Unfortunately, most of Europe isn’t far behind, with the U.K. leading the rest of Europe in this regard. The Netherlands seems slightly less affected, attributed to our bicycling habits. Even so, we too have a fast growing problem that needs to be dealt with.
First off, I’d like to apologize to you, Weirddave, for my out of line comments in the thread two or three weeks ago.
This is incorrect. There are, in fact, according to this PDF from the New Jersey Individual Health Coverage Program board, 13 companies. The prices seem a bit high to me (ludicrously high in some cases), but I don’t live in what is one of the most expensive states in the country to live in. I’d wonder how the rates compare to New York or California. I’d also wonder how many more of your facts are incorrect.
My problem isn’t that they were making money; it’s that they were doing so by making health insurance more difficult to afford by raising my insurance rates by 50%. Basically, I was going to be paying $100 a month more for the same level of service. Because of what my employer was paying me and what my expenses were, I could not afford it. That extra $100 a month would have pushed things to the point where it was a better financial gamble for me to do without health insurance completely. That’s why I told my employer, “If they do this, I will not be able to afford health insurance and I’ll have to opt out.” It really did come down to pay my health insurance or pay my mortgage. I was lucky. My employer persuaded the insurance company to come up with an alternate plan which resulted in a much smaller increase (I forget how much).
It’s capitalism in action. The seller tried to raise his price to much and one buyer refused to pay. On the other hand, we were a tiny company which made HR (aka 1 owner) much more responsive to 1 employee. The insurer didn’t have that much to lose by cutting our rates when we objected. If they’d tried this with a larger company I don’t know what would have happened. I might well have decided this was one expense I would have to cut. As I said, I’m in excellent health and, at the time of the rate increase, I wasn’t using my health insurance for anything on a regular basis. Basically, I did exactly what you told me to do: told HR, “This won’t work. I need an alternative.” As an administrative assistant then and an IT grunt now, that’s about the limit of what I can do unless I choose to launch a full-scale crusade.
What I object to is being told I want others to subsidize my health insurance when it seems to me it’s the other way around!
CJ
So your beef is that I said “only a couple” when there are actually 13 companies that are “offering” individual health insurance plans in NJ? ( one company’s lowest rate for 2 adults is $2500/month. Sure they’re “offering” insurance. Bet they don’t sell much of it. While technically they are selling individual health plans, is $2500/month practical for anyone you know?) Seems like a pretty quibbling semantical issue, especially considering that according to the chart you linked, my point is proved. Rates for two adults are well over a thousand dollars a month across the board for the most part, the exception being plans with extremely high deductibles and some HMOs.
However, you are undoubtedly technically correct. There ARE 13 companies offering individual health plans in New Jersey. Amend my earlier statement to say “now there are only a couple offering plans that are even marginally affordable”.
We need some clarification in terms. When we talk about “health care”, we’re not talking about “insurance”.
Insurance, at the root, is a business that evaluates risk vs. gain. What insurance does is provide benefits in the eventuality you incur a medical cost. Premium is derived from the amount of risk, with input from mortality and morbidity tables (hello, Actuaries!). Risk vs. gain is the game.
Health Care is the process of providing medical and surgical care to individuals. It can exist fully independently from insurance.
As to guarantee issue states, WierdDave couldn’t have stated it better. When we apply mandated risk acceptance with an unknown applying sample, we get what is known in the industry as “anti-selection”. This is when only the sickest people take the mandated coverage (the healthier folks may have jobs with better insurance), making the entire bloc of business a money-loser. This is why the premiums rose, and why the companies left NJ. Anti-selection is bad.
As far as Bush fixing the “health care problem”…the problem hasn’t even been identified yet. Is it tort reform (trial lawyers, who DO need to have clients, but tend to ask for damages considered excessive), is it the delivery system of our medical care? Is it the pharmaceutical costs, and their disproportinate effect on medical claims costs?
It’s easy to pick on the insurance companies. What needs to change? I don’t know, but as always, it will probably end up being a combination of things. If the government is driving it, I’m worried. A bipartisan government does not make long-lasting, well-reasoned decisions.
