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Wed Jul 31, 2019, 12:16 PM

It's Not Employer Coverage - It's Coverage By Big Insurance Companies.....

that just so happens to be contracted with by companies (employers) to be used as a so called benefit for their employees.

It costs the company money to offer this as a benefit and the trend has been that it has become a shared cost by the company and the employee to continue to maintain this benefit.

At one time - such health insurance cost was covered completely by the company - but due to rising pricing by the private insurance companies - such employer plans have gotten more expensive and the company has constantly had to re-negotiate the plan with lesser coverage to maintain it or have the employee share more in the cost for the plan for the same coverage.

Employers have to have someone(s) in their company to be the point person(s) to work with private insurance companies to continue to provide this benefit. This becomes a burden for the company - to analyze plans and their conditions. The private insurance companies are always modifying their plans with these employers.

The Private Insurance Companies want more money (increase the price) to offer the same plan or in order to maintain the same dollar outlay by the company they reduce the plan coverage to the employee to be able to allow the company to maintain its same cost for offering the benefit. For the employer/company - managing this benefit becomes a burden.

I sometimes wonder why employers even want to mess with this constant game played by the private insurance companies of rising prices and/or reduced plan coverage. It seems that they would save money by not having to deal with this constant game with private insurance companies. It frees up that money that these employers have to use on providing a health benefit and allows them to perhaps give a raise of pay of their employees or offer different and maybe better benefits to their employees (i.e., more vacation, etc).

Interesting thing is if an employee leaves the company - they lose their health insurance and are left to fend for themselves or hope they get another job that offers health insurance as an employee benefit.

Yeah - a Medicare For All plan is a plan managed by the government and not a private insurance company. It is not employer coverage - because every U.S. citizen would be covered by such a plan. Said citizen would not have to worry about health coverage if they leave their job. They would maintain their coverage leaving them the freedom to take a job anywhere and not becoming a prisoner to their present job because they have to have health insurance.

Instead of having money come from their paycheck to pay for such coverage - they would be covered because they are a taxpayer and the same dollar amount or less (a portion of their taxes) would be used to allow them to have this Medicare For All coverage. All taxpaying Americans would be paying into such system. The biggest pool possible. No need for penalties for not having coverage. It would be automatic.

Realize that the bad guys in all this are the Private Insurance Companies (Corporations). These are the same corporations that are 'for profit' and whose main concern is minimizing coverage; denying coverage and reducing plan benefits so that from year to year these companies can make even more profit.

The goal is to free us from the clutches of these For Profit Private Insurance Companies.

Certainly there is more to this than I was able to post here but I thought this would be a start for this conversation. ACA was a wonderful initial attempt to move in the direction of a 'medicare for all' plan. It was a compromise plan and a plan that the Repugs continually decimated in favor of the corporate private insurance industry.

I believe now we are in a position to move to the next step and the ultimate step - a medicare for all system.

Removing the duplicate administrations of the myriad of private insurance companies for one plan administrator will alone go a long way to pay for a medicare for all system. It will remove that 'for profit' motivation from such insurance - where every year these private insurance companies have to bank more money than the year before for their stockholders and upper echelon of company management.



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Arrow 24 replies Author Time Post
Reply It's Not Employer Coverage - It's Coverage By Big Insurance Companies..... (Original post)
global1 Jul 2019 OP
jalan48 Jul 2019 #1
theaocp Jul 2019 #3
lostnfound Jul 2019 #4
VMA131Marine Jul 2019 #2
lostnfound Jul 2019 #5
DENVERPOPS Jul 2019 #23
Merlot Jul 2019 #6
global1 Jul 2019 #7
Merlot Jul 2019 #8
global1 Jul 2019 #10
DBoon Jul 2019 #11
ProfessorPlum Jul 2019 #9
Hortensis Jul 2019 #12
Hermit-The-Prog Jul 2019 #13
Dyedinthewoolliberal Jul 2019 #14
Poiuyt Jul 2019 #15
JCMach1 Jul 2019 #16
customerserviceguy Jul 2019 #17
patphil Jul 2019 #18
slumcamper Jul 2019 #19
IronLionZion Jul 2019 #20
stewrat Jul 2019 #21
SouthernProgressive Jul 2019 #22
yonder Jul 2019 #24

Response to global1 (Original post)

Wed Jul 31, 2019, 12:19 PM

1. Interesting that it is referred to as "private insurance" rather than "corporate insurance".

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Response to jalan48 (Reply #1)

Wed Jul 31, 2019, 12:37 PM

3. Agreed. Henceforth, I shall call it that.

Bloodsucking vampires can take up a new career learning to fuck themselves.

