Health Care Choices

I know that the go-to argument against moving to single payer health care in this country (for those of us who aren’t elderly, poor, or veterans, anyway) is “Do you really want the DMV handling your health insurance?”

After sitting through another benefits meeting, filled with acronyms and conditionals and seemingly arbitrary numbers, it doesn’t sound that bad compared to the situation we’ve got now. I’d give anything for a health care system as efficient and transparent as the DMV.

“Your family deductible is X per person, capped at three family members, while your HRA isn’t capped! But the HRA is only for medical, not other expenses like dental or vision, which have to come out of an FSA or an HSA that you’ve rolled over from a previous plan!”

Oy.

11 Responses to “Health Care Choices”

  1. BrianN says:

    You are describing government programs, not health insurance, so yeah.

    Not that health insurance isn’t complicated, but at least you usually get to a couple of choices.

  2. matt says:

    I don’t know how common it is to get choices any more — my employer is switching to a one-size-fits-all plan for 2013, and from what I hear, a lot of others are as well.

    This might be partially driven by the health insurance exchanges coming online — even if your employer only offers one plan, at least there’s somewhere else to look now.

  3. BrianN says:

    I heard a Q&A last night on NPR, it sounds like you can only go to the exchange if your employer doesn’t offer healthcare, but I could have mis-understood.

  4. matt says:

    That seems like a stupid and arbitrary rule, so it’s probably the truth.

  5. matt says:

    Apparently it’s not. From https://www.healthcare.gov/am-i-eligible-for-coverage-in-the-marketplace/ :

    To be eligible for health coverage through the Marketplace, you:

    must live in the United States
    must be a U.S. citizen or national (or be lawfully present)
    can’t be currently incarcerated

  6. BrianN says:

    Well, that’s good. The question wasn’t directly about that and they might have been referring to the subsidy.

  7. waterwolf says:

    We should have a one payer plan and eliminate Medicare, Medicaid and all the other “choices”. It should be run by a National Blue Cross Plan and everybody pays into one pot. This would eliminate all or the Administrative overhead of running all of these plans. However, that’s exactly why we don’t have a one payer plan—-do you know how many people would be out of work?

    People should pay in on a sliding fee scale and us old people should NOT be exempt—we should pay our share. Of course AARP would cry foul and that would end the program.

  8. Pitt says:

    As soon as the government gives us all health insurance, it’ll take away the ability to buy cigarettes, 32 oz fountain drinks, hamburgers, butter, cases of beer, and Tom Cruise movies. And we’ll all be forced to jazzercise for 30 minutes per day with Michelle Obama and Richard Simmons.

    Health care is a mess. Eliminate the government programs entirely- let me buy my insurance through the same company I get my auto, home, and life insurance from. Or shop a different company, if I like. Or, and here’s an amazing though, let me self-insure.

    Fat people should pay more. Smokers should pay more. The older you get- the more you pay. Don’t ever get sick, don’t ever file a claim? Hey, here’s a dividend check. Incentives.

    How we arrived at this status quo of employers providing health insurance I’ll never know.

  9. Mike says:

    I’m certainly not going to complain about the Tom Cruise flicks… except _maybe_ Top Gun.

    Employer provided health insurance came about in the early 50’s (I think 53, but I’m too lazy to look it up right now) from employers who were in union negotiations. the unions wanted higher wages, and the company didn’t want to pay them (shocker, I know). The compromise came when employers offered to pay for healthcare rather than give the employees a raise. At the time it financially worked in their favor. The unions agreed, and viola: employer provided health insurance.

    Now, people never really went to the doctor for much (actually, it was house calls at the time so the doctor came to them) but now that it was on the employers dime, people called physicians for every little sniffle and doctors happilly provided their care (and billed the insurance extensively). Of course, within a few years this system was abused so heavily that employers had to do something, so they added formularies, set reimersment rates, prior authorizations, etc. and ever since insurances have been swinging back and forth between models that controlled costs well (HMOs, health maintanence groups, etc.) and models that were more costly but provided freedom to the user to more control who they see, whay they cover, etc..

  10. BrianN says:

    Actually it’s been around a lot longer than that (if you take Wikipedia at face value):

    ” The first employer-sponsored hospitalization plan was created by teachers in Dallas, Texas in 1929.[28] …
    Employer-sponsored health insurance plans dramatically expanded as a result of wage controls during World War II.[28] The labor market was tight because of the increased demand for goods and decreased supply of workers during the war. Federally imposed wage and price controls prohibited manufacturers and other employers raising wages high enough to attract sufficient workers. When the War Labor Board declared that fringe benefits, such as sick leave and health insurance, did not count as wages for the purpose of wage controls, employers responded with significantly increased benefits.[28]”

  11. Pitt says:

    So, basically, it’s all the government’s fault that I have to listen to Ted Cruz compare Obamacare to Green Eggs and Ham?

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