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What Percentage of Your Health Care Does Your Company pay? It’s a good Question, right?

Well in the need to fight for a strong public option or single payer (in light of the news that’s apparently coming out of the Washington/ The White House at the moment), we need to be properly prepared for the fight to influence our friends, neighbors, co-workers and politicians.

I actually posed that question to many of my "fancy swanky" liberal/activist, corporate or college educated smarty pants friends and colleagues recently. Surprisingly, only one could answer that question accurately out of 15. Yes; just one out of 15. And the one who answered correctly, ironically was not even college educated (Good "ole" American smarts, huh). Good for her!  But we have a problem (and it’s not just our Congress, President, media and health care companies), it seems. It’s us!

How do we (in America) know what we want, or what we’re fighting for, when we don’t even know what we have (in our own insurance plan)? I illustrated this, through a personal story I heard.

Warning! My post is long (Many highlights to abridge), and I posted this late last night; but hopefully it will be informative and helpful to you.

Now; I understand my quick poll, wasn't scientific. But it did point out a note worthy facet. Most American workers don't have any idea what percentage of their health care premium is paid for by the companies they work for. Subsequently, that means that most American's have little to no idea what their health care actually is, what it's composed of, and its various options,  plans that are available; mind you what it actually cost. So it should be of no surprise that so many American's (Republican's in particular, but also democrats and independents as well) are being mis-informed about health care, as we seemingly lose the cable TV/Political fight every night (and maybe even our once inspirational President to true, comprehensive, affordable health care reform).

The bottom line is, unless you work for a health care company, have shopped or paid for it yourself, you're a small business owner, ran out of money, or dealt with reimbursement or health care contracts on your job, the chances are you wouldn't know. It's a very complicated business, especially in this country (which makes it even more complicated). So why aren’t we armed, prepared and aware in this fight (just like any other good soldier or army prepared for battle)? It’s a good question. And I’m only talking about the basics here (your health care); not even comparative industrialized national Health Care delivery systems (equally important, but its usually never desired to be debated by the wing nuts). That's why we can't be beat out in a discussion regarding our own flawed Health Care systems in-equities. Because, our health care system is too flawed to begin with, to lose the debate.

But instead of giving the proverbial wonky, mumbo-jumbo or screaming liberal discourse (I’ve worked both in the health care-pharmaceutical industry for 10yrs, been a community activist, and been a small business owner, reviewing different health care plans) in light of today’s events/news on the possible deletion of the Public Option by the Democrats. I’d like to give a personal example, which best illustrates what’s wrong with the current employer based system and why we need a strong, affordable Public Option or Single Payer (which I’m not giving up on, for the future or a Christ-like miracle/turnaround in the near future) more than ever. Are you listening President Obama and Congress? Here’s the story/personal account.

When I started working for a major Pharmaceutical-Biotech Company 13 yrs ago as a Salesperson, I was studying in a local hotel close to home (Yes drug companies have so much money they can "hole up" their employees to study locally, in a in a first rate Business hotel, to have peace and quiet) for about 2 months, preceding my in-house corporate training.
While studying, I got to talk to my house keeper periodically (which you would to, if you spent six weeks in the same hotel room studying medical, pharmacological, competitor and managed care info), named Gloria. She was a pleasant, hard-working, black Caribbean immigrant who always seemed reliable for good conversation, friendly greetings and timely, well thought out housekeeping conveniences, in the sometimes stale hotel environment. One day, while taking a study break, she knocked on my door; walked in, greeted me and we started talking about work and life. Ultimately, we strayed on the subject of her health care. And during our conversation, Gloria mentioned to me, that she was paying over $200 a month for her health care premium, on a hotel house keeper’s salary ($18,000-$25,000 a yr at the time). Despite the expensive cost, Gloria valiantly stated how despite the fact she  was struggling to pay her enormous health care premiums, she was still happy to have health care and needed it immensely,  to support her children and family alone (Because her husband was a cab driver, and didn’t have any).  

