Yeah, this is a few days old … How about this: A business leader who doesn’t like subsidizing non-insuring employers! Go figure.
Robert A. Baker , president of the nonprofit Smaller Business Association of New England, said most of his 700 members already contribute more to employee health coverage than the standards require. The reform plan signed last year by former governor Mitt Romney specifies that companies are exempt from a $295 per employee annual assessment if they make a “fair and reasonable” contribution to employees’ healthcare. Specifically, businesses can avoid the fee if 25 percent of their workers participate in a company-sponsored plan, or the companies pay at least one-third of the insurance premium.“Most of our people provide 50 to 80 percent premium contribution, and very few provide less than 50 percent,” said Baker. “Thirty-three percent seems to be abnormally low if you want to keep good people working for you.” Fifty percent, he said, “should be the standard.”
See, someone’s going to pay for that care if the non-insuring employers don’t. And passing the vast costs off to employees — or the state, for that matter — is trying to get blood from a turnip. The new law has created a new set of expectations, and there’s no reason for some businesses to continue to get a competitive advantage for externalizing what should be their own costs.
Great to see even more employers calling for an end to the shell game of sloughing off costs to employees, and engaging in real shared responsibility — which most of them already do! Good on you, Mr. Baker. Keep it up.
Discuss
11 Comments . Leave a comment below.but the system as it's set up in MA is supposed to be three-way responsibility: employers, individuals, and the state. In the short term we're going to see more of the onus put on employers, since they got the best deal of all in the '06 negotiations.
So in response, business can ask for a totally new system, put all of the onus on the state, and be free of the responsibility except for taxation. That'd be perfectly sensible, in my view. Will it come to that? Not for a while, at least.
Health care should not be tied to employment.
However single-payer universal systems have been demonstrated to cost far less, and produce better results, as compared to the US's 'free-market' system.
Can you present any examples of actual private-insurance healthcare system, such as the one you're proposing, that has better outcomes and/or lower cost than single-payer universal systems?
If that's what works best, I'm all for it - but I don't know of any examples that have worked well.
There are examples of multiple-payer systems that work better than the US, but the state has a bigger role in each of them, generally providing a "floor" for health coverage (beyond the amazingly wasteful ER care uninsured folks get here).
May I direct you to Ezra Klein's "Health of Nations" series, which has nifty nutshell-comparisons of several countries' health care systems.
I'll read it closely later tonight.
I'm not in love with the phrase "single payer" because, as you point out, it's not quite accurate. There are other multiple-payer systems - but they all, I believe, consist of far fewer payers than we have in the US.
Having a small number of large entities (or just one huge entity) works in healthcare because it provides leverage and cost savings. Just like being huge helps Wal-Mart to pay (and charge) the lowest price.
In essence, a self insured plan means that the business carries a sort of 'super-deductible' in the $10 - $20 thousand range (these were small companies - big ones often carry millions). They agree to pay the first $10,000 of medical expense, and anything beyond that is paid by a specialty carrier, like Gerber, if the person spends, say, $25,000 in a single year. The premium on each person is usually in the range of dollars per month.
We would issue cards, and doctors would send us bills - we procesed and paid them and guaranteed the doctors a 30 day turn around, no contract or negotiation necessary. We had the company have an escrow account, and billed them for any medical expense paid each month, to keep that excrow account full.
I used to go out, and demonstrate to companies that if every man, woman, child and dog covered on their plan with some HMO ALL maxed out the $10,000, it would STILL cost them less in escrow and premium than they paid annually to the HMO. And if nobody GOT sick, they kept the money! And there was less hassle, prompter payment and better service.
How's that for an alternative?
there must be a hitch somewhere, no?
People kept asking if that were legal. Or if it were part of a bigger company.
Emloyers are so inured to health care being an expensive hassle that they couldn't believe it was legal or efficient.
I had several nice accounts (one of them a factory which makes a substance which Sen. Barrios wants to ban - I say no more) and they were all still perking along nicely when I was offered a more renumerative position.
Check out Mutual of Omaha and other self insureres - it was geting more common when I was in the field, and I bet it's even more common now.
Dirty secret time - did you know that a self insured company does not have to comply with state-mandated coverage/ for instance, we only covered pregnancy for employers who wanted to. That was legal too. Mental health? Maybe, maybe not.
The French pay something like $260 a month (no deductable) for the finest health care in the world. Since that includes the elderly, we can probably assume that the cost for those of working age is well under $260.
What would one of your self-insured plans cost (ballpark) per employee per month?
the real issues is with the smaller employers. Many of these companies do not offer healthcare benefits that they pay into.
on a system broken beyond repair. I have a list of the cost of drugs and the thousands percent markup they are sold for.
The CEO of my new crappy insurance plan pocketed 1.78 billion last year.
Massachusetts appears to be one of the pilot programs states in which all your personal medical records will be in "digital" format. Now I trusted my doctor who had my personal file in his office in paper format. Digital forms go anywhere at anytime to anyone and you of course will never even realize it. Check you XP programs list. How many of these items are "security updates"? The sickest part is that you have to sign 4 pages of bullshit informing you that your records are "secure".
Count the number of drug ads with the number 2 font "disclaimers" in any woman's magazine. That and I've even heard ads on FM radio for medical test subjects. My Ghandiesque answer to all this would be to simply stop going to the doctors but in the pro-active, pre-emptive action, post 911 world they have this shit all figured out. You HAVE to buy medical insurance.
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