Health

Rant

In Healthcare, Pro-Status Quo=Pro-Reform

Posted 29 months ago|5 comments|604 views
Written by
ActivelyFused
Tucson, AZ
Today let’s tackle something counter-intuitive. Namely:

If you like your current healthcare benefits, you are actually PRO-reform. Surprise! And yes, I know you don’t believe me so hear me out for a minute.

I understand you are probably one of the most vocal opponents of reform. You feel like your excellent benefits package is being threatened by all this talk of change. There are certainly lots of fear-mongers out there preying on that perception.

But let me tell you why, if you like what you’ve got, you really are pro-reform.

Employer-Based Benefits and Government Programs

Typically, if you like your benefits you are getting them either:

1. Through your employer, or
2. Through Medicare or another government program

You are indeed fortunate, as your benefits are likely to be fairly affordable and provide comprehensive coverage for pre-existing conditions, prescriptions, and preventive care. You are also probably pretty nervous that all this talk of healthcare reform means these benefits might be taken away from you.

So when Senator Joe Lieberman stands up and says most of the healthcare reform initiatives can wait, you breathe a huge sigh of relief. Not so fast—here’s what he means:

- As a politician, the easiest thing to do is nothing: Not rocking the boat helps his poll numbers go up so he can get re-elected.
- He won’t feel the effects of doing nothing about healthcare: Congressmen and women enjoy the Federal Employee Health Benefits Program, the widest selection of health benefits in the country, for less than 2% of their rank-and-file $174,000 salary. If costs go up, taxpayers cover the increase.

Why Pro-Status Quo = Pro-Reform

For you there is no such magic formula. Here is why your great benefits, and their cost to you, will not stay as they currently are.

First, the current trend of insurance costs is unsustainable. The price of insurance has risen 95.2% since 2000, while income has only risen 17.5%. These are findings from a study by Families USA, a non-profit that advocates for affordable healthcare (see External Links for the study URL).

What are you getting for that enormous increase? Fewer benefits. Higher deductibles. And bigger co-pays or coinsurance.

Let’s look at how it breaks down in Pennsylvania for an employer-purchased family and individual health plan in the tables below:

Group Health Insurance Premiums 2000-2008

Family
2000 Premium: $6,721 (Employer Share: $5,424; Worker Share: $1,297)
2008 Premium: $13,116 (Employer Share: $9,955; Worker Share: $3,161)
2000-2008 % Increase: 95.1% (Employer: 83.5%; Worker: 143.7%)

Individual
2000 Premium: $2,467 (Employer Share: $2,094; Worker Share: $373)
2008 Premium: $4,782 (Employer Share: $3,879; Worker Share: $904)
2000-2008 % Increase: 93.8% (Employer: 85.2%; Worker: 142.4%)

Worker Salary
2000 $24,834
2008 $$29,188
2000-2008 % Increase: 17.5%

Those are some ugly numbers for Pennsylvania workers. Their share of health insurance premiums went up 143.7% (family) and 142.4% (individual), while their salary only increased 17.5%!

The reasons for the increases include:

- Medical treatments—rising cost, increased use
- Inadequate oversight of insurance companies
- Lack of competition among insurers
- Cost shifting from uninsured (growing) to insured (shrinking)

Moreover, insurance costs are rising ever faster. Your employer and the government cannot afford to absorb these increases, so more and more of those costs will be passed on to you. In fact fewer employers are even offering benefits, from 69% in 2000 down to 63% in 2008.

So if you get kicked out into the individual insurance market, you will need both More Options and More Consumer Protections. That is what the healthcare reform bills like HR 3200 and the Senate HELP Committee's Affordable Health Choices Act are all about.

They also contain Medicare payment reforms (primarily to hospitals) to wring waste from the system, encourage providers to become more efficient, and most importantly, ensure there is enough funding to maintain seniors’ plush benefits coverage.

Yes, you read that right–there is NO benefits reduction for seniors in the healthcare reform bills.

Furthermore, the much maligned public option is there to increase competition (something co-ops with no experience or clout cannot do) and bring down costs over the long term, meaning larger paychecks instead of your current shrinking one.

Your Money Out The Window

Aetna CEO Ron Williams took home over $24 million in compensation last year, the largest compensation of the top 10 health insurers’ combined $85.5 million. That’s your premium money at work. Did you know they also categorize any claims paid on your behalf as losses? That’s right, your care impairs their profits.

But don’t feel bad. The largest 10 for-profit health insurers still made $12.9 billion in profits in 2007. That’s a 428% increase since 2000.

