The doctor has written a series about the health care industry:

http://www.medscape.com/viewarticle/862243

How can those figures be so far off the mark? If Hillary thinks that Obamacare only needs a little "tweaking" and "improving" to get me to the $3,200 mark, she is delusional. Do these people even have a clue as to what real people are paying for health insurance?

apparently they believe that we all have these Utopian jobs that pay us $250,000+ per year?

Exactly. They have no idea what the real world is like. She also will deliver a $0 effect on the deficit. Out of touch with reality. Why do people even say things like that. It makes them sound naive and incompetent. No that is not a Trump promotion, lol.

You can't get around basic math. The only way to pay for our health care system is for the government to pay for it. That means higher taxes (Trump hails he will lower them, with large reduction for business). Or to more directly raise premiums on the wealthy which is sort of what's happening. The more you make, the more you cover the health care needs of the country.

There's also a huge amount of waste in big business, including government of course, so they could work on improving efficiency to cut costs but change takes forever. They talk about it for ten years before it sinks in and anyone starts to walk the talk. Effecting changes in operations and culture throughout an organization is a bear, not a smooth or swift process.

I know one of the criticisms of Canadian type health care is that we pay 'higher taxes'. But if you folks are paying $14,000, $19,000, $24,000 yearly in healthcare premiums PLUS a deductible.... could that really be much more or less than we Canadians are paying in taxes (with basically zero deductible for most things)?? The numbers you folks are talking about here are unfathomable to me. We may have longer wait times for some tests in some areas, but it sounds like some of you are choosing to NOT have recommended tests because you can't or don't want to pay for them.... I may wait a bit longer, but I'll have my MRI or CT Scan - and never have to worry about paying for it.

But if you folks are paying $14,000, $19,000, $24,000 yearly in healthcare premiums PLUS a deductible...

Where did you hear that? According to the White House, premiums are $75 a month and families are saving over $2,500 a year on health care expenses.

I was aghast browsing plans and playing with the numbers last night. There were premiums for 2 people that were $29,000. I believe it was a platinum plan, needing a lot of services. I forget what income I plunked in. With deductibles, plans could run $40,000 for the year. Lots of outrageously expensive plans but I couldn't look any more at that point. How can any of them think that's viable. It's insulting to the general public's intelligence to even suggest. If they are really trying to sell those plans rather than work an agenda. That said, they are liable for everyone's crazy expensive health care bills. They need a money tree like the rest of us and, unfortunately, that is us.

The income cutoff for receiving the lower cost plans isn't all that much considering what the premiums jump to after that point.

brushstrokes, where did the white house hear that? That's a freakin' laugh! If that were the case, we wouldn't be griping!

Snookums, insulting? YES, yet there it is and people are paying it too!

I get it. I think he is joking about our delusional politicians. Funny!

Open Enrollment has begun! Our records show that you’ve previously enrolled in Marketplace coverage through HealthCare.gov.

Open
Enrollment is the time to come back, look at your options and choose a
2017 plan that meets your needs and budget. More than 8 out of 10 people
who enroll through HealthCare.gov qualify for financial help, and most can find monthly premiums for $75 or less.

To make it easier, we’ve already rolled your information into your 2017 application, and it’s ready for you to review.

They keep wasting money reminding me to come back. I've been on Medicare since September 2016. Our monthly premium before Medicare was $1,798.00

And did your premium say .... drum roll .... $75! Hooray!

Maybe the $2500 of savings is from the negotiated rate they were able to get on the $10,000 of services in our deductibles.

" ... most can find monthly premiums for $75 or less."

Even if that were the case, should you ever have to actually use that insurance for an accident, an MRI, a surgery, etc., you will empty your pockets at that time.

If you are young, you might be able to gamble and get away with a policy like that if you're lucky. But if those are the kinds of policies they are selling to entice young healthy people into the insurance pool, how are those super-cheap premiums supposed to serve to offset the costs for those who actually have to use their insurance? Doesn't ACA model depend on young healthy people offsetting the costs for everyone else?

