The Health of a Nation

NY Times ^ | April 3, 2006 | ALLAN B. HUBBARD

[napscoordinator]

doesn't korea have universal insurance?

They may have something like that but even with that they still pay something which is why they check finances before any medical procedure. And maybe one of the items the must have is their universal card. The only thing that I know is that everyone must have their payments paid before any procedure and that could be having some sort of insurance.

[Alberta's Child]

The first step in "fixing" this country's health care issues is to completely sever the connection between employment and medical insurance. There's no reason -- other than a historical anomaly related to wage controls during World War II -- for employers to pay any kind of insurance premiums for their employees.

The author makes a very important point here . . . health care costs in this country are rising simply because most people "buy" medical care as if it's free.

[Alberta's Child]

What makes a medical savings account so attractive is that you should raise the deductible every year when you don't meet the previous year's cap. If I can put aside $5,000 per year to cover medical deductibles and I only use $2,000 during my first year in the plan, then my deductible for the second year should be raised to $8,000 -- which includes the $3,000 I didn't use from Year 1 plus another $5,000 for Year 2.

[spikeytx86]

sounds good, though I don't know how you can settle up your tab if you are unconscious but I am sure they have a clause where you must be stabilized in an emergency before they ask for your visa card.

[babygene]

"What makes a medical savings account so attractive"

Two problems:

First, for health insurance (in Idaho anyway), having a high deductible saves you very little in the way of premiums. 10% savings for $5000 deductible.

And second, you don't qualify for a medical savings plan unless you buy the qualified insurance.

[spikeytx86]

I never understood it either. Just give the employee the money segregated for benefits in the form of higher pay and let them decide what is good for there family. They can buy individual insurance or they could form alliances like AAA for health insurance to provide low cost group rates. We should also do away with mandates. We should have ala carte health insurance.

[napscoordinator]

LOL. True, but I think that get the dependents. That is funny though.

[P-40]

I don't want a $500 auto deductable

Pocket the savings in an account set up for deductables and take the cheaper policy. You save money and still have the security against surprises.

[DoughtyOne]

Thanks for the comment. I'll check it out. I'm up for renewal fairly soon.

[DoughtyOne]

You know what, I don't have a problem with that. Pay higher wages and let the employee sort it out. What I will tell you though, is that with outsourcing, illegal immigration and foreign trade, I think you're kidding yourself if you think wages are going to escalate enough for people to buy their own insurance.

Under such a plan, I'd predict that employers will raise salaries to cover about 50% of the cost they are now paying, and let the employees pick up the tab for the rest out of their current salary. In effect, that will result in a wage cut for just about every person who had healthcare thorugh their employer.

[DoughtyOne]

Thanks. My response in 49 to another poster fits your comments as well.

[Alberta's Child]

Here's what I think is more likely . . . Employers decide to set a benchmark for how much they will cover -- say, 100% of the premiums at their 2005 levels, with 5% escalation every year after that. So if your premiums went up 10% this year, the employer would pick up half the increase and you would pay the rest. If your premiums went up 12% next year, then the employer would cover a 5% increase and you'd be on the hook for the other 7%.

I know this sounds harsh, but that's exactly the way it should be. Since the employee is the one who is being covered, and who is making all of his health-related decisions, it is the employee who should be covering the cost of his own insurance. It would obviously help if there were a transition period similar to what I described above, but that is only a temporary situation. The end result would eventually be employees paying 100% of their medical costs, and employers freed from an enormous anchor on their operations.

What I will tell you though, is that with outsourcing, illegal immigration and foreign trade, I think you're kidding yourself if you think wages are going to escalate enough for people to buy their own insurance.

Right. In other words, people can't afford the quality of the health care they're now getting. They just don't know it yet.

[DoughtyOne]

What you have essentially agreed to here, is that with illgal immigration, outsourcing and foreign trade, the ability for workers in the U.S. to maintain medical coverage is vanishing.

I agree. You cannot saturate a working environment with as many alternatives as we are without wages declining to the point that the U.S. Citizen will lose benefits.

I guess we should be happy we can still afford to eat for the time being.

I don't forsee an economy that will sustain 100% of our workforce owning their own businesses any time soon. God help the rest.