Healthcare and Insurance

[Koolblue13]

Good articles. They explained a lot to me.

Offering "free care" led to predictable results. Because Congress placed no restrictions on benefits and removed all sense of cost-consciousness, health-care use and medical costs skyrocketed. Congressional testimony reveals that between 1965 and 1971, physician fees increased 7 percent and hospital charges jumped 13 percent, while the Consumer Price Index rose only 5.3 percent. The nation's health-care bill, which was only $39 billion in 1965, increased to $75 billion in 1971.1 Patients had found the fount of unlimited care, and doctors and hospitals had discovered a pot of gold.

[JMS]

I have a question for anybody willing to answer.

In this country, when did healthcare become so expensive that a person had to have insurance in order to be able to pay for a doctor's treatment?

I know it didn't used to be this way at some point. Is it a result of greed on the part of doctors?

Short answer..

It's not the doctors it's the corporations...

Longer answer...

Higher prices came with the industrial age and the beginning of modern medicine. Back when we were a rural economy you could pay doctors with eggs and barter. You needed an operation, a bone set, or a pill you went to one man... That man was a communit resource and a fixture of the community. He couldn't live in a town of fifty people cause he needed a large enough population to support himself. Thus the doctor in your town became a symbol of permanence, growth and prosperity.

In the industrial revolution populations became much more concentrated and medicine came to be practiced in large inpersonal hospitals. Not only could these concentrated poulations afford multiple doctors they coudl afford specialists and complex equipment which could better diagnose cases.

A more comprehensive approach to Medicine became economically viable because of the concentration of population and new wealth of the communities. This started prices going up, but it also lead to vast improvements to care.

Modern Medicine started getting un weildly expensive in the 1960's. since the 60's we have had a series of reforms to try to hold down costs every decade. None of them have worked, some of them have actually increased the problem..

The most important "reform" was Ronald Reagan's in the early 1980's. Reagan believed in business. He thought if big business was introduced into healthcare ( mostly run by non profits and doctors, because of President Johnson's reforms up in the 60's )... medicine would be more efficient and hold costs down beter than the liberal touchie fealy spare no expense non profits and doctors. Big problem here!!. The non profits stayed in business because of special legal abilities granted to them in order to spread out the charges to the community. You walk into a hospital you don't pay for the services rendered, you pay basically what they think you can afford. You might only get an aspirin but you are paying for the diyalisis machine, the MRI, and the new trama unit. The costs of the entire hospital are spread across the every person who walks in the door regardless of services recieved!!

These powers put in the hands of big business proved to be disasterous. You see Reagan was wrong. American business isn't about efficiency, American business is about profits. If they can make profit by making things run more efficiently they'll do that. If they can make profit by simple charging more and denying services they'll do that too. Whichever is easiest!!...

Now all of the sudden healthcare was about profit. And aquireing profit was all about how much a company could afford to spend. This is because every outlay of cash could be passed back to the populous regardless of the utility of the expense. Any expense could be justified as a potential profit center.

And that's pretty much how we got here. Now it turns out after three decades of healthcare costs raising double the rate of inflation, that the federal healthcare systems of medicaid and medicare actually have significantly less overhead than the private business ones do.. On a scal of 6x's. So now the argument has changed. Today it's Business may not be more efficient, but it's more reliable...

Either way healthcare costs are strangling the economy and will reach 20% of the GDP in Obama's second term in office. An incredible sum. We could knock 50% of the cost out overnight, and cover every person in the country while doing it; if we just removed the corporate profit eliment from the mix.

[SnyderShrugged]

I've read that the root cause of the increase in cost for care was the HMO act of 1973. This act basically required employers with 25 or more employees to offer federally certified HMO options alongside traditional indemnity insurance.

This was the beginning of "insurance as a necessity" over the previous tact of only using it for catistrophic emergencies. Prior to this, most people paid cash for their mundane procedures and well visits. there was a shared need for physicians, providers, and patients to work together to keep costs low. Once the crutch became mandated, that all went away.

