Health Insurance

ATeam

Senior Member
Retired Expediter
Time for Health Care deregulation ?

Only if you think doctors should not be licensed, drugs should not be tested before they come to market, hospitals should not be inspected, quacks should not be hindered, insurance companies should not be required to keep cash in reserve to fund major claims, etc.
 

coalminer

Veteran Expediter
Retired Expediter
They say that the ridiculous drug costs are so they can recoup the research and development costs. I say show me, a simple one page document that shows how much they spent developing the drug, how much is costs to manufacture and that it is spread over the time they have the patent on it.


Lay it out and justify the cost and most people will understand. But corporate America does not price things according to what they cost to produce, they price it as to what people will pay. Which is why they sell the same drugs overseas for much less, they can't afford the high prices.
 

blackpup

Veteran Expediter
Only if you think doctors should not be licensed, drugs should not be tested before they come to market, hospitals should not be inspected, quacks should not be hindered, insurance companies should not be required to keep cash in reserve to fund major claims, etc.
Regulation does increase the costs of medical care, where do you draw the line on regulation ?
 

ATeam

Senior Member
Retired Expediter
Regulation does increase the costs of medical care, where do you draw the line on regulation ?

Your question assumes that a clear line can be drawn in the most general of categories (regulation). The question is too general to answer. You can come up with a general, too-much/too-little principle about regulation to guide the lawmakers and rulemakers that create regulations, but the politics of each case will be more powerful in determining the outcome.

Take something as simple as a truck tire. What regulations apply to it? (They include weights and measures, excise tax, tread depth, disposal, import rules, fair trade rules, DOT standards, and more). How many different government entities and manufacturer organizations apply regulations to that tire? For each regulation that applies, how much regulation is too much? How little regulation is not enough? If you repealed a particular regulation, what would the effects be? Given those effects, is it desirable or undesirable to repeal it? With any regulation that affects costs, there will likely be winners and losers. How do you decide who gets to win and who gets to lose?

Note also that it is not always true that regulation increases costs of medical care. A case was cited above in which a man is able to obtain a $91,000 drug for a tiny fraction of that cost. For him, regulation (Obamacare) greatly decreased the price he paid.

Note further that increased costs due to regulation in one area may decrease costs more in others and thereby create net value for society. Example: Asbestos is banned as a construction material now, making it likely that more expensive materials are used. Asbestos also causes diseases that shorten lives and are expensive to treat. The tradeoff made here is not just about the price of construction materials. The true value of the reg is difficult to quantify because it is not an apples to apples comparison.
 
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ATeam

Senior Member
Retired Expediter

From the cited article: "Since the early 1900s, medical special interests have been lobbying politicians to reduce competition."

To be fair, every profession does this. Plumbers, electricians, building contractors, doctors and many others advocated to have their trades licensed so the public would be protected, while it also restricts suppl and reduces competition. Notice the OOIDA-drive underway right now to increase, through regulation, the driver-training requirement for a new CDL.

In the fitness business, personal training is a relatively new profession as gyms themselves have now risen to saturate the country. Not long ago, there were only a handful of gyms in the US. Now they are everywhere. Personal training is part of the larger fitness trend. Trainers have formed certification organizations to brand themselves and distinguish themselves from "amateurs."

As with most other professions, it will only be a matter of time before trainers band together and convince Washington that the trade needs to be licensed. That will protect trainers from the less-qualified people who are out there undermining the profession (as the professionals see it), and it will increase the pricing power trainers have. The trainers will win the Washington debate because the independent amateurs will not band together in sufficient numbers and influence to fight the proposal.The organized professionals will hire a lobbyist to get this done.

In another fitness business subcategory, Diane and I were personally affected by the reduced-competition phenomenon the article describes. When we entered the business, it was legal for gyms and tanning salons to offer red-light therapy for skin rejuvenation. It is similar to a tanning bed, only with a certain type of red lamps. Unlike tanning, this therapy was safe and effective, and it was also offered by medical providers.

Now, because the medical lobby was successful in Washington, it is illegal for gyms and tanning salons to offer this service unless a medical professional is on site to administer it. Nothing changed in the therapy itself and the medical professional does nothing that was not previously done. The person gets under the lamps for a while and that's that. To my knowledge there has never been a single case where an injury or other adverse result came out o this therapy. But with the new regulation, the practical effect is to limit this service to the medical clinics that now provide it at ten times the price or more. The price skyrocketed because competition was reduced, exactly as the article describes.

This goes to the points I raised above. Red-light skin rejuvenation is a specific service about which the too-much/too-little regulation questions can be asked. In my opinion, consumers would be better served by less regulation. The more this safe treatment is made available, the cheaper and more convenient it will be, and the better citizens will be served. But if your gut instinct is to use this example to argue all regulations should be repealed, you effectively license every home-basement meth factory to expand its product line to become a legal supplier of pharmaceuticals of all kinds.

The problem is not the regulations. The problem is the system in which the regulations are created is corrupt. This is not about the rules. It's about the moral condition of the people who serve in public office, and the people who elect them. Voters are corrupt too. They routinely place their individual interests ahead of the public good.
 
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blackpup

Veteran Expediter
This country needs open and fair competition in all phases of life. Exactly how to meet that standard ?

jimmy
 

ATeam

Senior Member
Retired Expediter
As with the regulation question you asked, the competition question is too general to answer.

With competition, you can't get far even in general terms. In golf there is the handicap. In school there is grading on the curve. In sports, there are leagues and weight classes. These are attempts to level the playing field in the interest of fairness. But is leveling the playing field truly fair? How is it fair to take away a natural advantage from someone who has it? How is it fair to give a disadvantaged person an edge he or she would not otherwise have?

When you speak of fair and open competition, you can't even discuss competition until you decide what fair and open means.

