Japan's doctors are middle class, European doctors are middle class, but American doctors are upper class but have to climb out of debt more. By "middle class" I mean "middle middle" or "middle upper."
Don't those countries also have more state sponsored universities? In the US colleges are very competitive and it seems like they charge ridiculous amounts of money because in the end people will pay nearly anything to have a degree with So and So University on it. I wish there was more of an emphasis on going to college rather than what college you go to. When I was in high school state schools weren't even shown to me at the guidance office. In Buffalo we've got University at Buffalo and Buffalo State College, two really awesome schools btw, yet I wasn't shown anything on them. If I'd gone to Buffalo State from the start I would indeed be a director of films that I wanted to be when I was a teen.
The whole point is to really look at "how a doctor is created" and looking at shortcutting school years in favor of not piling on more schooling but getting them into training faster, cheaper, and better. The market has failed, there is a need for cheaper GP's and instead they're making NPs require DNPs, up originally from a four year degree nursing program.
They need to stop making med school so expensive, streamline the curriculums, and hold on residencies in the case of some specialties. Every doctor should have some basic knowledge but if you're going to specialize in heart surgery it would be better for you to spend a longer residency on your specialty rather than on general medicine.
If a man could go four to six and start out earning what an engineer earns today, you'd have a lot more doctors. The point is that we have a highly tiered system not by necessity, but by status and space and a reluctance to create new competition to current doctors. I feel that the experiments will come from the third world, rather than the first world for such changes in medical practitioners.
With all the cost cutting going on I wonder if doctors aren't already starting to get more competitive. If a clinic can get by with an LPN then a doctor needs to offer services that are worth the price or look for a job elsewhere. The place I go for non-emergency illness and injury has just one doctor, one RN, and six LPNs. The doc is a new addition and the LPN's all say he's amazing but that they had to fight the clinic administrators to get him onboard. Doctors are having to compete with RN's and LPN's for crappy jobs and new doctors can't really get "good" jobs at established practices. This reminds me of when I was looking for IT jobs and couldn't even get hired for Geek Squad(home of elderly ladies and high school students who don't know a thing about fixing your electronics) because they didn't want to pay me what I was worth and I only have an AS in IT!
This kind of stuff is great for all of the people who now have health care. I guess you can go to see a doctor for checkups. You won't be completely screwed if you have to go to a hospital. And that's great for all of you.
But what about the people who already have health care? If health care providers were making X amount of profit before the new regulations, and now they have clients that will lose them money, how are they supposed to keep making that X amount? The only thing they can do is to charge everyone else more for the plan they already have. It will be costing my family hundreds of dollars a year even though we all stay in great health. It just doesn't seem fair that people who are never going to need health insurance are going to be paying the same amount of money as those who plan to be spending hundreds of dollars a year from their health care provider. It's called "insurance" for a reason.
But what about the people who already have health care? If health care providers were making X amount of profit before the new regulations, and now they have clients that will lose them money, how are they supposed to keep making that X amount? The only thing they can do is to charge everyone else more for the plan they already have. It will be costing my family hundreds of dollars a year even though we all stay in great health. It just doesn't seem fair that people who are never going to need health insurance are going to be paying the same amount of money as those who plan to be spending hundreds of dollars a year from their health care provider. It's called "insurance" for a reason.
First of all, statistically plenty of people labeled "high risk" aren't necessarily a high cost - see my elaboration on my own condition a few posts back - the plan I had when I was a preteen was footed with a ton of cost, for the rest of my life in literal terms I'm LOWER RISK (technically immune from what our small pool of people with ODDD researched - but with a pool of 47 people that were researched circa 1992 last I heard the figure from an expert it's saner to assume we're just low risk, not immune) for all the most expensive treatments because of my condition, with the only higher risk being arthritic and cataract issues - neither of which are costly. Second of all, all providers receive the same compensation for treatments, it's the insurance companies that will lose out on money - not providers, because of this.
And as I stated earlier, the bill will be having insurance companies setting as sorts of new "pools" for people that were normally ignored or costly to receive insurance. (Although after following up after the other day - only high risk is coming in this year - looks like all the rest are Spring-Summer '11)
Additionally, keep in mind with how these are being paid for - just like an employer based plan - these aren't entirely funded by the citizen - these plans are actually going to be "charging" close to three times what the listed cost is, with the other portion being charged to the DHR for the individual state primarily with some coming from the Fed as well.
Which assuming normal shared cost numbers from the bill actually puts his plan at about $600/month - and that deductible he's got is quite high. (But manageable for anyone in a working degree of health, I'd imagine - not something I'd go for with my disability though personally)
[Which from my experience selecting plans for my employees back in the day - for total cost including employer portion that's about equivalent to the $250 deductible plans that BC/BS offered in my area - which seems fair to me overall]
Don't those countries also have more state sponsored universities? In the US colleges are very competitive and it seems like they charge ridiculous amounts of money because in the end people will pay nearly anything to have a degree with So and So University on it. I wish there was more of an emphasis on going to college rather than what college you go to. When I was in high school state schools weren't even shown to me at the guidance office. In Buffalo we've got University at Buffalo and Buffalo State College, two really awesome schools btw, yet I wasn't shown anything on them. If I'd gone to Buffalo State from the start I would indeed be a director of films that I wanted to be when I was a teen.
It's worse in France, where whatever college you went to determines your future. Japan's a real pain in the ass with their education testing and ranking system. I prefer a German education model with some third world ideas that's been shown to work.
They need to stop making med school so expensive, streamline the curriculums, and hold on residencies in the case of some specialties. Every doctor should have some basic knowledge but if you're going to specialize in heart surgery it would be better for you to spend a longer residency on your specialty rather than on general medicine.
I agree, but I was talking also about the undergraduate requirements. Frankly some of the requirements are bogus to get a 4 year degree and it looks more like a wish list than a practical education in some regards. Also, I question whether we should even have high schools and return back to the old system where college was high school.
With all the cost cutting going on I wonder if doctors aren't already starting to get more competitive. If a clinic can get by with an LPN then a doctor needs to offer services that are worth the price or look for a job elsewhere. The place I go for non-emergency illness and injury has just one doctor, one RN, and six LPNs. The doc is a new addition and the LPN's all say he's amazing but that they had to fight the clinic administrators to get him onboard. Doctors are having to compete with RN's and LPN's for crappy jobs and new doctors can't really get "good" jobs at established practices. This reminds me of when I was looking for IT jobs and couldn't even get hired for Geek Squad(home of elderly ladies and high school students who don't know a thing about fixing your electronics) because they didn't want to pay me what I was worth and I only have an AS in IT!
It's basically the economy, people want cheap workers to compete with people that get paid piss poor wages in the third world. Well... except that IT people are paid more in India than the United States... ooopps! The only reason why more Indians don't go back to India is because their women like the better equality here. Furthermore, Chinese workers are striking for better wages and Germany has a high tech field that maintains manufacturing at the expense though of PIGS. So it's a tricky balance with economics, and not a one shoe fits all system and shows things that Ricardo's trade formula was too simplistic.
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Ambition must be made to counteract ambition.
Individualities may form communities, but it is institutions alone that can create a nation.
Nothing succeeds like the appearance of success.
Here is my principle: Taxes shall be levied according to ability to pay. That is the only American principle.
Don't those countries also have more state sponsored universities? In the US colleges are very competitive and it seems like they charge ridiculous amounts of money because in the end people will pay nearly anything to have a degree with So and So University on it. I wish there was more of an emphasis on going to college rather than what college you go to. When I was in high school state schools weren't even shown to me at the guidance office. In Buffalo we've got University at Buffalo and Buffalo State College, two really awesome schools btw, yet I wasn't shown anything on them. If I'd gone to Buffalo State from the start I would indeed be a director of films that I wanted to be when I was a teen.
There's still a lot of emphasis on going to college. The general feeling where I went to high school was, if you don't go to college, you're going to be end being working at McDonald's for the rest of your life. There was much more emphasis on going to college than what college you went to. In fact, we were told that even if we have to go to a community college, we could always transfer to another non-community college later. There was a lot more emphasis on going to college than what college to go to, at least at where I went to high school. I don't know about the rest of high schools in the US.
