![\"user-pic\"](\"/mt-static/support/assets_c/userpics/userpic-291079-100x100.png\")
\"Saving a few dollars per year in premiums can backfire if the insurer hassles you at claim time\"
As an independant insurance agent I cant agree with this statement more. There are alot of crappy companies out there that are really cheap cause they don't pay out for ANYTHING!
![\"user-pic\"](\"http://consumerist.com/assets_c/userpics/userpic-98962-100x100.png\")
@SteveZim1017: With car insurance if I'm getting the cheapest insurance from a local dealer I look at my policy as I will definitely have to sue them if I have a real claim.
![\"user-pic\"](\"http://consumerist.com/assets_c/userpics/userpic-16563-100x100.png\")
But Chris, I don't understand. Our awesomest health insurance companies - who are awesome - are the bedrock of America's health care system: the most AWEsome in the world!
Don't you like awesome?!
![\"user-pic\"](\"http://consumerist.com/assets_c/userpics/userpic-414437-100x100.png\")
Not that it matters for health insurance, since without the public option and with the high cost of individual insurance, there is no way most people can afford to comparison shop insurers. You're stuck with who your employer goes with.
![\"user-pic\"](\"http://consumerist.com/assets_c/userpics/userpic-210139-100x100.png\")
@WiglyWorm: So... why don't we fix the tax code and allow people to shop for health insurance like we do for auto insurance? The reason our health insurance is almost always tied with out employer is that the tax code allows companies to deduct health insurance expense for their employees from their income, reducing their taxes.
And, as this snub also shows, you're looking at United Healthcare of NY. A NY resident can't buy insurance that's in NJ, VA, or anywhere BUT NY. So lets also allow for competition across state lines. Lets try these two things at least before we go the public option route. Because I don't think anyone believes that any company, for-profit or non-profit, can compete with a \"company\" backstopped by the Treasury...
![\"user-pic\"](\"/mt-static/support/assets_c/userpics/userpic-614388-100x100.png\")
\"A NY resident can't buy insurance that's in NJ, VA, or anywhere BUT NY. So lets also allow for competition across state lines.\"
In a theoretical model, this would solve everything. In practice, every insurance company moves its headquarters to Delaware to avoid taxes and increase profits, while prices remain the same or go up... I feel like every time a system has been changed to relax guidelines, consumers lose (look at the media industry, for example.) In how many industries do we have to try deregulation in before we recognize that companies are not human beings and as such do not (and should not be expected to) have a conscience or motive beyond increasing profits.
In a theoretical model, this would solve everything. In practice, every insurance company moves its headquarters to Delaware to avoid taxes and increase profits, while prices remain the same or go up... I feel like every time a system has been changed to relax guidelines, consumers lose (look at the media industry, for example.) In how many industries do we have to try deregulation in before we recognize that companies are not human beings and as such do not (and should not be expected to) have a conscience or motive beyond increasing profits
To expand on that, not only to companies NOT have a motive beyond increasing profits, in actuality they actually have a legal obligation to their share holders to make their profits as high as possible. Anything less can lead to a potential lawsuit from shareholders.
@TheWillow: Holy grammatical issues Batman! (... for example). In how many industries do we have to try deregulation before...
(and yeah, I'm aware the loosened restrictions don't constitute a \"true\" free market, but neither would anything else, since theory and practice tend to live in different universes.)
![\"user-pic\"](\"http://consumerist.com/assets_c/userpics/userpic-1235679-100x100.png\")
@Tux the Penguin: \"And, as this snub also shows, you're looking at United Healthcare of NY. A NY resident can't buy insurance that's in NJ, VA, or anywhere BUT NY. So lets also allow for competition across state lines. Lets try these two things at least before we go the public option route.\"
Why?
Other countries continually demonstrate that a single-payer system costs less than our current, gamed system and everyone is covered. Everyone.
Keeping the thieves running the bank, but with lateral policy changes, doesn't change anything. (You're still under the impression that there's 'competition?' Really?)
\"Because I don't think anyone believes that any company, for-profit or non-profit, can compete with a \"company\" backstopped by the Treasury... \"
This is also flatly untrue, as private companies operate in single-payer systems. Look to the private insurers in Canada, France, etc.