Regarding fair and open competition in "all phases of life," our gym business could compete better if we could be more easily seen from the street. That can be easily accomplished if the city would allow us to cut down the boulevard trees that block the sight lines. Other area gyms have better visibility than we do. In the name of fair and open competition in all phases of live, should the city change the ordinance to allow us to remove the trees?

If a public good is associated with the trees and I am not allowed to removed mine, should the cause of fair and open competition be addressed by requiring other gyms block their sight lines by planting trees on their boulevards?

How is it fair that other gyms can do without trees when I must keep mine? How is it fair that other gyms are not required to plant trees when I am prohibited from removing mine? If fair and open competition is the primary concern, tree policy should give way so it applies equally to all. Right?
 
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Mailer

Veteran Expediter
Owner/Operator
We along with many of our friends all with different insurance providers received word that our plans were canceling at the end of 2015. Our high deductible plan has been in place for many years with an HSA plan to help with the deductible. In all of the years we have had the Assurance Health Plan we never met our deductible yet each year our rates would go up from one hundred dollars to sometimes over three hundred dollars a year.

When I received the letter saying our insurance was ending I started researching. It appeared that our deductible per person was going to go up to $6500 and premium up to $954 a month. Talk about frustrated and irritated, less coverage more money.

Then I listened to a blog talk radio show "Ask the Trucker" and learned more about the Affordable Health Care Act and Owner Operators. Using our Adjusted Gross Income we qualified. For 2016 our premium is now 210.94 with a $175 dollar deductible and co-pay on doctors visits. We will also not need our HSA so in essence next year I will be saving about $800 a month on health care premiums.

When we could go to our doctor for DOT physicals we would get complete checks ups done. He though chose not to get certified as he said "I do not need that hassle, I am busy enough with out it". Now maybe we can get back to regularly scheduled checkups and continue to stay healthy as we are aging.

This is who I talked with to find out about getting insurance:
Transportation Contractors

I talked to Trey Walker and this is his direct line as well as his email. He has worked with several drivers in many different states.
[email protected] or call (877) 264-3196.

The Health Insurance Marketplace Calculator provides estimates of health insurance premiums and subsidies for people purchasing insurance on their own in health insurance exchanges (or “Marketplaces”) created by the Affordable Care Act (ACA). With this calculator, you can enter your income, age, and family size to estimate your eligibility for subsidies and how much you could spend on health insurance. You can also use this tool to estimate your eligibility for Medicaid. As eligibility requirements may vary by state, please contact your state’s Medicaid office or Marketplace with enrollment questions. We encourage other organizations to feature the calculator on their websites using the embed instructions.

Health Insurance Marketplace Calculator
 
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danthewolf00

Veteran Expediter
I'd love to see a cap on monthly insurance premiums.....since obamacare went in to effect my premium has gone up $20 every month which doesn't sound like a lot till you see that total hit $600+
 

ysracer

Expert Expediter
Owner/Operator
Nothing new there....

image.jpeg

Have you compared all available plans ? Sometimes you have to go with a different provider if you want the best deal, same as any other consumer purchase. Employers change plans and providers all the time to minimize cost, have for years. My premium has gone down $297.00/month since Obamacare started.

image.jpeg
 
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xiggi

Veteran Expediter
Owner/Operator
Nothing new there....

View attachment 12871

Have you compared all available plans ? Sometimes you have to go with a different provider if you want the best deal, same as any other consumer purchase. Employers change plans and providers all the time to minimize cost, have for years. My premium has gone down $297.00/month since Obamacare started.

View attachment 12873
Has the cost gone down or is some of the premium just being paid for you?
 
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ysracer

Expert Expediter
Owner/Operator
Both. The first year I bought a Gold plan. Second year I discovered that the Silver plans, for self employed like us qualifying for tax credits, offer better coverage, reduced deductible/max out-of-pocket costs, and, of course, a lower premium. So, there's that. But, again, if you line up all the offerings you can compare cost & coverage.

Last year I had Highmark BC/BS. That plan cost me $67.xx/month, face value was approx. $363.xx. My TOTAL out of pocket cost for the year, including monthly prescriptions, a few specialist office visits, AND a flashy bus ride to a Detroit hospital (Oakwood) - one day stay, CT scan, x-rays, blood tests, medications, IV, carotid artery ultrasound, EKG, EEG, etc.. was $10.00. Yes, ten dollars...

You see the plan I have this year. Premium went down to $47.03/month, face value is around $340.00. Deductible is same @ $100.00, but max out of pocket went to $1000.00 vs. $500.00. Generic prescriptions now $2.00 vs. $0.00. Still quite good !

When I was employed by a major corporation as recently as 2013 with "great benefits" (just ask them... ) PRE-OBAMACARE, and WITH THEIR BUYING POWER, the premium was $580.00/month, of which I contributed $200.00/month. My deductible was $1200.00 and max out of pocket per year was $3250.00.

So, the $297.00 above was an error. Should have said $240.00 ($580.00 minus $340.00). But the 2016 plan has much better benefits. If you want to include both monthly premium and tax credits it's gone down $533.00/month overall ($580.00 minus $47.00), and $153.00 from my pocket ($200.00 employee contribution minus $47.00). That's before the potential yearly (additional) out-of-pocket costs are considered ($3250.00 vs. $1000.00).

I am thinking that many who whine fall in to a few categories...
 
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xiggi

Veteran Expediter
Owner/Operator
Yp you sure get things wrong alot. It was a serious question. I would never say anyone should not take advantage of credits it is no different than us as drivers using all the tax deductions we can. At the same time when people talk about health insurance rates, we need to understand true costs because it impacts us all. Credits aren't magically free the money has to come frome somewhere.
 
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