Hobby Lobby Closing?

[ThirstyBarbarian]

My previous employer paid $14K for my family's high deductible health plan. My portion was another $1500. That same premium was paid for each employee regardless of their salary.

Check you W2, it shows how much your company paid for your insurance.

Under ACA you can buy a "Bronze Plan" which is would be similar to the high deductible plan except more preventive stuff is covered at 100%.

It will cost you no more than 9% of your income out of pocket.
Cost of insurance for a $30K employee:
Paid by employee in exchange market: $2700
Paid by employer in grandfathered group market: $15500

How long under these conditions do you think employer paid health insurance is going to last?

PS. I am not an advocate for the ACA. I am just pointing out that the ACA is designed to destroy the employer provided health care model.

You were getting a great deal from you previous employer!

I'm not sure I agree that the same exact bronze plan that would cost an individual $2700 would cost an employer $15,500. That is not a direct comparison of comparable plans. A high deductible plan for an individual in a group plan does not cost $15,500.

 

[jderimig]

How many people do you think would be willing to pay 9% of their income for health insurance? I expect a lot of folks would just do without at that price. 9% of my income would be just a few dollars more than my employer sponsored plan cost last year. I have no kids or spouse so my plan isn't as much as a family plan would cost. 9% of my income would put a huge crimp in my lifestyle.

That's the problem, everyone wants someone else to pay for it. If people directly had to pay for health care then the cost and delivery might just be a little more efficient.

 

[jderimig]

You were getting a great deal from you previous employer!

I'm not sure I agree that the same exact bronze plan that would cost an individual $2700 would cost an employer $15,500. That is not a direct comparison of comparable plans. A high deductible plan for an individual in a group plan does not cost $15,500.

Probably not. This figure was for a family plan (spouse + 2 or more dep).

However a moderate income family of four on a $50K household income will pay no more than $4500 for a bronze high-ded plan which is directly comparable to the $15,500 I quoted.

BTW, What was the great deal I got?

 

[ThirstyBarbarian]

How many people do you think would be willing to pay 9% of their income for health insurance? I expect a lot of folks would just do without at that price. 9% of my income would be just a few dollars more than my employer sponsored plan cost last year. I have no kids or spouse so my plan isn't as much as a family plan would cost. 9% of my income would put a huge crimp in my lifestyle.

If you do not have insurance that is all or partly paid by your employer, and you are in the individual market, then there is a good chance you are paying at least 9% of your income for insurance, if not more. My wife and I pay over $10,000 a year for health insurance. That's for an "inexpensive" high deductible plan. We each have individual deductibles of $4,000. That means, outside of preventive care, we wiil probably still pay allmost all of the cost of routine doctors visiits and prescriptions out of our own pocket, and the $10,000 is just to insure against the huge costs of things like hospital stays, cancer, heart attacks, and major accidents. For a lot of people, $10,000 is more than 9% of their pay.

The ACA is going to be a huge benefit to people like me and my wife who do not have health insurance through an employer and have been at the mercy of the individual health insurance market. We expect to lower our monthly premiums by about $300 per month.

 

[ThirstyBarbarian]

BTW, What was the great deal I got?

If your employer was providing you a plan that cost $14,000, and your cost was $1,500, then that was a good deal. Most employers do not cover that high a percentage of the cost of their plans. Ordinarily you would expect to pay much more than you were.

 

[jderimig]

If your employer was providing you a plan that cost $14,000, and your cost was $1,500, then that was a good deal. Most employers do not cover that high a percentage of the cost of their plans. Ordinarily you would expect to pay much more than you were.

OK. I thought $15K was high for a hi-deductible family plan in a group. But yes the employee contribution was low for the hi-ded option. There was definitely an incentive to get people to go that route. It worked for me.

 

[ThirstyBarbarian]

Getting sick or injured without medical insurance would probably put an even bigger crimp in your lifestyle.

Yes, bankruptcy is a crimp. Half of all personal bankruptcies are caused by uninsured medical costs. That's going to be one of the most interesting consequences of tha ACA that people don't think about, the dramatic decrease in bankruptcies. In California, the number of personal bankruptcies is expected to drop by about 125,000 a year.

 

[jderimig]

The ACA is going to be a huge benefit to people like me and my wife who do not have health insurance through an employer and have been at the mercy of the individual health insurance market. We expect to lower our monthly premiums by about $300 per month.

Why not just sign up only when if (heaven forbid) you get sick and save even more?

