Why is health care still tied to employers?

[GIGObuster]

@flickster

Why should an employer provide the same benefits to ex-employees?

Gee, what happened to the competition?

Maybe being a union member gave them a false sense of security that their job could never be eliminated…that’s the very lack of flexibility that helped sink the automakers, along with the unionized jobs in other industry that have been exported out of this country.

And there you have one of the best examples on why the health system that we currently have is an irrational one.

[flickster]

@GIGObuster

Gee, what happened to the competition?

I fail to see how an employer having to still provide the same benefits to ex-employees has anything to do with competition - other than it would prevent the company from being able to compete in the marketplace.

I would assume the ex-employees developed marketable skills while employed there. Those skills should allow them have value on the open employment market and firms should COMPETE to get them to sign on as employees.

Now on the other hand, if they are sitting around the union hall, that’s a whole different issue.

Sadly, the insurance companies (specially in the last example) demonstrate that they do not understand your “clear” points either.

I’ve been involved in the HR world for over 25 years, have NEVER heard of that type of scenario. Pre-existing conditions are waved as long as you enroll in your new plan while the old one is still in effect. Period.

[UltraVires]

@flickster

The concern is having coverage, I really don’t give a damn about the taxes

But you understand how tax policy encourages spending?

[flickster]

@jtgain

But you understand how tax policy encourages spending?

In relation to employer provided employee health benefits? You’ve lost me

[UltraVires]

@flickster

In relation to employer provided employee health benefits? You’ve lost me

If it encourages employers to buy policies for their employees, it would encourage employees to buy for them/families.

Or, if it didn’t. Why a tax break for the rich CEO, but not the burger flipper?

[GIGObuster]

@flickster

I’ve been involved in the HR world for over 25 years, have NEVER heard of that type of scenario. Pre-existing conditions are waved as long as you enroll in your new plan while the old one is still in effect. Period.

As one insurance company told my brother once: “Just because we told you (or the employer) that we approve a procedure does not mean that we would pay for it.”

The reality is that not all HRs are as lucky as yours. And I will have to doubt that never or that in recent days an insurer has never attempted to go back on his word.

The reality still remains, a pre-existing condition limits your freedom in the current system we have.

[mangeorge]

@gonzomax

Note, unions are disappearing. We had almost everyone covered when they were strong. Now health care coverage is fading. The quality and depth of coverage grows weaker.
Companies without unions had to match the benefit to attract and keep workers. As unions got better benefits other industries and companies had to go along. Unions are getting weaker and benefits are getting trimmed too.

In my case (not union), co-pays keep going up.
I think the corporations are making a concerted effort to wipe out the unions without being too obvious about it.
The downward slide seemed to gain energy when Regan busted the air traffic controllers.
Most of the good stuff is still grandfathered, so younger workers don’t understand that the unions vastly improved the lot of most American workers. It’s much easier to buy into the corporate propaganda.
Of course the unions aren’t innocent either.

[flickster]

@jtgain

If it encourages employers to buy policies for their employees, it would encourage employees to buy for them/families.

Or, if it didn’t. Why a tax break for the rich CEO, but not the burger flipper?

Not all employers are equal, and never will be.

You’re getting hung up on pre-tax deductions for health insurance premiums. That’s not just a CEO benefit. Every employer that provides participation in a group health plan makes pre-tax payment available to any of their employees that participate - from admin to CEO level. This is a plan allowable by law and has been in effect for a long time. Without looking it up, I would guess the 1980s. ASAIK, one of the reasons it was put in place was to encourage participation in group health plans.

[GIGObuster]

I guess another word that needs to be learned now is rescission:

The Ailments that put you on the Insurer's Drop List

So, how is the House Subcommittee on Oversight and Investigations finding out this shocking information about “inner workings” of the Insurance Industry? Simple – one of the Industry’s former Execs, actually “grew a conscious” – and is telling the truth about how these “Privateers” really operate:

Health Insurance Exec Speaks
Testimony of Wendell Potter before the U.S. Senate Committee on Commerce, Science and Transportation
by Wendell Potter, Date June 24, 2009

"**My name is Wendell Potter and for 20 years, I worked as a senior executive at health insurance companies**, and I saw how they confuse their customers and dump the sick--all so they can satisfy their Wall Street investors.