Japan's doctors are middle class, European doctors are middle class, but American doctors are upper class but have to climb out of debt more. By "middle class" I mean "middle middle" or "middle upper."
Wrong. Dutch doctors are definitely upper class.
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Which still translates into a bad system in that regard, but perhaps I should've been more specific on what countries I spoke of in the Euro zone.
It is a bad system. Don't get me wrong- it's still not as bad as the american one, and I do not have the actual numbers. However, where a med student in america would have a debt of about 100K, I do not think that the average med student over here would have one of much over 50K. Still, it's a pretty hefty fee to pay, especially with a starting salary of 3-5K.
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We have laboured long to build a heaven, only to find it populated with horrors.
It is a bad system. Don't get me wrong- it's still not as bad as the american one, and I do not have the actual numbers.
The american system isn't bad at all. if a doctor does some time in the trenches such as at a non-for profit or a public clinic they can get most and sometimes almost all of their loans forgiven.
same for lawyers. if they spend about 3 years as a public defendant they can get all or most of their loans forgiven.
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One of the major reformations that also went into effect a few days ago is that you can now stay on your parents' insurance until you are 26. So, congrats, you'll get to benefit from this too.
I fell off my parent's insurance after I graduated college, and I've been without it for 3 years. Thanks to this, I can get back on (I'm 25) and get all my checkups in before I age back out. Part time work and part time grad student just doesn't have afford me health coverage, and paying $450 for mediocre insurance isn't worth it for me.
The american system isn't bad at all. if a doctor does some time in the trenches such as at a non-for profit or a public clinic they can get most and sometimes almost all of their loans forgiven.
Not in most areas - Florida is one of the few regions with a large exception to that since they've got so many private non-profit clinics. (in large part to Cubans that "made it" and want to make sure poor Cubans get a chance)
In Maryland there's none up here that do that, outside of Pharm.D programs. And we're responsible for training nearly 20% of the doctors in the nation.
[Well, technically there are some research MD's that have programs for forgiving loans - but those are non-practicing]
I fell off my parent's insurance after I graduated college, and I've been without it for 3 years. Thanks to this, I can get back on (I'm 25) and get all my checkups in before I age back out. Part time work and part time grad student just doesn't have afford me health coverage, and paying $450 for mediocre insurance isn't worth it for me.
This is not a good thing. It's going to cost someone that $450. Whether it's your parents, the company your parents work for, the health insurance company, or the government, your family is going to be paying for it, either directly or indirectly. So if you and you're family don't think it's worth spending $450 on, how is the government forcing you to pay for this a good thing?
First of all, statistically plenty of people labeled "high risk" aren't necessarily a high cost - see my elaboration on my own condition a few posts back - the plan I had when I was a preteen was footed with a ton of cost, for the rest of my life in literal terms I'm LOWER RISK (technically immune from what our small pool of people with ODDD researched - but with a pool of 47 people that were researched circa 1992 last I heard the figure from an expert it's saner to assume we're just low risk, not immune) for all the most expensive treatments because of my condition, with the only higher risk being arthritic and cataract issues - neither of which are costly. Second of all, all providers receive the same compensation for treatments, it's the insurance companies that will lose out on money - not providers, because of this.
So what is going to happen to these insurance companies if they are all going to lose big time money?
Not in most areas - Florida is one of the few regions with a large exception to that since they've got so many private non-profit clinics. (in large part to Cubans that "made it" and want to make sure poor Cubans get a chance)
In Maryland there's none up here that do that, outside of Pharm.D programs. And we're responsible for training nearly 20% of the doctors in the nation.
[Well, technically there are some research MD's that have programs for forgiving loans - but those are non-practicing]
sorry val but almost every state in the union has some type of forgiveness or repayment help to medical students. also there are federal programs that help pay those as well.
That also doesn't include hospitals that will pay off a doctors student loans as an incentive for them to work there.
so there are actually plenty of resources in this.
So what is going to happen to these insurance companies if they are all going to lose big time money?
there are only 2 things that can happen. they will either fold or they will be forced to raise their rates on their other non-high risk patients to cover the costs.
i hate to tell ya but costs are not going to go down. in fact so far all the current results costs are going to increase for everyone.
I know for a fact next year my insurance is going way up as my company now has to get a 0 co-pay for preventive visits where as right now i have to pay 20 dollars. my insurance is going to go up by more than 20 bucks.
on top of that my deductables are going to increase even higher than they were.
so what will end up happening is that it will be to expensive for companies to fork out for employee healthcare. they will end up dumping people on the government system just to cut costs. this isn't going to be a fun ride at all.
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So what is going to happen to these insurance companies if they are all going to lose big time money?
Who's to say they are? You're prognosticating with partial data if you expect them to "lose big time money" charging a similar net rate to what you pay for an unknown condition...
And considering the verbage of the bill allows them to adjust their rates if they're making less that a given percentage of profit with appropriate evidenciary process if they take a loss one year, they'll be able to raise the rates to something approriate.
sorry val but almost every state in the union has some type of forgiveness or repayment help to medical students. also there are federal programs that help pay those as well.
That also doesn't include hospitals that will pay off a doctors student loans as an incentive for them to work there.
so there are actually plenty of resources in this.
And if you actually look at the Maryland THREE available, two you have to be Indian to qualify for (I'd imagine American Indian, but it's unclear) - and the other is $25-30k of forgiveness per year served while earning a $52k salary. Which is far less than a starting physicians average salary for the state....
Sure, that's three more programs then I was aware of (or could find information on) but none of them are worth a damn.
there are only 2 things that can happen. they will either fold or they will be forced to raise their rates on their other non-high risk patients to cover the costs.
Neither will happen if you actually read the damn bill the set it up.... if they post losses for a year on one of the "new pools" formed in the bill they're allowed to adjust their rates so that they maintain an explicit amount of profit. (Which varies based on pool type - 10% for high risk up to 40% for standard user group pools)
And they're expressly disallowed from adjusting rates on differing groups for costs not incurred by that group.
I know for a fact next year my insurance is going way up as my company now has to get a 0 co-pay for preventive visits where as right now i have to pay 20 dollars. my insurance is going to go up by more than 20 bucks.
That's unrelated to health care reform outside of the rare plans with exorbitant $100+ copays which didn't apply to your plan, that was a choice your insurance company chose to make - and the reason copays exist is for the comfort of the health care providers that accept the insurance. If you don't like it, get your doctor to pressure them to change it back.
on top of that my deductables are going to increase even higher than they were.
If they're increasing your deductible under an existing plan, then they're breaking the law - deductibles are frozen until towards the end of 2011 by law.
so what will end up happening is that it will be to expensive for companies to fork out for employee healthcare. they will end up dumping people on the government system just to cut costs. this isn't going to be a fun ride at all.
Which as has been stated before for anyone making over ~$40k/year the company would be out of their minds to not provide insurance for once you factor costs in with the tax benefits from providing.
Yes, people making under $40k might get screwed, but only about 10% of people earning under $40k receive employer based insurance anyhow.
Let me start off by saying that I do not live in USA, my experience with the USA health system are mostly from Classes in public health as we have recently been discussing the different health care system around the world, almost not 2 are the same, since different situations and circumstances requires different approaches.
My understanding is that the Insurance company actually does not lose money under the new scheme, sure they would have additional costs for needing to accept people who might require a higher medical cost (like OP), however this is offset by the compulsory coverage of even healthy individuals into the scheme. So for some insurance companies this can actually increase their profits.
But some people will say, but why do I need to pay for other people's health care. This seems like a strange attitude to me cause of my background, but doesn't paying a little bit extra each month much better than having to pay a large sum suddenly if a medical emergency comes up. Also studies have shown that the by improving the health of others you actually improve the health of everyone in the population, meaning you are actually benefiting from other people having improved health care! not to mention these people who can now get affordable health care might now be able to work again, where is previously they couldn't work as they can't afford the crazy amount that certain therapeutic agents costs.