@Tux the Penguin: By \"fix\" you mean, Pay new taxes on your employer's share of your medical insurance, an insanely regressive, wildly unpopular proposal.
By \"compete\" you mean, like how credit card companies \"compete\" by finding the laxest, lowest oversight state who'll bend over the quickest so they can more effectively hose their customers.
It's ironic that your comment has more NewSpeak than even the insurance companies fact-checked in Chris' article.
@Trai_Dep: No, I don't mean \"taxing\" employer's share of your medical insurance. Heck, we can do it even cheaper:
Create a refundable tax credit, dollar for dollar, for any health insurance premiums paid.
Oh look, no longer regressive (they get a 1:1 reduction in taxes, even meaning cash back in a 1:1 basis). Makes getting insurance on your own even more affordable. Right now your insurance payments are pre-tax, which means you only really get 0%-35% of the cost back, depending on your tax bracket. That means, if they were a full tax credit, you could suddenly afford insurance that costs three times as much (or more!) as you current pay out of your paychecks for your employer benefit.
As for your idea of the \"race to the bottom\" - why would the insurance market suddenly move all to, say, South Dakota - since it would be cheaper to operate there, but employers not dump employees into the government option... since its cheaper?
@Tux the Penguin:
Why should would or could a public option automatically be cheaper and drive insurance companies out of business?
Any public health insurance would have the same or greater operating costs as any other health care plan. Further, any public plan would have a vested interest in generating revenue for the government, just like the post office or any other similar public service.
@WiglyWorm: I'm increasingly becoming confused by the simultaneous assertions that government run health insurance will be the \"worst health care of all time\" and yet also be so cheap it drives private companies out of business.
It seems to presuppose that middle-class/wealthy Americans are *so* stupid that they would choose cheap, allegedly bad health care over more expensive, allegedly higher quality health care. Just like they all shop at Wal-mart instead of Bloomingdales, buy store brands instead of name brands and watch basic TV instead of cable.
![\"user-pic\"](\"http://consumerist.com/assets_c/userpics/userpic-287896-100x100.png\")
@WiglyWorm: Do you really think there isn't such a thing? What about insurance companies who won't pay for that experimental bone marrow transplant etc, I know your kidding, but I would bet they already exist at each and every company.
![\"user-pic\"](\"/mt-static/support/assets_c/userpics/userpic-350350-100x100.png\")
Canadians come to the U.S. for care do so because they want to get a procedure done faster than if they had it done in Canada and are willing to pay for it.
@WiglyWorm: \"Any public health insurance would have the same or greater operating costs as any other health care plan. Further, any public plan would have a vested interest in generating revenue for the government, just like the post office or any other similar public service.\"
The first point is laughable. First, if the public health plan had GREATER operating costs, it would be STUPID to implement. Why? Their premiums would be HIGHER than what we see now, meaning insurance companies would raise their premiums to match... after all, its there to encourage competition, right? But that's too much of \"big bad businessman\" to go with, so lets hit a second point. Medicare does not put the same amount of time into fraud prevention than, say, United. That's what drives up some of United's administrative costs, but that amount spent, we can assume, mean lower costs overall (you wouldn't spend $100 to investigate and prevent fraud if it only got back $50, would you?)
But onto the second point... the Post Office is not generating any revenue. Its losing BILLIONS. Heck, consumerist itself highlighted this. They have a monopoly on first class mail and STILL cannot make money. Why would health insurance be any different?
As for your nice flowchart... that does not take into account employers dumping employees to save money... since now they can just get the government option. The \"proposed\" penalty for not providing healthcare is an 8% payroll tax surchage. So if my side of the insurance is 10%, 8.5%, even 8.1%, I now have an incentive to drop it and just pay the 8%. That's how incentives work. You've got to be careful with them.
The first point is laughable. First, if the public health plan had GREATER operating costs, it would be STUPID to implement. Why? Their premiums would be HIGHER than what we see now, meaning insurance companies would raise their premiums to match... after all, its there to encourage competition, right?
But onto the second point... the Post Office is not generating any revenue. Its losing BILLIONS. Heck, consumerist itself highlighted this. They have a monopoly on first class mail and STILL cannot make money. Why would health insurance be any different?