I know from personal experience that members of Congress and the public have good reason to question the honesty and trustworthiness of the insurance industry. **Insurers make promises they have no intention of keeping, they flout regulations designed to protect consumers, and they make it nearly impossible to understand--or even to obtain--information we need.**
[...]
In the 15 years since insurance companies killed the Clinton plan, the industry has consolidated to the point that it is now dominated by a cartel of large for-profit insurers."

(emphasis added)
http://www.tnr.com/…

[continuing pg 2]

[...]
To help meet Wall Street's relentless profit expectations, insurers routinely dump policyholders who are less profitable or who get sick. Insurers have several ways to cull the sick from their rolls. One is policy rescission. They look carefully to see if a sick policyholder may have omitted a minor illness, a pre-existing condition, when applying for coverage, and then they use that as justification to cancel the policy, even if the enrollee has never missed a premium payment.
[...]
They also dump small businesses whose employees' medical claims exceed what insurance underwriters expected. All it takes is one illness or accident among employees at a small business to prompt an insurance company to hike the next year's premiums so high that the employer has to cut benefits, shop for another carrier, or stop offering coverage altogether--leaving workers uninsured. The practice is known in the industry as purging. The purging of less profitable accounts through intentionally unrealistic rate increases

And speaking about the freedoms of small business and freelancers:

Yes, Health Insurance Is A Small Business Killer

Yes, Health Insurance Is A Small Business Killer (WMT)

…Small businesses also pay more for health insurance than large companies. According to the Commonwealth Fund, small businesses now pay 18 percent more than large businesses pay to obtain comparable insurance.

A third effect of the tremendous rise in health insurance costs over the last decade has been to impose a huge financial burden on new companies. The cost for the average new company to provide its employees with family health insurance at the average cost for firms of its size (as reported by the Kaiser Family Foundation) is now $68,611 a year, more than double what it was 10 years ago. Granted, some of those costs aren’t paid by the employers, and some employees have individual coverage, making the actual numbers paid by employers lower, but it’s still a huge figure in comparison to new-firm revenue. According to the Kauffman Firm Survey, the average three-year old surviving firm generates only $152,000 in revenue annually.

Finally, because leaving a job to start a business causes one to give up employer health insurance, the employer-based health insurance system in this country is keeping some people from becoming entrepreneurs. A recent working paper by Rob Fairlie of University of California Santa Cruz estimates that workers with employer-provided health insurance have 2.5 to 3.9 percent lower odds of becoming self-employed than those without health insurance, suggesting that health insurance affects the start-up decision.

When politicians talk about small businesses and startups being the key to our economic future, are they being serious, or is it all rhetoric that sounds good? Because when you’re basing health policy on what’s good for Wal-Mart, which can buy healthcare cheaply, you’re making a very big decision about employment economics in a manner that favors big, stable business, to the detriment of small ones.

[flickster]

@GIGObuster

As one insurance company told my brother once: “Just because we told you (or the employer) that we approve a procedure does not mean that we would pay for it.”

The reality is that not all HRs are as lucky as yours. And I will have to doubt that never or that in recent days an insurer has never attempted to go back on his word.

The reality still remains, a pre-existing condition limits your freedom in the current system we have.

Insurance plans are not left up the whim of some jackass. There are written policies that must be followed. We’ve all had to work with a claims department to ensure proper processing, but the bottom line is that they must still provide the coverage outlined in the plan.

That said, jackasses are abundant. However, if one does get in play there should be an appeal process. But that’s getting more into insurance claim management than the basic principles of group health insurance plans which all operate under the same basic guideline when it comes to pre-existing conditions.

