Posted: 11/1/2006 3:03:23 AM EDT
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My family has a business that employes 12 people. We want those 12 to be the best. We offer good wages, heath, dental, and life insurance. It's time for us to sign the annual contract with Aetna. They raised our premium 45%.  So, Aetna, who posted 28% increase in profit the last quarter, has raised our rates and not improved our service or enrolled new Docs in the POS plan. I'm pissed. So much for the additional $$s going into employee pay. <Edit for spelling> |
They do if we want to keep the same level of care. What's really annoying is that we did not have any major claims during the contract period. It really seems that the insurance costs went up for purely profit motives. |
yip like all big deals now. all is going up up up,while the lil man's wages/income doesnt. what i make now, 5-7yrs ago in tis AO woulda got me ALOT more than what it does now.. just in houseing cost alone! |
you do realize that the way the system is set up it will not allow you to switch the same insurance if you find it cheaper. Meaning if you have Blue Cross/shield and pay 7K a year for you and spouse if you find the same plan for 5K you cannot switch, you have to allow 63 days of non coverage by that insurer to go by, then you can get the cheaper price. Seems like a scam to me. How would you like to be told you can’t buy the cheap gas at the station down the road because you use the one next to your house. |
This is simply not true. Don't know where you get your info, but I have been an insurance agent specializing in group health for the past 12 years. I have never run into a situation like this. 
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Well shit sarge ... I think I'll apply the same kind of business practices in my business. 1. Drop health insurance - We currently pay 50% of the premiums for our employees. 2. Increase our product's price by 45% on all new contracts. 3. Since we have no shareholders we can add the 28% increase in profits right to our pockets. My industry is regulated well enough and there's enough competition that I can't do steps 2 and 3. The only thing stopping us from doing step #1 is the market forces that take away good employees when they are dissatisfied. |
I've been told this by no less than 12 health care providers in VA. We have blue cross/shield now, I can get the same plan for a 1/3 of what my wife company pays. Blue cross WILL NOT allow us to get coverage independently with out a 63 day gap. If you can get me the same coverage for what I was quoted let me know. Money talks bullshit walks. A little more info. 1+ spouce, PPO, 300 deductible, $20 copay office visit, $20 copay prescriptions, dental 20/80 $4500-5K a year quotes. |
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Consider paying the full amount for a high dollar deductible plan for each employee. Then give your employees a large bonus (with the savings) that they can stick tax free into an HSA to be used as their high dollar deductible. You'll obviously have to check into this to find out the details, but my BIL has insurance for his family that works this way. |
Because what you might term "minor" may not be minor. Too many people push off health problems until it is too late. |
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www.ocregister.com/ocregister/money/health/article_1324012.php Here's a guy who's fighting the system. ETA the answer is that there no longer is a "market" for health services. It's broken, just like the electricty generation business in CA when companies like Enron "gamed" the market and gouged consumers out of Billions of dollars. Evert watch those "Scooter" ads and wonder. My wife had a teacher friend that had one of those in the classroom but occasionally would get up and walk around like Lazarus met George Jefferson. |
there is your answer. My ex ran the kids to the ER if they told her they didn't feel good to get out of going to school in the morning.
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If someone has a problem with the ability to tell the difference, well, I really am at a loss for words here.......see statment below........ 
