Originally posted by shots
Originally posted by marg6043
I got it now, I thought that American insurers were making people go to other countries for care.
Making it mandatory is probably in step two of their plan. First you volunteer, next they will make it mandatory.
[gets on soapbox]
I used to work for bxbs. What I'd like to add is this;
the healthy 80% of the population subsidizes the sick 20%. Thats how insurance works. The problem is the 20% is growing, and the 80% is
plain and simple
here is where your premium $'s go ;
85%-87% - paying claims
3% - 5% profit
that goes for almost every big national carrier
the top 2 reasons for the 14% trend in premiums is office visits and Rx, It is NOT surgery. Americans as a population are getting more chronic
diseases as a %age, and at younger ages. Thus, the claim costs go up.
Add to that the fact that the american population is getting fatter, and the culture is "just give me a pill or cut me open" the insurance
companies are not to blame
they are an easy target, but the blame lies in the guy at mcdonalds with a cigarette in his mouth.
we missed the bus in the 90's with managed care. noone wanted to hear about eating right or losing weight or preventative medicine. They hated the
idea of a network, but got used to it and then got used to the $10 copay with no balance to pay. we got spoiled
if you want the best equipment and doctors and to live to 85 while eating fast food and smoking, it comes at a price
how to fix it ?
right now, our system is based on where you work more than your personal costs to the system.
There are 3 categories of rating methodolgies in NY state
(assuming same benefits and plans)
community rated - 1 rate for all groups 2-50 employees
blended - part your companies actual claims costs, part the community rate for 51-499 empoloyees
over 500 = your companies actual claims decide your rates
If I work for IBM my costs will be much less than if I work for Joes computers even though I am the same risk
What I would do is use the car insurance model
everyone gets a rate based on their own risk, and can decide what plan they want Add incentives for losing weight, quitting smoking etc
just please don't let the gov't run it, have you ever tried to help someone with a medicare issue ???
[gets off soapbox]
[edit on 17-8-2006 by syrinx high priest]