Large employers prove Bernie is correct on healthcare

[antigop]

Large employer health plans are typically self-funded and do not use insurance companies for underwriting. (They do use insurance companies for administration and billing.)

Large employers do this because...

IT'S CHEAPER.

[Hoyt]

1. I think most do it because they can save money by not meeting the requirements of the ACA, etc.

Under the Patient Protection and Affordable Care Act, self-insured plans are exempt from the excise tax on health insurance premiums, community rating on premiums and mandates under essential health benefit rules. Plans also are exempt from the greater regulation insurers face regarding minimum-loss ratios and annual rate increase review.

You save on brokerage fees, of course, assuming you don't buy on the exchange. But, you have to have enough money, or buy insurance, if more people get sick than expected. For that reason, most employers with 500 don't self-insure because the risk and cost are typically too high.

In any event, self-insured employers save roughly 10 - 15% at best, but take on a big risk. That's not enough to do what Sanders is saying without significant tax increases. I'm fine with that if everyone gets decent insurance, as long as he's honest about it.

[antigop]

2. bzzzzt...wrong answer. They self-insured LONG before the ACA. nt

[Hoyt]

3. And they bypassed state and federal insurance regulations.

[antigop]

4. They self-insure because IT'S CHEAPER. Thanks for the kick. nt

[Hoyt]

5. Yeah, they can leave out coverage for autism, etc.

[antigop]

6. They self-insure because IT'S CHEAPER than paying an ins co for underwriting. nt

[Hoyt]

10. Yeah it's cheaper if you don't have to cover some services and can

afford the risk. Most companies do not self-insure. And even in best case it's not much cheaper when comparing same coverage.

[antigop]

11. "59 percent of private sector workers with health coverage were in self-insured plans in 2011."

http://www.nytimes.com/2013/02/18/us/allure-of-self-insurance-draws-concern-over-costs.html

Self-insurance was already growing before Mr. Obama signed the law in 2010, making it difficult to know whether the law is responsible for any recent changes. A study by the nonpartisan Employee Benefit Research Institute found that about 59 percent of private sector workers with health coverage were in self-insured plans in 2011, up from 41 percent in 1998.

[antigop]

12. and thanks for the kick! nt

[antigop]

13. it's cheaper because they save on underwriting. nt

[Hoyt]

33. So transfering the underwriting risk to the government is going to help?

[Fuddnik]

53. I first got health insurance in 1971 paid by Republic Steel Corporation. Union negotiated benefit.

They were self insured, and they covered everything BECAUSE IT WAS CHEAPER.

Get it?

IT WAS CHEAPER!

After mergers and buyouts, they remained self insurance, BECAUSE IT WAS CHEAPER.

Yes, I'm yelling, because you seem to have a hard time hearing.

IT WAS CHEAPER!!!!

[Skwmom]

8. Health insurance existed before and after the ACA.

Though I read the number of companies self funding is increasing. But they'll recoup their lost profits from the peons.

[Trajan]

27. That is one persistent right wingy voice you have there

I've always resisted doing this, but not anymore ...

[Hoyt]

39. And I'm sure you think Clinton, Krugman, Ted Kennedy (RIP), etc., are all right wingers.

At best, the OP proves we might save 10% or so IF Congress were to enact Sanders' plan, providers willingly cut their fees, people willingly accept what will be necessary to produce the cost savings Sanders uses for his projections, he can explain the huge tax increase as a savings (I get it offsets premiums), and everything else goes his way. Plus, it assumes people paying $700 a month now will be giddy with a reduction of $70 in what they now pay for premiums or taxes. Sure thing.

[Skwmom]

7. You are wrong. They like to spend more money.

rofl: :

[antigop]

9. with the money they save on healthcare, they can pay CEOs more and buyback stock! nt

[libdem4life]

14. Seems the point was lost here...the information I took away is that once you remove the paper

pushers who do nothing more than complicate, obfuscate, calculate and collect a large salary, it's much cheaper. That is what Medicare/Single Payer does, eventually. The "for profit" is taken out, and I know what those useless money grubbers make ... see also Wall Street ... and you and I pay dearly. Now they're Feeling the Bern, too.