There are also 6 healthcare lobbyists for every lawmaker in Washington, and so far $263 million has been spent on healthcare lobbying in 2009. All together that’s an awful lot of money that’s NOT being spent on your healthcare.

Take Action To Keep Your Benefits

So while there are hundreds of millions of dollars being spent to ensure things DO remain the same for entrenched special interests, your interests are not among them. If you like your healthcare benefits and want to keep them, it’s time to hop on the healthcare reform bandwagon.

To keep the status quo, we need change.
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COMMENTS
KDGllc
KDGllc
Las Vegas, NV
29 months ago: As stated, I don't think people realize just how much of their coverage is subsidized. My shock came when I left one of the major brokerage firms only to discover that my monthly (yes MONTHLY) COBRA premiums to continue my coverage were $2179! I was compelled to take the Nancy Reagan approach and JUST SAY NO! That was April of 2006 and I have not had affordable coverage since. Luckily, I have been in decent health (other than several minor athletic injuries that I chose not to get adequate PT and am 'paying' in other ways) and don't have any pre-existing conditions that would result in elevated premiums but it is still a secondary (vs. primary) expense for me and therefore I don't have coverage.

If you have a young or large family, you may get stuck in a go nowhere job just to get some medical coverage...
Altruist
Altruist
Eugene, OR
29 months ago: Good post. I am in the same boat as KDGllc. My COBRA was too expensive for my pension. By the time any health care reform would go into effect (2013) I will be eligible for Medicare so I will probably not be effected, however I care about the rest of the country and especially the uninsured.
I am hoping that if we can't get a good national program, that as Orin Hatch said, we can get individual states to experiment with different methods and then pick the winners. That is how Canada got their system. It started in the provinces. Oregon would probably be willing to get a single payer system going (with federal aid) and the experience of every other developed country in the world suggests that is the best way to get costs down. With a federal program the progressive states are being held back by the regressive states.
ActivelyFused
ActivelyFused
Tucson, AZ
29 months ago: Altruist--interesting idea. There are 19 countries (including the US) with variations of 4 different healthcare systems, so we have more than enough states to try out each one.

After all, the US ranks dead last in preventable deaths within those 19 countries. We rank last or next-to-last in the dimensions of an effective health system--quality, access, efficiency, equity, and healthy lives--compared to Australia, Canada, Germany, New Zealand, and the UK. We don't have much to lose!

As far as COBRA, when mine ran out (have to have insurance for a back injury and asthma medications) I discovered that small business insurance is even more expensive. I pay up to $25,000 before seeing any relief from medical bills, with a limited provider network. But it's still less than paying the uninsured price for care that's typically 300-500% more.
DuncanONeil
DuncanONeil
Milwaukee, WI
29 months ago: "First, the current trend of insurance costs is unsustainable. The price of insurance has risen 95.2% since 2000, while income has only risen 17.5%. These are findings from a study by Families USA, a non-profit that advocates for affordable healthcare (see External Links for the study URL).
This stat, while likely accurate, is essentially incomplete. The part that is missing is the issue of how money is being spent. While what I am about to say may be considered inappropriate it does illustrate the issue.
in the hundred years from 1895 to 1995 the moneys spent on the basics of food, clothing, and housing moved from 87% of income to 30%. This directly correlates to a huge increase in discretionary income. Further comparison of dispate numbers does not often work fot analysis.

What are you getting for that enormous increase? Fewer benefits. Higher deductibles. And bigger co-pays or coinsurance. "
Where is the data that benefits of employer plans are decreasing? What are the decrease? How does one define higher deductibles, and co-pays?
A lot of this feels like what I hear when a company and union come to an impasse. The choice is a pay freeze or decrease to keep a job or not concede and lose the job altogether.
ActivelyFused
ActivelyFused
Tucson, AZ
29 months ago: DuncanONeil--you apparently aren't a business owner. It's simple economics, where healthcare costs far outpace inflation, now with an economic slowdown to further drag companies down. To stay competitive in their markets, they need to pass on the costs to their employees.

Numerous studies have noted the general trend of healthcare costs outpacing income, coupled with benefits reductions, most recently the Kaiser Family Foundation just last week. KFF had similar findings to Families USA, comparing 1999-2008. Last year the cost of a family policy rose 5%, while wages rose only 3%.

They also found 40% of small business employees pay deductibles of $1000+, twice the percentage paying that in 2007 (yes, that's a year-over-year change.) Plus 41% of companies surveyed indicated they will likely increase the premium employees pay for coverage next year. So it's not just a "pay freeze", it's a significant and progressive annual pay reduction. That's not sustainable unless we all want to become unpaid volunteers in return for health coverage.

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