Obama Care

[Robert Thomas]

I got a letter today from my Health Care Provider today.



The first paragraph stated: The Health Care Act has a provision that if the Health Care Provider pays less that 85% of its gross intake to Health Care Facilities that the amount of funds under the 85% shall be refunded to the customer. (Yea for the Health Care Act, I am going to be in the money, where is my check) :banana::banana:



The second paragraph stated: That last year the Health Care Provider paid more than 85% so that because of this I would not get a refund this year. OK I am no longer getting a check this year, but it still seems like a good thing so maybe next year. :grin::grin:



The last paragraph stated: That my premium was going up next year, because last year they paid more than the 85%. At least for two paragraphs I had a little joy in my life thanks to the Health Care Act. :sad::sad::sad:

 

[H D]

Hahaha, the government has now forced the insurance companies to be MORE PROFITABLE! Oh, the irony.

 

[Richard L]

Sounds more like a shell game...Now you see it, now you don't...which shell has the check under it??? What a joke!



What's th point of the letter when each sentence contridicts the previous sentence.



...Rich

 

[EddieS'04]

What about this being taxed 1% on $$ in and $$ out of your bank accounts. Anyone heard of it.

I hear jan 1 is the begining. Part of OB care.

 

[H D]

Looks to me like they're saying "Because of the Health Care Act, we now have to charge you more."

 

[Bud Williams]

And sadly all this could have been stopped....damn looters and moochers!!! lol

 

[Timmy-The-Ute]

And we can't even drown our sorrow with milk and twinkies.:boohoo:

 

[Jim Upton]

It will be cheaper for big companys to pay the fine for not offering health insurance to there employees and forcing them to go on obamcare!! So if you have health insurance now at work, you may not for long. We are in bigger trouble here than most americans realize.

 

[Thomas Rogers]

Jupton3,



It might be cheaper for big companies to not offer health insurance and pay the penalties, but do you really see that happening? In most cases nothing other than competition with other employers for employees is forcing big companies to provide health insurance today. In other words, to provide a competitive, expected set of benefits, larger companies provide health insurance to employees, lest they don't attract/retain the employees they want.



I don't see the mandated coverage changing that.



Therefore, the mandate and penalities will hit smaller companies that typically don't offer insurance largely because they don't need to, no one is expecting them to, and they really cannot afford to, to now provide coverage. For those companies, coming up with another $2,000 in sales for all FT employees so that they can pay the penalty will be very, very difficult...and hit them hard.



TJR

 

[Richard L]

Most companies do not provide Healthcare now....The employees are paying for the majority of their healthcare in in the form of payroll deductions....the employer maybe only contributing a few dollars or make not contribution. The advantage for the employee and the larger companies is the sheer number of employees who will enroll and the insurance/health Plan agency can afford to give the bigger discount to the employees. Also, most healthcare plans obtain through your employer do not reject people based on pre-existing condition, except for those that requre a physical exam before you are hired...and that practice is growing.



One company I worked for years ago had an employee/family healthcare plan that cost over $250 per month and kept rising every year. When the company laid off workers, they could keep their insurance under the COBRA plan but they had to pay the employer portion of their coverage, which was only $15???



...Rich

 

[Thomas Rogers]

Richard L said:

Most companies do not provide Healthcare now....The employees are paying for the majority of their healthcare in in the form of payroll deductions....the employer maybe only contributing a few dollars or make not contribution

I'd like to understand that a bit more. I guess it depends on the industry, but from the jobs I have had from the employers that I have had the past 25 years or so, I've always had employer provided health coverage and the employer has always paid a majority (though a decreasing majority the last decade or so) of the premiums.



I was self-employed in 2002 and paid $800/month for a pretty good family plan. I understand that same plan costs almost double that now and even if shopping around costs well over $1200/month. Currently I have similar coverage through an employer and pay about $600 myself, so I pay a bit less than half.



So, for me and my industry (IT) most of the bigger companies seem to pay for health care and most pay a majority (though not an overwhelming majority) of the premiums...so has been my experience as I move from job to job, look at different companies, etc.



I'm not saying it is that way in every industry, but for larger companies that employ computer professionals full-time employers that pay a majority of the insurance with employers contributing a minority (even in %55/45%, etc) seems to be more what I have seen.



TJR

 

[Jim Upton]

I work for one of the largest companys in the world and we have already heard discussions that in the next contract we may be looking for our own insurance with out the companys involvement. It will be beneficial to the company and pay the penalty to keep overhead down and be more competitive in the world. Jim

 

[Richard L]

TJR,

I was also in the IT field but worked in the IT department of companies that were in widely diverse industries, like Building Materials, Healthcare, Insurance, Construction, and Consulting.