Take away private insurance payments (a sort of tax) and add a percentage to our taxes. Save money. Care for all. I just don't get the argument here.

[antigop]

15. " complicate, obfuscate, calculate" -- it all goes into underwriting. nt

[libdem4life]

19. They may be the worst of all...failed to mention those intrenched fixtures..that get paid very well.

[antigop]

18. and by self-funding, they don't pay insurance companies, except for billing and administration.

They get the insurance companies out of the picture (except for billing and administration).

[leftofcool]

20. I get the argument.

I like my insurance exactly the way it is. My premium is decently priced, I pay absolutely no deductible for any of my cancer treatments. I pay nothing for colonoscopies I have every six months. I pay nothing for CT scans every six months. I pay only a $500.00 deductible for major medical and only a 20.00 co-pay to my doctor. Most normal medicines like antibiotics are covered and I have no copays for medicine. Why would I want to give all that up to medicare that I have to fight to pay claims. And I know how hard the fight is because my husband is on medicare and they have yet to pay a dime for anything. Thank goodness for our "for proft" health plan.

[libdem4life]

26. I'm glad you have a fortunate insurance plan. But, see, many don't and have no access.

It sounds more like I've got mine...to heck with them. I'm on Medicare...I fully misunderstand your last statement.

Democrats usually care about the masses...the little people...the people without stellar healthcare plans who may be fortunate enough to work for a company that pays in or had the funds to afford the kind of insurance you describe. And you and your husband may be the exception.

It flies in the face of most of my experience...mine and others. So there you have it and I am happy for you.

[elias49]

30. "I've got mine" is the Libertarian way.

Repubs look out for business interests
Dems look out for people
Libs look out for themselves

[libdem4life]

43. One caveat...when it comes to social programs, Rs want them only when they personally need it.

Time after time I've watched right wingers do a complete turnaround or just go silent when one of their family needs something they voted again...which is most of the social programs on the planet.

[JDPriestly]

31. I have Kaiser and Medicare and love it.

You would probably like the French healthcare plan. It is great and costs far less than our health insurance.

[libdem4life]

49. Kaiser Permanente is a for profit organization. I had them for a number of years in Northern Calif

They had many steps built into health care that made it the best in class in that area. In fact, they owned the area as far as health care organizations go.

They had a 24 hour nurse hotline that kept a lot of the lesser issues out of the doctors office. The Physician's Assistant saw a lot of the next step up. You didn't see an MD until you needed to and then you waited no more than 15 minutes or so. If your doctor wasn't available, another saw you. And all of their MDs were on salary. Many were young. And I didn't have to pay much, as I recall. Oh, and they sponsored wellness classes, yoga classes, and paid for chiropractic visits. Also, they owned regional hospitals.

My only negative about them was that they were very aggressive with youth through the 50s but not the seniors. I worked with the Senior health care population for a time, and quickly noticed they were good with general health care and medicines, but not nearly as aggressive, particularly for surgeries and such.

This organization serves a highly diverse community and could easily be a model for others, IMO.

Living more rurally, here they have telemedicine where you talk to a doctor on Skype and can be prescribed drugs...all of the above is available except for the nurse hotline. Again, if it goes beyond that level, there are in-personal medical staff to serve you as needed.

We Can Do It and we Will Do It...I predict. Lots of good examples out there without "throwing it all away." What drivel. We have just lacked the national will. It will be ironic if it's Bernie that comes up with the Medicare for All or national health care that gets us on par with the other civilized countries and meets the needs of all of our people.

[JDPriestly]

51. Thanks. Isn't Kaiser doctor owned? It isn't investor owned, is it?

I don't have a problem with doctors owning healthcare organizations. It's the idea of people investing in a healthcare organization that I question.