Another big issue in USA is also Medical Litigation, while also a problem in UK and Australia, sounds like a big problem that increase the cost of Medical care. Contrary to what most people believe (this is sarcasm), Doctors usually wants to help their patients, and medical error/accidents do happen. Should a doctor's life be ruined because he makes a mistake while tired? or because of a patient of his has a rare side-effect from a medication that most doesn't know about? While some argue by suing everyone doctor who screws up for hundreds of thousands of dollars (sometimes millions? I don't know) would make people scared of making mistakes, this actually doesn't reduce medical errors in reality. Most medical mishaps are "system errors" rather than "individual errors". system error means there is something wrong with system that made the doctor in a vulnerable position to make such a mistake, for example, was there something in the medication labeling that allowed the doctor to give the patient the wrong drug? Litigation encourages a mentality of cover up, rather than talking it openly so new systems could be implemented to reduce the chance of this happening again. Obviously Doctors doesn't want to ruin their own life just because of 1 mishap, so their only options are taking out extremely expensive Medical malpractice insurances, which forces them to push up their cost even higher
But thats just my opinion. -
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And if you actually look at the Maryland THREE available, two you have to be Indian to qualify for (I'd imagine American Indian, but it's unclear) - and the other is $25-30k of forgiveness per year served while earning a $52k salary. Which is far less than a starting physicians average salary for the state....
Sure, that's three more programs then I was aware of (or could find information on) but none of them are worth a damn.
Please go back and actually read what is posted. it will help you discuss the topic and be informed of what you are talking about. there are several types of programs from both state and federal and even the private sector that help medical doctors pay off their student loans either a decent portion of it or all of it depending on where they live.
most doctors will move to a different state or the hospital or program that gives them the best incentive.
Some require a bit of time in the trench's but that is nothing out of the ordinary.
Neither will happen if you actually read the damn bill the set it up.... if they post losses for a year on one of the "new pools" formed in the bill they're allowed to adjust their rates so that they maintain an explicit amount of profit. (Which varies based on pool type - 10% for high risk up to 40% for standard user group pools)
And they're expressly disallowed from adjusting rates on differing groups for costs not incurred by that group.
thank you for backing me up with your post i appreciate it. I am insurance company X. We have several pools of insured.
after the first year we have a loss in all pools we are adjusting our rates upward in all pools to compensate for the difference. pool A will be increased 5% pools b,c,d,e will be increase 25%.
thanks for playing.
That's unrelated to health care reform outside of the rare plans with exorbitant $100+ copays which didn't apply to your plan, that was a choice your insurance company chose to make - and the reason copays exist is for the comfort of the health care providers that accept the insurance. If you don't like it, get your doctor to pressure them to change it back.
actually it isn't unrelated. it is perfectly stated in the bill that preventive care must be covered 100%. Our company is trying to sort through mess of a bill this is to see where they are at and what needs to be changed. this is one of those provisions.
preventive care has to be covered 100%. actually the reason for the co-pay is lower insurance costs.
There is nothing a doctor can do. he cannot override a federal law.
If they're increasing your deductible under an existing plan, then they're breaking the law - deductibles are frozen until towards the end of 2011 by law.
Yeah right that is why there are news reports of companies already raising their deductable plans to the maximum.
as far as i know the law doesn't actually take effect till 2011.
Which as has been stated before for anyone making over ~$40k/year the company would be out of their minds to not provide insurance for once you factor costs in with the tax benefits from providing.
Yes, people making under $40k might get screwed, but only about 10% of people earning under $40k receive employer based insurance anyhow.
I can tell you now that you are very much wrong on this. There are tons of people that make under 40K a year that get employer based insurance. so i don't know where you are getting your numbers from.
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Please go back and actually read what is posted. it will help you discuss the topic and be informed of what you are talking about. there are several types of programs from both state and federal and even the private sector that help medical doctors pay off their student loans either a decent portion of it or all of it depending on where they live.
most doctors will move to a different state or the hospital or program that gives them the best incentive.
Some require a bit of time in the trench's but that is nothing out of the ordinary.
I'm not about to dredge through all of those that aren't Maryland related since there's 90 others, but based on the examples in your link, no sane doctor would take those outside of those that qualify under the racial ones.
When I'd checked into it before I actually called up the local doctoral school (University of Maryland Medical - and yes, the UoM Medicine programs including executive positions are there on holiday weekends) since I had some curiosity anyhow and chatted with one of people that helps with job counseling - and as far as THEY'RE CONCERNED there's none. [likely they abbreviated it because none make any sense, but regardless]
thank you for backing me up with your post i appreciate it. I am insurance company X. We have several pools of insured.
after the first year we have a loss in all pools we are adjusting our rates upward in all pools to compensate for the difference. pool A will be increased 5% pools b,c,d,e will be increase 25%.
thanks for playing.
And? That's an issue with a loss in all pools - considering you have to present books that EACH POOL IS LOSING MONEY ON ITS OWN and you can't shift losses from one pool to another...
Assuming only these "high risk" plans are going to be dragging companies down (as was the statement that led to this tangent) only the "high risk" plans will have their premium increased.
actually it isn't unrelated. it is perfectly stated in the bill that preventive care must be covered 100%. Our company is trying to sort through mess of a bill this is to see where they are at and what needs to be changed. this is one of those provisions.
preventive care has to be covered 100%. actually the reason for the co-pay is lower insurance costs.
There is nothing a doctor can do. he cannot override a federal law.
100% coverage is post-copay in insurance speak. My old BC/BS program was 100% coverage on MRI's for example, I still had to pay my $20 copay when I got my MRI however.
And even then, your insurance company wouldn't be adapting to that now for that reason anyhow unless they're just trying to make bogus excuses - that part of the plan isn't scheduled for 2013-2014 (too lazy to check, but I know it's not one of the handful before 2012).
Yeah right that is why there are news reports of companies already raising their deductable plans to the maximum.
as far as i know the law doesn't actually take effect till 2011.
Link of ONE after September or so of 2009 when the lock went into place? (And only referring to existing pools obviously, since "new pools" weren't frozen until after HCR passed - and you're obviously talking about an existing plan)
If you're just referring to new pools, that's tangential (and not technically a "raise" since it's being set for the first time) and already evidenced by Mr. Stuff's thread starter plan that has a $1500 deductible that would terrify me.
I can tell you now that you are very much wrong on this. There are tons of people that make under 40K a year that get employer based insurance. so i don't know where you are getting your numbers from.
10% of 35-40% of the workforce is a substantial number, yes - but only 10% of people in that range received insurance through their employer in my last HR periodical (Employee Benefits Journal - http://www.ifebp.org/ for their URL apparently, although I see no online mirrors of articles) I have on the matter from 2009 when HCR was starting to be discussed in depth.
Keep in mind that for people making under $40k nearly 70% of them don't even work full-time, and as such have extremely limited benefits. And small private contractors don't have an employer to provide their insurance for them. Etc. etc.
I'm not about to dredge through all of those that aren't Maryland related since there's 90 others, but based on the examples in your link, no sane doctor would take those outside of those that qualify under the racial ones.
Like i said before Val your state of MD is not the end all be all of the world. at least i know you dont' have an arguement for what i said and you are wrong. nice attempt to save yourself but it failed.
As for what you said I think i will believe the offcials government posting from the Finaid office over you. Unless you think that you know more than the finaid office now?
And? That's an issue with a loss in all pools - considering you have to present books that EACH POOL IS LOSING MONEY ON ITS OWN and you can't shift losses from one pool to another...
Assuming only these "high risk" plans are going to be dragging companies down (as was the statement that led to this tangent) only the "high risk" plans will have their premium increased.
Again i proved you wrong, and you just can't admit it. you never do. it is simply amazing. i wasn't making an assumption i showed that insurance company X had losses across all pools and raised rates accordingly.
in fact just pool B could take a loss and they could raise pool b rates by 40% to compensate for that loss if they wanted to.
which is exactly what they will do.