[JMS]

I've read that the root cause of the increase in cost for care was the HMO act of 1973. This act basically required employers with 25 or more employees to offer federally certified HMO options alongside traditional indemnity insurance.

somebody should tell that to Walmart. They are the largest employer in the country and they don't offer most of their employee's jack with regards to insurance. In fact they hand out medicare applications with their job applications to pass the cost of healthcare to the taxpayers.

[SnyderShrugged]

somebody should tell that to Walmart. They are the largest employer in the country and they don't offer most of their employee's jack with regards to insurance. In fact they hand out medicare applications with their job applications to pass the cost of healthcare to the taxpayers.

Thats probably because the majority of their employees are part time.

[81artmonk]

The simple answer is that becoming a doctor didn't used to cast you a lifetimes of savings and almost a lifetime of paying that education off.

Doctors can no longer afford to work for food or merchandise.

The other answer is, where money can be made people will come in and make it. Thus insurance companies saw room to make profit.

[JMS]

Thats probably because the majority of their employees are part time.

Yeah why have 30,000 full time employees working 40 hours a week when you can have 33,000 pat time employees working 35 hours a week and not give them healthcare.

I know Fed-ex uses that loop hole in Memphis.. their the largest employer in Memphis. Wasn't sure if Walmart used that dodge.

[RocketCitySkins]

somebody should tell that to Walmart. They are the largest employer in the country and they don't offer most of their employee's jack with regards to insurance. In fact they hand out medicare applications with their job applications to pass the cost of healthcare to the taxpayers.

And you got your facts where?

I work for Walmart. I pay $48 every two weeks for insurance. This is $350 deductible after Walmart pays for the first $250 "wellness insurance". After I pay the deductible, I pay 80% up to a maximum of $5000 a year. After that I pay zero. This coming year there are many more plan options. I can pay lower premiums for a higher deductible or I can pay a higher premium for a higher initial wellness amount and a lower total out of pocket.

And I have worked for Walmart for 11 years and I have never seen a Medicare application. In fact we don't see a paper application of any kind. It's all electronic. Walmart doesn't have paper job applications. They have computer terminals setup throughout the store for job applicants.

Being single, I can't say what the same coverage for a family would be. I think it's around $135 every two weeks.

[DCSaints_fan]

I can't find it, but apparently there was a study that said that 80% of most people's medical costs are incurred int he last few months of their life. I think modern treatment w/r/t cancer and other degenerative diseases might have been the tipping point. Way back when, people were allowed to just "die" because not much could be done. Especially with very old individuals, we extend their life by a few months or years, but rack up tremendous bills in the process.

[RocketCitySkins]

Yeah why have 30,000 full time employees working 40 hours a week when you can have 33,000 pat time employees working 35 hours a week and not give them healthcare.

I know Fed-ex uses that loop hole in Memphis.. their the largest employer in Memphis. Wasn't sure if Walmart used that dodge.

Because I have been with Walmart over 11 years, I only have to work 28 hours a week to be eligible for insurance. Anyone who was hired in the last couple of years has to average 32 hours for insurance.

It is becoming increasingly harder to get a fulltime job at Walmart. I see the "possible new associate" scheduling and there will be only 2 or 3 fulltime openings to 25 parttime one.

[Koolblue13]

somebody should tell that to Walmart. They are the largest employer in the country and they don't offer most of their employee's jack with regards to insurance. In fact they hand out medicare applications with their job applications to pass the cost of healthcare to the taxpayers.

They can do a lot of things like that.

They must have had a very smart young Lawyer who had some big connections to be able to grow like they have.

[JMS]

And you got your facts where?

How about PBS?

http://www.pbs.org/now/transcript/transcript247_full.html

Not only were employees of Wal-Mart nationwide routinely directed to apply for Medicare, they were also regularly referred to government programs such as food stamps and Section 8 (subsidized) housing.

How about the NY Times?

