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Cost of Employer-Provided Health Insurance Rises Toward $19k a Year
- myroon5 9y agoPaywall bypass link: https://m.facebook.com/l.php?u=https://www.wsj.com/amp/articles/cost-of-employer-provided-health-insurance-rises-toward-19-000-a-year-1505838600 https://m.facebook.com/l.php?u=https://www.wsj.com/amp/artic...
- frgtpsswrdlame 9y agoIs there a good breakdown of where those dollars go?
- tyingq 9y agoYou mean once it goes from the employer to the insurer? Here's an article on Blue Cross that covers profits, claims, etc: http://www.wral.com/blue-cross-profits-soar-as-losses-on-aca-policies-fall/16559789/ http://www.wral.com/blue-cross-profits-soar-as-losses-on-aca...
- refurb 9y agoYes! This McKinsey report is the best I've seen in terms of tracking where the dollars go vs. other countries.[1] In summary, it's mostly going to outpatient care. The US spends only a small percentage more on in-patient care. In fact, the US spends less on durables and long-term care than most other countries. [1]http://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/accounting-for-the-cost-of-us-health-care http://www.mckinsey.com/industries/healthcare-systems-and-se...
- costcopizza 9y agoI don't think employers should even offer health insurance. Leave it to the consumer to buy just like all other insurance. In fact the increase in wages could be used to fund a basic preventative care plan (read not full on single payer) for all Americans.
- pstuart 9y agoWhat value do the insurance companies add for each dollar spent on healthcare?
- ekianjo 9y agoNot much. Negociation of prices with government and pharma companies, maybe.
- nasredin 9y agoYou get to call your insurance company and test your anger management skills every time they deny you coverage. OK that's not really "value". They do add jobs though. There's "coders", they deal with medical codes.
- nradov 9y agoClaims will have to be coded regardless of who pays the bill.
- pmorici 9y agoThey negotiate discounts with the providers.
- UnoriginalGuy 9y agoBut aren't the prices artificially inflated to build in the supposed "discount?" To use an analogy, it is like how vehicle manufacturers adds 10% to reach the MSRP, which is "discounted" at the dealership for every vehicle sold. It is a shell game, there is no winning when the game is rigged for the game's own existence. If discounts were banned tomorrow on medical services, you'd see the costs drop significantly to reflect that.
- uptown 9y agoThis page has some good data on 2018 rate increases, provider changes, mandate enforcement, etc. http://www.kff.org/health-reform/issue-brief/an-early-look-at-2018-premium-changes-and-insurer-participation-on-aca-exchanges/ http://www.kff.org/health-reform/issue-brief/an-early-look-a...
- tosser350 9y agoHealth insurance in general doesn't make sense. Insurance is supposed to be for random catastrophic events, not regular things like checkups. Car insurance doesn't pay for oil changes, the concept of health insurance doesn't make sense. That's the same reason I don't really agree with forcing companies to cover pre-existing conditions. That's like calling up a car insurance company after totaling your car and expecting them to cover it. It's no longer insurance at that point. The entire system needs to be remade.
- unit91 9y agoWhat?! Surely this can't be possible. We already have an Affordable Care Act...
- nasredin 9y agoKnock on wood
- mafsedan 9y agoNobody talks about the elephant in the room. It is the fact that 2/3rds of Americans are obese or overweight that makes health insurance so expensive.
- unabridged 9y agoHealth insurance companies are running out of time and they know it, this is their last ditch effort to get as much money as possible. There is no point to lower prices, why gain market share if there is no "later" when you can extract more profit? Why enter the health insurance market if you are not sure how long it will last?
- refurb 9y agoHuh? You think it's the insurance companies who are making the profit? You do realize that ACA caps their margins, right?
- projectileboy 9y agoBut only on policies issued through ACA marketplaces, no? Most health insurance in the US comes through employers.
- spectrum1234 9y agoHealth insurance companies don't make money. (~3.3% profits, vs US historical average of %8.5)
- vadym909 9y agoAbout time for someone to start offering an insurance plan where all consultation is via facetime/video chat and expensive non-critical operations are done in Mexico or a ship parked in Int'l waters close to major cities on either coast. Only get an emergency room insurance for the US!
- timsayshey 9y agoThere are startups popping up that offer consultation via facetime/video chat but unfortunately, they are only covering small areas or big cities at the moment. We're really behind on this in the US unfortunately.
- wavefunction 9y agoThat or provide universal health care not tied to employment. Given my experiences with in-person doctors I think video-chatting with one would be about the most idiotic waste of my time possible.
- timsayshey 9y agoWhere I'm from 90% of what a general practitioner does is give out antibiotics. I hate the over prescription of antibiotics but they could easily prescribe that over video chat. This would keep sick people at home and allow doctors to focus on people that actual need to come in to be physically examined.
- shiftpgdn 9y agoCould we legally ship medicine from India domestically if the starting point is an Indian flagged boat?
