There’s no option for me. My employer provided insurance is great , for private insurance. I pay about $500 in premiums, my copay is $25 for an office visit ( higher for urgent care or an ER) and my deductible for out-of network coverage is $1500 per person. But - my insurance costs my employer another $24K. I’m not sure it’s worth over $30K , considering that I may or may not be able to keep my doctor if I like him- just because the doctor was in-network last year doesn’t mean he will be next year. And while I might not have a problem paying my primary ( who no longer participates) $70 for an office visit rather than my $25 copay, that doesn’t mean the same will be true if the GI doctor stops participating and I have to pay $2675 for a colonoscopy rather than $25. Of course, I don’t know if he’ll charge me $2675 if he leaves the network - according to the claim form, he billed $2675 but accepted $642 from the insurance company. The whole billing system doesn’t make sense- I read someone that one of the reasons doctors bill so high is because insurance companies naturally won’t pay more than the bill so the doctors bill higher than any insurance company will pay. I still have to worry about whether I will end up with a non-participating provider in an emergency room situations , although my state provides some protection against balance billing. I can’t help but wonder how much less expensive the whole process would be if doctors didn’t have to have billing services and office staff to deal with the insurance companies - and whether taxes for a decent public healthcare system would be more than the over $30K I’m essentially paying now. ( Sure, my employer pays $24K, but that’s part of my compensation just like my paycheck)
Can I ask you what part of the ACA caused this ( if you know) ? I’ve heard people complain that they could not longer get the plan they had before because the ACA didn’t allow cheap plans with low coverage limits ( plans with yearly limits of $2K or $5K) and I’ve heard people say their costs went up because the compliant plans were more expensive but I’ve never heard anyone say that ACA required their company to change to a plan that was more expensive for the employees and had worse benefits.
I thought about bringing up unions, which are an exception to my previous comment in that they have a contract for several years, and negotiations have much more long-term consistency even beyond that. They are a pretty small minority though.
I’m skeptical, having worked in billing for healthcare insurance. If your company’s plan had to be gutted to meet ACA requirements, that means it either had extremely high deductibles and out-of-pockets, which you state it didn’t, or it didn’t cover any pre-existing conditions. All the plans my own family members were on were viable ACA-worthy plans. Most decent plans were.
It sounds a lot more like the company was trying to save money in the face of rising insurance costs (due to insurance companies jacking up their rates) by switching to a crappier plan, and then blaming it all on Obamacare. I saw this happen over and over again. Sadly, people believed the companies when they blamed Obamacare. If your company’s previous plan was any good, it would have remained a qualified plan, as did many, many insurance plans.
If you can point out what part of your old plan didn’t qualify under the ACA, please do. Because otherwise, it sounds like you were lied to.
Question: If I was self employed and purchased a plan on my own, would I be able to write it off my taxes as a business expense?
My husband’s new employer offers insurance that would cost us 25% of his salary. Not worth it.
We are members of a concierge clinic for a PCP and maintenance, and will join a Christian cost-sharing group for critical care.
What I find frustrating are the attitudes about the whole system:
I don’t like mine, so I won’t believe anyone else likes theirs.
I don’t like mine, so no one should have a choice.
Taxes? Costs? fingers in ears “la la la I can’t hear you!”
I guess every penny that is now spent on the system will somehow magically end up in the hands of the government bureaucracy that will always make wise and sensible decisions, will never have a problem with fraud, and won’t siphon off a huge chunk in administration costs.
Your employer can change it at any time! As if the government would never arbitrarily make changes or cut coverage.
Realities like the numbers of doctors and other personnel, and the number of facilities are blissfully ignored. Everyone seems to assume that upon passage all will be right and there will be no miserable lag time for the system to catch up to demand.
The point about employer-based coverage not necessarily being a guarantee that nothing will change is mainly a counter to the argument against switching to universal healthcare which is that people who like their current healthcare would lose it. The point is OK sure, but the current system has little to no guarantee as is.
I happen to like my health insurance, but overall the system is both extremely inefficient and failing too many people. Medical bills are still the number one reason for bankruptcy in the US, and as has been mentioned in this thread, a lot of people are satisfied with their insurance until they actually have a major medical problem and they find out that they weren’t as well-insured as the thought they were.
Personally as far as taxes go, I think single-payer will only work if we continue to tax it similarly to social security and medicare are taxed now, with a separate tax fund that’s a mandatory part of the budget (as far as details, increasing medicare income and payroll tax would probably make the most sense IMO). Otherwise the public option would be a safer long-term bet.
And what’s really terrible about the way it works now is that the employer portion of the premium is, essentially, paid in company scrip, like if you worked in an asbestos mine owned by a gilded era robber-baron. You either buy your insurance from the company store or you lose all of that money. If another plan would work better, tough shit, because your employer will pay nothing toward it and will also give you nothing for saving them on premiums.
So wait… you’re basically advocating a payroll tax on employers to make up for this shortfall? They’re going to LOVE that, especially if they’re paying less than whatever this payroll tax costs. And I suspect that’ll be passed on to employees via lower pay in a lot of cases.