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You can lay this problem at the feet of Bill & Hillary Clinton. In the early days of their administration, they tried to get universal(aka free, "top of the line" health care coverage for people who couldn't afford, and getting the people who were paying for their coverage to cover others), after comments from everyone and the HUGE escalating costs, the Clintons abandoned the idea of "health care reform." But unfortunately they put in motion forces that they had zero control over, and the end result is what we see today. To make complicated even more, there is a huge number of baby boomers that is getting older, and will be demanding medical services. How do you think the previous generation of seniors is getting away with reasonable price health care costs. The huge baby boomers are paying for it. There is no way the baby boomers that paid for their parent's generation is going to get the same benefits. No way. |
True, but the same amount of people almost never use the healthcare that's provided, which SHOULD even out the increases. Depends on how many employers have employees that have small children, are seniors, or are women. Healthcare costs for women are higher, due to the visits required for the GYN. Take birth control for example, you can't get more than a one year prescription for birth control pills. When that year is up, you MUST see the doc for an exam before they will prescribe the pill again. Then the annual mammogram that they insist you get after age 40. All I'm saying is, it's not always the employees that abuse it, it's the healthcare and the providers that force doc visits for routine maintenance. |
As an employee, I would MUCH prefer to get 1/2 of what a company pays to have me in their group policy in Cash and look for my own health insurance. I would make a ~4000 year more that way even with paying for my own coverage. Just remember, the healthiest 95% are paying for the sick 5%. |
The problem isn't the profit. It's the dishonesty. When they don't pay valid claims to make that profit, that is dishonest, unethical, and illegal. With our coverage we had with Golden Rule, they never paid a single claim for any of the 24 (total at any one time, we probably had 60 different guys insured while we were with them) employees we have. Not a single damn dollar. The company was so dishonest our local hospital (Spartanburg Regional Medical Center) stopped accepting Golden Rule. That was the first time in the history of that hospital that they had to cut off a large insurance company. We've since moved to BCBS. They're even worse so I don't know what the answer is to finding an honest insurance company. Us small guys have no way of fighting back.z |
And don't forget that your insurance has to pay for every illegal that stops by at the ER and can't (or won't) pay. |
You know what is special about 63 days? Its the length of time you need to be uninsured for an insurance company to not cover pre-existing conditions. Sounds illegal to me. If it is legal, you need to talk seriosly with your elected reps. to ensure that it becomes so. |
Ok, say I give you an Rx for 5 years on BCP. Then you keel over dead from a PE (pulmonary embolus)--because you started smoking last year (3 years into the Rx). What's going to happen? I'll get sued...because I gave you a prescription without warning you about the dangers of clots if you smoke and are on the pill....despite the fact that you were a non smoker when I gave you the Rx. Or a Mammogram...OK, yours is clear this year....why don't you wait 3 years instead of the recommended one? Then you develop Ca...my fault naturally, as your family has a history of Breast Ca (that you forgot to mention in the initial H & P). Not all the fault rests with the doctors. Defensive medicine is rampant and adds a LOT to the cost of healthcare. If you go to the ER with a headache...you get a CT scan. The ER doc may know you have a migraine, you know you have a migraine, but the "standard of care" is now for a CT just in the odd chance that this isn't a migraine like the last 50 times you've had it. And, the people who wait until too late to see the DR. The guy that should have seen the doctor the last 10 times he felt chest pain...saved 10 doctor visits, right? Then they find him collapsed on the floor and he has to go into intensive care for several weeks. How did that save money? I've worked in a county healthcare system...it SUCKS. People coming in to the ER for nothing more than a refill on their meds. Homeless looking for a bed and a sandwich, women coming in ACTIVE labor with no prenatal visits, etc. Increased healthcare costs come from MANY sources...including the patient themselves who wants the latest tests or meds that they heard about on Oprah (when a cheaper med would work fine). Edited***********I'm not even going to begin defending the insurance companies. The practice I work for fights with them EVERY day just to get paid. |
That's why I told him to look into high deductible plans and turning the remaining money over to the employees to use as their deductible. It may or may not work for him, but it works for my brother in law's family. |
I understand...I've worked in health care facilities. It's a tug of war between the insurance companies, the providers, and the patients. There has got to be a happy medium, though. I understand why docs have to have the patients come in, it's just a pain. Especially when you have doc offices around here that their first appointment is at 8:30, and the last appointment is at 4pm, and they break for lunch for an hour and a half. Why can't more providers offer evening hours, or a Saturday morning appointment? It's difficult enough to fit doctors appointments in for when you truly are sick, but for a maintenance appointment, it's hard to get the time off work. |
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Go to a foreign country and get citizenship. Sneak into the US. Now your health coverage is free. You may also drive without a license, registration, or insurance and can apply for welfare. Then you can work under the table tax free, making your money go much further than stupid Americanos who foot the bill for this. /not loving it.....
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not to mention all of the uninsured that visit the
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your right that's their MO, but it doesn't make sense when it's the same insurance they know we have no existing problems. I believe it boils down to a loss of revenue. My wife's company pays over 15K per employee for insurance same thing cost a 1/3 if we do it ourselves. |
Find a Doctor that does offer Sat. or Eve. hours. When his practice starts booming and the nearby practices start to decline, then they will offer similar hours. Market forces at work. Another tip--Call the Dr's office. I know of several that work outside of published hours, and if you are polite, they may schedule you early or late. |
The problem with that is that you're not talking about a free market. The medical cartel makes sure there isn't enough competition in the industry. That why, for example, with my wife's doctor you have to usually wait four or five hours in the waiting room for your 30 seconds with the doctor. With her neurologist her last emergency appointment after what we think was a stroke was eight weeks after her trip to the ER. The long delays for medical care are ridiculous.z |