

Linda, I will take my chances and that won't fly as there is a new minimum wage. Also if all employers except the exempt ones are required to provide coverage than it really won't matter. Always seeing the cup half empty, only because you already have insurance, many don't. Yes I AGREE with his plan. I will say it over and over as many tiimes as you post. So be ready for it.

caramel1
Caramel1  (Level: 128.2 - Posts: 21596)
Thu, 10th Sep '09 1:16 PM

Bully for you


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