It's a lot just the age difference, not a policy difference. I have a friend who is 40-ish who has the same plan I do (60-ish), and his premium is way, way, way lower than mine, like less than a third what I pay. If he were in his 20s or 30s it might well be $75, especially if for someone who qualifies for a subsidy.

Robo, I'm glad you are in that good situation. Somebody from Greece on the rose forum got all his tests and a full day in the hospital with cardiac specialists for the price of a rose bush. People can still pay for a specialist even if we have single payer for the basic stuff.

I remember watching all of it on C-SPAN when the congress was having the discussion before the law was passed. The public option or discussions for single payer were pushed aside. This giveaway to pharma and the overcharging health industry has the added insult of illegally forcing people to buy it. I put that treasure up there with citizens united.

The law has some good things but it's unjust and unaffordable for many. I agree, poor people need health care. But should middle class young people go without to pay for them? How is that fair? And then they get fined. This awful law has to go. I was with Bernie on this one. Obama Care is a giveaway to corporations.

The diet of the country is only adding to the problem. Low income people living on cheap unhealthy food is creating a health care mess. We can't afford to keep going this way. Fast food, snacks and sodas should pay the fines, not kids just out of school.

Scrap ACA and give us real healthcare we can afford. I think the penalty part is outrageous and should be unconstitutional. What will be forced on us next? Shame on those justices.

2015 - Bronze HSA $680 per month. No subsidy. 45/55 yrs old
2016 - Bronze HSA $860 per month. No subsidy. 46/56 yrs old
2017 - Bronze HSA $1003 per month. No subsidy. 47/57 yrs old.

This was for a Premera BCBS PPO plan.

We will switch to a Bronze HMO for $771 per month. We only do flu shot and prevention anyway.

Deductibles in the new plan are breathtaking. Over 7k each. 14k max oop.

But with the HSA we can weather a diagnosis or two.

My former employer offers 3 plans for retirees. They range from $17k to $23k (for both of us) depending on the deductible you choose.

34% of Americans get their health care from the government (Medicare/Medicaid/Va).

Somewhat over 50% get it through their employer.

7% of Americans buy their plans in the individual market. 80% of those qualify for a subsidy which is based on income. so those of us who pay the whole thing, we are a minority of a minority of a minority.

'Somewhat over 50% get it through their employer. .... so those of us who pay the whole thing, we are a minority of a minority of a minority.'

Do people save much through employer plans? I believe someone said it was only 10%. There was a time when employers covered most of the premium but I don't believe that's the case today. I don't see how it can be with medical costs being what they are today.

If that's true then that employers no longer pick up the tab, a lot of those employees would be responsible for paying the high rates too. I have heard some complaining from back before ACA. Either way, their company would be picking up the other portion if not them - still paying into the system).

The premiums are what they are outside of Medicare/Medicaid/Subsidies (elderly or those in need).

Does anyone know if government employees are paying these premiums like the rest of us or if our tax dollars pay for their health care?

Huh. Given the big jump last year I've been dreading logging in to see what my premium would be this year, but it actually went down (not the premium, just what I would have to pay). I was surprised.

Most federal employees pay something and get some if their costs subsidized by their employer, just like any other corporate insurance, only in this case the govt is the employer that pays, and it's a special program only available to permanent full-time federal employees.

ETA Here are the details for Congress:

http://www.factcheck.org/2009/08/health-care-for-members-of-congress/

From what I understand, employers only have to offer a plan that covers 60% of expenses (someone correct me if I'm wrong). That could leave employees footing the bill for a whole lot of medical expenses if they have a chronic illness, have an accident, etc. Apparently, if your employer offers one of these "minimal plans" you can't purchase insurance for yourself on the marketplace and receive a subsidy. You are stuck with what your employer offers. I imagine this leaves a whole lot of people with really crappy employer-provided policies that require them to pay a lot out of pocket for treatment. With the subsidized plans, you can choose whatever plan you want as long as you are able and willing to pay the extra premiums for a better plan. You'd get the subsidy either way if you qualify income-wise.

Thanks for the link.

This. This is what I was wondering. So it looks like, yes, taxpayers do pay for a rather large portion of government employee health care expenses, both premiums and medical care.

