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Is employer-provided health insurance worth it


By Dan8267   Follow   Thu, 21 Feb 2013, 9:32am PST   2,481 views   59 comments   Watch (1)   Share   Quote   Permalink   Like   Dislike (2)  

Soliciting opinions. Is employer-provided health insurance a better or worse deal than what you can get in the free market? Do you know of a good or bad health insurance provider? If so, speak up here.

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Dan8267   befriend   ignore   Sat, 23 Feb 2013, 4:55am PST   Share   Quote   Like   Dislike (1)     Comment 20

@Patrick

Google really likes your site. I just did a search for BlueOptions Predictable Cost 535 review and http://patrick.net/?Healthcare was the number one hit because of this thread, which is only two days old.

There has to be a way you can capitalize on this. Maybe have a form where people can fill out what health insurance they have, how they rate it, and write a review like users on Amazon.com do. Then use a nice SEO path like /healthInsurance/{InsuranceProvider}/{PlanName}. For example, http://patrick.net/healthInsurance/BlueCross/BlueOptionsPredictableCost535.

I mean, geeze, you're the number one Google search result for a specific plan just because of this one thread. You gotta take advantage of that. Marketers would kill for that page ranking.

Patrick   befriend   ignore   Sat, 23 Feb 2013, 5:29am PST   Share   Quote   Like (1)   Dislike     Comment 21

Thanks for the suggestion Dan!

Dan8267 says

There has to be a way you can capitalize on this. Maybe have a form where people can fill out what health insurance they have, how they rate it, and write a review like users on Amazon.com do. Then use a nice SEO path like /healthInsurance/{InsuranceProvider}/{PlanName}. For example, http://patrick.net/healthInsurance/BlueCross/BlueOptionsPredictableCost535.

Yes, that's a good idea. But how would I make money from it? Ads I suppose, but ads have never worked well for me.

Patrick   befriend   ignore   Sat, 23 Feb 2013, 5:30am PST   Share   Quote   Like (3)   Dislike     Comment 22

Dan8267 says

this plan only costs about $125/month ($1500/yr).

I don't believe it.

Certainly there is nothing like that for a family of 4 with the parents in their 40's.

MMR   befriend   ignore   Sat, 23 Feb 2013, 6:35am PST   Share   Quote   Like (2)   Dislike     Comment 23

Situations like this are the reason why I'm pretty darn sure I'll never accept insurance after I'm done. Based on studying insurance reimbursements from different insurance companies for various procedures, I don't think it is exactly rocket science to come up with rates that a person could reasonably afford to pay out of pocket and also present to the patient in advance.

Insurance is a noose around the neck forcing doctors to become shift-working salaried employees who are minimally concerned about doctor-patient relationships that once made medicine a highly rewarding profession, both personally and professionally.

CaptainShuddup says

just because you're insured, life saving procedures and follow ups, are ofter not done because of executive decisions or if you want those done, you'll have to pay out of pocket. Like CT scans after mass removal, to make sure they got it all. Usually they are told by the ins companies to wait three months, against the Doctors suggestion. Also the waits to get procedures done or hell even diagnosed. Two of the people I'm talking about complained to their doctor for up to 6 months before they were even diagnosed.

Where as the poor people in the emergency room, they get every thorough test ran before they leave. They know they have cancer the day they complained.

MMR   befriend   ignore   Sat, 23 Feb 2013, 6:40am PST   Share   Quote   Like   Dislike (1)     Comment 24

Although I know some dirtbag gunners, the vast majority want to make a good living without necessarily having to choke off those who need help. I suspect that people who are 'all about money' don't often pursue medicine, since there are far easier ways to make money, like getting an MBA at a top 5 school.

The extortionists are the insurance companies and ambulance chasing bottom feeders.

Patrick says

Note that neither of these requirements has anything to do with taxes. It's just about preventing extortion.