Now I didn’t ask Gloria what percentage of her company’s premium she was paying. But I'm guessing it was approximately 33%-50% at the time, based off of the $200+ a month premium she was paying). I remember feeling terribly guilty, confused and miffed about this revelation? Why?

Gloria’s situation illustrated one of the proverbial "Black Holes" with the American Employer Based Insurance system and (why we need single payer or a strong, affordable public option), that’s not discussed often enough. Too many American’s are paying too much or are under-insured, and don’t even know it (or know it and can’t do anything about it, cause you’d have to change jobs to a company that may not have better insurance, than your current crappy company anyway)!

We have a bizarre system here. I was, making triple that house keepers salary, while paying only 10% of her premium amount (I paid only $26 a month, courtesy of my fancy fortune 500 pharmaceutical job,  compared to her $200+ a month Hotel job), while I had a better more comprehensive PPO (Physician Provider Organization) plan than she had. And when I stayed within my network; which I always did; I would have no additional out of pocket fees for any major surgeries or procedures (no deductibles, co-pays or bogus limits). And if I would have opted for my companies HMO plan, I would have paid absolutely nothing up front, and on the back end of my HMO plan. I repeat. Isn’t there something wrong with this system? I’m sure rich people in Europe may pay a lesser percentage of their health care cost or taxes than people poorer than them. But I doubt you’d ever see poorer citizens in Europe paying a higher percentage of their health care premium or taxes than the rich, while receiving inferior care, like we do here in America? Our system is totally absurd! And we tolerate it everyday; not knowing any better.

The lesson here is; just because you have health care (whether you pay for it or your employer does) in America; it doesn’t mean it’s affordable, good, comprehensive or convenient. That’s why we have to demand a strong, affordable public option (since we’re not getting single payer it seems); and not just to have the rotten crumbs of compromise.  We want a strong, viable, affordable public option period Congress and Mr. President (more on that later)! Many of you can stop reading here, if you lack the time or patience to read the rest of my post. You’ve gotten the basic premise/gist from my Gloria example. But if you do; I just want to comment on some of the opposition, lies, our debate inadequacies and cost. Enjoy the rest and I apologize for the length

So; as I stated previously, what we have is a lot of people paying too much for their health care who don’t even know it. And I would guess, a lot of them including those dullards protesting against so called "Government", public option, or Single Payer health care, are some of them. But should we be surprised by most of those protesters, lack of intelligence or info? Aren’t those the same folks participating in the Birther crowd/mob movement, anyway?

Remember their premise? A guy (Obama) gets elected for state Senator, United States Senator and President of the United States and this same group of whackos wants us to believe that, between his wily competitors, a voracious media and various/numerous alphabet Government agencies; none of them investigated and discovered that our Sleeper Cell "Kenyan President" wasn’t an actual legal citizen?  Lol. Oh yeah; those guys, right!? Either the protesters are stupid or they think we are?  Well; it’s the Fox TV/Cable TV majority; not the actual 75% of real Americans that actually wants a public option), that are stupid. What do they know about health care (mind you their own)?

The truth is; some employers/employees have good health care plans, some have bad ones, some have terrible and great ones. Some companies also pay a very high percentage of their premium (anything over 90%) and some companies also pay a very low percentage (50% and below). There are no set parameters for our current system. But there are too many people walking around, who think they have good health care, when they don’t!  No one really knows what their getting; till they change jobs, and hopefully get a better one, or when it’s too late (bad news from the insurance companies, when you need it the most, unfortunately). It’s just the wild, wild west out there, totally dependent on your companies choice, benevolence, profits, philosophy and desires; not yours. President Obama was supposed to be our Wyatt Earp and where is he and his Congress-Critter gun? Can you afford a $7-$17,000 health insurance premium (because that’s what’s most of your employers health care plans cost now)? The average premium is actually over $10,000; and American workers are now paying an average of 33%, of their employer premiums, while 75% of American’s that currently have health insurance (remember their dropping fast) receive it from their employers. That’s way too much!  No American should be paying any where near $3300 out of pocket for their health care cost (the supposed national average now for the American worker) in any new or reformed system. Spending two or three thousand dollars a year for the average American worker would not be true reform (unless/even if everything was paid for practically, like Europe and all unfair pre-conditions and the fine print were removed). But I don’t' even want it that way!