As for your nice flowchart... that does not take into account employers dumping employees to save money... since now they can just get the government option. The \"proposed\" penalty for not providing healthcare is an 8% payroll tax surchage. So if my side of the insurance is 10%, 8.5%, even 8.1%, I now have an incentive to drop it and just pay the 8%. That's how incentives work. You've got to be careful with them.
@WiglyWorm: \"But in your first post you rightly pointed out that insurance companies can deduct their portion of healthcare costs from their income, therefor, no matter what they pay, the incentive is actually to provide health care and deduct the cost, as that has a much smaller impact on their bottom line than an 8% penalty would.\"
The payroll tax is 8%. Highest marginal corporate tax rate (today) is 35%. So, if the health insurance cost was greater than 12.3% (8/(1-.35)), the company would dump the employee into the public plan. Yes, various different forms of companies would change it, as would the profitability of the company, but so would the personnel hours of people to administer the health plan.
I'm just highlighting the fact that contrary to what Obama says, people will lose their current healthcare benefits. The cost for annual insurance for ME (or at least my company) for one of my full time employees, plus spouse and all dependants, is $13,611 annually ($1130.64 a month). I know this number because if they don't take insurance, I pay them that each month. None of my employees make more than 67k. I, on average, pay 20%. If the public option goes through, I have a HUGE incentive to dump employees. I'm certain that one of my partners would be fighting me left and right to do just that. I, on the other hand, would prefer to keep my employees happy, since there work ultimately makes me my money.
@Tux the Penguin: But even if you *did* dump them, the vast majority would find a non-public individual insurance options. It's not some vast socialist plot, which many people seem to believe.
You do not, and that's encouraging, but let me ask you this: If your employees had the choice between:
A) Having the health care that you provide
or
B) Being free to shop around and find the best coverage for them in a legitimately competitive marketplace.
Which do you think they would pick? Assuming, obviously, that the coverage in B is equivilant or superior to the coverage in A? I know I would pick B. Wouldn't you?
@WiglyWorm: Oh, we fully agree that a good marketplace to shop around for medical insurance would be best, but at best, all we're going to have is the current marketplace (which sucks) with a new public option.
Not much more competitive since most people cannot afford health coverage on their own.
But in case you missed it, I give my employees that option. My cost is 1130.64 a month for full coverage. If they only cover themselves, they get the difference. They can reject it all together and get an extra 13k to shop for their own. But most just use to to defray the cost of their spouse's coverage.
So what is your great idea for creating a marketplace? The public option alone wouldn't do that. We'd need to open up the states to interstate competition, not to mention remove mandates to cover various things. What if I want just a catastrophic health insurance plan with a 10k deductible, using an HSA to cover that deductible? Good luck finding something like that.
I said in my first response to you that I think a public answer alone is not the solution.
Federal consumer protections need to be enacted. Guidelines with requirements about coverage, preexisting conditions, etc. It needs to be done at the federal level to avoid the scenario laid out by someone above where companies just headquarter in the most lax state (which you can't deny they will).
Once those guidelines are enacted, then we can open up the state lines for competition. These are all good steps which must be done, and I agree with you 100% on them.
I know the federal guidlines are there in the bill. I believe the inter-state insurance has to be handled by the states (but could possibly be over-written by the interstate commerce clause in the constitution), and I'm not aware of any plans to do this unfortunately.
So let me ask this:
1) If interstate competition is for some reason not encouraged, isn't having at least one nation wide plan either for competition or to fall back on as a last resort (public option) a good thing?
2) If interstate competition IS allowed and we see a vibrant marketplace, what harm does a fall-back federal plan do? If it is poor quality cheap insurance, those who can afford better will get better, while those who cannot at least have something. If it is good quality more expensive insurance, then it just increases competition. I see no problems whatsoever.
If your problem with the public option is simply that it is being pitched by some as an all or nothing \"this will fix healthcare!\" magic bullet, then I share your frustration, however, the bill is much deeper than that. The focus on the public plan is simply a tactic by big healthcare to obfuscate the issue because many parts of the plan are going to be good for consumers and therefore bad for them.
Oh, you won't find any disagreement with me that there are far more problems with our health care system than just the lack of public health insurance.