Yes, there are some industries like IT, where they will pay a larger cost for the employee's health care, but they are slowly dwindling away. There are even a few that have different healthcare plans for certain departments or position levels.



If you work in the IT department of a company who's major business is not IT, things are often very different. Many no longer even pay for the employee's healthcare, let alone any family members.



In 1988, I was hired as the Programming Manager at a local hospital. The first year my healthcare was paid 100% with no co-pay per visit as long as I used the hospitals clinics and facilities. For my Family, I had to pay about $100 per month, they also had to use the same hospital owned clinics and facilities, and but the to pay a $15 co-pay per visit.



The next year they stopped covering the employee healthcare and the premiums jumped to $200....as well as the coverage was also watered down and everyone had to pay the $15 co-pay per visit, and they would not longer pay for visits to specialist outside the hospital owned network. Each year, either the premiums rose, or the coverage was reduced.



On of the companies I workded for an got layed off because of downsizing, I was offered COBRA insurance if I paid the employer's portion, which was only an additional $15



I eventually dropped all employer based healthcare coverage and started using my Military based Tricare insurance which hands down beat any employer provided coverage, and still does. But the companies I have worked for since, have not provided any prepaid healthcare for the employees, and very little towards their family plan.



I think the bigger the company, and the more employees they have, the cheaper the rates are, and should be per individual. Having worked for an Insurance company, I can assure you they are charging heavy premiums and they are not losing any money on selling healthcare insurance policies to individuals or companies.



The real problem is that individua or familyl healthcare insurance is very expensive to purchase on your own, and is much lower when purchased in a group policy like employees purchased through the Employer's group plan. Now days, very few companies are paying anywhere near the 50 percent you claim....and of course, they claim that too and they can claim it as a tax write off just like we can.



...Rich

 

[Richard L]

TJR,

I was also in the IT field but worked in the IT department of companies that were in widely diverse industries, like Building Materials, Healthcare, Insurance, Construction, and Consulting.



Yes, there are some industries like IT, where they will pay a larger cost for the employee's health care, but they are slowly dwindling away. There are even a few that have different healthcare plans for certain departments or position levels.



If you work in the IT department of a company who's major business is not IT, things are often very different. Many no longer even pay for the employee's healthcare, let alone any family members.



In 1988, I was hired as the Programming Manager at a local hospital. The first year my healthcare was paid 100% with no co-pay per visit as long as I used the hospitals clinics and facilities. For my Family, I had to pay about $100 per month, they also had to use the same hospital owned clinics and facilities, and had to pay a $15 co-pay per visit.



The next year they stopped the free coverage for the employee healthcare and the premiums jumped to $200....as well as the coverage was also watered down and everyone had to pay the $15 co-pay per visit. Also, they would not longer pay for visits to specialist outside the hospital owned network. Each year, either the premiums rose, or the coverage was reduced making it less and less attractive and more and more expensive.



One of the companies I worked for and later got layed off because of downsizing, I was offered COBRA insurance if I paid the employer's portion, which was only $15 yet they hyped up their contribution as being significantly more. That's when I started doing a little investigating on my own and discovered that most employer do not pay anything close to what they want employees to believe for employee benefits...and they get huge tax breaks for what ever they pay!



I eventually dropped all employer based healthcare coverage and started using my Military based Tricare insurance which hands down beat any employer provided coverage, and still does. But the companies I have worked for since, have not provided any prepaid healthcare for the employees, and very little towards their family plan.



I think the bigger the company, and the more employees they have, the cheaper the rates are per individual. Having worked for an Insurance company, I can assure you they are charging heavy premiums and they are not losing any money on selling healthcare insurance policies to individuals or companies.



The real problem is that individua or familyl healthcare insurance is very expensive to purchase on your own, and is much lower when purchased in a group policy like employees purchased through the Employer's group plan. Now days, very few companies are paying anywhere near the 50 percent you claim....and of course, they claim and they claim it as a tax write off, but not every individual tax payer can?



...Rich

 

[H D]

Home Depot's employee health care plans are HMO only, have few benefits that my wife and I actually needed and was more expensive than when we contacted BCBS directly and got their Premium PPO family plan with maternity coverage. We currently pay $420/month with very good coverage. HD's insurance didn't even offer maternity. Few doctors are accepting new HMO patients, especially in my town. The ones that are, we wouldn't go to anyway. It's funny that people can be so picky with the auto shops they go to but spend very little time knowing their physicians. Just an interesting (only to me maybe) thought.



