And the problem is, the minimums to avoid monthly maintenance fees are often way too HIGH for much of the poor. For instance HSA Bank wants >$5,000 daily balance to avoid a full $30 per year in Monthly Maintenance fees. I think many more are >$2,500 minimum balances. So someone who can only put in $30-$50 a month (for whom tax-advantaged accounts are less attractive anyway due to paying lower tax rates) basically has half their tax “savings” eaten by the banking fees.
Cyberhwk
/Ex-HSA Owner
Last year I had a chest pain heart attack scare I was admitted into the hospital for observation. One day only, charge was $8,300.00!!!
Well to be fair, if you’re on minimum wage, you’ll be able to save that amount of money by…
…The heat death of the universe. If you’re lucky.
Oh please. That’s only 143 8-hour days. All you’d have to do is work every day for four months straight, not eat, and sleep in the street. Isn’t your healthcare worth that?
Well, all those extra pounds will simply melt away.
In the overall, this is true – an employer’s compensation cost includes benefits, so it makes no difference to the employer if the employees receive lower salaries and higher-cost insurance, or higher salaries with lower cost insurance.
But on an individual basis it doesn’t work that way. My husband’s employer offers a choice of health care plans. We could with some research determine what plan costs the employer the least – but we can’t get the amount saved by the employer added to my husband’s salary. We could, for example, select the high deductible plan and also elect to not have an HSA. The employer would save the $1000 they would have otherwise added to our HSA – they would not increase my husband’s salary $1000.
My friends did not need to shop around because they had an insurance company that had already shopped around for them. That is why they did not have to pay whatever the hotel wanted to charge them. A heart attack or any other emergency would be similar. You have an insurance company that has an arrangement with a hospital and either you get shipped directly there or get shipped there directly after being stabilized. It is therefore possible to shop around for healthcare and thus reduce prices.
The niece confirmed that the doctors who the insurance company was already paying were high quality.
Exactly, by negotiating you were able to act as a comparison shopper and get a deal. By being locked into a network because of their job your friends were not. That is why we need more people like you and fewer like your friends.
That is awful and yet we still have people who think the status quo is so good that it is crazy to change it.
Generally employers try to get you to pick lower priced plans by only paying part of the plans cost and thus making lower priced plans cheaper. That his employer refuses to pass along the $1,000 savings underscores how crazy the system is that bundles health insurance and employment.
Is that before or after America wises up and goes metric?
That just means you are locked into whatever hospital makes the deal that is most advantageous FOR THE INSURANCE COMPANY. That doesn’t mean it is the best deal for me, either financially or in terms of outcomes.
Hotel rooms at similar points on the price scale are pretty much interchangeable, and if you get a room at the Ramada versus the Days Inn, it’s not going to be particularly significant in the long run. Similarly, it’s no big deal if my auto insurer has rental-car arrangements with Hertz versus Enterprise versus Avis–they’re all relatively similar, and they all get the job done. I would never pick an auto insurer based on which car rental place they have a deal with (quite aside from the fact they can change their contractor mid-year).
Health care, though, is fundamentally different. Different hospitals have quite different specialties and areas of expertise; somebody upthread, for example, pointed out the difference that a stroke center can make in how much function you regain. In my town, one of the two major hospitals has an advanced stroke center, and the other one doesn’t. That doesn’t mean the other hospital is “low quality”; it just means that for that particular health problem, they don’t have quite as much expertise, equipment, staffing, etc., to achieve the best possible outcome.
Now it may make perfect sense for my insurer to shop around and determine that for THEM, Hospital B is the most advantageous, because on average their costs will be the lowest for a reasonable level of care. That does not imply that costs for any one health problem will be lower; they might be higher on some and lower on others. The insurer pays for the aggregate, but I pay for my own health problems. I might well end up paying more at Hospital B than at Hospital A, even though the arrangement is better for my insurer because they are paying for thousands of patients with myriad health problems.