Dan8267   befriend   ignore   Sat, 23 Feb 2013, 1:14pm PST   Share   Quote   Like   Dislike (2)     Comment 25

Patrick says

Dan8267 says

this plan only costs about $125/month ($1500/yr).

I don't believe it.

Certainly there is nothing like that for a family of 4 with the parents in their 40's.

Well, obviously ensuring 4 people is going to cost more than insuring just one. The $125/month is for an individual plan. The family plan costs more. I ran the numbers at the US News site for a family of 4 in Florida and got this result... $350/month but with a $20k deductible, which is a bit high even for just guarding against catastrophes. Of course, if you are married, there's probably other coverage you might want to get like maternity that's not covered by this plan.

Dan8267   befriend   ignore   Sat, 23 Feb 2013, 1:24pm PST   Share   Quote   Like (1)   Dislike (2)     Comment 26

Dan8267 says

7 tips for choosing a health savings account by BankRate

I love the fact that someone here is so petty that he's disliking every post I make, even if it's just a link to tips or faqs on health insurance. Every time I see such a dislike I know that I pissed off some troll so much that I'm always on his mind and ruining his day, and that puts a smile on my face.

elliemae   befriend   ignore   Sun, 24 Feb 2013, 4:18am PST   Share   Quote   Like (1)   Dislike (1)     Comment 27

CaptainShuddup says

So I went to the owner of the company and told him I had to quit and become indigent, so that I could get the best healthcare in the world.

CaptainShuddup says

The only people who have it made in this country are the piss poor people who go the Emergency room, and get operations through social worker welfare groups.

CaptainShuddup says

In the last 10 years, I know about 5 people who got serious stage 1-3 cancers, and were treated and never saw one bill. They are all alive today and cured.

I know about 6 people who had cancer on employer based insurance. and 4 of those people are dead.

Where as the poor people in the emergency room, they get every thorough test ran before they leave. They know they have cancer the day they complained.

I realize that you are angry - happens alot, btw - but you are over-generalizing. Can't remember who, a poster from long ago, had a mantra that "the plural of anecdote is not data." That applies in your example.

1) Many people don't qualify for Medicaid. That will change under Obamacare, but in many states one doesn't qualify for Medicaid unless they are under 18, over 65, or handicapped/disabled (such as SSI recipients). If it were as easy as quitting your job to receive medical coverage, there wouldn't be so many unfunded hospital patients. You make it sound so easy - "I'll just quit my job and then all my troubles will be over..."

2) Medicaid isn't the "best healthcare in the world." A patient whose payment source is Medicaid is assigned a hospital case manager and his costs/treatments are only provided if necessary. Even then, if the treatmens/tests can be provided in a less expensive environment, the patient will have to receive them on an outpatient basis.

3) Medicaid reimbursements to providers (including hospitals, nursing homes/rehabs, labs, physicians, etc) are shit compared to private insurance. Hospitals are paid months later at a substantially reduced rate.

4) People who are admitted through the emergency room and sent up for an operation receive the care due to medical necessity regardless of the payment source. If the treatment can wait, the patient will have to jump through all sorts of hoops but if it's medically necessary and life threatening, the patient will be sent for surgery.

5) Your anecdotal evidence about the cancer patients who were cured vs those who died is inflammatory - but every cancer is different, every patient is treated according to his disease process. That five people with stage 1-3 cancer were treated and cured (or are in remission) can't be compared to the 4/6 people who died. What stage were they? What type of cancer was it? When was it diagnosed? How was it treated?

The latter patients had insurance - so they could have made arrangements to pay the copayments. Either way, they had access to treatment.

For all we know, the first patients you described had stage 1 breast cancer or encapsulated prostate cancer, while the 4/6 had pancreatic cancer or metastatic lung cancer.