Wal-Mart Memo Suggests Ways to Cut Employee Benefit Costs

An internal memo sent to Wal-Mart's board of directors proposes numerous ways to hold down spending on health care and other benefits while seeking to minimize damage to the retailer's reputation. Among the recommendations are hiring more part-time workers and discouraging unhealthy people from working at Wal-Mart.

Text of Internal Wal-Mart Memo

In the memorandum, M. Susan Chambers, Wal-Mart's executive vice president for benefits, also recommends reducing 401(k) contributions and wooing younger, and presumably healthier, workers by offering education benefits. The memo voices concern that workers with seven years' seniority earn more than workers with one year's seniority, but are no more productive.

To discourage unhealthy job applicants, Ms. Chambers suggests that Wal-Mart arrange for "all jobs to include some physical activity (e.g., all cashiers do some cart-gathering)."

http://www.nytimes.com/2005/10/26/business/26walmart.ready.html

Back in the spring, amid relentless criticism that Wal-Mart Stores was failing to provide affordable health care to employees, executives at the company decided to take a detailed look at its benefits.

Wal-Mart knew its health costs were spiraling upward out of control, said M. Susan Chambers, the senior executive who led the initiative, but it was surprised to discover that its critics had a point. Almost half of the children of employees were covered only by government social-service programs like Medicaid or had no insurance at all.

http://www.nytimes.com/2005/10/29/business/businessspecial2/29health.html

Walmart doesn't give healthcare to the majority of it's employees and it is the largest employer in the country

I work for Walmart. I pay $48 every two weeks for insurance. This is $350 deductible after Walmart pays for the first $250 "wellness insurance". After I pay the deductible, I pay 80% up to a maximum of $5000 a year. After that I pay zero. This coming year there are many more plan options. I can pay lower premiums for a higher deductible or I can pay a higher premium for a higher initial wellness amount and a lower total out of pocket.

Ah the impiracle evidence testimonial. Are you a manager or a worker? Do the majority of the workers at your store have coverage?

And I have worked for Walmart for 11 years and I have never seen a Medicare application. In fact we don't see a paper application of any kind. It's all electronic. Walmart doesn't have paper job applications. They have computer terminals setup throughout the store for job applicants.

States are Battleing against WalMart.

In the national debate over what to do about the growing number of working people with little or no health insurance, no other company may be taking more heat than the country's largest employer, Wal-Mart Stores.

http://query.nytimes.com/gst/fullpage.html?res=9507E5DB1E3DF932A35752C1A9629C8B63&sec=&spon=&pagewanted=all

[JMS]

Because I have been with Walmart over 11 years, I only have to work 28 hours a week to be eligible for insurance. Anyone who was hired in the last couple of years has to average 32 hours for insurance.

It is becoming increasingly harder to get a fulltime job at Walmart. I see the "possible new associate" scheduling and there will be only 2 or 3 fulltime openings to 25 parttime one.

So do the part time employees get healthcare who don't have 11 years in, knowing that Walmart turns over their workforce by about half every year?

http://www.pbs.org/wgbh/pages/frontline/shows/walmart/secrets/stats.html

Are their other benifits to walmart in only employing part time workers other than savings on health insurance?

[Special K]

ZGuy - Our health care system is set up on a profit basis, whereas systems in other parts of the world are not. Between exponentially increasing technological advances and an increasingly monopolistic health care insurance industry, our health care costs far exceed our GDP and are the fastest rising costs in the world. That's why any solution to this health care crisis must have addressing health care costs as their first priority.

I don't know the answer to this but I have a question that is sort of related. Why is it if an uninsured person goes to the doctor and the bill is $200, they are expected to pay the entire $200. But if I go to the doctor with insurance and they file a claim my insurance statement will show the bill for $200 and then a much lower amount that is considered acceptable by the insurance company or that the doctor has agreed to take of $120. Where is the other $80 dollars that the uninsured person has to pay that I don't. Maybe wrote off on income taxes?

