Dropping People when They Get Sick.

[LGilmore]

"You are correct. Most people don't use the benefits of major med. My mistake. I assume your words were pointing out my flaw"

So......is it just that you don't see a purpose for major medical coverage?

I think you've painted yourself deeply into a corner on this one and I for one, would love to hear your rational for your position?

 

[bobson]

"You are correct. Most people don't use the benefits of major med. My mistake. I assume your words were pointing out my flaw"

So......is it just that you don't see a purpose for major medical coverage?

I think you've painted yourself deeply into a corner on this one and I for one, would love to hear your rational for your position?

What are you talking about? We were discussing mini-meds. I think they serve a function in the insurance marketplace. Mini meds use to really help people out. I guess they are illegal now.

The fact is the majority people don't use the benefits of major med. Just as the majority of people don't use the benefits of homeowners insurance, or car insurance, or term life insurance, or general liability insurance. Do you understand how insurance works?

 

[somarco]

Gotta jump in and ask a question of Bobson.

Do you write a lot of mini-meds? Do you have E&O insurance? Can you sleep well at night?

 

[DS4]

Mini meds use to really help people out.

I really don't understand this statement. Of the mini meds I have seen, most all would have been better off without a mini med, saved the premium and just paid cash for their expenses.

 

[RayNY]

DS4, I'm in your boat. Overwhelmingly, clients would have been better off saving the premium and just paying OOP. True if they just use the plan for discounts on normal expenses. Especially true if they ever have a major bill (cancer, serious injury, etc).

A traditional Catastrophic plan is almost always a better bet, at least that limited your liability when that worse-case scenario happens.

IMO, that's what insurance is for, to protect from the unforseen. It's NOT there as a financing program to pay for routine and expected costs (even if that's what it's been warped into on the health side).

 

[scagnt83]

The problem with all of this is that there is a real gap in this nation in the ability to afford those small routine expenses. So Health Insurance over the years has morphed into something that covers "everything", because there was/is a huge demand for this.

I started in the insurance biz with Aflac... Their whole pitch is "covering those pesky out of pocket costs". So you pay for insurance, just to pay for more insurance that covers the small part that the main insurance doesn't cover.

For someone who has a couple grand in savings and can easily cover a deductible, an Aflac policy would not make sense. But a HSA combined with a high deductible would make a lot of sense for that person.

On the flip side, a lot of people out there have trouble coming up with a couple hundred dollars for out of pocket expenses. Much less a few thousand.


I am no expert on mini-med plans at all. But I do understand the perceived benefit that a low income individual could see in it. They would be better off just saving that money and paying out of pocket. But the problem with our society (and we cant change this with legislation) is that many of those people will not save it. Or a different need/s will eat away at the savings. This is true even of people who can easily afford insurance.

Most people do not look at the hard dollar amount of benefits they received in care for the year. And then compare that to their premium. Most who are remotely healthy and do this, will start to see the value in a high deductible plan with HSA.

But because people do not. They want an "everything" plan.
On the everything plan the price of all healthcare is negotiated between the insurer and the doctor. It is obvious that it is way too easy for the doctor to inflate costs, and for the insurer to not prudently negotiate and just gradually pass down those costs to the consumer. It even inflates the insurers pockets to an extent by doing this so why would they negotiate too hard? Until now, corporate america has been picking up the majority of those inflated costs. But all that sh$t has increasingly been rolling downhill and taking more out of consumers bank accounts.

Now with this new "Affordable Care Act", it has guaranteed that prices will continue to be set by the doctor/insurer. And now both have a new reason to say that care will be more expensive since this "Affordable Care Act" has huge admin expenses. Which of course just trickles down to the policy holder/payer.
On top of that, it is now shifting a large portion of the cost to "select" (aka financially successful in life) individuals as well as corporate america. Which ultimately is just taking buying power away from sectors of the economy that those low/middle income individuals are most likely to be employed, which obviously decreases their chance of financial success.

So this need for "everything" plans by the middle/low income group, actually shoots the lower/middle income people in the foot because it creates more doctor/insurer payment arrangements, which in turn increases the cost of healthcare, which hurts the low/middle income the most. It is a huge catch-22, Joseph Heller would love it!


If the government wants to make something mandatory, they should make it mandatory to contribute a certain % of income to a hsa! Put the negotiating power back in the hands of the people!

Now I am starting to see some articles indicating that some doctors are considering switching to a cash only practice. So ACA might actually drive certain portions of the population back to a doctor/patient payment arrangement.