|
PerniciousKnid posted:Do people usually attribute this to their specific plan, or to a rise in health costs in general? In my group of about 20, I'd say:
* Bit of a confound here. The employer was stingy on raises so there was pre-existing resentment getting rolled in.
|
#
?
Apr 7, 2018 18:55
|
|
|
|
| # ? May 15, 2024 11:24 |
|
|
Malcolm XML posted:hello i am leaving the socialist worker's paradise of the NHS to the hellscape that is employer provided health insurance Not a Dr, lawyer, HR pro, or insurance agent! Better PPO all the way on this one. If we were talking about your contributions being higher, then it'd be a really convoluted question involving tons of follow up questions about your salary, general health, additional people you're covering, and on and on and on. But, since we're talking about $60 a month difference between an mediocre plan, an annoying high deductible plan, and a fairly nice plan, just opt for the best one. Those prices and coverages are better than most people get, even with employer provided coverage. Count yourself lucky.
|
|
#
?
Apr 7, 2018 21:50
|
|
|
blackmet posted:Not a Dr, lawyer, HR pro, or insurance agent! yeah my issue with the better ppo is that I lose access to a HSA, which can work as a tax efficient savings vehicle. Aside from the prescriptions (for perennial allergies lol) I'm in pretty good health and I'm young. Also i can illegally import drugs from india if it matters.
|
|
#
?
Apr 8, 2018 14:52
|
|
|
Malcolm XML posted:yeah my issue with the better ppo is that I lose access to a HSA, which can work as a tax efficient savings vehicle. Aside from the prescriptions (for perennial allergies lol) I'm in pretty good health and I'm young. Well...If you contribute the $50 a month difference into your HSA + the 500 the employer gives you, it effectively lowers your deductible to $400 your first year, which isn't bad. Plus, HSA funds can used for dental and vision. Dental, even with insurance, can be the most expensive part of health care for otherwise young and healthy people. My mouth has cost me a couple grand over the past couple years. Most company plans have decent prescription coverage, especially if you can get generics. My 3 prescriptions for mental health and cholesterol cost $6 a month. I doubt you'll need to resort to bringing in drugs from India. So, yeah, the HSA is probably fine in your case. Just avoid the cheap one
|
|
#
?
Apr 8, 2018 19:48
|
|
|
Malcolm XML posted:hello i am leaving the socialist worker's paradise of the NHS to the hellscape that is employer provided health insurance Definitely not the HSA, since an HSA requires drug benefits be applied to the deductible, so your 3 non-generic prescriptions will be the pharmacy allowed amount instead of a copay. EDIT: Well, depending on the allowed amount of your non-generics, it might not be a bad idea. You can just look them up on GoodRx or whatnot to see what you'd pay at your pharmacy without insurance to get a rough estimate. What's the drug benefit on the two PPO plans? Is it the same coinsurance rate as the medical? Does it have separate medical and drug OPMs, so if you hit the 2500 drug OPM for the better PPO you also satisfy the 2500 medical OPM?
|
|
#
?
Apr 9, 2018 18:28
|
|
|
Reik posted:Definitely not the HSA, since an HSA requires drug benefits be applied to the deductible, so your 3 non-generic prescriptions will be the pharmacy allowed amount instead of a copay. EDIT: Well, depending on the allowed amount of your non-generics, it might not be a bad idea. You can just look them up on GoodRx or whatnot to see what you'd pay at your pharmacy without insurance to get a rough estimate. Hmm I ran the numbers on the drugs and if I buy it in the US I will blow through the hdhp deductible to the point where it's covered in like 5 months. The same drug that costs the NHS 20 quid a pop (and me nothing) is $200 on the free market. The opm are separate I believe
|
|
#
?
Apr 10, 2018 00:16
|
|
|
Stickman posted:I suspect that most people who haven't yet used their insurance for anything major are satisfied with it, and that probably gets you a good way towards "most" Americans. Yeah, this is my guess. If you have health insurance and don't need to use it much, you're probably going to rank it as good. A significant percent of people would be covered by "are healthy and/or well-off enough that healthcare costs aren't an issue." There's also the fact that "are happy with their insurance" != "wouldn't prefer, or at least be okay with, government insurance."
|
|
#
?