Siege,
I’m not defending that your company raised rates, and I applaud you and you boss for doing what you did. More people should be doing exactly that type of thing, the medical billing system in this country is completely out of whack, in a large part because there is no financial accountability in the system. I’m just saying that until people speak up, companies are going to try and maximize profits, that’s what they exist for, and I find it difficult to fault them for it. Hell, if people were willing to pay $100K for a Saturn, don’t you think that’s what GM would charge?
Thanks to Tuckerfan and DMC for the information on taxation. Much appreciated.
Lest my initial post be interpreted as being less than enthusiastic about Canadian universal health care, I’d like to clarify that I feel lucky to live in a country with such a system in place.
You haven’t proved anything. How many companies have withdrawn from New Jersey? I see no reason to believe that your previous estimate that there were 25-30 companies is any more accurate than your estimate of a “couple” now. What rates did they charge then for individual insurance? Have those rates gone up consistently with the rate increases nationwide or have they gone up at a higher rate? 10% higher, 100% higher, 1000% higher? How do New Jersey rates compare with rates in peer states? You’ve not provided any evidence, not even anecdotal evidence, that your assertions are true. Why then should I agree with your conclusion?
This is not quite true. The US is ranked 26th in terms of life expectancy at birth.
Andorra, Australia, Austria, Belgium, Canada, Cyprus, Finland, France, Germany, Greece, Iceland, Israel, Italy, Japan, Luxembourg, Malta, Monaco, Netherlands, New Zealand, Norway, San Marino, Spain, Sweden, Switzerland and the UK all have a higher life expectancy than the US.
As far as anecdotal evidence goes, I have plenty to give in relation to the state of Illinois, specifically in the Chicago area. I don’t have a lot of time to find cites, so if someone would like to back me up, that would be fine. This is anecdotal, however.
Back in 1996, the first aspect of HIPAA came into being (insert choir of angels here). Specifically within the industry, it dealt with the removal of rate-ups (adding premium to individuals based upon health history) and declinations, provided the employee had a year of prior coverage. Additionally, Illinois mandated that insurance companies could only rate up small (2-26 lives) groups to a maximum of 66% (I believe…it’s been a while).
What this did was to make the small group market a virtual dumping ground for the sick. If an employee had a fairly serious condition, they would go to a small-group employer and get coverage. In the worst scenario, a sick employee would have to wait 12 months until being covered for their serious condition.
This, predictably, made the insurance companies do one of two things: either they would rate the entire group up to the state (IL)-allowed maximum of 66%, regardless of health conditions, or secondly…leave.
When I was an insurance broker (ask the broker!), we had approximately 25 small-group markets to choose from for our small clients. As of 2005, there are about 8-10 companies that will write small group, of which only 3 have Standard and Poor’s ratings of an acceptable rating.
Yay, IL!
What “evidence” are you looking for? That companies left NJ? Mine was one of them, and trust me, there were a lot more. That the rates you linked to are fucking outrageous? Here in Md. I can write policies for 2 people for $300, or do a fucking search on ehealthinsurance for any damn local state you like and see how far out of line NJ rates are. That the rates are up? Gee, I dunno, I suppose you’ll just have to take my word on that one, considering that this is exactly what I do and have been doing since right after NJ made those changes. What the fuck licenses in insurance do you hold or what expertise do you have that leads you to suggest that I’m making this all up?
There. You’ve proved that one company left NJ. Yours.
My last COBRA was $350 a month, and my current employer is paying about $400 a month. Both are for bare-bones policies. (I’m single - 47.)New Jersey being a more expensive state than Colorado, the lower rates didn’t seem out of line to me, and I don’t know what the non-HMO policies cover. They may be a good deal to people with that kind of money to spend.
Rates are up everywhere! Are the increases in NJ comparable to increases everywhere else?
I’m pleased to find that you are an authority, knowledgeable enough to know that there were only a “couple” of companies still offering individual policies. Perhaps when the board goes to custom titles, you can have yours be “Health Insurance Expert”.
I have a natural skepticism of anything that comes from your keyboard. This thread has shown me no reason to change that.
So you’re just blowing smoke for the hell of it. Good to know.