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Response to jalan48 (Reply #1)

Wed Jul 31, 2019, 12:46 PM

4. GREAT point. Nt

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Response to global1 (Original post)

Wed Jul 31, 2019, 12:21 PM

2. One thing I would add

Most large companies actually self insure medical plan benefits. They just use insurance companies to administer the plans and maintain provider networks.

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Response to VMA131Marine (Reply #2)

Wed Jul 31, 2019, 12:48 PM

5. I know people recently laid off by self-insured companies: tended to be older or sicker.

We suspect the desire to cut costs was a motivating factor. Hard to prove, though.

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Response to VMA131Marine (Reply #2)

Wed Jul 31, 2019, 03:20 PM

23. Another MAJOR thing that should be noted

It's not you get on Medicare and you are home free.

Just check the rates for "B", "C", and "D".

Medicare is next to nothing in coverage without all three supplementals. Note also, that none of those include eye, ear, or Dental care.

I support health care for all, much like other civilized countries, paid thru additional government taxes, but "Medicare For All" isn't the answer.......

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Response to global1 (Original post)

Wed Jul 31, 2019, 12:58 PM

6. If the publi option becomes available wouldn't corporations just

tell all their employees that they no longer offer insurance and go sign up for the public option?

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Response to Merlot (Reply #6)

Wed Jul 31, 2019, 01:17 PM

7. Firstly - I Believe It Is A Myth Perpetrated By The Private/Corporate Insurance Industry That.....

people will be upset losing their employee offered health insurance. Those politicians that spread that talk are usually well under the clutches of private/corporate insurance company campaign donations.

And I agree with you - most employers - in a shot - would abandon their company offered insurance plans for a public option. Like I said in my OP - it is a hassle for a company to manage that benefit almost on a year to year basis.

Even the companies that self-insure have to deal with the pool of employees they are dealt. If they have a older/sicker workforce - that increases the companies cost to be self-insured. That's why self-insured companies are usually larger companies with a lot of employees - to broaden out the pool. They hire younger (healthier) employees that don't require a large amount of health care.

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Response to global1 (Reply #7)

Wed Jul 31, 2019, 01:22 PM

8. That makes sense - why would people be upset to loose the insurance

that makes them jump through hoops, is complicated, unstable, expensive, and still may not cover everything in an emergency or long term care situation? Why indeed.

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Response to Merlot (Reply #8)

Wed Jul 31, 2019, 01:24 PM

10. You Hit The Nail On The Head.....

and it really upset me that some of the moderate Dems on the stage last night appeared to be spreading Repug talking points. You got to ask yourself why and maybe follow the money.

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Response to Merlot (Reply #8)

Wed Jul 31, 2019, 01:32 PM

11. anyone covered by private insurance has horror stories about huge bills delayed or denied treatment

Example: Doctor is in plan, procedure is covered, but facility isn't in plan = letter from insurance company saying coverage is denied immediately prior to procedure

Another example: Insurance company sends nondescript postal mail supposedly about an audit. Looks like junk mail, nothing to indicate urgency. The actual content of this forgettable letter is a statement that your spouse will be dropped from coverage due to having a different last name.

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Response to Merlot (Reply #6)

Wed Jul 31, 2019, 01:23 PM

9. This! I've been saying this forever

we have to stop saying "you can keep your coverage" when that decision isn't up to the government, it's up to each individual company. And most of them, as you indicate, will breath a sigh of relief and slough their employees onto the public plan.

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Response to global1 (Original post)

Wed Jul 31, 2019, 01:32 PM

12. Let's not be dishonest. Workplace insurance is an EARNED BENEFIT,

income taken in the form of health insurance that costs less than it would paid out of pocket. It used to be a great deal.

As costs soared, though, more and more employers want out from under it and more and more employees found they'd do better through the ACA. Or someday, another program. I went part-time specifically to qualify for the ACA, and I fully intended to sign up for its single-payer option as soon as it became available.

And let's also not be dishonest by pretending that MfA plans require molding everyone into Sanders-shape pegs to fit into a Sanders-shape hole. Some of our candidates are running on MfA plans that don't require that at all. Those relatively few employers who might want to offer better than the national program as an incentive for people to work there should always have that freedom, and employees of those companies should always have that option.

And I'll vote against any candidate who doesn't share that principle.

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Response to global1 (Original post)

Wed Jul 31, 2019, 01:55 PM

13. and it is still health care for profit

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Response to global1 (Original post)

Wed Jul 31, 2019, 01:58 PM

14. I agree.

I work for a social service agency and we are organized. When contract talks come up, insurance is always on our agenda. We know, and the agency does too, that the real issue is the insurance industry. My union (SEIU) is huge nationally.

I have suggested to my local union staff that the SEIU ought consider providing insurance for its members. With the size of the pool, they would probably get a decent price. But then I remember one of Peter Drucker's questions he always asks management of any enterprise; 'what business are you in?'.