[Kent_Clark]

@flickster

I fail to see how an employer having to still provide the same benefits to ex-employees has anything to do with competition - other than it would prevent the company from being able to compete in the marketplace.

I would assume the ex-employees developed marketable skills while employed there. Those skills should allow them have value on the open employment market and firms should COMPETE to get them to sign on as employees.

Now on the other hand, if they are sitting around the union hall, that’s a whole different issue.

I’ve been involved in the HR world for over 25 years, have NEVER heard of that type of scenario. Pre-existing conditions are waved as long as you enroll in your new plan while the old one is still in effect. Period.

I’m highly offended by the implication that employees who don’t have health insurance are either not capable of finding jobs with companies who offer it or sitting around a union hall waiting for someone to give them insurance.

There are millions of self-employed Americans and millions more who work for small companies with fewer than 10 employees, and thus don’t qualify for a group rate.

To suggest that all those self-employed and small business employees simply find jobs with bigger companies will cause at least two unintended consequences.

A) Individuals who might aspire to become small businesses and small businesses that aspire to become large businesses will go out of business, wreaking havoc on the economy.

B) Large companies won’t be able to absorb the subsequent surge in applications, so we’ll wind up with a bunch of uninsured workers that are now unemployed, as well.

Why should an employer provide the same benefits to ex-employees?

Because, in the case of my wife, she worked for the same employer more than 30 years, partly because she was promised health insurance after she retired. Of course she doesn’t receive the “same” benefits as current employees – her former employee no longer picks up any of the cost of the insurance. But at least she HAS insurance.

And shouldn’t a company that competes by promising continuing health insurance to ex-employees, thus providing a superior benefits package, be able to attract better employees because it’s offering better benefits?

[flickster]

@kunilou

I’m highly offended by the implication that employees who don’t have health insurance are either not capable of finding jobs with companies who offer it or sitting around a union hall waiting for someone to give them insurance.

There are millions of self-employed Americans and millions more who work for small companies with fewer than 10 employees, and thus don’t qualify for a group rate.

To suggest that all those self-employed and small business employees simply find jobs with bigger companies will cause at least two unintended consequences.

A) Individuals who might aspire to become small businesses and small businesses that aspire to become large businesses will go out of business, wreaking havoc on the economy.

B) Large companies won’t be able to absorb the subsequent surge in applications, so we’ll wind up with a bunch of uninsured workers that are now unemployed, as well.

This is a more important issue for some than others. All I’m saying is that it continued group health insurance is important to you, especially due to pre-existing conditions, then plan accordingly. My wife & I have coordinated career moves around this very issue in the past. We made sure at least one of us was working where a group plan was available at all times, or carried COBRA coverage until that condition was satisfied. All I was trying to do was provide accurate information regarding the rules and how they apply.

And shouldn’t a company that competes by promising continuing health insurance to ex-employees, thus providing a superior benefits package, be able to attract better employees because it’s offering better benefits?

Absolutely, an employer providing such benefits would compete very strongly for available talent. However, they would also still have to be able to compete in the marketplace for their products so that risk of additional overhead would have to be factored in.

[tumbleddown]

@flickster

We made sure at least one of us was working where a group plan was available at all times, or carried COBRA coverage until that condition was satisfied.

I’m glad that this was an option for you. Had I picked up the COBRA coverage when I was laid off from my last job with insurance, I would’ve gone broke, as in burned through my savings, in a matter of weeks. The cost of COBRA, monthly, was significantly more than my unemployment compensation, and I didn’t have a spouse to rely upon to help pay my way.

It’s easy to say “just make sure you get COBRA” but it’s not nearly so easy to do.

[I_Love_Me_Vol.I]

@flickster

Participating in a group plan with your current employer does not make you a slave to that company and prevent you from taking a more desirable position.

Unless, perhaps though no fault of your own, you are a marginal employee who is barely holding on to his job and sweating bullets lest he should be laid off.