100% coverage is post-copay in insurance speak. My old BC/BS program was 100% coverage on MRI's for example, I still had to pay my $20 copay when I got my MRI however.
And even then, your insurance company wouldn't be adapting to that now for that reason anyhow unless they're just trying to make bogus excuses - that part of the plan isn't scheduled for 2013-2014 (too lazy to check, but I know it's not one of the handful before 2012).
so now you know more than the HR and lawyers that work for my company? i can tell you this they wouldn't be implimenting something if they didn't have to more so if it was going to raise their costs. so evidently again they know more than what you do.
Link of ONE after September or so of 2009 when the lock went into place? (And only referring to existing pools obviously, since "new pools" weren't frozen until after HCR passed - and you're obviously talking about an existing plan)
If you're just referring to new pools, that's tangential (and not technically a "raise" since it's being set for the first time) and already evidenced by Mr. Stuff's thread starter plan that has a $1500 deductible that would terrify me.
I am sorry val but your experience as an HR person is no longer valid. the rules have changed and so have how companies offer insurance. I don't know any company except for maybe google that have low cost deductables. almost every company across the board have gone with high cost deductables and they keep raising them.
why? cost. it is cheaper on them and the employee. more so in a time when people are either getting laid off or cut back in hours they can't afford to pay high cost health insurance yet after this bill starts taking effect that is exactly what they are going to do.
This year though because of obama's crap healthcare plan employee's are facing premium hikes and deductable increases as well. sorry but companies are adjusting deductables in 2010 as the article states above.
Keep in mind that for people making under $40k nearly 70% of them don't even work full-time, and as such have extremely limited benefits. And small private contractors don't have an employer to provide their insurance for them. Etc. etc.
Well we don't include people that don't qualify there val. We would only count those people that qualify for medical coverage through their employeer.
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Like i said before Val your state of MD is not the end all be all of the world. at least i know you dont' have an arguement for what i said and you are wrong. nice attempt to save yourself but it failed.
First of all it's VAC, get it right already.
Secondly, considering we're the state singly responsible for educating over 20% of the doctors that are educated in our nation, we're quite important in this regard.
Look at the one's from Florida, there's quite a few that seem valid - until course if you actually look at how many doctor's your state produces though and it's under 1% of the nation's doctors.
Programs do no good unless they're in the regions of highest need. Maryland is the MOST in need of doctor financial assistance sensibly since we're #1 in doctor production for the NATION.
(Similarly on the convex with us being the single richest state per capita in the nation, it's rather ridiculous how much Federal assistance our state gets for welfare programs - we're something like #6 in how much we get - even though sensibly that should be a bill we should be footing locally since we can afford it - especially when you look at the per capita income's of the state's above us in aid which are all in the bottom 10 per capita besides New York]
Again i proved you wrong, and you just can't admit it. you never do. it is simply amazing. i wasn't making an assumption i showed that insurance company X had losses across all pools and raised rates accordingly.
You made a hypothesis, which was completely tangential to the discussion up to that point - yes, in the case of all pools losing money they can do that - considering the discussion had been regarding ONLY THE HIGH RISK POOLS dragging everyone else down until you tried to change the topic to something tangential however, you have an excellent example of why you are on my ignore function.
so now you know more than the HR and lawyers that work for my company? i can tell you this they wouldn't be implimenting something if they didn't have to more so if it was going to raise their costs. so evidently again they know more than what you do.
Considering none of those people do anything directly related to premium adjustment or anything else insurance related outside of paying the bills the insurance company tells them to, what the hell are you trying to say here?
And if you're willing to give the exact binder numbers and everything for your group plan I could check the changes that are in process and give my opinion on their likely reasoning behind it because there's a hundred different reasons to adjust insurance policy numbers. (Even footing a larger bill can be beneficial for an employer between certain amounts for tax purposes at up to a 300% rate in some rare cases - there is a cap, but the HCR bill come FY2011 will be raising that cap which would fit the timeframe without having the binder number to get a detailed policy change list from)
[And not that I expect you'll take me up on the binder number - but note that a binder number isn't the same as your policy number, it rarely appears on the cards, you generally need to go to your EOBs and the like for it - and sometimes even on there it's unlabeled (generally in those cases it looks similar to a bank routing number)]
I am sorry val but your experience as an HR person is no longer valid. the rules have changed and so have how companies offer insurance. I don't know any company except for maybe google that have low cost deductables. almost every company across the board have gone with high cost deductables and they keep raising them.
There's a difference between $1500+ deductibles, the $50-200 deductibles when I started and the $500 deductibles that are commonplace today.
In fact, once again going to my wonderful HR periodicals that update that information every 3 months - the current average yearly deductible on employer based policies was at $415 as of the Spring 2010 issue. (I can't find my Summer issue for some reason) [of course I read your link after typing this, irony that they said the same thing: "an average of $400", before you dispute it... since you don't like to read your own links]
This year though because of obama's crap healthcare plan employee's are facing premium hikes and deductable increases as well. sorry but companies are adjusting deductables in 2010 as the article states above.
Not on EXISTING PLANS, yes - for those that go to new plans that can happen, otherwise they're frozen until 2012. Now as a result some places are being "forced" into new plans because of this, since many companies (mine was one) like to revise their health insurance numbers every year to some degree - only way under the current freeze to do that is to create a new pool, not adjust one.
Jesus Christ, you're arguing like you're some sort of expert on the topic with someone who did more of this type of paperwork in a month than you've done in your entire life most likely. (And that's not even getting into the non-career related nonsense I've had resulting and my own family's experience... or my first real job...)
Well we don't include people that don't qualify there val. We would only count those people that qualify for medical coverage through their employeer.
Then where do you put the 5% of America that works part-time in various careers that provide health insurance for part-time work?
Either way you try to cook the numbers you ditch a substantial number of people - my version makes sure everyone is counted - as they should be.
Secondly, considering we're the state singly responsible for educating over 20% of the doctors that are educated in our nation, we're quite important in this regard.
nice of you to entirely dodge the point. There is more to the world and to the US than the state of MD. in fact there are 49 other states that belong in the US. i know i know it probably doesn't matter but when we actually look at the big overall picture it does matter quite a bit.
It still means that there are programs both state, federal, and in the private sector that will pay either all of, or a large chunk of a doctor's student loans. this is a fact there is no getting around it.
You made a hypothesis, which was completely tangential to the discussion up to that point - yes, in the case of all pools losing money they can do that - considering the discussion had been regarding ONLY THE HIGH RISK POOLS dragging everyone else down until you tried to change the topic to something tangential however, you have an excellent example of why you are on my ignore function.
*sigh*
again you miss the point. Do you not realize that as an insurance company i can make it look like i never made a profit and took a loss on any said pool that i would like?
so even if i have pools A, B, C, D, and E and pool A is my high risk pool. i can constantly show a loss there and if it drags the other pools down i can show losses there as well and therefore i can raise my rates accordingly.
the high risk pools will have an effect on everyone else. as insurance companies will show losses in order to get the rate hikes they need to adjust for the high risk pools.
you just don't like the fact that someone constantly punch's holes in your arguements with sources.
Considering none of those people do anything directly related to premium adjustment or anything else insurance related outside of paying the bills the insurance company tells them to, what the hell are you trying to say here?
COnsidering they are the ones that set what policy that they have and the fact that they have to comply with the new laws means they know more about it than you do.
There's a difference between $1500+ deductibles, the $50-200 deductibles when I started and the $500 deductibles that are commonplace today.
In fact, once again going to my wonderful HR periodicals that update that information every 3 months - the current average yearly deductible on employer based policies was at $415 as of the Spring 2010 issue. (I can't find my Summer issue for some reason) [of course I read your link after typing this, irony that they said the same thing: "an average of $400", before you dispute it... since you don't like to read your own links]
maybe you should try reading them for a change since well the links point out that both premiums and deductables are going up. in fact all deductables are going up for everyone. companies are going to have the same rates for all employee's not just new ones and older ones. to much paper work to keep track of who has what.
again i will rely on the articles that prove this.
i like the last couple paragraphs myself. seems that 400 number is not quite correct as it was. and this was as of 7 days ago.