 

[ThirstyBarbarian]

I'm confused about the potential incurred costs claimed by Hobby Lobby in their suit. The maximum penalty that I can find for not offering the mandated insurance is $2000 per full-time employee which about $1 per hour per employee.

Also, the employer mandate has been put off for one year, so it does not kick in until 2015. There is no penalty next year.

 

[ThirstyBarbarian]

Why not just sign up only when if (heaven forbid) you get sick and save even more?

Well, for one thing, in the past you would be denied for a preexisting condition. You could not get insurance if you were already sick. The ACA is changing that, but it is also requiring everyone to buy insurance so they don't game the system, like you are talking about.

But more importantly, insurance does not pay for things that already happened when you were uninsured. So if you had an accident or sudden major illness, like a heart attack, you would not be able to get insurance after the fact to pay for the hundreds of thousands of dollars you had already incurred. It's like not getting car insurance and planning on buying it after you have an accident --- the insurance won't pay for the accident you already had before you got insurance.

 

[jderimig]

Well, for one thing, in the past you would be denied for a preexisting condition. You could not get insurance if you were already sick. The ACA is changing that, but it is also requiring everyone to buy insurance so they don't game the system, like you are talking about.

No its not, you can simply pay a "tax" and avoid buying insurance. The SCOTUS ruled you cannot force individuals to buy insurance but you can tax them if they don't. The current penalty err I mean tax is too low to get healthy youngsters to buy in. Unfortunately because of the SCOTUS ruling HHS can't arbitrarily increase the penalty. An increase of a tax can only come from congressional action. Good luck with that.

But more importantly, insurance does not pay for things that already happened when you were uninsured. So if you had an accident or sudden major illness, like a heart attack, you would not be able to get insurance after the fact to pay for the hundreds of thousands of dollars you had already incurred.

So buy the super low hi-ded plan (if there is one) for those sudden on-set things and then "upgrade" for the maintenance or forseeable expensive medical conditions like cancer, diabetes, arthritis etc.

Which is why many people (like professional actuaries) are predicting a premium death spiral for the latter plans. (Which I think is by design).

 

[ThirstyBarbarian]

OK. I thought $15K was high for a hi-deductible family plan in a group. But yes the employee contribution was low for the hi-ded option. There was definitely an incentive to get people to go that route. It worked for me.

I like the high deductible plans myself. I don't believe in being over insured. If I can pay for things like a routine doctor visit out of pocket without much trouble, then I'm ok doing that, and I don't need to insure against it. What I do want to be insured against are catastrophic costs, like a lengthy hospital stay, or a major surgery, that might cost hundreds of thousands of dollars. So the high deductible plans work for me.

I also like the HSA accounts that come with high-deductible plans. My wife and I have now saved enough in our HSA to fully cover the deductible for both of us for several years, so even if something truly horrible were to happen, we wouldn't necessarily need to pay anything out of pocket.

 

[ThirstyBarbarian]

No its not, you can simply pay a "tax" and avoid buying insurance. The SCOTUS ruled you cannot force individuals to buy insurance but you can tax them if they don't. The current penalty err I mean tax is too low to get healthy youngsters to buy in. Unfortunately because of the SCOTUS ruling HHS can't arbitrarily increase the penalty. An increase of a tax can only come from congressional action. Good luck with that.



So buy the super low hi-ded plan (if there is one) for those sudden on-set things and then "upgrade" for the maintenance or forseeable expensive medical conditions like cancer, diabetes, arthritis etc.

Which is why many people (like professional actuaries) are predicting a premium death spiral for the latter plans. (Which I think is by design).

The current tax may be too low to encourage healthy people to join, and there will probably always be people who will game the system. For myself, I want to be insured (but not over insured). I have a lot to lose financially to an uninsured castrophic loss. I tend to think that many of the 30 million or so uninsured in the country actually do want to be insured too and most of them are not looking to game the system or opt to pay a penalty instead of get insurance.

Something young healthy people should know is that they may be at lower risk of expensive chronic illness, but they are at higher risk of accident. They are more likely to be surprised by an unexpected castrophic loss, and the gaming strategy will not work in that case.

We'll know a lot more next year, after the exchanges have been open and all the millions of uninsured have had a chance to see what insurance will cost them.

 

[Peartree]

Just a warning. this has remained civil so far, but the farther the conversation moves toward specifics, the more likely it is to go over a line we don't care to cross. I think the question of the OP has been answered. This might be a good time to give this subject a rest.