I support a public option both for the reason I alluded to in my original post, and also because health care in my opinion is a right, not a responsibility. Just because you are a 1099 employee or small business doesn't mean you should be charged half your paycheck for poor insurance. We're talking about a very small subset of people, though, who would be using a public option there, it's only there for a backstop to fulfill our societal obligation to make sure people have health care.
Realize for a moment that America is the only industrialized nation that does not provide health care in some form for our citizens...
Huh? We don't have Medicare, Medicaid or SCHIP?
![\"user-pic\"](\"/mt-static/support/assets_c/userpics/userpic-86968-100x100.png\")
@WiglyWorm: Something I am curious about when people claim health care as a right is what amount is a right, and when does it become a luxury. For example, cosmetic surgery is health care, but in many cases probably shouldn't be a right.
I guess what I'd say is this: to give everyone the presently best available health care would consume so many resources as to swallow almost the whole economy. This is impractical. Given that we can't give everyone concierge care or unlimited elective procedures, what subset of health care is actually a right, and what is not a right?
@huadpe: Do you recall all those horror stories of Socialized Medicine, where you have to wait and wait until you see a doctor?
Those are the cases where care isn't critical.
And purely optional procedures (say, cosmetics) are paid out-of-pocket.
A rational approach to health care, in other words.
![\"user-pic\"](\"http://consumerist.com/assets_c/userpics/userpic-425645-100x100.png\")
@Trai_Dep: I'm waiting and waiting to see a doctor now! I had surgery two weeks ago, and my post-op in appointment has been postponed twice. I'm half expecting them to postpone it again. Meanwhile, I can't return to work until the surgeon checks things out and gives me the green light. At least if this were under a public option, I wouldn't be paying for the privilege.
Contrast this to the surgery I had in Japan, covered by their nationalized health care system, where I went in, was diagnosed, made an appointment for surgery, had surgery, stayed in the hospital for a week, went home for another week, and then went in and had the follow-up. Great quality of care and easier access than I've ever had getting so much as a physical in the States.
Personally, I'm mostly amused by those who are so confident of the evils of nationalized health care but have never actually lived in a country that had it. I've lived in two countries with socialized medicine and had extremely positive experiences, and I didn't meet a soul who would trade their system for what we currently have in the U.S. Yeah, our doctors and technology are great- fat lot of good it does you if you can't get access to the magical medicine cave.
@huadpe:
Elective procedures such as cosmetic surgery are rarely covered under today's system. I wonder what about a public plan makes people think that the government would subsidize it. I would surely be against that, myself.
When I say healthcare is a right, what I mean is this:
Someone is crossing the street, I don't care who you are, from a homeless person, to a CEO, and everyone in between... if you're hit by a car, you have the absolute and undeniable RIGHT to be picked up by an ambulance and receive not just the life saving hospital services, but also the rehabilitation needed to learn to walk again. Our current system only assures the right to life saving treatment, and even then (in my state) only if you are below the poverty line.
I guess what I'd say is this: to give everyone the presently best available health care would consume so many resources as to swallow almost the whole economy.
Great Britain spends 40% of their GDP and guarantees health care for all their citizens. Britain's economy is currently stronger than ours. I don't think the added spending would collapse our economy. We would, of course, have to cut elsewhere, but I'm okay with that...
@huadpe: \"I guess what I'd say is this: to give everyone the presently best available health care would consume so many resources as to swallow almost the whole economy.\"
And yet, nowhere is this true, particularly where universal healthcare is the norm. Canada, France, etc. And everyone is covered. Everyone.
Funny how reluctant insurance apologists are to admit that the fears they're pushing have already been debunked by working, existing systems.
![\"user-pic\"](\"/mt-static/support/assets_c/userpics/userpic-660502-100x100.png\")
@ShruggingGalt: 99.99% don't. Its the very specialized health care that almost no one will ever hear about that is done here. Also the citizens that are injured while visiting the US.
@ShruggingGalt: Elective procedures may not be scheduled soon enough for some.
Why are we going to Canada for our prescriptions?
Anecdotal cases exist for every system, but since Canada has a lower infant mortality rate, greater lonegevity and no one is left uncovered or going bankrupt over their medical bills, their system trumps ours by light years.
