CDZ Some ideas about how to revise health insurance coverage

A couple quick points because that's all I have time for right now.

Businesses today voluntarily take on the costs associated with offering group health insurance policies/coverage to their employees.
Only because they have to. In order to attract, motivate and retain good employees, employers know they have little choice but to at least consider offering health coverage because their competition is. My +/- 100 business owner clients struggle with both the costs of coverage and the cost of regulation/administration daily.

Pay higher salaries and tell potential employees that "we pay more, but don't offer health coverage." I think were my firm to offer, say, $5K-$10K more per year in salary than do our insurance offering competitors, applicants would see that as ample compensation for the lack of a health care benefit. Given the quantity of new hires we have each year and our cost to offer health care insurance, we'd either break even or come out a tiny bit ahead doing that (hard to say right now; it's been a few years since I saw that analysis and the benefits landscape changes far too quickly for me to just keep up with it), especially insofar as we pay fully for the coverage of our employees (they pay @$35/month per adult dependent, and $15 for minors, if they elect to obtain that coverage via the firm). Hell, we'd cut at least @250K/year just by reducing the staff in the HR department who manage the health care benefits. Even more would be saved by not having to administer the firm's infrastructure components that support providing health insurance info, analysis and enrollment tools to our employees.

In short, there are alternatives to offering health insurance as a way to attract workers. The salary alternative is just one alternative. Employers who are willing to get creative have lots of alternatives.
  • Mortgage loans or loan assistance in lieu of health insurance.
  • Reimbursement for any number of other costs employees may incur in lieu of health insurance.
  • Guaranteed tuition reimbursement up to a given sum in lieu of health insurance.
From the business' standpoint, it basically comes down to a basic cost-benefit analysis.

It's worth noting that a few companies actually earn money because their employees participate in the health insurance plans they offer. Those companies are huge, however, and the sums earned aren't "Earth shaking," but they do pay for the cost of administering the companies' health care benefit offerings and leaves a few hundred grand in miscellaneous earnings.

Tort reform that addresses not only the cost of malpractice insurance, but the even higher cost of preventive medicine -- Please explain how tort reform "addresses" the cost of preventive medicine?
As high as malpractice insurance premiums are, they pale in comparison to the costs of "preventive medicine", the over-testing and over-diagnosing done to protect the provider from a lawsuit down the road. If Tort Reform better protected the provider, average diagnostic costs would decrease, at least somewhat.

I think what you mean is "defensive" medicine. I see the correlation now. "Preventive" medicine is stuff like getting physicals, regular breast exams, teeth cleaned regularly, etc.
 
A couple quick points because that's all I have time for right now.

Businesses today voluntarily take on the costs associated with offering group health insurance policies/coverage to their employees.
Only because they have to. In order to attract, motivate and retain good employees, employers know they have little choice but to at least consider offering health coverage because their competition is. My +/- 100 business owner clients struggle with both the costs of coverage and the cost of regulation/administration daily.

Pay higher salaries and tell potential employees that "we pay more, but don't offer health coverage." I think were my firm to offer, say, $5K-$10K more per year in salary than do our insurance offering competitors, applicants would see that as ample compensation for the lack of a health care benefit. Given the quantity of new hires we have each year and our cost to offer health care insurance, we'd either break even or come out a tiny bit ahead doing that (hard to say right now; it's been a few years since I saw that analysis and the benefits landscape changes far too quickly for me to just keep up with it), especially insofar as we pay fully for the coverage of our employees (they pay @$35/month per adult dependent, and $15 for minors, if they elect to obtain that coverage via the firm). Hell, we'd cut at least @250K/year just by reducing the staff in the HR department who manage the health care benefits. Even more would be saved by not having to administer the firm's infrastructure components that support providing health insurance info, analysis and enrollment tools to our employees.

In short, there are alternatives to offering health insurance as a way to attract workers. The salary alternative is just one alternative. Employers who are willing to get creative have lots of alternatives.
  • Mortgage loans or loan assistance in lieu of health insurance.
  • Reimbursement for any number of other costs employees may incur in lieu of health insurance.
  • Guaranteed tuition reimbursement up to a given sum in lieu of health insurance.
From the business' standpoint, it basically comes down to a basic cost-benefit analysis.

It's worth noting that a few companies actually earn money because their employees participate in the health insurance plans they offer. Those companies are huge, however, and the sums earned aren't "Earth shaking," but they do pay for the cost of administering the companies' health care benefit offerings and leaves a few hundred grand in miscellaneous earnings.