So let’s stop saying we want a public option, and make it clear we want an actual Strong, Affordable Public Option! With out that; our health care delivery system will just continue to be un-affordable and morally wrong, if we have a public option that cost people $3300 a yr. That’s not a break; unless you were paying $5000 a yr in percentage of premiums already. But wasn’t that the problem about our system I highlighted in the first place (no fair or reasonable parameters)?  I think everyone should pay the $26 a month I was paying for my comprehensive PPO plan. As a matter of fact; I feel no individual should pay more than $600 a yr, and no family should pay more than $1200 a yr in out of pocket premium cost. It should be just like a first rate employer subsidy (90%). Why do you think young people always reject health care? Well if it cost thousands of dollars, you would to. It doesn't mean they don't want it (they do). It's just not practical and affordable at those cost, unless you’re making $130,000 a yr, when you’re healthy. You see President Obama, what’s the point of having mandates, if their un-affordable. Now; what about those birthers and critics, you ask?

Most workers (and protesters) don't even realize that the $0-$600+ (or what ever your number is) a month they rejected, spend, or have drawn from their pay check, is only a portion of what their health care cost. They know they pay it. But it’s just a number drawn from their check. It's not the actual total (they don’t know)! Actually, the company you work for is just nice enough to pay a percentage of the overall premium (or zealously covets a tax break when their exorbitantly profitable. This creates some rich irony, doesn’t it? Those same town hall protesters that complained about their taxes going up with "Government Health Care" don't realize is, if they lost their job, their health care, or if their company decided to pay only 50% of a $10,000 premium, from 80%; their payments would suddenly be over $400 a month (and of course we’re not including the those older protesters oblivious that they receive dastardly Government run Medicare). Mmmhh; $5000 a year would be way more than any new straw man tax increase that far right-insurance supporters are always fear-mongering/crying about (if they aren’t actually dubiously paying exorbitant fees now, themselves), don’t "ya" think? Lastly; their payments would be over $800 a month if they lost their job or health care completely (as many workers shockingly learn for the first time what their employer health care actually cost, when they have to actually pay for/extend it, through COBRA).

Fortunately the Obama Administration has decided to pay a significant percentage of COBRA payments for a limited amount of time 66% at 3-6months), via the recent $787 billion stimulus. But those same Republican detractors complaining about their taxes going up with "A government take over of health care; still don't realize that it would be the best thing for them and all Americans (especially small business owners). Because if the Government took over health care, their taxes would be cheaper than the actual expensive and rising health care cost premiums that business owners and American's are paying now. Have they seen or paid those prices? No! How come the Democrats and Left-leaning TV pundits don’t beat a skeptical media and Republicans over the head with that repeatedly? Do you think they get that? Even family practice physicians want reform. Why? Because it simplifies paper work, due to the existence of over 1300 insurance companies with various forms and policies, and it also  makes sure they’ll get paid/reimbursed (though some greedy specialist and surgeons fear reform, because they couldn’t bill endlessly for many costly, needless medical/surgical consults and procedures anymore, like they used to). Also; are Americans really that happy with their health care that they can’t even explain?

When, we read these polls that state that 70% of American's are happy with their health care. What these polls are really saying is, that their just happy having health care period (like Gloria the housekeeper). But I would like to know again; how can you be happy with your health care, when American's pay such varying amounts, percentages, have different plans, providers, etc., irregardless of income? There are no set parameters, disclosure or info in our country that the average person can follow, when your employer pays your health care. It’s all hidden from you, unless you really do your research (read your policy, asks your companies benefits provider, or read helpful articles on the best companies to work for, seeking the part about what percentages a particular company pays). Would you like to know that the supposedly good insurance plan you had was inferior to your friends, and he was paying only 20% of your premium cost, though he or she made more money than you?

