Maryland is considering a plan that would require residents to purchase health insurance. Very similar on the surface to the Massachusetts plan, but with a few key differences. Via Balt Sun:
The plan would be a radical change from the current system of employers
choosing which health plans to offer to workers. It would set up an
insurance exchange where individuals could choose from any plans
offered by insurers and keep the same coverage when moving from job to
The plan wouldn’t apply to large employers, but the cutoff on employer size hasn’t been set.Employers would pay much of the cost, with each employer setting a
dollar figure it would contribute toward the purchase. And the state
would provide a subsidy for lower-income workers.
The Maryland Health plan doesn’t include any mandate on employers –
making it different from the Massachusetts law. But Cowdry said
"individual responsibility would put greater pressure on employers" to
"be in the game" by contributing to insurance coverage.
If the idea actually goes anywhere, Maryland would become the second state to embrace the idea of mandated coverage. Given the amount of attention and credibility Romney has gained by taking credit for coming up with the idea, it seems inevitable that more states will launch similar experiments. So who will be next? In California, Arnold’s office has been hinting that a major health care policy announcement of some kind is on the way. I wonder if they could be planning something along similar lines. — John Irvine
“What will you do in the case where a person with such a plan has to be treated in hospital and can’t pay the deductible?”
They can put the $5000 on their credit card and pay it off. Maybe cancel their cellphone and stop their cable TV for a year. At least they aren’t being hit with a $200k or more bill. That is want catastrophic insurance is for.
“And what to these plans do for low income people wanting access to day-to-day healthcare treatment?”
“They’re going to be in the same place they are now – except they’ll be pissing their money away into a mandatory insurance company plan with no benefit.”
The benefit is that they are covered for catastrophe.
“And what do you do with all the illegal aliens working here who also require healthcare?”
A different issue all together. Fine them, jail them, deport them, and put up a boarder fence.
I think people need to look up the definition of insurance again. It is there for the catastrophe not the day to day oil changes.
I understand Peter. You are in the same boat as the hundreds of employers I meet with year in and out. They all THINK they have to do it like they always have, and in reality, they have had other options since the 1950’s, in terms of providing benefits to their employees.
That’s why health insurance is so expensive. They’ve added so much fluff to it, it’s not longer JUST insurance. And everyone is so stuck on the “benefits”, when they only really need the insurance.
Employers also think that in order to be fair, they have to buy it for everyone who wants it. Not true. The rule is “what you do for one, you must do it for all”. But, you don’t have to buy it that way.
Well Tim I’m no fan of insurance companies, especially health insurance, got out of the heath insurance scam/game/hoax about a year ago when I found that when I needed BCBS they did their best to screw me. My second job out of college was selling whole life insurance so I do know that side of the rip off game, I lasted 6 months as I had to go home at night and live with myself. My understanding is when a group plan is offered by your company it’s the only one in your choices – I guess I am wrong. I’ve always just taken the company plan with no questions. Never been sick enough to use them so I guess they seemed OK. That’s the thing about health insurance here, great until you use it; this is not a bill, this is not a bill, this is not a bill – this is the bill, pay up or loose your home. That’s one of the reasons I advocate a single pay government run system. Americans just need to find enough honest politicans not on the corporate take to set it up. I’m not holding my breath. Democrats are talking a lot, let’s see if they actually do anthing different.
Peter, what most peope don’t understand is that “group” insurance does not have to be purchased like it currently is, and that the benefits provided by the plan don’t have to be purchased from the insurance company.
Everyone can have the same benefits, you just don’t buy them from the insurance company. Even if everyone had different plans, as employees, behind the scenes, they can all have the exact same level of benefits ( copays, deductibles, etc. ).
The way “group” is sold and underwritten currently, it’s a huge ripoff. Check out the information of what premiums are, claims paid, commissions paid for any given group, and tell me it’s not a financial windfall or the carriers, who do NOTHING for you unless you actually hit that deductible. Even then, your group loses with the rate increase. There is a better way to manage all this, and it’s by cutting the carrier’s “management” out of it for all the nickel and dime stuff.