Apr 10, 2018 03:06
|
|
|
Ytlaya posted:Yeah, this is my guess. If you have health insurance and don't need to use it much, you're probably going to rank it as good. A significant percent of people would be covered by "are healthy and/or well-off enough that healthcare costs aren't an issue." It's pretty much this, due to the Pareto distribution of healthcare spending. The vast majority of people are happy with their insurance and happy with their out of pocket drug costs because the vast majority of people just don't spend enough to the point where an insurer would even worry about it. But it breaks down quick when you're around the top 15% or so of healthcare spending or when you're in the hospital and start getting billed by out of network physicians. e: also on the subject of networks, abolishing the whole concept would be one of the most visible changes of UHC and would really improve patient outcomes in rural hospitals since they could start using telemedicine, which is currently a billing nightmare The Phlegmatist fucked around with this message at 18:03 on Apr 10, 2018 |
|
#
?
Apr 10, 2018 16:48
|
|
|
Malcolm XML posted:Hmm I ran the numbers on the drugs and if I buy it in the US I will blow through the hdhp deductible to the point where it's covered in like 5 months. The same drug that costs the NHS 20 quid a pop (and me nothing) is $200 on the free market. If you're meeting the deductible, a HDHP should not out-perform a traditional PPO. Also, in order to qualify as an HSA I think it would have to have a combined max out of pocket, but self-funded plans don't have to follow the same rules as actual insured products, so maybe they just have to have a combined deductible? Do the two PPO plans have a copay setup for their drug benefits?
|
|
#
?
Apr 10, 2018 17:57
|
|
|
Reik posted:If you're meeting the deductible, a HDHP should not out-perform a traditional PPO. Also, in order to qualify as an HSA I think it would have to have a combined max out of pocket, but self-funded plans don't have to follow the same rules as actual insured products, so maybe they just have to have a combined deductible? Everything shares the same drug coverage after the deductible. The drug coverage is copay based yes. From my analysis it looks like the hdhp is just out and out better than the ppo given that the deductible 1/3 covered by the company, is half the price per month(so the difference means essentially 2/3 is covered now) This seems weird to me though
|
|
#
?
Apr 12, 2018 16:51
|
|
|
Malcolm XML posted:Everything shares the same drug coverage after the deductible. The drug coverage is copay based yes. People are better consumers of healthcare when in high deductible plans, so companies often give greater subsidies to those plans than to PPO plans. It's very possible that the HDHP is your best option, especially when you consider that you can pay your premiums AND out-of-pocket payments pretax through your HSA (whereas under the PPO only the premium is tax advantaged)
|
|
#
?
Apr 12, 2018 17:05
|
|
|
esquilax posted:People are better consumers of healthcare when in high deductible plans, so companies often give greater subsidies to those plans than to PPO plans. Hahah this is demonstrably false. https://www.kff.org/private-insurance/issue-brief/consumer-assets-and-patient-cost-sharing/
|
|
#
?
Apr 12, 2018 17:15
|
|
|
Peven Stan posted:Hahah this is demonstrably false. Then reword it into "significantly reduce their health care spend under an HDHP plan"
|
|
#
?
Apr 12, 2018 17:16
|
|
|
esquilax posted:Then reword it into "significantly reduce their health care spend under an HDHP plan" HDHPs expose the cost behind healthcare and it turns out most patients don't want to deal with that level of spend. Payers absorb like 90% of the cost of drugs for members. Who the hell in their right mind would pay that much OOP for Linzess, the pooping drug.
|
|
#
?
Apr 12, 2018 18:29
|
|
|
esquilax posted:Then reword it into "significantly reduce their health care spend under an HDHP plan" I guess it's certainly true that if you dramatically increase the OOP cost for a product that people will purchase less of it, but it turns out that is a very bad thing when the product in question is healthcare (at least until people develop the ability to self-diagnose the severity of their health problems with 100% accuracy).
|
|
#
?
