Referring back to the original question.
Employers should not provide health insurance. One of the big problems with health care right now is that the system is not designed with incentives to provide good care. Doctors are paid based on what procedures they are able to bill their patients for, their incentive is to please the insurance company or medicare/ medicaid. The insurance companies cater to businesses and their goal is to minimize costs for business while providing the benefits package the companies HR department feels is a good mix... no where in this mix is my need to be healthy really addressed beyond the efforts to minimize my cost to the insurance carrier.
I want my doctor to be thinking about how best to please ME and I want him to be compensated based on how well he takes care of ME. Likewise I want to choose insurance based on my needs. Company provided insurance plans are there to make employers happy not patients.
Pre-existing conditions are a big issue but I think the solution to that should be separate from whether or not your employer is providing your health insurance.
+1
Are employer contributions to health insurance tax deductible by the employer in the US?
Yes. I would argue that this puts the self insured at an even greater disadvantage. Republican have pushed for a tax credit for individual and family insurance that roughly mirrors what companies get as well as for individual tax advantaged medical savings accounts. I tend to like this approach.
Tying health care to employment creates a lot of challenges from portability to restricted choices. The trade union model is much more portable but still limited.
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Ogre, I don't understand how your wife's company insurance plan takes away options from you. Are you also covered under her plan as a spouse? You said you are an independent contractor, so do you buy your own insurance or are you on her plan, or is it a combination instead of one-or-the-other? Just asking for clarification about your set-up.
We use the insurance through my wife's work for both of us. If we paid for insurance out of pocket we would not go with the plan we get through my wife's work.
As for how it limits choice, all of your healthcare choices flow from your insurance plan. Your insurance plan dictates which doctors you can see, which specialists, whether things like acupuncture or alternate medicines are available. Most insurance companies dictate which hospitals you go to, where you can get X-rays done, which pharmacies you use... all of it is determined by your health care plan. Some of them are more liberal in letting you select from a fairly large list but if you are insured by Kaiser then you often don't even pick who your primary care physician is.
Even more to the point, if we were given the cash we wouldn't get nearly the coverage we currently have. I would pay for a plan with a higher deductible and save the thousands of dollars which is currently spent every year on our insurance we don't use and that money would eventually be available for our retirement, or later in life health expenses.
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Are employer contributions to health insurance tax deductible by the employer in the US?Yes. I would argue that this puts the self insured at an even greater disadvantage. Republican have pushed for a tax credit for individual and family insurance that roughly mirrors what companies get as well as for individual tax advantaged medical savings accounts. I tend to like this approach.
I am a huge fan of Health Savings Accounts, one of the best things that has happened to private health care choice in years. I was super happy that this was a choice this year for us. The fact that the only way to deduct health care costs from your taxes is to have your work pay for it is part of why private insurance is so expensive.
I can't say there is much else that Bush did that I like but I give him major props for HSAs.
Tying health care to employment creates a lot of challenges from portability to restricted choices. The trade union model is much more portable but still limited.
I agree, one big issue with trade unions is that most people do not belong to them.
The problem with individuals buying insurance is that insurance companies can choose who they insure, employer groups mitigate that. I think any solution which eliminates employer groups needs to incorporate protections into it for people who would otherwise be un-insurable.
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How do you feel--should employers be required to provide health insurance?
Is it an employer's responsibility to ensure you are insured?
If the employer didn't cause your injury or malady, why is it their responsibility?
Honestly curious. No Trolls allowed!!
1) No.
2) It is not their responsibility.
3) Look at the history of health care costs, the reason why employers first offered health insurance as a benefit, and the skyrocketing costs after the government got in the health care business with medicare/medicaid. All paths lead to government interference where it didn't belong. Then tell me why anyone trusts the government to fix a problem they caused by getting even more involved.
IHO an employer only needs to provide a safe working environment and job training, everything else is the employee’s responsibility.
As for how it limits choice, all of your healthcare choices flow from your insurance plan. Your insurance plan dictates which doctors you can see, which specialists, whether things like acupuncture or alternate medicines are available. Most insurance companies dictate which hospitals you go to, where you can get X-rays done, which pharmacies you use... all of it is determined by your health care plan. Some of them are more liberal in letting you select from a fairly large list but if you are insured by Kaiser then you often don't even pick who your primary care physician is.
Technically, this is not true. An insurance company has no power to prevent you from going to whichever doctor/hospital you choose. They do have the ability to say "We will only pay if you go to this doctor/specialist."
Perhaps a minor point, but one that needs to be kept in mind. I can go to whichever doctor I want. I may have to pay for the visit out of my own pocket. I can use whichever pharmacy I wish, even if I must come up with the cost of the medicine on my own.
Kaiser cannot prevent you from visiting an independent physician. They don't have that power.
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I am a huge fan of Health Savings Accounts, one of the best things that has happened to private health care choice in years. I was super happy that this was a choice this year for us. The fact that the only way to deduct health care costs from your taxes is to have your work pay for it is part of why private insurance is so expensive.