Not on EXISTING PLANS, yes - for those that go to new plans that can happen, otherwise they're frozen until 2012. Now as a result some places are being "forced" into new plans because of this, since many companies (mine was one) like to revise their health insurance numbers every year to some degree - only way under the current freeze to do that is to create a new pool, not adjust one.
showing that companies are increasing their premiums and all deductables on all employee's.
Jesus Christ, you're arguing like you're some sort of expert on the topic with someone who did more of this type of paperwork in a month than you've done in your entire life most likely. (And that's not even getting into the non-career related nonsense I've had resulting and my own family's experience... or my first real job...)
No i am simply doing research on the matter and looking at articles that say that what you are claiming is not correct. it takes a simple google search and about 5-10 mins worth of reading to see what is going on.
so far i have posted 2 articles on the subject that say yes companies are and have been raising premiums and deductibles on employee's. and the only thing you can respond with is your state, your now outdated work experience and your family.
that is it. no articles no sources no anything. yet you want to complain about other people.
Then where do you put the 5% of America that works part-time in various careers that provide health insurance for part-time work?
Either way you try to cook the numbers you ditch a substantial number of people - my version makes sure everyone is counted - as they should be.
please go back and read what i wrote. i said you don't include people that are part time and do not qualify for benefits.
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nice of you to entirely dodge the point. There is more to the world and to the US than the state of MD. in fact there are 49 other states that belong in the US. i know i know it probably doesn't matter but when we actually look at the big overall picture it does matter quite a bit.
Shouldn't to most important factor be the portion of doctors that can receive the assistance?
Assistance being available means nothing if there's no one there to actually make use of it....
Sure, playing devil's advocate and assuming (I think it would be a leap though) that every one of the other 49 states has programs that are actually useful to most recent doctors we'd have 80% or so of the education of doctors covered.
Of course, each of those programs has maximum numbers that they can offer assistance to, etc. etc. which muddles the water a ton even if you assume every state but Maryland is a goldmine for those purposes.
[Frankly, if I can get a full list sometime of the highest states in doctor production, I'd be curious to see if the other top dogs have lousy ones too - but not sure where to find solid %'s on them as a non-resident - MD's was easy since I'm a resident (my guesses would be NY, Washington State, Mass, and Virginia though - but its worthless to look over their programs without knowing how much they produce)]
so even if i have pools A, B, C, D, and E and pool A is my high risk pool. i can constantly show a loss there and if it drags the other pools down i can show losses there as well and therefore i can raise my rates accordingly.
That has been illegal since 2004 when the Republicans passed one part of their health care plan they tried to get through during Clinton's era. Pools must be tracked and maintained entirely independently of each other.
The recent HCR bill went on to beef that up further. Your hypothesis if it ever happens will result in the Federal government suing that insurance company into the dirt.
Pool A can't draw on Pool B for any reason or vice versa. High Risk people that the plans would allow into an EXISTING pool could do that, but that's not what is happening here. (Nor is it planned to happen at all to my understanding - obviously that's up to the insurance company's discretion to try that route, it seems foolish to me for them to do that if they feel the people are truly high risk - but regardless it's tangential and would be VOLUNTARY on the part of the insurance company)
COnsidering they are the ones that set what policy that they have and the fact that they have to comply with the new laws means they know more about it than you do.
Then do me a favor, get me the number to your HR representative so I can chat with them about their understanding of the reasoning behind your insurance changes.
I know you of course won't do that, while "quoting" them left and right - and even if you did their answers would be the same as mine back in the day when posed with those sorts of questions "The home office requested us to review our insurance numbers and we adjusted them according to their request"
maybe you should try reading them for a change since well the links point out that both premiums and deductables are going up. in fact all deductables are going up for everyone. companies are going to have the same rates for all employee's not just new ones and older ones. to much paper work to keep track of who has what.
again i will rely on the articles that prove this.
And yet another link that talks about the AVERAGE which includes people on new insurance polices and nothing about the raises that people on EXISTING policies are seeing in deductibles in the like.
Ain't it convenient that you keep reading magical text that isn't there? Hallucinations are bad.
i like the last couple paragraphs myself. seems that 400 number is not quite correct as it was. and this was as of 7 days ago.
Are you talking about the end paragraph of the first page? Because the one on the last page seems completely irrelevant.
And as for the one of the first page, we were talking about EMPLOYER PROVIDED PLANS not individual plans. Smaller pools always have higher deductibles, that's insurance 101.
showing that companies are increasing their premiums and all deductables on all employee's.
Once again, not stated if they're changing plans or sticking with the existing - as I KEEP SAYING it's quite possible to change under a new binder number but it's counterproductive outside of fear-mongering some have done. (often funded by the insurance companies that reap the rewards from their panic - a wonderful self-feeding cycle)
Also note in the case of that survey nearly half the respondents didn't answer the full survey which would from most groups lead to the survey being tossed out for any additional items. People on the extremes for experiences are the most likely to take a survey to completion - quoting results while having around half of your pool completing a different amount of the survey leads to skewed results.
No i am simply doing research on the matter and looking at articles that say that what you are claiming is not correct. it takes a simple google search and about 5-10 mins worth of reading to see what is going on.
so far i have posted 2 articles on the subject that say yes companies are and have been raising premiums and deductibles on employee's. and the only thing you can respond with is your state, your now outdated work experience and your family.
You're breezing over things and missing key points - you're arguing that existing plans can be altered when they can't and you KEEP MISSING THAT IN YOUR ARTICLES - if today we've got 10 mil people paying $1/mo for insurance and next month we add 10 mil people with new policies paying $2/mo the average cost of insurance will have gone up by 50% even while the people on the existing $1/mo plan don't pay a dime.
I pray you're bright enough to understand that. Stop reading into things, and find direct evidence of EXISTING PLANS being increased in cost/deductible since mid-'09.
[Additionally note since most of what you've posted is "fuzzy" on the timeframes since it's just polls and the like many of those people may have been referencing hikes that happened before the freeze occured since it wasn't that long ago (roughly 12 months - and often policy changes regarding cost don't happen until Q1 even if put into effect earlier)]
that is it. no articles no sources no anything. yet you want to complain about other people.
please go back and read what i wrote. i said you don't include people that are part time and do not qualify for benefits.
You want to pick and chose who you include - and regardless part time workers need insurance too last time I checked.
Don't those countries also have more state sponsored universities? In the US colleges are very competitive and it seems like they charge ridiculous amounts of money because in the end people will pay nearly anything to have a degree with So and So University on it. I wish there was more of an emphasis on going to college rather than what college you go to. When I was in high school state schools weren't even shown to me at the guidance office. In Buffalo we've got University at Buffalo and Buffalo State College, two really awesome schools btw, yet I wasn't shown anything on them. If I'd gone to Buffalo State from the start I would indeed be a director of films that I wanted to be when I was a teen.
They need to stop making med school so expensive, streamline the curriculums, and hold on residencies in the case of some specialties. Every doctor should have some basic knowledge but if you're going to specialize in heart surgery it would be better for you to spend a longer residency on your specialty rather than on general medicine.
With all the cost cutting going on I wonder if doctors aren't already starting to get more competitive. If a clinic can get by with an LPN then a doctor needs to offer services that are worth the price or look for a job elsewhere. The place I go for non-emergency illness and injury has just one doctor, one RN, and six LPNs. The doc is a new addition and the LPN's all say he's amazing but that they had to fight the clinic administrators to get him onboard. Doctors are having to compete with RN's and LPN's for crappy jobs and new doctors can't really get "good" jobs at established practices. This reminds me of when I was looking for IT jobs and couldn't even get hired for Geek Squad(home of elderly ladies and high school students who don't know a thing about fixing your electronics) because they didn't want to pay me what I was worth and I only have an AS in IT!