It seems to me that they should pay into the system just like the rest of the working force in this country. I guess if you are a government employee, you are able to become part of their utopian elite.

This would appear to be a good place to spread some of the cost around instead of dumping everything on us.

Congress et al? Big cushy salaries that can actually afford the premiums, summers off, allowed to work until they are 90 while corporate America throws their experienced workers out at 55 to cut back expenses on the larger salaries they've worked hard to grow over the years.

'On average, the government pays

72 percent of the premiums for its workers, up to a maximum of 75 percent depending on the policy chosen. For example, the popular Blue Cross and Blue Shield standard fee-for-service family plan carries a total premium of $1,327.80 per month, of which the beneficiary pays $430.04. Washington, D.C.-based employees who prefer an HMO option might choose the Kaiser standard family plan. It carries a total premium of $825.15 per month, of which the employee pays only $206.29.

In addition, members of Congress also qualify for some medical benefits that ordinary federal workers do not. They (but not their families) are eligible to receive limited medical services from the Office of the Attending Physician of the U.S. Capitol, after payment of an annual fee ($491 in 2007). But services don’t include surgery, dental care or eyeglasses, and any prescriptions must be filled at the member’s expense.

House and Senate members (but not their families) also are eligible to receive care at military hospitals. For outpatient care, there is no charge at the Washington, D.C., area hospitals (Walter Reed Army Medical Center and National Naval Medical Center). Inpatient care is billed at rates set by the Department of Defense.'

ETA: A $1300 per month family plan from BC!? They get much reduced premiums to begin with!

I really do not think companies are paying anywhere remotely near the $6,000, $8,000, $10,000, $12,000, $15,000, $24,000 per year of these premiums for their employees.

There was a time when companies offered very good comprehensive plans and your contribution was nothing to speak of. No way with these prices.

Exactly.

But apparently, the employer can't require that the employee pay more than 9.69% of their income for insurance premiums in order for it to fall under the definition of "affordable." Otherwise, they have to pay fines to the IRS if even one of their under-covered full-time employees gets their own subsidized plan on the exchange. So, why wouldn't employers cut their losses by offering a bare-bones "minimum policy" to their employees? Since they aren't required to offer the same plan to all employees, they can offer better plans with better coverage and smaller co-pays for management and other talent they want to attract or keep, and give the "grunts" minimum policies.

I did not realize the level of employee had anything to do with a company's plan offerings. I'm surprised that would fly as Obama takes great pride in his effort and that is absurd to say the least to place greater value on the lives of those in management by not even offering the better plans to all.

They are going to pay a lot more for management's policies if they are required to pick up a certain percentage of the premium since premiums rise based on income level in order to cover the cost of everyone.

I just noticed that $1300 premium in the link was for a FAMILY not an individual! So the government is getting much lower rates than we are and passing that on to the rest of us too.

My back hurts!

>I did not realize the level of employee had anything to do with a company's plan offerings.

Oh yes, but that was happening long before Obamacare. Walmart, for instance, was notorious for only offering store employees a very expensive plan that covered almost nothing, but you can be darned sure the folks in the corporate HQ didn't have use that plan. Investors praised it as brilliant, because it meant that almost no floor employees ever actually signed up for insurance, saving the company a big old bunch of money.

That is obscene that a government employee only has to pay $400 a month for a family plan. I would like to know how that is justified while the rest of us are being brought to our knees!

Because we (the taxpayers) are the actual employer of all government employees. So we are just providing them affordable insurance via Obamacare as required by law. :-)

LOL! Touche. Please write the President.

The issue now with Obamacare is that a large employer like Walmart must now offer their low-paid employees a minimal policy (covers 60%). So the employees are stuck with large out of pocket expenses should they need to use it. And, they can't get a better, subsidized plan on the exchanges on their own because their employer is providing an "affordable" policy.

What good are "affordable" premiums if you can't afford to use the insurance?

:-), Snookums!

These loopholes must be closed so everyone gets to play on the same field one way or another, with the plan of their choice not locking you into someone else's idea of what's good enough for you. If your employer offers an inadequate plan, you should still be able to buy from the marketplace, especially if you need the subsidies to survive.