60% of US bankruptcies are connected to hospital bills.
Sixty-two percent of all bankruptcies filed in 2007 were linked to medical expenses, according to a nationwide study released today by the American Journal of Medicine. That's nearly 20 percentage points higher than that pool of respondents reported were connected to medical costs in 2001.Of those who filed for bankruptcy in 2007, nearly 80 percent had health insurance.
USA...USA....USA....what we lack in healthcare, we make up for in jingoism.
@MostlyHarmless: And I know people who go to south america for Plastic Surgery because most insurance wont cover skin removal after gastric bypass, and others who go to mexico for dental work.
![\"user-pic\"](\"http://consumerist.com/assets_c/userpics/userpic-6173-100x100.png\")
@Hanshiro: But those systems are not run by Amurricans and therefore must be ignored.
(Shhh! Nobody mention medicare!)
![\"user-pic\"](\"http://consumerist.com/assets_c/userpics/userpic-388919-100x100.png\")
I used the tool before reading this story, and I picked United Healthcare as well. Zero complaints in Minnesota? I should have submitted some paperwork.
![\"user-pic\"](\"http://consumerist.com/assets_c/userpics/userpic-483337-100x100.png\")
insurance? what's insurance?
![\"user-pic\"](\"/mt-static/support/assets_c/userpics/userpic-665956-100x100.png\")
@LostAtoll:
It's the thing everyone tries to save a few bucks on by buying the cheapest policy then has the nerve to be upset when said policy doesn't cover jack. Of course, it doesn't matter if it doesn't pay jack because they're just going to sue their agent for not selling them the expensive policy they turned down in the first place.
But I'm not a bitter agent or anything.
![\"user-pic\"](\"http://consumerist.com/assets_c/userpics/userpic-436259-100x100.png\")
@LostAtoll: Its when a company takes money from you so that they can pay you back a higher amount when something back happens... except that they dont.
![\"user-pic\"](\"/css/images/default.gif\")
There seems to be a catch to this. I work for a P/C insurance company, and generally we would use different writing companies. When I did a search for my company in NJ, it offered results for different the writing companies.
Also, as somebody mentioned above, they numbers seem a little off, one of the writing companies I chose had a ratio over 12,000. One other had a 5, but the rest were low, one .13 and the rest 0.
Not sure what a customer would make of that, when you buy our insurance, you generally don't ask for a specific writing company, you would go with the best rate. And all claims are handled by our own claims department, it isn't separated by which writing co. you choose.
![\"user-pic\"](\"http://consumerist.com/assets_c/userpics/userpic-4147-100x100.png\")
Must... not... make... obvious reference!
//Scouter must be broken or something!
Complaint Ratios for Year 2008
National Median Complaint Ratio 1.00
USAA Complaint Ratio 0.56
USAA rocks. Now I have proof.
@VA_White: Indeed...USAA is pretty amazing. I was getting an estimate from a recent accident (not my fault), and the person working at the body shop said they are the easiest to deal with on their end as well.
It's good to have proof that it's not just in my head!
![\"user-pic\"](\"http://consumerist.com/assets_c/userpics/userpic-24730-100x100.png\")
My auto insurance's (State Farm) ratio of 0.34 is balanced by my health insurance (Aetna) of 4.80!
I have Progressive (auto) and UnitidedHealth. CRAP.
@pattiesmart: I had UHC when I broke my neck and they couldn't have been easier to deal with. I had to pay some on the incident (which included a learjet and helicopter ride) and first surgery, because they only pay 90% on an emergency situations but they even paid for the air transport. The docs had to do a 2nd surgery on me after some hardware on my spine moved a bit and I never saw a bill from that surgery.
Your mileage may vary but you may never have an issue with them.
@pattiesmart:
Actually, Progressive is fantastic when it comes to claims handling. I wouldn't use this article as your guide. Talk to people you know who've had insurance with whichever carrier you're considering.
I'm an independent agent, and I moved my auto insurance to Progressive after having so many clients rave to me about their claims service. Incidentally, I would recommend buying your Progressive policy through an independent agent and not directly from Progressive. And before I get accused of anything, I don't sell personal insurance.