The union is not in the insurance business so they aren't going to go there. The answer is making insurance a right for every person living here. Take the best of what the other industrialized nations have done with this issue and make it fit the US. It can be done. Those that claim it can't either have a stake in the way things are, or don't truly understand what we are talking about....

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Response to global1 (Original post)

Wed Jul 31, 2019, 02:12 PM

15. Nobody is emotionally attached to their health insurance provider

It's not like buying the same kind of car or something like that. In fact, I'll bet most people don't even know what health insurance they have.

If you work for a company, you take the kind of insurance they offer. Remember, the company can change insurance companies, or if you switched jobs, you'd probably get a different plan. Nobody cares. You just want insurance.

I would gladly take a single payer health insurance over private (or corporate). It would be better and would cost less.

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Response to global1 (Original post)

Wed Jul 31, 2019, 02:15 PM

16. About to experience this I am afraid... Family is currently on ACA

It's Texas. I am taking a new job with benefits. I will probably just be over the premium level for keeping my good ACA insurance.

Choice? Really?

What planet are Republicans living on?

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Response to global1 (Original post)

Wed Jul 31, 2019, 03:01 PM

17. There's a 900-lb. gorilla in the room

We have a medical/insurance system that breaks people up into tiers.

At the top tier, you have people with Cadillac insurance, with modest premiums deducted from paychecks, low deductibles and co-pays, and high caps on benefits being provided, often by companies that don't do a lot of squeezing on healthcare providers (relatively).

The next tier consists of people with lower-quality insurance, they have higher deductibles and co-pays, and not as much of their needs (psychiatric, for instance) are covered. That's where probably most people are.

The next tier after that is the folks on Medicare or Medicaid, or some other such governmental system. They have to be able to find healthcare providers that will take the lower reimbursement payments offered, and those providers know they're not going to recover all of the co-pays, deductibles, etc., so they build that into the acceptance rate of those patients.

At the bottom are people with zero insurance, who get charged the full rip-off price for anything, because they're not "members" of some sacred group, and they often face the choice of doing without necessities to pay a bill, or filing for bankruptcy. They pretty much get emergency care only, and don't often bother to seek timely treatment from the healthcare industry.

When unions negotiate top-quality benefits for their members and the members' families, the employers see the value of putting these workers into that top tier. The employees have less financial stress, and can get in sooner to better quality providers, and be back on the job sooner.

Medicare-for-All lumps all of us into one tier, and that's threatening to people in the top two tiers.

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Response to global1 (Original post)

Wed Jul 31, 2019, 03:12 PM

18. I agree Medicare for All is not about taking away people's insurance.

It will bring us close to universal healthcare coverage. The insurance companies don't like it because the government would dictate the rules of coverage.
This could slow down or even stop the rapid rise in healthcare costs while making sure everyone could get good coverage at an affordable cost.

It's an idea whose time has come, but we need both Houses of Congress and the White House to do it.
Look how the Republicans torpedoed the ACA under Obama.

Ultimately, health insurance has to be non-profit, as does the entire medical industry.
Other countries have successfully done this, we should be able to do it here.
The health of our citizens is one of the best investments we can make for our country's future.

Patrick Phillips

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Response to global1 (Original post)

Wed Jul 31, 2019, 03:12 PM

19. Is it just me, or do we SUCK at messaging?

Does it not occur to the DNC, DSCC, DCCC, or campaigns that we MUST penetrate thick skulls.
We are failing miserably, IMHO. Nothing of significance is getting through--and what does becomes fodder for ridicule or worse.

(from a town of 1500 people in rural Iowa, where most people have a mediocre high school education, have limited interest in or exposure to cultural opportunities, and very limited experience interacting with people other than WASP types).



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Response to global1 (Original post)

Wed Jul 31, 2019, 03:14 PM

20. I'm sure many employers would save costs with Medicare for all

it would be easier for them to pay the tax than to have their HR departments work with insurance companies to develop plans and benefits and premium/deductible pricing. Smaller employers would likely benefit more since they have less bargaining power with insurance companies.

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Response to global1 (Original post)

Wed Jul 31, 2019, 03:19 PM

21. the trouble I see with medicare for all...

is it may shift the financial burden from employers to taxpayers. Would Fortune 500 Employers that are self insured and or purchase insurance be taxed to offset what they are currently paying out? Or does the price get shifted to the consumer? Employers would love to be free from paying health benefits.

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Response to global1 (Original post)

Wed Jul 31, 2019, 03:20 PM

22. It's a bond we must break. I realized that a couple of decades ago. NT

 

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Response to global1 (Original post)

Wed Jul 31, 2019, 03:32 PM

24. That is an important distinction.

Change the descriptor from the much cozier "private or employer" to the cold, clanky and ever-greedy "corporate".

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