 

[r1dermon]

The current tax may be too low to encourage healthy people to join, and there will probably always be people who will game the system. For myself, I want to be insured (but not over insured). I have a lot to lose financially to an uninsured castrophic loss. I tend to think that many of the 30 million or so uninsured in the country actually do want to be insured too and most of them are not looking to game the system or opt to pay a penalty instead of get insurance.

Something young healthy people should know is that they may be at lower risk of expensive chronic illness, but they are at higher risk of accident. They are more likely to be surprised by an unexpected castrophic loss, and the gaming strategy will not work in that case.

We'll know a lot more next year, after the exchanges have been open and all the millions of uninsured have had a chance to see what insurance will cost them.

the ACA includes a provision for under 30 year olds to obtain catastrophic coverage health insurance with absurdly high deductibles which protect against (obviously) catastrophic events such as major accidents, injuries, cancer...etc...the deductibles are in the 8,000-10,000 range.

as an aside, my health insurance costs 4900 a year, 14,700 paid by employer, 250 deductible per person, 750 total. it's interesting to see what people are paying for health insurance in different parts of the country.

 

[SAC of MMMSClub]

Can't we all just get along and be tolerant of the outward differences we may have? Rather than spending time and energy fighting and arguing why don't we sit down and all work together to find a compromise that is in the best interest of us as people.

Both sides of this discussion think that they have the moral high ground when in reality they all are only supporting their own agenda with NO REGARD to the best interest of the general population.

That is all I have to say on the subject.

NO! we can't because the really tolerant say their last words facing a brick wall or to the inside of a burlap sack tied to a post. When they came for the.......when they came for me, there was no one left to care.

 

[shrox]

NO! we can't because the really tolerant say their last words facing a brick wall or to the inside of a burlap sack tied to a post. When they came for the.......when they came for me, there was no one left to care.

Yes, good time to stop. I have health care for the first time in 5 years...

 

[jderimig]

the ACA includes a provision for under 30 year olds to obtain catastrophic coverage health insurance with absurdly high deductibles which protect against (obviously) catastrophic events such as major accidents, injuries, cancer...etc...the deductibles are in the 8,000-10,000 range.

as an aside, my health insurance costs 4900 a year, 14,700 paid by employer, 250 deductible per person, 750 total. it's interesting to see what people are paying for health insurance in different parts of the country.

That is not an absurdly high deductable depending on what the premium is. It moves people towards saving to cover future health expenses, what a concept!

I like Thirsty have a high-deductible plan with a $3200 family deductible and $8000 max out of pocket limit per year. I max out contributing to my HSA each year (~$6K). Out of the $6K about $2K comes from the savings versus the lower premium of the hi-d plan as compared to a standard core plan with lower deductible. I estimate the total cost for this plan (mine and employer) is around $16K.

My calculations say if you can have up to 1 hospital stay longer that 5 days every 3 years and you are better with my HiD plan because of the annual limit. There is a perverse incentive though once you hit your deductible or out of pocket limit within a calendar year. When that happens you want to "load up" on all the procedures you can get before the year runs out.

 

[r1dermon]

it's only absurdly high because im 28, so to me, health insurance isn't worth it at this point in my life...although im sure in another 15-20 years, barring anything abnormal in the mean time, my dependency on the system will increase substantially. perhaps the best insurance is a gym membership, motivation, and a healthy diet. certainly the cheapest. lol.

 

[belfert]

it's only absurdly high because im 28, so to me, health insurance isn't worth it at this point in my life...although im sure in another 15-20 years, barring anything abnormal in the mean time, my dependency on the system will increase substantially. perhaps the best insurance is a gym membership, motivation, and a healthy diet. certainly the cheapest. lol.

How are you going to pay the bill if you get hit by a car, or some other catastrophe befalls you? People with even the best lifestyles can get hit with cancer or other disease that can cost $100,000 easy. I know someone who got cancer who has a good lifestyle and the total costs were way over $100,000. (They have insurance.)

I've heard about plenty of people who end up owing tens of thousands of dollars in medical bills because they had a catastrophic incident of some sort and no insurance.

 

[shrox]

How are you going to pay the bill if you get hit by a car, or some other catastrophe befalls you? People with even the best lifestyles can get hit with cancer or other disease that can cost $100,000 easy. I know someone who got cancer who has a good lifestyle and the total costs were way over $100,000. (They have insurance.)

I've heard about plenty of people who end up owing tens of thousands of dollars in medical bills because they had a catastrophic incident of some sort and no insurance.

What about the costs? Why are the costs for medical care so ridiculously high?

Things that you would have been considered a wuss for complaining about are now emergency room visits.

 

[belfert]

What about the costs? Why are the costs for medical care so ridiculously high?