Even fewer are accepting new Medicare/Medicaid patients. Physicians will not work 80 hour weeks and on-call schedules to not get paid (and those plans DO NOT PAY!). And if you think doctors are overpaid, you obviously have not talked to a doctor in a rural area (probably because you can't find many if you tried).



Doctors who can afford to are getting their finances in order to retire right now. Doctors who cannot afford to are wanting to move to private practices. Doctors who work in public hospitals and ERs...well, I'll just say that health care will remain one of those "you get what you pay for" situations; nothing will change for those who do not pay.



The personality of the majority of doctors doesn't make money their main concern, but they're not fools, either. The really intelligent people choosing career paths will likely start looking to other career fields. Look into Georgia's 2010 HB1040 to see the direction health care is going. If you haven't already, you'll start noticing that a majority of the things your doctor used to have to do as a matter of regulations, your LPN/RN now will do. Contrary to the belief of many nurses I know, they are not as versed in medicine as your doctor. I love nurses, but they're not doctors for a reason.



If a high achiever is looking at 40 hour work weeks as a mid level pencil pushing attorney or engineer for $125k a year with 6 years of education, he's going that direction rather than a general practitioner working 80 hour weeks, 8 years of school, residency and $300k+ in debt out of the gate for the same salary (over-estimating for many rural general practitioners). Look for less scrupulous and desirable medical schools to start lowering entrance requirements and graduation standards.



And to top of the decreasing pay of physicians, their tax rates are going to shoot through the roof in the very near future. 20%-40% pay reductions are currently happening in physician's contracts with hospitals and their taxes are about to jump.

 

[Richard L]

Hugh,

Where I live it's the opposite of what you are seeing. The doctors are closing their private practices and joining in with the large clinics and HMO's The are guaranteed a salary, have little or no overtime or extended hours and don't have to worry about filine insurance claims or if the patient does not pay, An the HMO handles all the malpractice insurance....it's all covered by the HMO they work for In addition to their salary, they get annual bonuses based on the amount of revenue brought in by their department.



Two years ago, my doctor and her husband closed their private practice and went to work for the local VA hospital.



You are correct that is is hard to find a doctor because they only accept so many patients and when they meet that limit, they just will not take anymore patients regardless of their Healthcare coverage. Some patients are complaining that they signed up with an HMO that has a clinic just a few blocks away, but were assigned doctors at clinics miles away because those were the only doctors who had openings for new patients.



I am curious just how ObamaCare is going to handle the situation where everyone has healtchcare coverage, but can't get in to see a doctor?



....Rich

 

[H D]

I am curious just how ObamaCare is going to handle the situation where everyone has healtchcare coverage, but can't get in to see a doctor?



....Rich

From my previous post:

Look for less scrupulous and desirable medical schools to start lowering entrance requirements and graduation standards.

I don't see another viable option for increasing the number of physicians. We've already had a market failure in the field but short of increasing medical school subsidizing along with increasing salaries, it will not be as desirable a career.



Funny, the VA here is the nightmare of doctors. It's all red tape and paperwork with no medical practice. For every hour spent with a patient, it's four hours of bureaucracy.

 

[Richard L]

Hugh,

Probably true about paperwork and bureaucracy, but the doctors don't really get involved in that part...that's what the administrative staff does. In a private practice, the doctor has to pay the administrative staff to do that work...when you are a physician in an HMO or the VA, that's not your problem....That why its so attractive to get out ouf your private practice....



...Rich

 

[H D]

That's not how it's done at the VA here. Doctors spend too little time with patients and too much time in administration. My father-in-law and his partners no longer practice with the VA for that reason. They only operate their private practice and do contract work with the local proprietary hospital. Perhaps its because of the type of medicine they practice, pain management/anesthesia and is not typical of the other specialties.

 

[Richard L]

Hugh,

That's not the way VA want's it done....perhaps more mismanagement at your local VA hospital. The push at the VA hospitals as well as most HMO's and healthcare facilities has been to get the physicians to see more patients and let the administrative staff deal with the paperwork. There is always paperwork that the physician will have to do themselves, but the staff does most of the ground work in getting the papers read for the physician's signatures. Of course the physician is responsible for review the patient's records and following proper medical practices and procedures.



Of course there are hospitals and clinics who try to save money by hiring less or they hire unqualified support staff for the physicians and that forces the doctors to do more of the paperwork themselves.



Perhaps it's a little better here since Ft Hood is the largest military base in the US with steady flow of troops going and returning from the Middle East...so many military members settle close by to take advantage of the military support facilities like, commissary, PX and local VA hospitals that seem to be well staffed. Also, the fact that Texas does not have a state income tax is a big bonus for retired military...like myself.



....Richard