Hopefully Hillary will tweak this one. Although I have no confidence in any of them knowing what or how to fix anything since they live in another world, not the real one.

My former employer has been slowly shifting costs onto the employee. this started in 1999. prior to this time, the company offered everyone the same health plan for no cost.

It has taken 17 years , but now employees are offered a choice of 3 high deductible health care plans.

Every year the company adjusts the employee portion by 1%. The company now pays 72% of the cost and the employee 28%.

The company pays on average approx 15,000 per employee for health benefits, so the employee cost is close to $4500 per year for the lowest deductible family plan. when I was there about 3 years ago we started people at about $28,000 per year.

Our company has a good plan - same for all employees. The only difference between the more highly compensated and the more entry level is that the higher your compensation the higher your contribution which of course makes coverage more affordable to people who are paid less. I like this approach even though I pay more as a result.

Our contribution didn't go up at all last year and we're getting a moderate increase this year. I think the company believes it's health insurance offering is critical to attract and retain talent. Under the current circumstances it will likely retain me another five years beyond what I previously planned.

As a retiree I can get the same plan but last I checked it was about $2000 per month for DH and me - could be more now. I think I currently pay about $600 per month.

jn3344,

Is that $20,000 premium for an individual? I am very surprised either way that companies are willing to pay that much.

So if a company offers a plan, you must take it even if the premium is high?

This sounds like a good case for less government interference in our choices.

The retiree HDHCP? There are 3 of them, and for a couple they range from 17k for the highest deductible to 23k for the lowest deductible . it's optional. I buy our insurance on the exchange as noted above.

If you are talking about the insurance for regular employees? My figure was an average of 15k per employee. This number represents our total expenditure divided by number of employees. The company was large enough to self insure, which the majority of large companies do.

The $4500 was the share I saw employees paying for family plans with the lower deductibles and oop maximums. It's complicated . Usually someone would have a sick spouse o r kid if they selected this plan. otherwise they would choose a high deductible .

I don't know if it is required you take the company plan. I know a number of employees were insured under a spouses plan if that plan better fit their needs. I believe a form needed to be signed but it has been a couple years.

I don't think you can buy an ACA plan on the exchange (or receive a subsidy) if your workplace offers a plan.

Interesting aside - non high risk birth in our area is now up over $20k. How would a young couple be able to start a family? High risk or multiple premature - sky's the limit. Cost in the millions not that unusual.

I guess we will have to accept that instead of being able to bring health insurance to everyone like planned, most of us will have to die.

I wonder if wild inflation will be next.

No we don't have to accept any of this. After the election, get ready to make some noise. They will try and manipulate us with something or other but we just need to keep focusing on the main issues, not the distractions. progress is up to us. As Bernie says, real change starts with the people.

It seems we have already been making noise.

Other than sending us large bills, the only other thing they could do is print off fake money to pay them.

I saw a clip of a protest when Hillary was trying to reform healthcare as First Lady. It was horrid the way they were treating her, rather like a riot. I don't know what they were protesting but it was vile.

Jellytoast really needs to write to the President to present her case. As their employers, we need to cut the benefits we provide to government employees!

They better have a disaster recovery plan in place for when all these insurance companies bow out of the health insurance business.

Our school district is preparing the taxpayers for "The Cadillac Tax" the district will have to pay due to lavish healthcare benefits. We're already paying the highest property tax in Ohio, with 80% to schools, more than a fair share, but the ACA will punish us all, indeed.

The school district could change the benefit to fall under the Cadillac tax, like the vast majority of businesses have done.

"So if a company offers a plan, you must take it even if the premium is high?"

If the premiums fall outside of "affordable" guidelines, you can purchase insurance on your own on the exchange, along with a subsidy if you qualify.

"If your employer offers an inadequate plan, you should still be able to buy from the marketplace, especially if you need the subsidies to survive."

This makes more sense! People need to be able to use their insurance if they need to. Unfortunately, the ACA has determined that 60% coverage is adequate.