I can't say there is much else that Bush did that I like but I give him major props for HSAs.
HSAs are a joke. They are wonderful if you are young and healthy but if you have an expensive medication that requires you pay for the whole thing month after month until you hit your deductible limit, then they suck big time. On top of that, to have possible premium payments and a co-pay even after hitting the deductible limit...what a lousy option. Figures Bush came up with it.
HSAs are a joke. They are wonderful if you are young and healthy but if you have an expensive medication that requires you pay for the whole thing month after month until you hit your deductible limit, then they suck big time. On top of that, to have possible premium payments and a co-pay even after hitting the deductible limit...what a lousy option. Figures Bush came up with it.I am a huge fan of Health Savings Accounts, one of the best things that has happened to private health care choice in years. I was super happy that this was a choice this year for us. The fact that the only way to deduct health care costs from your taxes is to have your work pay for it is part of why private insurance is so expensive.
I can't say there is much else that Bush did that I like but I give him major props for HSAs.
HSAs are a good idea, but I'm not thrilled with the execution.
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HSAs are a joke. They are wonderful if you are young and healthy but if you have an expensive medication that requires you pay for the whole thing month after month until you hit your deductible limit, then they suck big time. On top of that, to have possible premium payments and a co-pay even after hitting the deductible limit...what a lousy option. Figures Bush came up with it.I am a huge fan of Health Savings Accounts, one of the best things that has happened to private health care choice in years. I was super happy that this was a choice this year for us. The fact that the only way to deduct health care costs from your taxes is to have your work pay for it is part of why private insurance is so expensive.
I can't say there is much else that Bush did that I like but I give him major props for HSAs.
There are thousands (millions?) of young healthy people who are completely uninsured right now so having a "wonderful" option for them is a great idea in my book. Just because it's not a good option for YOU doesn't mean it's a bad option for everyone.
I am not young but I am fairly healthy. If HSAs were not an option I still wouldn't spend the ridiculous amounts of money on a PPO or HMO plan, I would buy a high deductible insurance plan and save the money.
As it is, I can put money into an HSA so I have money in the bank to pay for those medications when I am older and need it. Previously my only choice was to put money into a HMO or PPO plan where it just goes out the window every month enriching the health plans... I like the idea of keeping my money thanks.
Wow Dennis! I was just looking at you pics from last year how is your hip doing?
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Technically, this is not true. An insurance company has no power to prevent you from going to whichever doctor/hospital you choose. They do have the ability to say "We will only pay if you go to this doctor/specialist."
Perhaps a minor point, but one that needs to be kept in mind. I can go to whichever doctor I want. I may have to pay for the visit out of my own pocket. I can use whichever pharmacy I wish, even if I must come up with the cost of the medicine on my own.
Kaiser cannot prevent you from visiting an independent physician. They don't have that power.
Which touches quite well on the other point I made in that post, paying for services I don't need or won't use. Hundreds of dollars per month of compensation my* employer is paying to compensate me but I receive little or no benefit from it. Insurance companies love that.
Which touches quite well on the other point I made in that post, paying for services I don't need or won't use. Hundreds of dollars per month of compensation my* employer is paying to compensate me but I receive little or no benefit from it. Insurance companies love that.
I worked at a place that gave us the option of paying for AFLAC's 'cancer insurance.' If you were diagnosed with cancer, you were paid something like $25k. It only cost something like $12/month. Total scam.
Insurance is supposed to provide a financial firewall between you and a cost you simply cannot afford. Most people can't afford to pay for major surgery on their own, for instance. Somewhere along the line, "health insurance" got morphed into "paying for services you use on a regular basis" like routine doctor's visits.
I don't call my auto insurer when I get the oil changed on my car, but health insurance has a copay for effectively the same thing when I go to my physician for a yearly physical. Makes no sense to me.
Then again, when I need opthamological surgery, I'll be happy that little rider was in the policy.
Which touches quite well on the other point I made in that post, paying for services I don't need or won't use. Hundreds of dollars per month of compensation my* employer is paying to compensate me but I receive little or no benefit from it. Insurance companies love that.I worked at a place that gave us the option of paying for AFLAC's 'cancer insurance.' If you were diagnosed with cancer, you were paid something like $25k. It only cost something like $12/month. Total scam.
Insurance is supposed to provide a financial firewall between you and a cost you simply cannot afford. Most people can't afford to pay for major surgery on their own, for instance. Somewhere along the line, "health insurance" got morphed into "paying for services you use on a regular basis" like routine doctor's visits.
I don't call my auto insurer when I get the oil changed on my car, but health insurance has a copay for effectively the same thing when I go to my physician for a yearly physical. Makes no sense to me.
Then again, when I need opthamological surgery, I'll be happy that little rider was in the policy.
You have nailed one of the most fundamental failures of the health insurance system. This has contributed to the attitude of "Someone else is paying for it, so who cares if it's wasteful." that third party payment tends to encourage.