Because insurance companies have a contractual agreement with hospitals and physicians as to how much they can charge for a certain procedure and how much they will be reimbursed.

And no, physicians cannot "write off" those differences in income practices. That sure would be nice though.

[SnyderShrugged]

How about PBS?

How about the NY Times?

Walmart doesn't give healthcare to the majority of it's employees and it is the largest employer in the country

Ah the impiracle evidence testimonial. Are you a manager or a worker? Do the majority of the workers at your store have coverage?

But nevermind the actual testimonial from an 11 yr walmart employee. Dont let those nasty fact thingies get in the way of a good anti-walmart rant, right?

[SnyderShrugged]

So do the part time employees get healthcare? Are their other benifits to walmart in only employing part time workers other than health insurance?

It sure looks like PT's get it (thus his 28 hr comment)

[JMS]

But nevermind the actual testimonial from an 11 yr walmart employee. Dont let those nasty fact thingies get in the way of a good anti-walmart rant, right?

Empirical evidence is not the most convincing evidence. Wallmart has more than a thousand stores and over one million employees. How many stores have you worked at? How many employees do you know?

Are you a manager or a worker?

Fact is NY Times, PBS, and Wall Stree Journal are pretty good sources to base ones opinion on and I only had to look for a few minutes to find them. How much you want to bet I could find more articles if I continued to look?

[TheKurp]

It's pretty simple actually.

People over the last 30 years have gotten fatter. Fat people are sick more often and have a higher mortality rate, thus raising the costs of medical care.

http://content.healthaffairs.org/cgi/content/full/hlthaff.w4.480/DC1

Concluding Comments

Both the rising prevalence of obesity and higher relative per capita spending among obese Americans accounted for 27 percent of the growth in real per capita spending between 1987 and 2001. During this period, the prevalence of obesity increased by 10.3 percentage points—to nearly 24 percent of the adult population. The rise in obesity contributed to large spending increases for the three medical conditions examined (diabetes, hyperlipidemia, and heart disease). Our estimates are valid only for the civilian, noninstitutionalized population. To the extent that changes in obesity prevalence and the impact of obesity on spending differ in the institutionalized population, our estimates may over- or understate the impact of obesity on cost growth nationally.

The obesity-attributable cost estimate of 27 percent incorporates two trends: the increase in obesity prevalence and the increase in spending on the obese relative to those in the normal-weight category. This latter component captures changes in medical technology that provide physicians better options for treating obese patients and the diseases common among them.19 Thus, our obesity-attributable spending growth estimate is inclusive, rather than exclusive, of changes in medical technology and simply represents a different approach to characterizing spending growth.

Obesity has a sizable impact on the U.S. health care system. It is associated with higher rates of mortality, even among those without other risk factors such as smoking or a previous medical condition. Similar to previous estimates, our results indicate that costs incurred by the obese were 37 percent higher than costs for those with normal weight in 2001.20 Moreover, growth in obesity and spending on obese people accounted for 27 percent of the growth in inflation-adjusted per capita health care spending between 1987 and 2001. To date, there is no evidence that the rise in the share of the U.S. population with BMI greater than 30.00 is abating. These results suggest that future cost containment efforts need to attack the rising prevalence and costs of obesity head on. This will require a focus on developing effective interventions to promote weight loss among obese people.

[SnyderShrugged]

Empirical evidence is not the most convincing evidence. Wallmart has more than a thousand stores and over one million employees. How many stores have you worked at? How many employees do you know?

Are you a manager or a worker?

Fact is NY Times, PBS, and Wall Stree Journal are pretty good sources to base ones opinion on and I only had to look for a few minutes to find them. How much you want to bet I could find more articles if I continued to look?

They arent nearly as good a "source" as a person who has worked there 11 years.:2cents:

[JMS]

It sure looks like PT's get it (thus his 28 hr comment)

Wallmart turns over about half of it's workforce every year. And according to their own company memo's target older employees with replacement to save on potential healthcare costs.