Your anger at what you perceive to be a system of free healthcare vs that for which you are paying renders your arguments useless. You are looking for cause & effect based on payment source - and although that does exist (such as the person who has no health insurance and can't access a physician, therefore a sign or symptom of a serious condition isn't caught until it seriously impedes the patient's ability to maintain his lifestyle), it doesn't exist here.

Dan8267 says

I love the fact that someone here is so petty that he's disliking every post I make, even if it's just a link to tips or faqs on health insurance. Every time I see such a dislike I know that I pissed off some troll so much that I'm always on his mind and ruining his day, and that puts a smile on my face.

I have the same problem - a trollster who dislikes me enough to stalk my posts & dislikes them. I imagine them masturbating as they do it.

Mr Happygoluckofus   befriend   ignore   Sun, 24 Feb 2013, 10:29pm PST   Share   Quote   Like (1)   Dislike     Comment 28

So you're saying I'm Ellie? I didn't imply everyone gets medicaid, I simply stated that those that have it, fare far better than those LIKE MY SELF, that are paying out of the ass for insurance, and still are nickle and dimed on every turn. On top of that, good Doctors are still hard to find.

My guess based on what you're saying. Florida has a better system than Utah.

elliemae   befriend   ignore   Mon, 25 Feb 2013, 7:59am PST   Share   Quote   Like (1)   Dislike (1)     Comment 29

CaptainShuddup says

So you're saying I'm Ellie?

I'm fairly sure that you're not Ellie, because when I looked in the mirror this morning all I saw was the same lovely face as I always see.

CaptainShuddup says

I didn't imply everyone gets medicaid, I simply stated that those that have it, fare far better than those LIKE MY SELF, that are paying out of the ass for insurance, and still are nickle and dimed on every turn. On top of that, good Doctors are still hard to find.

Many private physicians don't work with Medicaid due to the piss-poor reimbursement. And just like all insurance plans, there are limitations as to the services Medicaid patients receive.

CaptainShuddup says

My guess based on what you're saying. Florida has a better system than Utah.

No - Medicaid eligibility is pretty much the same from state-to-state at the moment. This will change when the healthcare reform kicks in, but for now the eligibility categories for Medicaid in Florida is:

•Low income families with children
•Child-only coverage
•Pregnant women
•Non-citizens with medical emergencies
•Aged or disabled individuals

Florida families with children may qualify for Medicaid coverage if they meet the following requirements: •Family income below the limits for Temporary Cash Assistance (TCA). In 2011, the limit is $364 for a family of four and increases approximately $62 for each additional family member. For more details see the TCA eligibility chart.
•Countable assets less than $2,000 (excluding your homestead)

$364 for a family of four? I'm hoping (and guessing) that you make more than that. Most people who are receiving unemployment benefits don't quallify for Medicaid.

I'm not trying to be contrary here. It's just that you seem to have a misconception that people who are on Medicaid are happy just to be screwing the system. They're not - they're struggling to get by. If they're fortunate enough to receive the assistance mentioned above, they're pretty fucking poor.

Also - your comment about people on Medicaid having every test run isn't accurate. I work in the field and have seen many, many examples of patients who were referred to a primary physician without any testing having been done at all. Emergency rooms are supposed to be for emergent conditions, not diagnostic purposes. Many hospitals have case managers who have to approve testing before its done, because MD's would run every test possible for every patient if they could.

And if they ran every test, and found every condition, and treated it - well, where would we be? Oh, yea - healthier.

Btw, Walmart started a $4.00 prescription program that most pharmacies (except CVS) follows. For many common medications, it's cheaper to get 30 days worth at $4 than to pay an insurance copayment.

curious2   befriend   ignore   Mon, 25 Feb 2013, 9:14am PST   Share   Quote   Like   Dislike (1)     Comment 30

elliemae says

And if they ran every test, and found every condition, and treated it - well, where would we be? Oh, yea - healthier.