But what about the people who already have health care? If health care providers were making X amount of profit before the new regulations, and now they have clients that will lose them money, how are they supposed to keep making that X amount? The only thing they can do is to charge everyone else more for the plan they already have. It will be costing my family hundreds of dollars a year even though we all stay in great health. It just doesn't seem fair that people who are never going to need health insurance are going to be paying the same amount of money as those who plan to be spending hundreds of dollars a year from their health care provider. It's called "insurance" for a reason.
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First of all, statistically plenty of people labeled "high risk" aren't necessarily a high cost - see my elaboration on my own condition a few posts back - the plan I had when I was a preteen was footed with a ton of cost, for the rest of my life in literal terms I'm LOWER RISK (technically immune from what our small pool of people with ODDD researched - but with a pool of 47 people that were researched circa 1992 last I heard the figure from an expert it's saner to assume we're just low risk, not immune) for all the most expensive treatments because of my condition, with the only higher risk being arthritic and cataract issues - neither of which are costly. Second of all, all providers receive the same compensation for treatments, it's the insurance companies that will lose out on money - not providers, because of this.
And as I stated earlier, the bill will be having insurance companies setting as sorts of new "pools" for people that were normally ignored or costly to receive insurance. (Although after following up after the other day - only high risk is coming in this year - looks like all the rest are Spring-Summer '11)
Additionally, keep in mind with how these are being paid for - just like an employer based plan - these aren't entirely funded by the citizen - these plans are actually going to be "charging" close to three times what the listed cost is, with the other portion being charged to the DHR for the individual state primarily with some coming from the Fed as well.
Which assuming normal shared cost numbers from the bill actually puts his plan at about $600/month - and that deductible he's got is quite high. (But manageable for anyone in a working degree of health, I'd imagine - not something I'd go for with my disability though personally)
[Which from my experience selecting plans for my employees back in the day - for total cost including employer portion that's about equivalent to the $250 deductible plans that BC/BS offered in my area - which seems fair to me overall]
Re: People misusing the term Vanilla to describe a flying, unleash (sometimes trample) critter.
It's worse in France, where whatever college you went to determines your future. Japan's a real pain in the ass with their education testing and ranking system. I prefer a German education model with some third world ideas that's been shown to work.
I agree, but I was talking also about the undergraduate requirements. Frankly some of the requirements are bogus to get a 4 year degree and it looks more like a wish list than a practical education in some regards. Also, I question whether we should even have high schools and return back to the old system where college was high school.
It's basically the economy, people want cheap workers to compete with people that get paid piss poor wages in the third world. Well... except that IT people are paid more in India than the United States... ooopps! The only reason why more Indians don't go back to India is because their women like the better equality here. Furthermore, Chinese workers are striking for better wages and Germany has a high tech field that maintains manufacturing at the expense though of PIGS. So it's a tricky balance with economics, and not a one shoe fits all system and shows things that Ricardo's trade formula was too simplistic.
Ambition must be made to counteract ambition.
Individualities may form communities, but it is institutions alone that can create a nation.
Nothing succeeds like the appearance of success.
Here is my principle: Taxes shall be levied according to ability to pay. That is the only American principle.
There's still a lot of emphasis on going to college. The general feeling where I went to high school was, if you don't go to college, you're going to be end being working at McDonald's for the rest of your life. There was much more emphasis on going to college than what college you went to. In fact, we were told that even if we have to go to a community college, we could always transfer to another non-community college later. There was a lot more emphasis on going to college than what college to go to, at least at where I went to high school. I don't know about the rest of high schools in the US.
Wrong. Dutch doctors are definitely upper class.
Starting out or after a number of years?
Ambition must be made to counteract ambition.
Individualities may form communities, but it is institutions alone that can create a nation.
Nothing succeeds like the appearance of success.
Here is my principle: Taxes shall be levied according to ability to pay. That is the only American principle.
After a couple of years. Just as in the states, they get out of med-school with a pretty hefty loan to pay back.
Which still translates into a bad system in that regard, but perhaps I should've been more specific on what countries I spoke of in the Euro zone.
Ambition must be made to counteract ambition.
Individualities may form communities, but it is institutions alone that can create a nation.
Nothing succeeds like the appearance of success.
Here is my principle: Taxes shall be levied according to ability to pay. That is the only American principle.
It is a bad system. Don't get me wrong- it's still not as bad as the american one, and I do not have the actual numbers. However, where a med student in america would have a debt of about 100K, I do not think that the average med student over here would have one of much over 50K. Still, it's a pretty hefty fee to pay, especially with a starting salary of 3-5K.
The american system isn't bad at all. if a doctor does some time in the trenches such as at a non-for profit or a public clinic they can get most and sometimes almost all of their loans forgiven.
same for lawyers. if they spend about 3 years as a public defendant they can get all or most of their loans forgiven.
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I fell off my parent's insurance after I graduated college, and I've been without it for 3 years. Thanks to this, I can get back on (I'm 25) and get all my checkups in before I age back out. Part time work and part time grad student just doesn't have afford me health coverage, and paying $450 for mediocre insurance isn't worth it for me.
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Not in most areas - Florida is one of the few regions with a large exception to that since they've got so many private non-profit clinics. (in large part to Cubans that "made it" and want to make sure poor Cubans get a chance)
In Maryland there's none up here that do that, outside of Pharm.D programs. And we're responsible for training nearly 20% of the doctors in the nation.
[Well, technically there are some research MD's that have programs for forgiving loans - but those are non-practicing]
Re: People misusing the term Vanilla to describe a flying, unleash (sometimes trample) critter.
This is not a good thing. It's going to cost someone that $450. Whether it's your parents, the company your parents work for, the health insurance company, or the government, your family is going to be paying for it, either directly or indirectly. So if you and you're family don't think it's worth spending $450 on, how is the government forcing you to pay for this a good thing?
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So what is going to happen to these insurance companies if they are all going to lose big time money?
http://services.aamc.org/fed_loan_pub/index.cfm?fuseaction=public.welcome
sorry val but almost every state in the union has some type of forgiveness or repayment help to medical students. also there are federal programs that help pay those as well.
That also doesn't include hospitals that will pay off a doctors student loans as an incentive for them to work there.
so there are actually plenty of resources in this.
there are only 2 things that can happen. they will either fold or they will be forced to raise their rates on their other non-high risk patients to cover the costs.
i hate to tell ya but costs are not going to go down. in fact so far all the current results costs are going to increase for everyone.
I know for a fact next year my insurance is going way up as my company now has to get a 0 co-pay for preventive visits where as right now i have to pay 20 dollars. my insurance is going to go up by more than 20 bucks.
on top of that my deductables are going to increase even higher than they were.
so what will end up happening is that it will be to expensive for companies to fork out for employee healthcare. they will end up dumping people on the government system just to cut costs. this isn't going to be a fun ride at all.
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Who's to say they are? You're prognosticating with partial data if you expect them to "lose big time money" charging a similar net rate to what you pay for an unknown condition...
And considering the verbage of the bill allows them to adjust their rates if they're making less that a given percentage of profit with appropriate evidenciary process if they take a loss one year, they'll be able to raise the rates to something approriate.
And if you actually look at the Maryland THREE available, two you have to be Indian to qualify for (I'd imagine American Indian, but it's unclear) - and the other is $25-30k of forgiveness per year served while earning a $52k salary. Which is far less than a starting physicians average salary for the state....
Sure, that's three more programs then I was aware of (or could find information on) but none of them are worth a damn.
Neither will happen if you actually read the damn bill the set it up.... if they post losses for a year on one of the "new pools" formed in the bill they're allowed to adjust their rates so that they maintain an explicit amount of profit. (Which varies based on pool type - 10% for high risk up to 40% for standard user group pools)
And they're expressly disallowed from adjusting rates on differing groups for costs not incurred by that group.
That's unrelated to health care reform outside of the rare plans with exorbitant $100+ copays which didn't apply to your plan, that was a choice your insurance company chose to make - and the reason copays exist is for the comfort of the health care providers that accept the insurance. If you don't like it, get your doctor to pressure them to change it back.
If they're increasing your deductible under an existing plan, then they're breaking the law - deductibles are frozen until towards the end of 2011 by law.