@pattiesmart: So progressive sucks hmmm? I am in the market for auto, and am toying around between Progressive, State Farm and Geico...
![\"user-pic\"](\"http://consumerist.com/assets_c/userpics/userpic-838428-100x100.png\")
@MostlyHarmless: State Farm seemed to be much more expensive for me then Progressive, Geico was was off the charts comparitively, and if you quote through them they'll spam the crap out of you asking you requote, etc. For months after you go through their opt out process even..
@morgasco: The quotes I got from Progressive and State Farm (with renters) were very close. State Farm without renters insurance was a bit higher, and Geico was a bit higher than that. So yeah, they cost a bit more, but if SF gives better service than Progressive, I dont mind paying.
@MostlyHarmless: I didn't have any issues at all getting claims paid for my auto through State Farm, so if they're close by all means go and support the local agent. Just keep an eye on the bill at renewal time and make sure they're still pricing you competetively.
@morgasco: Cool cool. I usually pull quotes from different sources once my renewal date gets close. So far no one has even gotten close to what esurance has offered me. Well, till now atleast. Now all the three I mentioned have better quotes, and I would prefer to be with a local insurer.
![\"user-pic\"](\"http://consumerist.com/assets_c/userpics/userpic-542520-100x100.png\")
Nothing makes a point like a disembodied cat head.
![\"user-pic\"](\"http://consumerist.com/assets_c/userpics/userpic-68654-100x100.png\")
i think we just DDoS'd the database. \"the consumerist effect\" stricks again!
Hooray for BCBS of Georgia! Only .06!
Honestly, my HMO is great. HMOs get a bad rep, but I've never had any problem with mine. I even had to get an MRI a few months ago and they covered the entire cost (about $4k).
@dripdrop:
HMOs are fine if you know how to use them. A lot of people don't understand networks, and they get themselves into trouble by going out of network for things or not getting referrals.
I have a PPO, and I love it.
![\"user-pic\"](\"http://consumerist.com/assets_c/userpics/userpic-466847-100x100.png\")
Some months ago there was another article on car insurance and another poster mentioned Wawanesa. If that person still reads Consumerist...THANK YOU!
I checked them out and as I live in Oregon, I could get a car insurance policy. They halved my insurance bill, my mother's, my brother and SIL's, my uncle's, my ex-husband's and my boyfriend's. I have handed their URL out to many other acquaintances.
Given that insurance companies usually don't pay out anyway, I may as well pay the least possible. I tried to check out their complaint ratio, but the site is quite borked.
@MostlyHarmless: I stayed in Japan and had surgery done rather than come back to the U.S., despite being insured in both countries. It was less expensive, and I received better quality of care staying in Japan than either I or my relatives have in the States. Blasphemy, I know.
Incidentally, there's probably a reason why Canada has the 8th highest life expectancy and we have the 50th (according to the CIA Factbook). Both Canada and the U.K. also have lower infant mortality than we do. I don't think it's just due to Canadians tunneling under the wire and sneaking their way into U.S. hospitals, as delightful as that might be to believe.
@FaustianSlip: And in case I wasn't clear, Japan has a nationalized health care system. I suppose someone forgot to tell their ridiculously long-lived population that they're supposed to be trapped in an Enders Game-esque maze of death panels.
![\"user-pic\"](\"/mt-static/support/assets_c/userpics/userpic-1227501-100x100.png\")
I filed a complaint with my State's \"Office of Insurance Regulation\" and was told that the insurer can pretty much do whatever they want regarding canceling homeowner policies (even if the reason stated for the cancellation is untrue). It's been several months and I'm still waiting for a written response to my complaint. I guess that's my answer.
![\"user-pic\"](\"http://consumerist.com/assets_c/userpics/userpic-87429-100x100.png\")
![\"user-pic\"](\"http://consumerist.com/assets_c/userpics/userpic-57429-100x100.png\")
![\"user-pic\"](\"http://consumerist.com/assets_c/userpics/userpic-439678-100x100.png\")
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![\"user-pic\"](\"http://consumerist.com/assets_c/userpics/userpic-536414-100x100.png\")
Somehow, Geico in Vermont has a complaint ratio over 8000? I don't think it's working right... :P