Apr 12, 2018 18:36
|
|
|
Remember the olden days in dnd aca threads, when it was contended that $7,000/year in out-of-pocket costs would only be a thing for those seriously ill, in which case those out-of-pocket costs would be a bargain? Instead, those out-of-pocket costs are in play when the doc has you get an MRI, or when you tell the doc during your "free" annual physical that you're concerned about a symptom or two and the "preventive" turns into the "diagnostic."
|
|
#
?
Apr 12, 2018 20:46
|
|
|
esquilax posted:People are better consumers of healthcare when in high deductible plans If by ‘better consumers’ you mean ‘routinely avoid preventative or even necessary healthcare because they also have to eat,’ then yes.
|
|
#
?
Apr 12, 2018 20:53
|
|
|
Reminder that high deductibles caused 25 percent of people with serious medical conditions to not seek care last year.
|
|
#
?
Apr 12, 2018 20:55
|
|
|
Malcolm XML posted:Everything shares the same drug coverage after the deductible. The drug coverage is copay based yes. The HSA is required to have drug claims applied to the deductible before using copays, but the ppo plans may have drug copays without hitting the deductible first.
|
|
#
?
Apr 12, 2018 21:01
|
|
|
esquilax posted:Then reword it into "significantly reduce their health care spend under an HDHP plan" yeah dead people are typically significantly better consumers of healthcare from an insurance perspective
|
|
#
?
Apr 12, 2018 22:22
|
|
|
You can see all kinds of companies using HSAs to eat around the edges. The industry I'm in typically has lavish medical plans courtesy of a good risk pool of young, healthy, and mostly rich employees. One of our competitors ditched the traditional $350 deductible PPO for HDHPs with a $1,350 deductible. It is functionally the same because they seed your HSA with $1000 a year effectively giving you the same spend as the $350 deductible, but at the first sign of economic meltdown they're going to shrug their shoulders and start reducing that $1000 a year to $750 a year or $500 a year.
|
|
#
?
Apr 13, 2018 01:17
|
|
|
Willa Rogers posted:Instead, those out-of-pocket costs are in play when the doc has you get an MRI, or when you tell the doc during your "free" annual physical that you're concerned about a symptom or two and the "preventive" turns into the "diagnostic." It goes back to the Pareto curve of healthcare spend and also the fact that PPACA was literally written by Aetna. Meanwhile none of our legislators seem to even know dick about the healthcare system in this country so they were just like "okay. that sounds good."
|
|
#
?
Apr 13, 2018 01:44
|
|
|
Peven Stan posted:You can see all kinds of companies using HSAs to eat around the edges. The industry I'm in typically has lavish medical plans courtesy of a good risk pool of young, healthy, and mostly rich employees. One of our competitors ditched the traditional $350 deductible PPO for HDHPs with a $1,350 deductible. It is functionally the same because they seed your HSA with $1000 a year effectively giving you the same spend as the $350 deductible, but at the first sign of economic meltdown they're going to shrug their shoulders and start reducing that $1000 a year to $750 a year or $500 a year. Yeah this is my fear.
|
|
#
?
Apr 13, 2018 11:57
|
|
|
Malcolm XML posted:Yeah this is my fear. It happens. Healthcare costs are getting so high that employers are shifting more of the cost burden to employees and this is really not a good thing for the group market.
|
|
#
?
Apr 13, 2018 14:30
|
|
|
The Phlegmatist posted:It happens. The idea that this is an inevitable result of our healthcare system and not the inevitable result of our general corporate avarice baffles me. It should go without saying that health reform needs to remedy this problem.
|
|
#
?
Apr 13, 2018 14:39
|
|
|
The Phlegmatist posted:It happens. Healthcare costs are getting so high that employers are shifting more of the cost burden to employees and this is really not a good thing for the group market. Of course the entire "market" for health care is hosed up and corporations are greedy motherfuckers. Paracaidas posted:The idea that this is an inevitable result of our healthcare system and not the inevitable result of our general corporate avarice baffles me. The US Healthcare system is designed to extract maximum profit so it inevitably leads to soaring costs. There's no inventive to reduce costs since that reduces profits.
|
|
#
?