Which as has been stated before for anyone making over ~$40k/year the company would be out of their minds to not provide insurance for once you factor costs in with the tax benefits from providing.
Yes, people making under $40k might get screwed, but only about 10% of people earning under $40k receive employer based insurance anyhow.
Re: People misusing the term Vanilla to describe a flying, unleash (sometimes trample) critter.
My understanding is that the Insurance company actually does not lose money under the new scheme, sure they would have additional costs for needing to accept people who might require a higher medical cost (like OP), however this is offset by the compulsory coverage of even healthy individuals into the scheme. So for some insurance companies this can actually increase their profits.
But some people will say, but why do I need to pay for other people's health care. This seems like a strange attitude to me cause of my background, but doesn't paying a little bit extra each month much better than having to pay a large sum suddenly if a medical emergency comes up. Also studies have shown that the by improving the health of others you actually improve the health of everyone in the population, meaning you are actually benefiting from other people having improved health care! not to mention these people who can now get affordable health care might now be able to work again, where is previously they couldn't work as they can't afford the crazy amount that certain therapeutic agents costs.
Another big issue in USA is also Medical Litigation, while also a problem in UK and Australia, sounds like a big problem that increase the cost of Medical care. Contrary to what most people believe (this is sarcasm), Doctors usually wants to help their patients, and medical error/accidents do happen. Should a doctor's life be ruined because he makes a mistake while tired? or because of a patient of his has a rare side-effect from a medication that most doesn't know about? While some argue by suing everyone doctor who screws up for hundreds of thousands of dollars (sometimes millions? I don't know) would make people scared of making mistakes, this actually doesn't reduce medical errors in reality. Most medical mishaps are "system errors" rather than "individual errors". system error means there is something wrong with system that made the doctor in a vulnerable position to make such a mistake, for example, was there something in the medication labeling that allowed the doctor to give the patient the wrong drug? Litigation encourages a mentality of cover up, rather than talking it openly so new systems could be implemented to reduce the chance of this happening again. Obviously Doctors doesn't want to ruin their own life just because of 1 mishap, so their only options are taking out extremely expensive Medical malpractice insurances, which forces them to push up their cost even higher
But thats just my opinion. -
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Please go back and actually read what is posted. it will help you discuss the topic and be informed of what you are talking about. there are several types of programs from both state and federal and even the private sector that help medical doctors pay off their student loans either a decent portion of it or all of it depending on where they live.
most doctors will move to a different state or the hospital or program that gives them the best incentive.
Some require a bit of time in the trench's but that is nothing out of the ordinary.
thank you for backing me up with your post i appreciate it. I am insurance company X. We have several pools of insured.
after the first year we have a loss in all pools we are adjusting our rates upward in all pools to compensate for the difference. pool A will be increased 5% pools b,c,d,e will be increase 25%.
thanks for playing.
actually it isn't unrelated. it is perfectly stated in the bill that preventive care must be covered 100%. Our company is trying to sort through mess of a bill this is to see where they are at and what needs to be changed. this is one of those provisions.
preventive care has to be covered 100%. actually the reason for the co-pay is lower insurance costs.
There is nothing a doctor can do. he cannot override a federal law.
Yeah right that is why there are news reports of companies already raising their deductable plans to the maximum.
as far as i know the law doesn't actually take effect till 2011.
I can tell you now that you are very much wrong on this. There are tons of people that make under 40K a year that get employer based insurance. so i don't know where you are getting your numbers from.
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I'm not about to dredge through all of those that aren't Maryland related since there's 90 others, but based on the examples in your link, no sane doctor would take those outside of those that qualify under the racial ones.
When I'd checked into it before I actually called up the local doctoral school (University of Maryland Medical - and yes, the UoM Medicine programs including executive positions are there on holiday weekends) since I had some curiosity anyhow and chatted with one of people that helps with job counseling - and as far as THEY'RE CONCERNED there's none. [likely they abbreviated it because none make any sense, but regardless]
And? That's an issue with a loss in all pools - considering you have to present books that EACH POOL IS LOSING MONEY ON ITS OWN and you can't shift losses from one pool to another...
Assuming only these "high risk" plans are going to be dragging companies down (as was the statement that led to this tangent) only the "high risk" plans will have their premium increased.
100% coverage is post-copay in insurance speak. My old BC/BS program was 100% coverage on MRI's for example, I still had to pay my $20 copay when I got my MRI however.
And even then, your insurance company wouldn't be adapting to that now for that reason anyhow unless they're just trying to make bogus excuses - that part of the plan isn't scheduled for 2013-2014 (too lazy to check, but I know it's not one of the handful before 2012).
Link of ONE after September or so of 2009 when the lock went into place? (And only referring to existing pools obviously, since "new pools" weren't frozen until after HCR passed - and you're obviously talking about an existing plan)
If you're just referring to new pools, that's tangential (and not technically a "raise" since it's being set for the first time) and already evidenced by Mr. Stuff's thread starter plan that has a $1500 deductible that would terrify me.
10% of 35-40% of the workforce is a substantial number, yes - but only 10% of people in that range received insurance through their employer in my last HR periodical (Employee Benefits Journal - http://www.ifebp.org/ for their URL apparently, although I see no online mirrors of articles) I have on the matter from 2009 when HCR was starting to be discussed in depth.
Keep in mind that for people making under $40k nearly 70% of them don't even work full-time, and as such have extremely limited benefits. And small private contractors don't have an employer to provide their insurance for them. Etc. etc.
Re: People misusing the term Vanilla to describe a flying, unleash (sometimes trample) critter.
Like i said before Val your state of MD is not the end all be all of the world. at least i know you dont' have an arguement for what i said and you are wrong. nice attempt to save yourself but it failed.
As for what you said I think i will believe the offcials government posting from the Finaid office over you. Unless you think that you know more than the finaid office now?
Again i proved you wrong, and you just can't admit it. you never do. it is simply amazing. i wasn't making an assumption i showed that insurance company X had losses across all pools and raised rates accordingly.
in fact just pool B could take a loss and they could raise pool b rates by 40% to compensate for that loss if they wanted to.
which is exactly what they will do.
so now you know more than the HR and lawyers that work for my company? i can tell you this they wouldn't be implimenting something if they didn't have to more so if it was going to raise their costs. so evidently again they know more than what you do.
I am sorry val but your experience as an HR person is no longer valid. the rules have changed and so have how companies offer insurance. I don't know any company except for maybe google that have low cost deductables. almost every company across the board have gone with high cost deductables and they keep raising them.
why? cost. it is cheaper on them and the employee. more so in a time when people are either getting laid off or cut back in hours they can't afford to pay high cost health insurance yet after this bill starts taking effect that is exactly what they are going to do.
http://www.executivehm.com/news/medical-costs-to-jump-for-employers/
This year though because of obama's crap healthcare plan employee's are facing premium hikes and deductable increases as well. sorry but companies are adjusting deductables in 2010 as the article states above.
Well we don't include people that don't qualify there val. We would only count those people that qualify for medical coverage through their employeer.
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First of all it's VAC, get it right already.
Secondly, considering we're the state singly responsible for educating over 20% of the doctors that are educated in our nation, we're quite important in this regard.
Look at the one's from Florida, there's quite a few that seem valid - until course if you actually look at how many doctor's your state produces though and it's under 1% of the nation's doctors.
Programs do no good unless they're in the regions of highest need. Maryland is the MOST in need of doctor financial assistance sensibly since we're #1 in doctor production for the NATION.
(Similarly on the convex with us being the single richest state per capita in the nation, it's rather ridiculous how much Federal assistance our state gets for welfare programs - we're something like #6 in how much we get - even though sensibly that should be a bill we should be footing locally since we can afford it - especially when you look at the per capita income's of the state's above us in aid which are all in the bottom 10 per capita besides New York]
You made a hypothesis, which was completely tangential to the discussion up to that point - yes, in the case of all pools losing money they can do that - considering the discussion had been regarding ONLY THE HIGH RISK POOLS dragging everyone else down until you tried to change the topic to something tangential however, you have an excellent example of why you are on my ignore function.