That's a myth of "preventive care." Many tests are harmful and produce ambiguous results, leading to unnecessary procedures that can injure or even kill. More interaction with the medical-industrial complex does not necessarily lead to better health, in fact it often leads to the opposite. That's why there was such a big fight over Obamacare's mandatory pre-payment for mammography, even on women where it is more likely to kill them than to "save" them (not to mention Elizabeth Edwards, who was "saved" by enduring more than five years of treatment for a cancer she might never have got if she hadn't paid for so much radiation testing). It's amazing that in some states women are actually being charged more for medical insurance than men, even though women used to have safer risk profiles; the only explanation I've seen is the rise of mammography producing more cancer, and now Obamacare will make that mandatory with no co-payment thus producing even more of it. Nobody lives forever, and maximizing spending does not always help.

elliemae   befriend   ignore   Tue, 26 Feb 2013, 11:25am PST   Share   Quote   Like (1)   Dislike (2)     Comment 31

curious2 says

That's a myth of "preventive care."

I've long said that you and I view preventative care as two different things. You have repeatedly stated that, to you, preventative care means MRI's.

I, on the other hand, view preventative care as access to an MD to be seen on a regular basis. I include the ability to pay for medications for chronic conditions that indigent people often go without, and they end up with serious problems as a result.

Treatment for Diabetes before it becomes insulin dependent. Medications for Rheumatoid Arthritis that help to stave off the disease, resulting in a better quality of life for the patient. Mild doses of blood pressure medications to keep the condition from escalating to the point that it's life-threatening.

People need access to healtcare, rather than only to be treated when a condition becomes life-threatening or so fucking debilitating that the patient's lifestyle is threatened. MRI's and x-rays aren't ordered in every instance - often a simple change of diet can help a patient with a condition long before it becomes life-threatening.

Without access to healthcare, these options aren't available. Please understand that I'm not negating that many tests are ordered too often - but a blood test can save a life. A physician visit can help a patient to be diagnosed before a condition is life-threatening.

You and I will continue to disagree as to the definition of "prevatative care." I view it as access to healthcare, while you appear to view it as over-access to healthcare.

Meanwhile, until healthcare reform kicks in, many people lack the ability to be seen by a physician, to recieve medications for conditions and to learn how to live with the hand that they're dealt.

ducsingle5313   befriend   ignore   Tue, 26 Feb 2013, 11:31am PST   Share   Quote   Like (1)   Dislike     Comment 32

Dan8267 says

That perfectly describes Aetna's Flexible Spending Accounts. Each year, you lose what you don't spend and you lose everything if you change jobs.

All Flex Spending Accounts are like this. Not just Aetna's.

errc   befriend   ignore   Tue, 26 Feb 2013, 11:36am PST   Share   Quote   Like (1)   Dislike     Comment 33

True preventative care would be based in nutrition, as malnutrition is the basis for the majority of these "conditions" people seek healthcare for.

Look at the crap that people put in and on their bodies, its no wonder so many people are "sick". The human body is an amazingly resourceful machine, it just needs to be treated properly. The government and its accredited mouthpieces and professionals are mostly to blame. A generation has been misled to believe that the food pyramid provides a proper macronutrient prodile, ha! 12 servings of breads and grains per day, and a bunch of fruit and some veggies, some sweets and avoid animal proteins and fats at all costs. Do the opposite of everything the government suggests in regards to nutrition, and avoid your physician at all costs, and you will likely live a long and healthy life. You can DIY that plan like a good little american,,,,

epitaph   befriend   ignore   Tue, 26 Feb 2013, 11:38am PST   Share   Quote   Like   Dislike     Comment 34

If you are <30 probably not.

ducsingle5313   befriend   ignore   Tue, 26 Feb 2013, 11:40am PST   Share   Quote   Like   Dislike     Comment 35

drew_eckhardt says

I pay 28% in Federal taxes, 9.33% in state taxes, and 1.45% in Medicare which allows me to spend 63% more on employer coverage than private market for the same impact on what's left over.