Apr 13, 2018 14:47
|
|
|
Malcolm XML posted:The US Healthcare system is designed to extract maximum profit so it inevitably leads to soaring costs. There's no inventive to reduce costs since that reduces profits.  It's the idea that employer behavior is being motivated by these soaring costs that has me befuddled. The idea that employers, out of a sense of decency, wouldn't be doing the exact same poo poo at 2008 cost levels is uncharacteristically generous to executives for these forums.
|
|
#
?
Apr 13, 2018 14:54
|
|
|
Paracaidas posted:
The reason why employer-based insurance sticks around isn't because of altruism or decency. It's because that it's incredibly tax-advantaged compared to raising employee wages. Healthcare costs have been outpacing inflation for, uh, approximately forever. Nevermind wage growth. The high cost of healthcare is why we get weird poo poo like Caterpillar becoming its own PBM. Some of our members are paying more to insure their employees than they're actually paying them in wages. poo poo's bad and it's gonna keep getting worse.
|
|
#
?
Apr 13, 2018 16:32
|
|
|
The Phlegmatist posted:The reason why employer-based insurance sticks around isn't because of altruism or decency. It's because that it's incredibly tax-advantaged compared to raising employee wages. Healthcare costs have been outpacing inflation for, uh, approximately forever. Nevermind wage growth. Yeah first sign of the dollar melting down or some kind of world bank imposed structural adjustment and the tax break on employer sponsored health insurance is going in the dumpster.
|
|
#
?
Apr 14, 2018 16:43
|
|
|
Some members of the GOP already want to get rid of all employer-based insurance since it's "distorting the free market" or whatever. Which is exciting, because employers would simply claw back whatever they were spending on healthcare and not raise wages to compensate.
|
|
#
?
Apr 14, 2018 19:01
|
|
|
New thread title please: Goldman Sachs in biotech report: Is curing patients a sustainable business model? https://www.cnbc.com/2018/04/11/goldman-asks-is-curing-patients-a-sustainable-business-model.html
|
|
#
?
Apr 17, 2018 16:11
|
|
|
viral spiral posted:New thread title please: 
|
|
#
?
Apr 17, 2018 16:30
|
|
|
viral spiral posted:New thread title please: Will building new homes and home ownership destroy the rental market?
|
|
#
?
Apr 17, 2018 17:35
|
|
|
quote:"The potential to deliver 'one shot cures' is one of the most attractive aspects of gene therapy, genetically-engineered cell therapy and gene editing. However, such treatments offer a very different outlook with regard to recurring revenue versus chronic therapies," analyst Salveen Richter wrote in the note to clients Tuesday. "While this proposition carries tremendous value for patients and society, it could represent a challenge for genome medicine developers looking for sustained cash flow." I remember when "cures get sat on because ongoing treatments are more profitable" was just a goofy conspiracy theory 
|
|
#
?
Apr 17, 2018 18:49
|
|
|
Zamujasa posted:I remember when "cures get sat on because ongoing treatments are more profitable" was just a goofy conspiracy theory MY GENOMICIST BOYFRIEND says that gene therapy cures have to be applied more than once anyway so there's some ongoing revenue for the capitalist machine
|
|
#
?
Apr 17, 2018 18:59
|
|
|
Zamujasa posted:I remember when "cures get sat on because ongoing treatments are more profitable" was just a goofy conspiracy theory Also literally the plot of Johnny Mnemonic
|
|
#
?
Apr 17, 2018 20:53
|
|
|
Lote posted:Will building new homes and home ownership destroy the rental market? Ironically, it would destroy affordability if done incorrectly. But housing to insurance is not a great analogy.
|
|
#
?
Apr 18, 2018 17:26
|
|
|
https://twitter.com/ryanlcooper/status/989511874843639808?s=21
|
|
#
?
Apr 26, 2018 17:42
|
|
|
I'm an employee benefits broker and I mention Goodrx in every one of my enrollment meetings. It is a great tool and a very easy app to use. It's also free.
|
|
#
?
Apr 26, 2018 21:58
|
|
|
|
| # ? May 15, 2024 11:24 |
|
|
I can't believe we live in a timeline where the "Free medication coupons!" app is legit and NOT using it is the scam.
|
|
#
?
Apr 27, 2018 13:23
|
|