[libdem4life]

54. It is definitely not doctor owned. I have no idea who owns it,but don't think it's a 401c3

[Turn CO Blue]

50. Well, bully for you! We pay over one-third of our gross income for premiums,

hubby has to have an MRI every 6-12 months, which last time, our portion was $2300.

Oh, and we still fight the greedy fuckers to pay claims, even though they're getting over $20K from us and over $12K from the employer each year.

Yeah, yeah, you got yours, so everybody else can just lump it.

[Uncle Joe]

16. Kicked and recommended.

Thanks for the thread, antigop.

[antigop]

17. you're welcome, Uncle Joe. nt

[Omaha Steve]

21. Our health insurance is self funded with the City of Omaha

It uses Coventry for administration and billing. We employees and retirees have been told several times how this eliminates big salaries and stockholders.

K&R!

OS

[antigop]

22. thanks, OS! nt

[Spitfire of ATJ]

23. The larger the pool the cheaper the rates....

The ultimate large pool is ALL of us.

[antigop]

24. Everybody in the pool! nt

[SheilaT]

25. In my last job my employer was a large company

and they self-insured, using an insurance company for administration and billing.
Best insurance I ever had. For at least three years in a row there was no raise in the employee share.

They also offered several options. Everyone got a basic plan, and you could purchase a "buy up" plan for a bit more money (I think I pad all of fifty bucks a month). I have excellent health and I loved it. Once I tripped over my own two feet and fell down on a concrete surface, breaking an arm. I paid perhaps sixty dollars all told out of pocket. Only time I ever needed to use it. Oh, except for when I got a shingles vaccine, and with my plan there was no copay.

A co-worker with multiple health issues likewise had the buy up plan and likewise found it excellent.

Plans like that at similar costs should be available to everyone.

[antigop]

28. "Plans like that at similar costs should be available to everyone. " +1000 nt

[JDPriestly]

29. K&R.

I may be wrong, but I think that mos of our health insurance used to be non-profit. Then there was a move to for-profit starting in the 1970s - the 1990s. I remember when certain companies were allowed to buy non-profit hospitals in California in the 1990s. I'm quite familiar with a couple of the purchases and the problems that arose when funds of institutions that were purchased that originated with tax-deductible donations had to be dealt with by the Attorney General's office.

[antigop]

32. thanks, JD. nt

[SheilaT]

35. I believe you are right.

I also recall most hospitals being non profit. Sometime in the 1960's, I believe, for profit hospitals started, at least some of them by groups of doctors who saw they could make lots of money that way.

[Still In Wisconsin]

34. Don't tell the empty pantsuit...

she can't be bothered with pipe dreams like universal health care.

[antigop]

36. gotta keep the money flowing to those insurance company CEOs. nt

[Still In Wisconsin]

37. Exactly. You can usually tell people's true character by the company they keep.

Shrillary's company? Banksters, insurance executives, and Wall Street bigwigs.

[SammyWinstonJack]

44. Hehe.

[antigop]

40. they self-funded a LONG time ago...they are not just doing this "now'. nt

[antigop]

47. well, I would suggest you read it. Thanks for the kick! nt

[antigop]

41. "59 percent of private sector workers with health coverage were in self-insured plans in 2011."

http://www.democraticunderground.com/12511026776#post11

[antigop]

42. and thanks for the kick! nt

[turbinetree]

45. And lets not forget.......................just how twisted things are ....

http://abcnews.go.com/GMA/dead-peasant-life-insurance-policies-fair/story?id=8724327



Honk-----------------------for a political revolution Bernie 2016


It is about getting a progressive President, U.S. Supreme Court, Congress, and State and Local Legislatures

[antigop]

48. I know I've hit the nail on the head when...nt

[madokie]

52. One of my brothers

works for a company who self insures. In the 40 years he's worked for them he's had a couple accidents, one that wasn't even on company time nor on company property and his medical bills were paid in full, no co pays nothing but the very best care one could expect. Plus at 75 YO they still keep him on the payroll and allows him to work when he feels like it and wants too.

there are good companies in this country and there would be a lot more if the republiCONs would get out of the way.