Oh, and since your last post demonstrates pretty clearly that you don’t know the difference between COBRA coverage and individual health insurance plans, perhaps you might want to educate yourself a little bit on the subject at hand before continuing. Then you can go on with your little grammatical nitpick without worrying that you are making even bigger mistakes yourself.
Weirddave, I’m still confused a bit. When someone brought up the possible option of legislation that would regulate the cost of healthcare, your rebuttal was what you considered poor legislation that affected the availability of healthcare, with no regard to cost.
While it’s possible that I’m missing something, I’ve read the two posts in question several times over and just don’t see that you’ve responded to the point at all.
I think the problem is what another poster brought up: The dichotomy of terms. My posts have been directed at issues affecting the cost of health insurance, which is seperate from issues reguarding the cost od health care (although on rereading, my HIPAA digression did blur the line a bit, I admit)
Here was the initial comment:
Your response was:
At this point, I was confused, and apparently so were others, as you were responded to with:
To that, you had this to say:
I’m not seeing a connection between limiting the amount an insurer can charge and limiting their profitability, but I am perfectly willing to be educated.
On another front, you seem to be arguing specifically about individual health insurance, while the OP, and the majority of the issues being raised in this thread are with health insurance in a more general fashion, or even specifically employer provided/subsidized coverage. I’m not sure that what is a problem for one is necessarily a problem for the other, and vice versa. If you feel differently, the onus is on you to demonstrate why.
Finally, throwing around random rates for insurance coverage doesn’t mean a whole lot without the necessary background as to what that coverage entails. I can get coverage for myself $100 or $500 (or more) in the same state, but what I get for my money varies greatly between the two.
Well, limiting what an insurance company can charge certainly limits their profitability, wouldn’t you agree?
No, I don’t disagree, which is why I made sure to differentiate between individual policies and employer sponsored ones. It’s when people have to pay for their insurance themselves that the rubber meets the road, isn’t it? If a third party ( like an employer ) is willing to pay for insurance, than it doesn’t matter what it costs, does it?
You make a good point, but when a link is provided that insurance in NJ starts at $610 for a couple, and that for a policy with a ten thousand dollar deductible ,and then goes up from there, it’s clear that we are talking about obscene amounts of money which most folks can’t afford…
Yes, but the converse isn’t necessarily true, which was the argument you were making. If you limit me to charging $100, you limit my profitability. If you limit my profits to 25% of my gross, you don’t. In fact, you encourage me to raise my prices. 25% of a billion dollars is a hell of a lot more than 25% of five hundred million, so I’m shooting for that billion, and as long as it doesn’t cost me over half of my customer base to double the price, I come out ahead.
One of the complaints in this thread, and it’s one that I’m personally familiar with, is that even employer provided/subsidized insurance currently sucks eggs for many of us. The OP had that issue, in that even with insurance, his out of pocket expenses were quite large. I happen to be privately insured, even though my employer offers low priced health insurance. I didn’t go this route because I like throwing money away, I did it because my employer’s offering sucks horribly. Their maximum yearly coverage amount of the best plan they offered was $15,000. If I were to use that, and were to have an emergency which required an expensive procedure, I’d probably be bankrupt in no time. That’s for a person who is not only employed, but very well employed. There’s something wrong with our system.
Yes, but that’s private insurance, which is pretty expensive everywhere for the good stuff, and I don’t think nearly as widely used as the alternatives. I still think that the majority of the people in this country either have insurance through their employer, or are too poor to even afford your more reasonable policies. These two groups are also the ones with the biggest complaints from where I sit.
Yes. Countries like Bangladesh, Kenya, Nigeria, Zimbabwe and Sri Lanka. In fact, I don’t see one country in that list (with the possible exception of Israel) that have a higher infant mortality rate than the US while simultaneously being anywhere near the US level of technological and economical development.
So let’s look at some actual competition. My own country of Sweden, which is what you’d probably consider a socialist country, has an infant mortality rate below half of that of the US, and Swedes live on average three years longer. Norway, another pinko state in your eyes, isn’t far behind, and nor is Denmark, to round out the Scandinavian commie crowd.
How come, if the American system is so much better than ours, that your figures are so much worse?