Moreover, the cheaper outcome based on direct costs isn’t necessarily the cheaper outcome long-term. If I don’t recover as much function after a stroke, that might not be my insurer’s problem at all–for example, if I can’t return to work, my health insurer has no obligation to pay for long-term care or home health aides or other kinds of assistance. That’s a different policy with a different company. That’s Somebody Else’s Problem. As long as the care is good enough and cheap enough across all of the members of the group plan, whether it’s good enough and cheap enough for ME isn’t a consideration for my insurer.
In other words, your niece contributed exactly nothing to shopping around based on price.
Couple of years ago, my wife had a severe gall bladder attack and we went to emergency. The triage nurses and other support people all work for the Health Authority, and are paid as employees (ultimately from medical services plan payments). These MSP payments are $150/month for a family of three. If you make less than $30,000/year, these MSP payments are reduced until you make $22,000/year, at which point you do not pay. But you are covered. Of course - everyone is covered because everyone needs healthcare!
The drugs and other supplies were not too costly, as our entire province buys in bulk and gets a deal - especially on drugs. Surgeon and surgical staff were paid as specified in the negotiated agreements with the Doctors of BC.
End result was that she received great treatment, very quickly. She had her surgery within 12 hours. Very professional.
I’m not sure what the “Final bill” was, since everyone was paid as a matter of course (without having to bill insurance companies), and the supplies and drugs were simply purchased in bulk and then used for my wife’s procedures, with no worries about “who to charge”
Certainly a LOT LESS TIME was spent fussing about costs and who to bill, and what the insurance would cover, and what’s going on. This must contribute to lower costs for everyone. The best part in my opinion was that our family could focus exclusively on my wife’s health, surgery and recovery, without giving a moment’s thought to “how will this affect our finances?”
Er… no.
Actually, we did without a LOT of healthcare we reasonably “needed” because we just did not have the money even at the discounted rate. Even at discounted rates we simply could not purchase all the maintenance medications my spouse needed because at the time their cost exceeded our gross monthly income. Even at a 50% reduction off retail. Even with special programs to make drugs “affordable”.
Wait, I’ve got something better: Here’s a thread where I detail problems with getting a test I need for a prospective job as a no-insurance cash-only person (For the record, I was living in Indiana and had to go to a hospital in Illinois to get the test done)
That same year when I tried to get a tetanus booster - for which I was willing and able to pay the full cost out of pocket - I was repeatedly told no. I was told more than once to wait until I was injured and then got to an ER - which, by the way, would have cost about 20 times what the booster costs, and which there was no way in hell I could have paid it.
Maybe things have gotten better since then. Maybe not. But there are significant problems to 1) being without insurance and 2) trying to obtain medical care if you don’t have a lot of cash up front and 3) obtaining medical care even if you have cash to cover everything.
There are all sorts of assumptions built into the current system that jack people around and are just plain stupid from a public health and good medical practice standpoint.
Hell, $1,500 is about a tenth of my monthly costs. This “plan” is idiotic, if you ever have to use it. . . I suppose one could get lucky and get hit by a train, so that you don’t suffer at length and bankrupt your family before you did.
which would be a huge unnecessary drain - I think it’s impossible to over estimate how stressed people are here by needing healthcare, unless they are very well off.
Was this in the US of A? Sounds too sensible to have happened here.
Ha ha ha ha!
No.
This, of course, is the Canadian system. If I change jobs, my medical coverage remains the same. If I lose my job, my medical coverage remains the same. My families experiences with the medical system here have all been very positive. My parents have gone through many procedures, and it’s been good. My Mother in law did have to wait 6 months for knee surgery, but she was mobile, and her pain was handled well in that time. No, she could not skip the line and demand instant service because she’s rich, and therefore more important and better than the person with more urgent medical needs… but I’m OK with that.
Sadly, I don’t believe you will ever have a similar system. The middle layer of insurance companies are making way, WAY too much money from you now. They will NEVER let go of this, and they are VERY powerful politically.
You are so right.
You wouldn’t have a small garage apt for rent available after Nov 8 with room for one old lady, three cats, and two lovable and well-behaved dogs, would you? I’m lovable and well-behaved, too. I can cook.
We do have a nice suite downstairs… However, here is the bad news…