Things that you would have been considered a wuss for complaining about are now emergency room visits.

Government should really be working to reduce the costs of medical care instead of making sure everyone has health insurance. If the cost of medical care was less it would be easier to cover everyone.

ER visits aren't what is driving up health care costs. The real cost drivers are malpractice costs, the high cost of drugs, and new expensive treatments for diseases we couldn't cure before. It can cost $200,000 to $300,000 for cancer treatment including chemotherapy. 50 years ago chemotherapy was brand new and would not have been routinely used until the 1970s or later. I bet treating the same cancer in the 1960s would have cost 1/10 what it does today, but the death rate was higher too. There are drugs on the market today that can cost upwards of $1000 a day!

 

[jderimig]

What about the costs? Why are the costs for medical care so ridiculously high?

Because there a no-market or regulatory mechanism to control demand.

 

[shrox]

.... There are drugs on the market today that can cost upwards of $1000 a day!

Why? Why do I have to pay for their R&D, marketing, opulent offices, bonuses and fears (insurance in case they get sued)?

 

[jderimig]

Why? Why do I have to pay for their R&D, marketing, opulent offices, bonuses and fears (insurance in case they get sued)?

Edit. That stuff you mention is a drop in the ocean but popular with the pundits. All that info is in the companies 10K filings, all of that is less than 3% of revenues. Which is also less than the new federal 3% tax on medical devices. Guess who is going to pay for that?

The drugs that cost $1000 day are priced that way because they are worth it (to the person getting it). Under the current system they pay the same for health care whether they get the drug or not, so they demand the drug.

When GE Medical systems develops the next uber expensive nuclear imaging device do you think anyone in that company asks "Do you think the patients can afford this?".

Of course not because they know there are no market forces on the demand side to control this technology spiral. The next $10million cold fusion imager goes into one hospital and then all the other competing medical groups have to buy one to compete. The overall fixed system costs increases along with the insurance premiums.

 

[shrox]

Edit. That stuff you mention is a drop in the ocean but popular with the pundits. All that info is in the companies 10K filings, all of that is less than 3% of revenues. Which is also less than the new federal 3% tax on medical devices. Guess who is going to pay for that?

The drugs that cost $1000 day are priced that way because they are worth it (to the person getting it). Under the current system they pay the same for health care whether they get the drug or not, so they demand the drug.

When GE Medical systems develops the next uber expensive nuclear imaging device do you think anyone in that company asks "Do you think the patients can afford this?".

Of course not because they know there are no market forces on the demand side to control this technology spiral. The next $10million cold fusion imager goes into one hospital and then all the other competing medical groups have to buy one to compete. The overall fixed system costs increases along with the insurance premiums.

I don't want competition in health care!!!! It's marketing! I want competent and dedicated people working in a workable system!

I'd like to see a break down of cost per pill. I was on a $3600 to $6000 a month prescription, 90 pills a month. By 2015 you'll be able to grow it yourself for free.

 

[jderimig]

I don't want competition in health care!!!! It's marketing! I want competent and dedicated people working in a workable system!

There is no competition now. That is the problem. No one selects their hospital or medical provider based on price.

Point me to a competent and working system that doesn't have the element of some competition in it.

Edit: The late Martin Friedman has a proposal for health reform. Take the top 100 most common medical events. You get the fixed price voucher for each. You shop, you find a provider who charges less than the voucher and you keep the difference.

 

[r1dermon]

How are you going to pay the bill if you get hit by a car, or some other catastrophe befalls you? People with even the best lifestyles can get hit with cancer or other disease that can cost $100,000 easy. I know someone who got cancer who has a good lifestyle and the total costs were way over $100,000. (They have insurance.)

I've heard about plenty of people who end up owing tens of thousands of dollars in medical bills because they had a catastrophic incident of some sort and no insurance.

oh i have health insurance. lol. i have a wife and 4 year old, and i live in MA, so it's mandated (not that i'd risk not having it anyway). it's just a bit eye opening to see that in total, my health insurance costs over 20,000 dollars before the benefits kick in, and on average i use less than 25% of that.

 

[shrox]

There is no competition now. That is the problem. No one selects their hospital or medical provider based on price.

Point me to a competent and working system that doesn't have the element of some competition in it.

Edit: The late Martin Friedman has a proposal for health reform. Take the top 100 most common medical events. You get the fixed price voucher for each. You shop, you find a provider who charges less than the voucher and you keep the difference.

I see ads all the time about which hospital to choose here. That's competition and marketing.

 

[jderimig]

And that is bad how?