- nickhalfasleep 9y agoEven better, open embassies that are full ER's.
- tertius 9y agoOr lower costs. Hospitals charge an order of magnitude too much.
- transverse 9y agoMore paywalled crap. Don't you have a better link?
- ryanmarsh 9y agoCurrently spending $18,382.32/yr Math checks out.
- tertius 9y agoBonkers. If you're a christian you could lower that considerably. Medishare.
- l8again 9y agoBernie Sanders "Medicare for All" plan makes all the sense in the world. Expand medicare for everyone. Pay the government instead of insurance premium. Medical costs go down. Doctors/hospitals might earn less, but will have guaranteed payments. Medicare, a government program, is considered the gold standard of healthcare, so this isn't the government's first rodeo.
- GarrisonPrime 9y agoThe only reason it's the gold standard is because it's everywhere. Having worked in 6 hospitals since 2006, I'm not quite sure how you think expanded medicare is any sort of solution.
- abalone 9y agoNor are we quite sure how you think it’s not, other than logically fallacious argument from authority.
- tertius 9y ago> Doctors/hospitals might earn less No, they HAVE to earn less. Also, if the exact same medicare that pays out today is replicated to the whole population the medical industry will go broke overnight.
- tehlike 9y agoMaybe that will force the industry to increase their efficiency(hopefully not through decreased attention to patient, but through cost reduction, better negotiation power with pharma industry and all)
- prklmn 9y agoThat's what the hospitals have been doing recently through consolidation of both hospitals and private practices. Not reducing their costs overall per se, but trying to grow as much as possible to increase buying power. I'm of the opinion that this is a bad road to go down, one with a lower degree of competition and choice compared to what we had 15 years ago.
- patrickg_zill 9y agoMy view: we need price transparency. Find out a medical code, call 3 different hospitals in your area and try to nail them down on a price for that billing code - the variance will be large; but given they should all have similar price structures and pay wages that are roughly the same, they shouldn't vary by much more than 5% ...
- tehlike 9y agoYes. This. Price transparancy and the ability to predict the eventual bill will increase competition Edit: predicting eventual bill, not the outcome.
- abalone 9y agoExcept that won’t work for the most expensive medical care because you don’t have time to comparison shop, if you’re even conscious.
- refurb 9y agoWhy not? Most medical care isn't urgent. Cancer treatment, joint replacement, heart surgery are a few examples. Most of the time you're waiting a week to do the procedure.
- abalone 9y agoAs I said, it doesn't work for the most expensive medical care. The most expensive medical condition is sepsis.[1] You're not gonna shop around if you have sepsis. Also in the top 10: heart attacks, pneumonia and strokes. [1] https://www.hcup-us.ahrq.gov/reports/statbriefs/sb204-Most-Expensive-Hospital-Conditions.jsp https://www.hcup-us.ahrq.gov/reports/statbriefs/sb204-Most-E...
- prklmn 9y agoI think you are spot on. I want to see a website where you can go to plug in whichever procedures you need, and you will see the the itemized costs, and whether it's covered by your insurance or not, associated with that procedure for every provider within an X mile radius from your address. It's absurd that this doesn't already exist. Uploading this pricing data to the database would have to be mandated by the federal government.
- md2be 9y agoThere are simple answers Health Insurance affordability in the US. Rationing. No NOT via a single payer system where some all-knowing official decides who does and does not get care. Rather, the rationing is done by the buyer. For example, Buyer one could decide to only buy a policy which covers only generic drugs, which would exclude all patented drugs (newer and even superior), Buyer 2 could decide to buy a policy which covers generic drugs and patented drugs in one or more specialties (e.g., cardiac). The theme is let the buyer decide, not everyone wants to live the last 10 years of their life struggling to regain their youth.
- comicjk 9y agoAre there examples of such a system working anywhere? It sounds plausible, but the fact that it didn't arise pre-Obamacare gives me pause. It seems like the demand for it might not be prevalent enough, or the savings too small. I'm interested in new models, but I'm tired of the US thinking it has to be special with its healthcare system and wasting a trillion dollars a year.
- matchbok 9y agoYou fundamentally don't understand how this works. The fact that you repeated the "some bureaucrat decides who gets care" line proves it. Your "market" approach fails the minute someone is born with preexisting conditions. Or if someone needs emergency care, but doesn't have the right plan. Try again.
- sbenitoj 9y agoIt genuinely blows my mind that some of the top comments are pro-socialized medicine. This is a forum populated primarily by hackers and people interested in starting or working at start-ups -- should we also have a single payer of all hackers? The notion is laughable, but it's put forth seriously when it comes to medical care. Like all problems of costs being "too high" this one is caused by artificially restricted supply (govt regulation of medical system) and skyrocketing demand (much of which is driven by the abysmal nutrition advice the US govt has doled out over the past 50 years which has only made 2/3 of the country obese and overweight). Control economies do not work, how much more evidence do we need before people stop saying "this time is different, we just need the RIGHT people this time"?