Considering none of those people do anything directly related to premium adjustment or anything else insurance related outside of paying the bills the insurance company tells them to, what the hell are you trying to say here?
And if you're willing to give the exact binder numbers and everything for your group plan I could check the changes that are in process and give my opinion on their likely reasoning behind it because there's a hundred different reasons to adjust insurance policy numbers. (Even footing a larger bill can be beneficial for an employer between certain amounts for tax purposes at up to a 300% rate in some rare cases - there is a cap, but the HCR bill come FY2011 will be raising that cap which would fit the timeframe without having the binder number to get a detailed policy change list from)
[And not that I expect you'll take me up on the binder number - but note that a binder number isn't the same as your policy number, it rarely appears on the cards, you generally need to go to your EOBs and the like for it - and sometimes even on there it's unlabeled (generally in those cases it looks similar to a bank routing number)]
There's a difference between $1500+ deductibles, the $50-200 deductibles when I started and the $500 deductibles that are commonplace today.
In fact, once again going to my wonderful HR periodicals that update that information every 3 months - the current average yearly deductible on employer based policies was at $415 as of the Spring 2010 issue. (I can't find my Summer issue for some reason) [of course I read your link after typing this, irony that they said the same thing: "an average of $400", before you dispute it... since you don't like to read your own links]
Not on EXISTING PLANS, yes - for those that go to new plans that can happen, otherwise they're frozen until 2012. Now as a result some places are being "forced" into new plans because of this, since many companies (mine was one) like to revise their health insurance numbers every year to some degree - only way under the current freeze to do that is to create a new pool, not adjust one.
Jesus Christ, you're arguing like you're some sort of expert on the topic with someone who did more of this type of paperwork in a month than you've done in your entire life most likely. (And that's not even getting into the non-career related nonsense I've had resulting and my own family's experience... or my first real job...)
Then where do you put the 5% of America that works part-time in various careers that provide health insurance for part-time work?
Either way you try to cook the numbers you ditch a substantial number of people - my version makes sure everyone is counted - as they should be.
Re: People misusing the term Vanilla to describe a flying, unleash (sometimes trample) critter.
nice of you to entirely dodge the point. There is more to the world and to the US than the state of MD. in fact there are 49 other states that belong in the US. i know i know it probably doesn't matter but when we actually look at the big overall picture it does matter quite a bit.
It still means that there are programs both state, federal, and in the private sector that will pay either all of, or a large chunk of a doctor's student loans. this is a fact there is no getting around it.
*sigh*
again you miss the point. Do you not realize that as an insurance company i can make it look like i never made a profit and took a loss on any said pool that i would like?
so even if i have pools A, B, C, D, and E and pool A is my high risk pool. i can constantly show a loss there and if it drags the other pools down i can show losses there as well and therefore i can raise my rates accordingly.
the high risk pools will have an effect on everyone else. as insurance companies will show losses in order to get the rate hikes they need to adjust for the high risk pools.
you just don't like the fact that someone constantly punch's holes in your arguements with sources.
COnsidering they are the ones that set what policy that they have and the fact that they have to comply with the new laws means they know more about it than you do.
maybe you should try reading them for a change since well the links point out that both premiums and deductables are going up. in fact all deductables are going up for everyone. companies are going to have the same rates for all employee's not just new ones and older ones. to much paper work to keep track of who has what.
again i will rely on the articles that prove this.
http://articles.moneycentral.msn.com/Insurance/article.aspx?post=1800256&
i like the last couple paragraphs myself. seems that 400 number is not quite correct as it was. and this was as of 7 days ago.
Time to wake up.
http://247wallst.com/2010/09/03/family-healthcare-costs-rise-but-workers-pay-for-the-increase/
yet another article.
showing that companies are increasing their premiums and all deductables on all employee's.
No i am simply doing research on the matter and looking at articles that say that what you are claiming is not correct. it takes a simple google search and about 5-10 mins worth of reading to see what is going on.
so far i have posted 2 articles on the subject that say yes companies are and have been raising premiums and deductibles on employee's. and the only thing you can respond with is your state, your now outdated work experience and your family.
that is it. no articles no sources no anything. yet you want to complain about other people.
please go back and read what i wrote. i said you don't include people that are part time and do not qualify for benefits.
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Shouldn't to most important factor be the portion of doctors that can receive the assistance?
Assistance being available means nothing if there's no one there to actually make use of it....
Sure, playing devil's advocate and assuming (I think it would be a leap though) that every one of the other 49 states has programs that are actually useful to most recent doctors we'd have 80% or so of the education of doctors covered.
Of course, each of those programs has maximum numbers that they can offer assistance to, etc. etc. which muddles the water a ton even if you assume every state but Maryland is a goldmine for those purposes.
[Frankly, if I can get a full list sometime of the highest states in doctor production, I'd be curious to see if the other top dogs have lousy ones too - but not sure where to find solid %'s on them as a non-resident - MD's was easy since I'm a resident (my guesses would be NY, Washington State, Mass, and Virginia though - but its worthless to look over their programs without knowing how much they produce)]
That has been illegal since 2004 when the Republicans passed one part of their health care plan they tried to get through during Clinton's era. Pools must be tracked and maintained entirely independently of each other.
The recent HCR bill went on to beef that up further. Your hypothesis if it ever happens will result in the Federal government suing that insurance company into the dirt.
Pool A can't draw on Pool B for any reason or vice versa. High Risk people that the plans would allow into an EXISTING pool could do that, but that's not what is happening here. (Nor is it planned to happen at all to my understanding - obviously that's up to the insurance company's discretion to try that route, it seems foolish to me for them to do that if they feel the people are truly high risk - but regardless it's tangential and would be VOLUNTARY on the part of the insurance company)
Then do me a favor, get me the number to your HR representative so I can chat with them about their understanding of the reasoning behind your insurance changes.
I know you of course won't do that, while "quoting" them left and right - and even if you did their answers would be the same as mine back in the day when posed with those sorts of questions "The home office requested us to review our insurance numbers and we adjusted them according to their request"
And yet another link that talks about the AVERAGE which includes people on new insurance polices and nothing about the raises that people on EXISTING policies are seeing in deductibles in the like.
Ain't it convenient that you keep reading magical text that isn't there? Hallucinations are bad.
Are you talking about the end paragraph of the first page? Because the one on the last page seems completely irrelevant.
And as for the one of the first page, we were talking about EMPLOYER PROVIDED PLANS not individual plans. Smaller pools always have higher deductibles, that's insurance 101.
Once again, not stated if they're changing plans or sticking with the existing - as I KEEP SAYING it's quite possible to change under a new binder number but it's counterproductive outside of fear-mongering some have done. (often funded by the insurance companies that reap the rewards from their panic - a wonderful self-feeding cycle)
Also note in the case of that survey nearly half the respondents didn't answer the full survey which would from most groups lead to the survey being tossed out for any additional items. People on the extremes for experiences are the most likely to take a survey to completion - quoting results while having around half of your pool completing a different amount of the survey leads to skewed results.
You're breezing over things and missing key points - you're arguing that existing plans can be altered when they can't and you KEEP MISSING THAT IN YOUR ARTICLES - if today we've got 10 mil people paying $1/mo for insurance and next month we add 10 mil people with new policies paying $2/mo the average cost of insurance will have gone up by 50% even while the people on the existing $1/mo plan don't pay a dime.
I pray you're bright enough to understand that. Stop reading into things, and find direct evidence of EXISTING PLANS being increased in cost/deductible since mid-'09.
[Additionally note since most of what you've posted is "fuzzy" on the timeframes since it's just polls and the like many of those people may have been referencing hikes that happened before the freeze occured since it wasn't that long ago (roughly 12 months - and often policy changes regarding cost don't happen until Q1 even if put into effect earlier)]
that is it. no articles no sources no anything. yet you want to complain about other people.
You want to pick and chose who you include - and regardless part time workers need insurance too last time I checked.
Re: People misusing the term Vanilla to describe a flying, unleash (sometimes trample) critter.