Tort reform that addresses not only the cost of malpractice insurance, but the even higher cost of preventive medicine -- Please explain how tort reform "addresses" the cost of preventive medicine?
As high as malpractice insurance premiums are, they pale in comparison to the costs of "preventive medicine", the over-testing and over-diagnosing done to protect the provider from a lawsuit down the road. If Tort Reform better protected the provider, average diagnostic costs would decrease, at least somewhat.

I think what you mean is "defensive" medicine. I see the correlation now. "Preventive" medicine is stuff like getting physicals, regular breast exams, teeth cleaned regularly, etc.
Crap, yes, sorry, defensive medicine. Focus Mac, focus.

Regarding the business costs, I'd love to take the whole thing off their backs. They can offer plenty of other benefits, such as retirement plans, etc.

People should have their own individual, portable plans that are separate from employment or lack thereof.
.
 
Crap, yes, sorry, defensive medicine. Focus Mac, focus.

NP...everyone has their moments.

Regarding the business costs, I'd love to take the whole thing off their backs.

Why would "you" (via public policy) need to do that? Business managers/owners can do that on their own. All they need to do is perform a cost-benefit analysis and either drop their health care insurance benefit or keep it.
 
Crap, yes, sorry, defensive medicine. Focus Mac, focus.

NP...everyone has their moments.

Regarding the business costs, I'd love to take the whole thing off their backs.

Why would "you" (via public policy) need to do that? Business managers/owners can do that on their own. All they need to do is perform a cost-benefit analysis and either drop their health care insurance benefit or keep it.
Case in point. At least in my area, most construction companies, logging companies and other seasonal employers do not offer much, if anything, in the way of benefits. They do, however, offer substantially higher wages compared to "year-round" companies, for similar work.
 
Crap, yes, sorry, defensive medicine. Focus Mac, focus.

NP...everyone has their moments.

Regarding the business costs, I'd love to take the whole thing off their backs.

Why would "you" (via public policy) need to do that? Business managers/owners can do that on their own. All they need to do is perform a cost-benefit analysis and either drop their health care insurance benefit or keep it.
Case in point. At least in my area, most construction companies, logging companies and other seasonal employers do not offer much, if anything, in the way of benefits. They do, however, offer substantially higher wages compared to "year-round" companies, for similar work.
I think that, in a way, makes my point.

There are many industries in which health care is generally not offered, and it would remain that way as long as not many break the mold.

Whether cost benefit analyses are done or not, the rule applies: We'll offer health insurance because people competing for our employees do.

Medicare/Medicare Advantage/Medicare Supplements for all would fix that.
.
 
Crap, yes, sorry, defensive medicine. Focus Mac, focus.

NP...everyone has their moments.

Regarding the business costs, I'd love to take the whole thing off their backs.

Why would "you" (via public policy) need to do that? Business managers/owners can do that on their own. All they need to do is perform a cost-benefit analysis and either drop their health care insurance benefit or keep it.
Case in point. At least in my area, most construction companies, logging companies and other seasonal employers do not offer much, if anything, in the way of benefits. They do, however, offer substantially higher wages compared to "year-round" companies, for similar work.
I think that, in a way, makes my point.

There are many industries in which health care is generally not offered, and it would remain that way as long as not many break the mold.

Whether cost benefit analyses are done or not, the rule applies: We'll offer health insurance because people competing for our employees do.

Medicare/Medicare Advantage/Medicare Supplements for all would fix that.
.
That's your solution? Ever wondered why it is that most Canadians, with the means, cross the border for certain life saving procedures? I'll give you a hint. Many older men in Canada schedule next years' annual prostate exam before leaving the clinic, and it's not for convenience.
 
Calculate net costs and add to current Medicare Tax - Can you explain what you mean by that, please?
While the average costs of the plan would be brought down by all the younger participants (I've seen estimates of around 70% - 70% of our health care costs happen after age 62), it's possible (I'd say almost certain) that the overall costs of the program would require an increase in the Medicare tax, currently 2.9%.

??? What on Earth makes you think insurers don't perform the type of analysis you've suggested? What do you think actuaries, accountants and financial analysts do?

Opening the door to the industry that specializes in preventive/diagnostic services, motivating these clinics to pop up faster than Starbucks™, is good, smart economics. -- By"opening the door," do you mean reducing barriers to entry? If so, which of the current barriers to entry strike you as most onerous, being thus the ones that should ideally be removed first?
The only real barrier to entry for these kinds of clinics currently is volume. If the plan were properly and fully utilized it would flood the neighborhood GP office. The demand for these kinds of clinics would increase necessarily, and there are the profits. Also, since they'd be specializing in basic services only, that would almost certainly streamline costs.

Surely you don't mean volume of patients filling the doctor's waiting room thereby inhibiting other patients from getting through the door? (or something similarly literal?) Did you click on the "barrier to entry" link I provided? Volume isn't a barrier to entry.
 

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