Text 10810, 98 rader
Skriven 2013-10-18 19:21:37 av Mark Hofmann (1:261/1304)
     Kommentar till en text av Janis Kracht
Ärende: Re: Obama Scare Premiums
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JK> "Welcome To My World" <tm> <g> as far as benefits go. Like I said
JK> earlier, our health insurance is about at the level of catastrophe
JK> insurance. It's been like this for a while.

In Maryland, people that have no health insurance go to the ER for everything.
That accounts for a fairly large percentage of people in the neighborhood,
where it is located.  They never pay a dime.

Obamacare won't change this.  These same people pay no tax, no not sure how
that fee will work.  Even if they paid for insurance, they would never pay the
deductible.  Still leaving the tax payors holding the bag.

JK> Seriously, that is how the small company we work for has dealt with the
JK> cost of health insurance for quite a long time. The company is in Ohio..
JK> we're in NY.

Many small companies have the worst health benefits availible, since they don't
have the money or the mass amount of employees to get a good discount.

JK> Not over here.. those "mandates" have not affected the cost of our
JK> insurance at all.

I'm sure the insurance companies are not providing all the new mandates to
policy holders out of the goodness of their heart.  They are getting the extra
money somewhere.  Maybe they are getting revenue from the 32oz soda fine/law.
:)

JK> This makes no sense as far as being related to cost of insurance.. First
JK> you're saying that premiums are being doubled (i.e. the cost will be
JK> passed on to the insured).. Then you're saying that hosp. staff is being
JK> cut supposedly because the hospital can afford to pay their employees
JK> wages.. Come on :( :(

Hospitals in Maryland are self-insured.  When an employee goes to the doctor,
hospital, etc, the payment comes directly out of the hospital's budget.  Due to
the massive increases in healthcare costs, they had to not only cut the budget
for medical payments for employees, but they also laid-off around 5% of the
staff (500 people) because the state rembersement has been at 1% for the past 4
years in a row - not keeping up with inflation and the cost of doing business.

Hospitals are also not for profit.  We operate typically in a 2-5% margin. Any
profits from that margin go back into the organization.  That is very lean
compared to companies on the stock market.  

The entire dynamic for how hospitals and providers is changing to a "location
based system", where the larger area you are in, the more reimbursement
potential.  Hospitals are stock piling money they have to try and get more
territory based on this new system.  

One thing that also scares me is the "re-admit penalty".  If a patient comes
back to the hospital for the "same issue", the hospital won't get paid for the
second stay.  They are not going to want to admit people back in and will do
what they can to avoid this from happening.

Perfect example is the many drug users in that area.  They come back over and
over and over again for the same thing.  Is it the hospital's fault that these
people continue to use drugs and won't quit?  
 JK> I have to wonder where you are getting this information from.. Being a
JK> member of the "health field" means didly if you have no idea how health
JK> insurance works..

I get the information directly from the executives, being the CFO, CEO, and
legal departments in a large ($1 billion annual revenue) health network.  I
take part in many meetings with these people and been in the healthcare field
for the past 20 years.  Dealing with insurance companies, collections, payors
of all types.

JK> Just an aside...Ron and I worked very closely with the medical/hospital
JK> industry writing the software that most hospitals use for transmitting
JK> data to Insurance companies so it's not like we have no idea exactly how
JK> it all works <g>.

These days being in IT, you can't help but learn how the business operates.  It
is necessary in order to design the proper solutions that best suite the
business.  

JK> Understand that one, Mark, seriously.. we've seen our wages "drop" in the
JK> same way.

I always try to point out to people that their "raise" isn't really a raise, if
at the end of the day, your cost of living went up more, extra costs for taxes,
insurance, etc.  Just like in business, the bottom line is what matters.  The
"raise" is a farce to fool some people.

JK> Btw, we just took a look, and in the Baltimore Business Journal it's
JK> reported that a 40 year old non-smoker can get a silver plan in MD for as
JK> low as $208.00 a month.
JK> 
JK> Geez, we're paying $610.00 a month :)

Yes, I saw those plans.  $208/month with a $10,000 deducible.  Not exactly a
bargain to me.  Especially when these peope are used to not paying anything and
getting free healthcare in the ER.

- Mark

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