The school district could change the benefit to fall under the Cadillac tax, like the vast majority of businesses have done.

If it's that easy, it would have been done. However, contracts negotiated with unions must be renegotiated with unions. And, if it's going to cost members more $, they're not renegotiating.

I don't quite (at all) understand the Cadillac Tax. Is it a tax levied on businesses for providing too good benefits for their employees???

I tried to research the Cadillac tax too and it was so heavily jargoned and drawn out that I could not get basic information so exited.

I know I've said this before but as a Canadian I had to have emergency surgery at the ER earlier this year. Walked in, didn't even have my health card because it was expired, walked out later that night never having signed anything or pay a cent. called the billing clerk at the hospital the next week with my new expiry date and she already had it. No muss no fuss no worries and no cash involved. I pay approximately 50% of my income in taxes and federal contributions off the top plus 15% sales tax on many items and services and I'm happy to do so. In return I have access to equitable and excellent public schools, Canada pension plan and employment insurance. Oh and it takes about 15 minutes to do my tax return.

there are four main ways the Canadian System saves money and promotes efficiency:

1. Prices for services are set by the provincial governments who act as the public insurer. as we discussed for example a single issue office visit at a GP is $30 In my province.

2. A whole huge layer of middleman and complexity is removed because the system is so simple. What might be a whole wing for billing in an American hospital is a room in a Canadian hospital. Not to mention we don't have intermediate insurers taking a cut.

3. Government negotiate the price of prescription drugs.

4. Family doctors are trained to act as gatekeepers and cost managers. For example if they can solve your problem they wont refer you to a specialist. there's no such thing as an MRI on demand In Nova Scotia unless you want to pay $900 for a private one. This is the most frustrating aspect of the system. but it does make sense, essentially if you're demanding a bunch of testing that doesn't fit the gold standard of care you were likely to be denied.

Sounds good to me. People are happy with socialized medicine in Europe too where they aren't bankrupted with medical problems but rather are taken care of.

I guess if you are high income, the 50% tax rate could be a staggering amount to relinquish. Wealthy people I know are not happy with their tax rate as it is or carrying the lower classes. They can afford the health insurance, private or good neighborhood schools, have retirement plans. I have no idea how the cost of all that would compare. I've never heard of employment insurance.

The 50% tax rate would be staggering to everyone if they had to pay it no matter what their income level. A significant number of people in the US pay no income tax.

True, but remember that for a very long time the highest marginal tax was 90% and it didn't even get down below 70% until 1981. And still the economy grew, people didn't stop trying to make money, or any of the things we keep getting threatened with whenever even a modest tax hike on the top incomes is suggested.

We have progressive taxation so if you make under about $11.5k is untaxed, the first $45k is taxed around 25%-30% (federal and provincial), the top income bracket (200k+) is taxed 54%. Plus contributions to Canada pension plan and employment insurance. I believe most Canadians would have tolerance for an even more progressive tax system based on their opinions about wealth redistribution which tend on average to be Pro.

Schools are funded through provincial and not Municipal taxes, and of course Health Care is provided through taxes so this may be one reason why we start paying taxes even at a fairly low income bracket.

From a philosophical point of view, there is extremely little National conversation about welfare cheats. Welfare is way too little to live on in my opinion. There's no such thing as food stamps and people on income assistance can spend their tiny little bit of money however they want. Once again reducing overhead and complexity of administered benefits. Our largest province is toying with the idea of basic income.

From the perspective of being a more radical socialist involved in the education system, I wish that we provided free before and after school care, free or low cost daycare in public schools, and at least two healthy meals and two snacks per day for any kids that want it. And medical screening in schools for things like vision and hearing problems. Taking care of these basic needs would really go a long way toward combating food insecurity for children and improving educational outcomes.

I have to correct what I said earlier! I took a look at my pay stub and only about 30% goes to taxes. The other 20% that's deducted is CPP, EI, pension and health and few other things. I forgot about how I have to pay out to my pension and health-care plan. I hopped up income tax brackets a couple of years ago and I guess I was over estimating my personal wealth, I kind of wish I was in the 50% tax bracket.