I watch the ripples change their size
But never leave the stream
Of warm impermanence
And so the days float through my eyes
But still the days seem the same
And these children that you spit on
As they try to change their worlds
Are immune to your consultations
They're quite aware of what they're goin' through

Friday, January 30, 2009

Doctor, doctor, gave me the news...

Yeah, I know, I've heard it all. It's the bad loans and massive defaults, unscrupulous idiots that rated high risk securities as AAA, houses of cards, blah blah blah.

Guess what's really dragging the economy down? Nope, but energy costs come in a close second. It's the cost of health care. Seriously.

Okay, well, so we're having open enrollment and I'm a bit touchy about it. We have had two raises in the past year. The first one in August finally caught us all up to the health care increase we saw in January 2008 ($10 a week). We just had another $10 raise, but since I wanted a plan with something lower than $10,000 deductible (yes, also a split $20/$50 copay for Primary Care/Specialist visit) it's going to cost me about $18 more per week. So I'm looking at an effective paycut of $8 a week over last year for (roughly, with some of the provisions it's actually a little less) the same coverage.

We're also changing providers (starting this Sunday, guess who doesn't have a card yet... everybody in the shop). So this also had me asking my health care providers about the insurance plans. See, for the company we're going with (which, strangely enough I own stock in) my providers don't accept some of their plans (I think we're good). And here's the kicker, most health care plans negotiate "fair and reasonable rates" with those who provide the services (you know, the doctors). The doctors haven't seen an increase in those fees for fifteen years (yeah, shocked, shocked I was to hear...). So all those "increased costs of medical care" you keep hearing about, yeah, it isn't going to the doctors. We also now have four tiers of drug coverage and copay. Four. Remember when it was one, and then they split it to two (generics and brand name)? Four.

In the future, when I rant and rave about this, you'll know why I root for a sweeping overhaul in how we pay for health care. Also, why I'm a big proponent of a government managed system. Failing that, I'll take something like Germany or Switzerland. Health care is sucking business dry. Just imaging if we could fix that cost how much that would help out economy and employment numbers (remember the last major union contract fights, and the on going ones, are all about health care costs and who is going to pay them). And there still would be costs, heck, right now I pay more for my portion of heath care than I do in FICA, so no, increasing my taxes by 200% wouldn't be that big a deal. In fact, I would be better off. And if that's all it cost, my employer could do a whole lot more with the money they saved.

I know people like to dis Canada for their health system and the wait times. Truth is that if it's an emergency, you get right in. And we have waits here in the US. Make an appointment with a new doctor. No, really, I'll wait. (insert elevator music here) Did you get an appointment earlier than three months from now? Didn't think so. I know people in real pain, who have specialists they've seen (including having surgery) who also have to wait over a month for an appointment.

So this year I'll be selling most of that stock. It's already worth half of what it was worth last year. I didn't pay for it (stock allowance when a mutual went public). But if I'm going to lobby heavily for government health care, it's going to be worthless.

3 comments:

Janiece said...

Steve, I'll pay more out of pocket if health care goes national - my company provides really good benefits.

And I'm still for national health care.

Steve Buchheit said...

Janiece, every year it's a discussion if we should make our employees for the village chip in for their health care. We don't pay them crap (okay, I've helped move that up, but still) so I'd like to keep that free to them as long as possible. But, yeah, we could pay them more if it weren't for that cost.

Now the major arguments are about Single vs Family coverage. How it's not fair that we consider Heath Care coverage equal when it really isn't. At work they wanted to charge us differently for individual, + spouse, and family. Seems they keep forgetting what "Union" means. With the village we've had discussions over how it's unfair to our employees with the "total cost" being lopsided.

My big argument against that is just what are we incentivising here. Are we going to punish people for having families (typically younger workers)?

It's the same as the split copay. I know they're trying to incentivise General Practitioners, but the insurance companies are putting the pressure on the wring end of the market, making it even less desirerable to be a GP. The exact opposite of what they want to do.

Steve Buchheit said...

"pressure on the wrong end of the market"

Okay, not making sense, time for bed.