Association plans? Don’t even get me started. Talk about taking on risk… you’re grouping together under GROUP UNDERWRITING with other companies, who may or may not have better health than you do. And discounts? Look at GM.. what.. some tens of thousand of employees on their plan…. are they getting a discount? Hell no. Why? They are buying the most ridiculous plan out there. They can keep those kind of benefits, they just don’t have to buy it that way from the carrier. That’s the problem. Everyone thinks they have to buy the benefits from the carrier to have them or provide them, and that just isn’t true. Same thing with individual plans… everyone has been led to believe they “aren’t as good” or that “employers can not pay for them without tax consequences to the employee”. Wrong. Read the tax law and tell me again? Go ahead and argue with the IRS if you wan’t, but they are on your side as an employer on this one. Wanna retire early? Good luck if you have group insurance.
Let’s take this analogy for example:
Let’s say you have to buy a car for everyone in your company. The car is baically for their own use, but you are going to pay for all the cars and in order to make sure everyone has the same deal, you buyhe car with al the options. This is group insurance.
In reality, all you need to do is buy a basic car and only pay for any options any particular person needs. The same “options” are availabe to anyone who needs them, but you don’t put it on the car unless the individual is going to use it. Some people will never turn on that high dollar stereo ( maternity coverage ). Some people won’t drive enough to do anything more than one oil change a year ( office copays ). Some folks will wreck their car and need to get it all fixed ( catastrophic ). Others won’t drive the car at all ( opt out ). Some drive their spouse’s car spousal coverage ). They all have the same options AVAILABLE to them, but you only pay for what actually gets used. Make sense now?
The answer is here, people just need to be able to handle the truth when it comes to insurance, their friendly “agent” down the street who works SO HARD for them (not), and how the real rules of the game are in their favor.
“I think with this mandatory stuff there should be made available a cut rate very high deductible plan that covers emergencies.”
pgbMD, in a mandatory plan like that people will buy the least cost high deductible plan but will never have any money in the bank to cover the deductible. Look at the savings rate for most Americans, they’re one paycheck away from bankruptcy. Just the kind of people you’re trying to bring into the system and contribute something. What will you do in the case where a person with such a plan has to be treated in hospital and can’t pay the deductible? And what to these plans do for low income people wanting access to day-to-day healthcare treatment? They’re going to be in the same place they are now – except they’ll be pissing their money away into a mandatory insurance company plan with no benefit. Boy, where do I sign up for that corporate gravy train. And what do you do with all the illegal aliens working here who also require healthcare? Do you think they will sign up?
I think group plans with common benefits reduce costs and allow the insurer to predict a certain amount of outcome. I think if you start to allow variations within the group then all you get is a group of individual plans. Now group plans may have been just a way to market insurance and get more business but they did usually provide less cost. Except in my case when I tied to get tagged on to my wife’s work group. BCBS charged more than double getting the same coverage through the group than it did through a single plan for me. I could never figure that out – but who can figure out this broke system, especially BCBS.
As a way to institute a national single pay system if you start to fractionalize the risks (different groups) then you loose the overall reduced premium and cost administration of common shared risk. How’s this for a group plan – See your own doctor when you want and he makes the healthcare decisions along with you, get your healthcare paid by a single paid government insurer (no bankruptcy from health bills), you don’t even get a bill – no paperwork. That’s essentially what the Canadian system is with less cost to the economy. Would you want something more?
Explain to me why group plans are so good… I am just curious as to your thoughts on this. You are not alone. Many people think “group” is the way go, for one reason or another. What are your reasons?
Sorry typos fixed.
I think with this mandatory stuff there should be made available a cut rate very high deductible plan that covers emergencies. I think this would be very attractive to the unmarried 18-40 year old crowd. The problem is that the state regulators are cramming all sorts of required benefits into these mandatory plans (of course driven by lobbists). I would be interested to see if MD or MA come up with such a cut rate plan.