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There are thousands (millions?) of young healthy people who are completely uninsured right now so having a "wonderful" option for them is a great idea in my book. Just because it's not a good option for YOU doesn't mean it's a bad option for everyone.
I am not young but I am fairly healthy. If HSAs were not an option I still wouldn't spend the ridiculous amounts of money on a PPO or HMO plan, I would buy a high deductible insurance plan and save the money.
As it is, I can put money into an HSA so I have money in the bank to pay for those medications when I am older and need it. Previously my only choice was to put money into a HMO or PPO plan where it just goes out the window every month enriching the health plans... I like the idea of keeping my money thanks.
The problem is when HSAs are presented as the only option, they do not work for a large chunk of the population. You are still enriching the insurance companies, I spend double (almost triple) what I did on a PPO or HMO plan. I end up having to pool most of my annual money into hitting the deductible, leaving me with very little left over to actually build towards the next year.
In the end, it will not work for you either. You will get sick or break your leg, etc. and you will blow through your chunk of HSA savings, leaving you with nothing but a new year of high costs (deductible, coinsurance, premiums...) to pay. Or worse, you'll end up on some expensive medication, costing you $1000 a month before you hit your deductible and even then you usually end up paying a % of the costs for the rest of the year. I've seen it happen to at least a dozen "healthy" people over the years.
The problem is when HSAs are presented as the only option, they do not work for a large chunk of the population. You are still enriching the insurance companies, I spend double (almost triple) what I did on a PPO or HMO plan. I end up having to pool most of my annual money into hitting the deductible, leaving me with very little left over to actually build towards the next year.
In the end, it will not work for you either. You will get sick or break your leg, etc. and you will blow through your chunk of HSA savings, leaving you with nothing but a new year of high costs (deductible, coinsurance, premiums...) to pay. Or worse, you'll end up on some expensive medication, costing you $1000 a month before you hit your deductible and even then you usually end up paying a % of the costs for the rest of the year. I've seen it happen to at least a dozen "healthy" people over the years.
Two years in a row that had happened to me based on a planned surgery and then four additional inhospitalizations in a period of 12 months. Because of that, we had to time the missus' surgery just right before Christmas last year as the plan deductible was met or else we'd have to start all over again this year and we wouldn't have gone through with it. Now having lost my job, I can't simply afford COBRA for the both of us based on whatever I may be collecting ... if I collect. I'm still waiting for unemployment to make their determination and I haven't received a thing from my former employers other than tax stuff for 2009 and it's nearing the end of the month.
Congress just needs to stop with the friggin bi-partisan squabbling and deep six the lobbyist and just give us the plan that they have for themselves. How more difficult can it be? /soapbox.
In the end, it will not work for you either. You will get sick or break your leg, etc. and you will blow through your chunk of HSA savings, leaving you with nothing but a new year of high costs (deductible, coinsurance, premiums...) to pay. Or worse, you'll end up on some expensive medication, costing you $1000 a month before you hit your deductible and even then you usually end up paying a % of the costs for the rest of the year. I've seen it happen to at least a dozen "healthy" people over the years.
Agreed. I've seen this happen to a friend of mine. It's ugly.
Not that it helps everyone, but in the context of this thread I think it's appropriate to mention that the US Government does offer a small tax deduction for having high (uncovered) medical expenses. You must exceed 7.5% of your Adjusted Gross Income (AGI). This is covered on the IRS' website. Check with your tax preparer, or if you use TurboTax it will prompt for this. Get all your information together first (like a summary of usage from your health plan and a list of purchases from the pharmacy and drugstore.com, etc.).
http://www.irs.gov/publications/p502/ar02.html
Not that it helps everyone, but in the context of this thread I think it's appropriate to mention that the US Government does offer a small tax deduction for having high (uncovered) medical expenses. You must exceed 7.5% of your Adjusted Gross Income (AGI). This is covered on the IRS' website. Check with your tax preparer, or if you use TurboTax it will prompt for this. Get all your information together first (like a summary of usage from your health plan and a list of purchases from the pharmacy and drugstore.com, etc.).
http://www.irs.gov/publications/p502/ar02.html
Did for 2008 and will be doing it for 2009. I know I hit it, but like you said, it's a small deduction.
Did for 2008 and will be doing it for 2009. I know I hit it, but like you said, it's a small deduction.
I guess every little bit helps though. We're on a high-deductible health plan. Every year we've met the deductible by May or so.
Did for 2008 and will be doing it for 2009. I know I hit it, but like you said, it's a small deduction.I guess every little bit helps though. We're on a high-deductible health plan. Every year we've met the deductible by May or so.
Individual deductible is $400.00. OOP Maximum is $2000.00.
Family deductible is $800.00. OOP Maximum is $4000.00. We definitely hit it last year in August and it didn't include the last in-hospitalization last month where I paid almost another $2k up front OOP for potential costs that may not be covered. May get $750 back on appeal, but we'll see.