There’s no such thing as a free lunch. Someone is going to have to pay for it- the trick is going to be to readjust taxation in the absence of insurance premiums such that the tax burden isn’t higher on anyone but possibly the rich. And IMO, that’s a tall order.
Nope, he’s proposing to make an explicit payroll tax out of what is already a de facto payroll tax.
I think you’re missing the point that this money is already being paid out.
We’re all already paying for it - but it’s be rebranded so many many people are not aware of the true costs of our current system, or how it’s being paid, or the pitfalls that don’t show up until you have an emergency.
The thing is that it’s a de facto payroll tax for which employers control the payment and the amount. I don’t see a lot of support for a de jure payroll tax out there.
For example, I’m sure that my employer pays more of my total insurance cost than the people who pay $1000/month in premiums and have a $5000 deductible. I don’t think either employer would like the idea that they’re now mandated to pay the same amount- one would probably view it as the removal of a perk they can wield to attract better employees (at a cost), and the other would view it as unreasonably increasing costs. Whether or not it’s morally right or wrong doesn’t much come into whether employers will support this tax.
And do we KNOW that this mandatory payroll tax will actually foot the bill? That’s the kind of thing I’m talking about- before this will get traction, someone’s going to have to show that between rejiggering the amount of money paid for insurance vs. UHC and whatever savings can be had by simplifying/unifying the current byzantine system, that we can have UHC without any larger out-of-pocket increases in tax to the average middle class person.
It is a bad thing that employers can wield this power. One of the benefits of implement UHC is that people are no longer beholden to their employers for healthcare. This is a feature of UHC, not a bug. Losing a job is traumatic enough already, it’s truly horrific if that also means losing your insurance. It’s a significant drag on the economy that healthcare is such a major consideration for somebody switching jobs, and most especially for an entrepreneur who wants to start a small business.
In any event, I’m not advocating any particular implementation. I think funding UHC out of income tax is probably preferable. But I’m pointing out the arithmetic - that there is already effectively a $30k payroll tax that goes to private insurers, so if this $30k is simply redirected to a public insurance pool, nobody’s economics have changed.
Before UHC:
Employer pays $70k to employee plus $30k to insurance company
Employee receives $70k
After UHC:
Employer pays $100k
Employee receives $100k minus $30k in some form of tax that funds UHC
To call this a $30k tax increase is misleading - everyone is economically exactly the same.
It’s not going to work exactly like that because employers aren’t going to pass along their savings to their employees until competition or other factors requires them to. But those that have been offering health insurance will see a boost in profitability under single payer and we can recoup some of that in our tax collections.
We can do this and the naysayers are wrong.
My primary point is the basic arithmetic that this $30k is already being “taken out” of the current system, even if it’s not nominally a tax. So if $30k taken out somewhere in taxes (income, payroll, corporate, whatever) to fund UHC, it’s not some huge new net subtraction from the overall pot.
You still didn’t answer my question, and went off on a right/wrong tangent. Can it be funded without raising taxes on people or not?
And my point was that employers aren’t going to like it even if it’s the right thing to do, and are liable to apply intense lobbying pressure to prevent it. Remember, this isn’t going to happen by presidential fiat- whoever champions this is going to have to get a majority of the House and Senate on board, as well as the President. And more than likely fight off lots of lawsuits as well. Building consensus and explaining how it doesn’t unduly screw anyone in particular is going to be critical, regardless of the rightness/wrongness of anyone’s positions.
I’m not at all against UHC, but I also think that it’s going to take some convincing beyond “it’s the right thing to do”, and a lot of that convincing is going to have to take the form of proving to people and employers that they’re not going to pay more for less under this system, even if it does help other people. The public in aggregate aren’t concerned about “other people”- they want to know first and foremost how it’ll affect them and their families. And if they’re like most people, they’re not going to take kindly to change that is going to cut into their current financial situation.
Well, I guess an example of it working better than the U.S. system would help, right? Do you have an atlas and a pin?
My guess is that major corporations will fight it because it’s one way they lose leverage over their workers. However, small businesses will be very in favor of it because it really brings their costs to employ workers down dramatically. The smaller businesses tend to not be able to afford the better health care plans, so it’s a real drain on both their bottom line and the “perk” of attracting good help.
I love my employer-provided private insurance.
It costs less than $200/month for my entire family. My wife has had two minor surgeries, and we’ve had 5 children born under our current plan. We’ve paid very close to $0 out of pocket.
That’s a misleading question to ask. The right question is whether or not this will raise costs to the average citizen.
Yes, most employed people are going to pay more in taxes in a single payer US.
It’s ‘Ok’ because even though I pay a lot, it works pretty well and we don’t get much hassle from the insurance companies when we need to have something done (mostly dental, prescription meds and my basal cell carcinoma visits and surgeries).
I don’t ‘Love’ it because I pay so much. Now, the insurance I had where I paid maybe $100-$200 a month for insurance that actually cost $2200 a month (this was in the 2000s) - that’s something I could love.
It doesn’t ‘Suck’ because it mostly works when we need it. It’s not like we’re paying a ton of money and getting nothing out of it.