If I earned less money I'd also be paying 6.2% on Social security and 1.0% California State Disability insurance which would allow me to spend 85% more on the employer plan.

How do you avoid paying Social Security and CA Disability by making more money?

MMR   befriend   ignore   Tue, 26 Feb 2013, 12:06pm PST   Share   Quote   Like (1)   Dislike     Comment 36

Blood tests are extremely useful; especially for checking levels of vitamins and minerals, as well as for blood counts, renal function, liver function, blood lipid levels etc. Generally speaking, this information is extremely useful for determining whether the nutrients you consume are being absorbed and assimilated by the body.

Regarding type II diabetes, the best treatment is dietary modification and exercise. Most doctors tell their patients this, but very few are qualified to tell patients how to do this and I suspect that insurance makes it harder for those who are qualified to tell patients. Still, many doctors only keep other doctors in their referral network, effectively preventing patients who are at risk of developing diabetes from getting the help they might need.

Blood sugar that is managed with diabetes meds is not the same as blood sugar that is managed with diet and exercise.

If access to healthcare only results in a prescription for a drug and not any meaningful game plan for modifying risk factors/lifestyle changes, then effectively speaking, many dr visits are extraneous and do little to improve quality of life. In many instances, it is a revenue engine driving the overutilization trend

Ideally visiting the dr. for real preventative care is an ideal that we all should aspire to. Unfortunately, for doctors taking insurance, the incentive to do so is extremely poor, as the reimbursement rate for 'well visits' is far lower than sick visits. Also, I'm not sure on this, but there might even be limits on how many well visits a doctor could have with the same patient, but don't quote me on that last part because I'm not sure.

My personal experience is that, these days, the majority of doctors who truly emphasize wellness rarely take insurance. Insurance turns private practices into production lines.

elliemae says

lease understand that I'm not negating that many tests are ordered too often - but a blood test can save a life. A physician visit can help a patient to be diagnosed before a condition is life-threatening.

curious2   befriend   ignore   Tue, 26 Feb 2013, 12:13pm PST   Share   Quote   Like (1)   Dislike     Comment 37

MMR says

the majority of doctors who truly emphasize wellness rarely take insurance. Insurance turns private practices into production lines.

Exactly. Elliemae, you know I like and respect you, but the scams that Obamacare covers aren't the preventive measures you're looking for. The reason you're required to buy Obamacare is because a rational person wouldn't buy it if offered a free choice. The industry's worst players bribed politicians to require you to buy it, because that's the only way they could sell their crap at the incredibly high prices they demand. Then, once you've spent all you can afford on that "affordable" policy, you have nothing left to buy what might really help you. And there is often little correlation between spending and results, in fact there can be an inverse correlation, especially in insuranceworld. This is the point John Mackey and others have been trying to make, that Obamacare forces everyone to prepay into the most injurious and wasteful aspects of the medical industrial complex at the expense of better solutions that actually improve health.

Likewise employer-sponsored insurance offers all sorts of opportunities for kickbacks, fraud, and abuse, because the employee has little or no choice about what to buy. But, as I acknowledged earlier, individual mileage may vary: some people with high covered expenses, or with gold-plated policies that are basically scams to take advantage of the tax subsidy, may benefit. On the whole, Americans lose.

Regarding arthritis, the best preventive measures are (a) don't smoke, (b) don't injure your joints, e.g. don't eat so much that you become overweight. None of these involve insurance or taking drugs. If you have arthritis, OTC ibuprofen is better than Vioxx (now withdrawn), and costs 2 cents/pill, and because it's OTC it might not be covered by insurance anyway.

elliemae says

You have repeatedly stated that, to you, preventative care means MRI's.

Actually, I've hardly ever mentioned MRIs, but I do observe intensive marketing and mandatory prepayment for "preventive" radiation, including C-T scans with no benefit.