• 1.2 million: The number of Wal-Mart associates in the U.S. Any full- or part-time Wal-Mart employee, up to and including the CEO, is considered an "associate," in Wal-Mart parlance. Internationally, Wal-Mart employs an additional 330,000 associates.
  
• 600,000: The number of new employees Wal-Mart hires each year.
  

http://www.pbs.org/wgbh/pages/frontline/shows/walmart/secrets/stats.html

An 11 year vet might be a manager, who you would expect to get healthcare.

That doesn't refute the NY Times, PBS or Wall Stree Journal statement that most of Wallmart employees are encouranged to join federal aid programs like medicare, foodstamps and section 8 ( low income housing assistance )... This behavior from the largest employer in the nation.

Doesn't refute any of the statements I've made.

I would like to hear you refute the statements though...

• Do you think most of walmart employees get healthcare?
  
• Are you a manager?
  
• Do most of the people at the store you work at recieve benifits?
  

[JMS]

They arent nearly as good a "source" as a person who has worked there 11 years.:2cents:

Actually they are, and I've explained why they are. Your observations only reflect one store, while walmart is more than 1000 stores..

But please answer my questions because so far you haven't really refuted any of the statements I've quoted from these reputable sources.

• Do you think most of walmart employees get healthcare?
  
• Are you a manager?
  
• Is their a difference between managers and clerks with regards to recieving healthcare?
  
• Do most of the people at the store you work at recieve benifits?
  

I'll be interested in reading your answers thanks.

[Elessar78]

don't know how much I trust a video produced by an insurance company.

[SnyderShrugged]

Actually they are, and I've explained why they are. Your observations only reflect one store, while walmart is more than 1000 stores..

But please answer my questions because so far you haven't really refuted any of the statements I've quoted from these reputable sources.

• Do you think most of walmart employees get healthcare?
  
• Are you a manager?
  
• Is their a difference between managers and clerks with regards to recieving healthcare?
  
• Do most of the people at the store you work at recieve benifits?
  

I'll be interested in reading your answers thanks.

1. yes, I believe healthcare is available for employees who choose to take it and work at least 28hrs a week (based on the ost from the 11 yr employee who said he works part time , thus most likely not a manager)

2. I am not a walmart employee, but I did stay at a Holiday inn express last night;)

3. I do not know if there is a difference in options between the managers and clerks (since I have never worked there), but I once upon a time did work in a large retail store chain and everyone was elligible for the same health insurance regardless of the level. No idea if its the same for walmart folks. Best to simply ask the guy that works there for that info

4. I dont work at walmart so I cannot answer that question with any degree of accuracy.

[SnyderShrugged]

JMS, from the walmart website, under "associate benefits"

Medical Benefits

Over the years, we’ve improved our health benefits to provide our associates with a stronger, more affordable benefit package that gives them more options and helps them live healthier lives.

More affordable

Today, every associate who works in the United States can become eligible for individual health coverage costing as little as $5 per month in some areas and no more than $8 per month nationwide. As soon as an associate becomes eligible for benefits, their children are eligible too.

More choices

Our associates have more than 50 ways to customize their health coverage options. They can select from a menu of deductibles, health care coverage options, and health credits and premiums. They can create plans to meet a variety of health care needs.

Fewer limits

We want our associates and their families to have the peace of mind that their healthcare needs will be met, now and in the future. So, our health coverage includes no lifetime maximums on most health care expenses after one year of continuous coverage.

Working towards 100 percent

More than 92 percent of our associates have health insurance today — either through us or through other coverage. That’s a number we’re proud of, but also one we’re working to increase every day.

http://walmartstores.com/HealthWellness/7626.aspx

looks like some of your "sources" may be a bit faulty

[SnyderShrugged]

I see what must have happened JMS, You must have been using slightly dated hit pieces. It looks like their overhaul was implemented Jan 1, 2007.

http://www.iht.com/articles/2007/09/19/business/walmart.php?page=1

Your concerns for the Wal-Mart employees have officially been put to rest