Then, thinking ahead to the unthinkable (losing your job); what if you are not a very desirable potential hiree? Maybe just not that good at what you do, or anything else. Maybe you are just not a very smart, talented or skilled person. And when jobs are scarce (like now) it is that much more difficult for you to find a new “more desirable” job or any job at all.

Are you a slave now? Is this then job-lock? Or are you just a human not deserving of health insurance that you could ever hope to pay for?

Your Bootstraps (pull), Invisible Hand, Freedom, Pursuit of Happiness, Shining City on the Hill, and all that. Right? Fuck no. Step on a rusty nail and die, motherfucking piece of shit.

[I_Love_Me_Vol.I]

Shit! In rereading the end of my last post I realized that it looks like I am telling** flickster** to step on a rusty nail and die. That is not the case. I screwed up and did not write clearly. My bad. What I meant (sarcastically) was that the hypothetical poor sap in my examples should just step on a rusty nail and die. NOT that flicksterr should.

Very sorry about that.

[UltraVires]

@tumbleddown

It’s easy to say “just make sure you get COBRA” but it’s not nearly so easy to do.

Agreed. COBRA has to be the most worthless program in the world.

Oh, I can pay out of pocket for my regular company health insurance at an increased rate? How much? Fourteen-hundred per month, you say? We’ll that’s great, except for the fact that I’m unemployed! I’m trying everything I can to scrape by until I get another job, and you will “allow” me to pay over a thousand dollars per month for health insurance.

Thank you, much, however I must buy food first!

[Kent_Clark]

@flickster

This is a more important issue for some than others. All I’m saying is that it continued group health insurance is important to you, especially due to pre-existing conditions, then plan accordingly. My wife & I have coordinated career moves around this very issue in the past. We made sure at least one of us was working where a group plan was available at all times, or carried COBRA coverage until that condition was satisfied. All I was trying to do was provide accurate information regarding the rules and how they apply.

Leaving aside some of the outrage expressed in several of the previous posts, your argument is flawed.

Not all career moves are planned.

COBRA is a temporary solution. If you haven’t been able to find a job that provides insurance before your COBRA expire, you may not be able to obtain insurance. Even with COBRA, insurance premiums may be financially out of reached for an unemployed person.

Employers aren’t required to provide health insurance, and indeed, many don’t.

ETA: And it isn’t just marginal employees who lose their jobs.

Your argument, in effect, comes down to “Can’t get health insurance? Well, you should have gotten it, then you’d have it.”

[gonzomax]

It seems to be a human reaction. I have health care. You don’t. What is wrong with you? When 50 million have none and many more have poor coverage that can not be depended on, there is a large body of people you can feel superior to.
Unemployment is a huge problem. Most of the people laid off can not keep up with Cobra. It would take your whole unemployment check.

[flickster]

Just wanted to provide a cite for my comments regarding pre-existing condition exclusions

HIPAA, which was passed in 1997, helps to ensure that people with pre-existing conditions can still get health insurance.

A year is a long time to wait for medical coverage, so HIPAA uses what is known as “credible coverage.” This term refers to any health insurance you had before your new insurance plan, as long as it was not interrupted by a period of 63 or more days. This time period can be longer, depending on your state laws and the type of insurance plan you were on. Once you have proven that you have had uninterrupted insurance before your current plan, this insurance coverage can be credited toward any pre-existing condition exclusion you may have. In fact, if you had at least one year of group health insurance at one job and then received health insurance at a new job without a break of more than 63 days, the new health insurance plan cannot impose a pre-existing condition exclusion on you at all. If however, a break in coverage is greater than 63 days, all the health insurance coverage before the break is not counted toward your pre-existing condition exclusion period.

(Bolding Mine)

[mangeorge]

Quality health care should be available to everyone, no exceptions. If it’s not, something’s wrong. It surprises me how many Christians (I’m atheist) I know who don’t agree. What would Jesus say?
Socialize medicine. Let the medical establishment, with government oversight, run it. It’s pretty obvious that Big Business (and insurance companies) can’t do the job. Let them make cars.
Peace,
mangeorge