Mr Happygoluckofus   befriend   ignore   Tue, 26 Feb 2013, 9:50pm PST   Share   Quote   Like   Dislike     Comment 38

elliemae says

•Low income families with children

•Child-only coverage

•Pregnant women

•Non-citizens with medical emergencies

•Aged or disabled individuals

You just listed 80% of the population.

elliemae   befriend   ignore   Tue, 26 Feb 2013, 11:23pm PST   Share   Quote   Like   Dislike (1)     Comment 39

CaptainShuddup says

You just listed 80% of the population.

I had the pleasure once of denying benefits to those who fell in the middle. It was horrible.

Mr Happygoluckofus   befriend   ignore   Wed, 27 Feb 2013, 12:06am PST   Share   Quote   Like   Dislike     Comment 40

elliemae says

I'm not trying to be contrary here. It's just that you seem to have a misconception that people who are on Medicaid are happy just to be screwing the system. They're not - they're struggling to get by. If they're fortunate enough to receive the assistance mentioned above, they're pretty fucking poor.

Ellie I never implied they are screwing the system. If you would just try to look deeper past your Liberal eye liner and mascara, you would realize that what I am actually saying and have said all along. I would rather pay higher taxes and Medicaid be expanded to everyone.

And my point to my story was, I was prepared to quit work and become indigent, so yes, I would have qualified as a "Low income family with Children".

And had, the BEST insurance in the world.

zzyzzx   befriend   ignore   Wed, 27 Feb 2013, 12:57am PST   Share   Quote   Like (1)   Dislike     Comment 41

MMR says

I suspect that people who are 'all about money' don't often pursue medicine,

I'm pretty sure that the "all about money" types frequently pursue medicine.

drew_eckhardt   befriend   ignore   Wed, 27 Feb 2013, 1:24am PST   Share   Quote   Like   Dislike     Comment 42

ducsingle5313 says

How do you avoid paying Social Security and CA Disability by making more money?

I'll still pay $7050 in Social Security ($14,100 including the employer's share) and $1009 in CA SDI this year.

The numbers just don't change based on how much compensation I take home instead of spending on benefits due to the earnings caps which means the cost difference between taxable and not taxable insurance products is lower for me than if I earned less.

Given a dollar in income
- If I take it home my employer spends $1.0145 and I take home $0.61
- If I spend it on pre-tax benefits they spend $1 and I get $1 in benefits (64% more value based on what I earn, 66% based on what they're spending)

In the same tax brackets below the caps
- If I took home a dollar my employer would spend $1.0765 and I'd keep $0.54
- If I spent it on benefits they'd spend $1 and I'd get $1 in benefits (85% more value based on what I earn, 100% more based on what they spend).

The impact of pre versus post-tax would be 33% higher below the caps based on the number on my pay check and 50% based on what my employer is spending.

elliemae   befriend   ignore   Thu, 28 Feb 2013, 12:54pm PST   Share   Quote   Like   Dislike (1)     Comment 43

curious2 says

Regarding arthritis, the best preventive measures are (a) don't smoke, (b) don't injure your joints, e.g. don't eat so much that you become overweight. None of these involve insurance or taking drugs. If you have arthritis, OTC ibuprofen is better than Vioxx (now withdrawn), and costs 2 cents/pill, and because it's OTC it might not be covered by insurance anyway.

1) I don't smoke, never have
2) My joints were not more mistreated than anyone else's duing my youth.
3) I'm not obese - a few pounds over my ideal weight, but not fat.
3) OTC Ibu doesn't work for Rheumatoid Arthritis.

There is no preventing RA. It's an autoimmune disease where my body reacts to everything - such as a minor infection.

If you get a hangnail you pull it off and move one. I get a hangnail, I get an infection. I have to carefully treat it with antibiotics and attentive wound care. If I'm not careful, it becomes such an issue that I have to go to the MD to be treated. And this minor infection can cause my body to go into a flare. Ohhhhhh, boy, what a