- matchbok 9y agoName me a free-market healthcare system, please. I'll wait, because it doesn't, and will never, exist. Sort of sad how you fall for the trap of the "regulation" boogeyman. Regulation is what covers preexisting conditions, buddy.
- comicjk 9y agoI'm not in favor of single payer healthcare, but to say there's no evidence that it works is inaccurate. Healthcare in Canada provides the same health outcomes as ours for half the price. If that doesn't interest you because they do it with the wrong philosophy, you're an ideologue. In fact, the evidence that your proposed changes would give a 50% reduction in cost seems a lot slimmer than the case for straight-up single payer.
- avs733 9y ago>Control economies do not work, how much more evidence do we need before people stop saying "this time is different, we just need the RIGHT people this time"? The current system is just a different control economy. Companies don't really care about the cost because non-transportable health care is one lever of control that enables then to depress wages.
- walterstucco 9y agoA lot of things are wrong in your comment First, it's not socialist, healthcare is a fundamental asset in modern societies Having different healthcare standards for different social classes is detrimental for society development Second, public healthcare is not a single player system, is a decentralised system with many actors competing under the same rules If you don't believe me, just take a look at what happens in Japan or Europe or in Italy (my country, generally a disaster but second after Japan for average life expectancy) That's exactly what a hacker culture supports US healthcare reflects US mentality that market can fix itself so instead of net neutrality you're going towards net conglomerates
- NTDF9 9y agoIt's cheaper to fly to India, stay in an upscale hotel, meet personable doctors, get treatment, relax and come back. Not saying this is practical for everything but people really should start considering alternate countries for healthcare. The US is a mess.
- watertom 9y agoThe only solution is for employers to stop offering healthcare. Give the equivalent in salary to employees and let the employee figure it out. When this starts to en masses healthcare will get figured really quickly, i.e. single payer The Fortune 1,000 won’t do this because they can control employees, wages and competition. Getting a small company off the ground is so much harder because only recent grads are willing to take a job without healthcare. I’ve turned down a dozen companies because of healthcare issues. I also find it strange that we discuss guaranteed income as a viable solution but not guaranteed healthcare.
- pfranz 9y agoI know lobbyists are pushing their agenda, but why is nobody talking about the economic freedom of untethering employment to heathcare? So many people are tied to less than ideal jobs or prevented from starting their own business because of insurance. You also constantly hear about companies hiring contractors or cutting hours just under the margin where they owe benefits. It's funny that I often hear about how expensive COBRA is and how it's not a good deal. That's what your employer is paying for your insurance. (in an ideal world) that is would-be compensation of your's. I know the actual cost of healthcare isn't pretty, but it does no one favors by hiding it and tying it to your employer with weird tax incentives.
- wahern 9y agoWith Kaiser Permanente Northern California, for a family of 4 $18k buys you a gold plan with $0 deductible, and $20k buys a platinum plan. This is on the open market. I just priced it on their website. Most plans are substantially cheaper. HMOs are really the way to go, but unfortunately Americans stupidly prefer to pay a huge premium for more choice (or at least one very specific dimension of choice). A family member who is a long-time partner at a law firm forced her firm to purchase a plan that allowed her to keep her doctor of 20+ years. This happened during the nationwide market reconfiguration as the mandates rolled out and insurers aggressively re-architected their plans and provider networks. Now she rants and raves about how Obamacare raised the costs of healthcare, and her partners resent her for forcing the huge premiums on everybody. She's totally unwilling to consider that the problem was entirely of her own making; that her firm could be paying a fraction of their current costs for the same quality of care, just not including that one specific doctor. HMOs aren't very common, and in many regions they seem to suck. Fortunately, Northern California Kaiser is one of the best hospital systems in the nation. If you live in the Bay Area I highly recommend it. Kaiser aggressively pursues cost-cutting measures and efficient service delivery procedures. Appointments go through a phone bank of nurses with a rotating staff doctor, so minor illnesses like a cold or flu don't require wasting your primary physician's time. For more serious but still common injuries like a broken wrist you're directed to, e.g., their sport injury unit clinic; again saving both the ER and the primary physician's time. Kaiser runs their own labs, and the volume of people their labs efficiently handle is incredible. All the doctors are employees (as opposed to independent, affiliated providers like in many for-profit hospitals), and Kaiser doctors very consistently apply uniform policies on best practices, prescriptions, etc. I think they're large enough that they run their own studies; at least that's the sense I get when I've inquired about why they choose X instead of Y. All of this comes across to some people as impersonal, but personally I think it's amazing. I've never had an interaction (nor have any of my family members, AFAIK) that left me feeling cheated for attention, even though there's always the sense that everybody--doctors, nurses, staff--is working to keep things moving along at a brisk pace. The way they've balanced conflicting requirements is really laudable. After being with Kaiser for many years, other hospital systems seem downright chaotic.
- justforFranz 9y agoHey, doctors have a lot of shitty real estate investments they need to cover.