I think with this mandatory stuff there should be made available a cut rate very high deductible plan that covers emergencies. I think this would be very attractive to the unmarried 18-40 year old croud. The problem is that the state regulators are cramming all sorts of required benefits into these mandatory plans (of course driven by lobbists). I would be interested to see in MD or MA come up with such a cut rate plan.
“Interestingly, what can happen is that insurance providers flee the market, and the last remaining one or two behemoths “negotiate” for favorable rate-hikes and/or a seperate “high risk” pool or else they’ll pull out too.”
I’m not sure many will flee unless they are forced to insure a certain % of high cost sick people. That’s probably where the big guys with deeper pockets will end up affording to stay. Hear in NC the state mandates that any home insurer doing business here also insure a certain amount in the east of I95 flood/hurricane zone. Most just insure the minimum and take the hit once in a while. I’ve never had a problem with getting competive home insurance quotes. There’s a lot of uninsured homes there as well, you notice it in your federal taxes thanks to FEMA – the insurer of last resort and the local redevelopment financier that states and local communities love to tap into. Everyone loves someone elses taxes.
Tim, I did not take from your post that you support this, but I do agree with group plans – shared risk/common benefits, just like single pay government run universal coverage where the group is everyone in the country. Health insurers add nothing of value, they just add a layer of costs and assume no duty to control costs in the overall market. It will be interesting to see what minimum plan is mandated. As with the MA “plan” I bet MD will use a teaser rate to get the legislation passed then start to jack up the premiums after that. It’s going to take a long time for policians to figure out that moving the deck chairs will not save the ship.
Right. I wasn’t saying it was a good idea, just that some of what they are asking for is already possible and in place.
Making it mandatory is ridiculous, just as buying the same plan for everyone with typical “group” insurance plans. Everyone can have the same benefits, but you shouldn’t have to, and DON’T have to buy it from the insurance carriers that way.
The main reason GM is in such financial trouble with their health insurance is just that… they have bought a fully loaded low deductible plan for everyone. I would venture to say their family rate with Anthem BCBS is onthe order of 12 to 15 hundred per month… easily.
Interestingly, what can happen is that insurance providers flee the market, and the last remaining one or two behemoths “negotiate” for favorable rate-hikes and/or a seperate “high risk” pool or else they’ll pull out too. This is otherwise known as “blackmail,” but we’re too polite to call it that.
Point is that, yes, unless you fix the underlying problem, forcing everyone to lay down on the broken glass doesn’t really help, ultimately. Someone’s gonna get hurt, and it ain’t the glass.
Here we go again. These mandatory plans assume the present insuranace/healthcare system costs are efficient and as low as a “competitive” private market can provide – blind ideology. It does not address cost control and again relies on the employer to provide much of the subsidy, just when Ford and GM met with G. Dumbya Bush to talk about the crushing cost of healthcare to their bottom line. I think the heavily lobbied ( political bribery) insurance industry is behind these plans. What better way to increase your bottom line than to mandate people buy your cost inflated product while you control the rules through the legislature. And how many people who now require no public subsidy will require one, not only to pay for health insurance, but to pay for co-pays and deductibles. And what incentive will these plans provide to reduce/control costs – none. They will dump additional money into the industry fueling more price increases. “No provider left behind.”
It would set up an insurance exchange where individuals could choose from any plans offered by insurers and keep the same coverage when moving from job to job.
It’s called individual insurance… nothing new about that.
Employers would pay much of the cost, with each employer setting a dollar figure it would contribute toward the purchase.
Already doing that many places, too.
And the state would provide a subsidy for lower-income workers.
They already do this in many states for those who can’t get individual or group insurance elsewhere. The plans are a bit more expensive, but they are very nice plans. This would only be necessary for a very amsll percentage of any employee roster, however.