So when President Obama says "if you like your health care keep it". The insurance companies know the deal, and the knives are out and the fight has begun. Is anyone really that surprised? They are afraid, that if American’s had viable (hopefully affordable) option to choose, with out leaving their job; that those same insurance companies would be out of business (as President Obama surmised in a speech/video clip spoken several years ago). Why are we running from that fact? That’s why so many special interest seem against reform (except actual American citizens; and businesses not affiliated with Health Care companies); and many Democratic politicians, seemed to be forced to do this. We shouldn't run from Government run Single Payer or the Public Option, like our politicians. Those choices are all better than our current system (and we need to better/skillfully articulate that to all parties involved)! Really; how do we expect people to know about the 7 different bills currently residing in Washington, the Canadian or European System, Medicaid, Medicare and the VA Health care system, when we don’t know about our own health care plan?

Once again, "Most of us don’t pick our own Health insurance in America". For 75% of American’s that have insurance, their employer chooses their health insurance (which is why on my first question leading off the article, no one knew what percentage of their premium their employer paid) for them. They only choose from limited options. One of the current systems problems is; no one is going to leave their job to see what better plan that some other company offers either. That’s unrealistic. So how are most American's happy with their health care, if they don't have the option to choice or solicit other plans (when most American's receive their health care through corporations/employers, which offer pre-set, regional carriers, they didn’t necessarily want in first place)? But the right wing/Insurance protectors will still try to convince you its better in the current system.

I saw Dick Armey; argue on Meet The Press Sunday that more insurance will mean more options. We can’t fall for that lie anymore. He’s just preparing the big give away to the Health Care industry! The reality is the complete opposite, actually. It actually doesn’t matter how many insurance companies, your company offers you, because you’re still picking from a group that your company chooses for you (especially if you can’t afford the premiums). At least with the public option; if you don’t like the insurance (or the cost of it), your company offers, you can choose from the public option (and hopefully its various plans). I would also hope, the public option offers a HMO, a PPO, POS, etc., plan and it will be affordable, like good corporate or government employee insurance plans (just like you said about your plan in the In the United States Senate, President Obama). When guys like Dick Army talk about choice, freedom and the "evils" of rationing with "Government Health Care". He's being totally disingenuous! All health care delivery systems have to have a certain level of rationing in order to contain cost. Insurance companies do it everyday and all the time. No system can be left completely unbridled. But how often do we hear Democrats or Republicans bring that up? Secondly; these are the same clowns (the wing nuts), who lambasted Medicaid, Social Security and Managed Care (Brought on to control unlimited doctor billing and Medicaid, Medicare fraud) when they were introduced and when Bill Clinton initiated reform in the nineties.

What is your plan, how much does it cost, and what’s your percentage? I know I keep asking. But those are the basic questions that we should be able to answer before we ever weigh in/comment on the current health care debate, I think? Because if you don’t. It means you don’t know much about your own health care plan; and subsequently health care in general, to be debating prospective wild-eyed birthers, corporate shills and various right wing misfits (of course 75% of American’s want a Public Option, cause they know their paying too much and being denied services from their insurance companies), that the media has allowed to highjack the message. Are we losing the fight?

Ironically, the same guy that had great health insurance before (me, your writer/author); has none right now. It’s just too expensive for someone in my relative good health, to pay those humongous premiums, at the moment. It can be scary sometimes, though, when I think about suffering and injury (Remember, it’s not all about good health and eating alone; you can get into a traffic accident, etc., when you least expect it). I may have to eventually go back to the private work force, and hope that I can get re-hired in my previous "hi fallutin" industry (or a reasonable facsimile, since Pharmaceutical companies, are not always the nicest companies in the world, or maybe start/create another  new business, more profitable business).  Now that’s the other problem with out health care system of course (that you know and have discussed already); many people can’t afford it, or don’t have it! And this will also stunt growth of the economy if entrepreneurs like me, are forced to go back to the work force, just to have more affordable health care, instead of creating new businesses, innovations and opportunities. Are you listening Washington?

This is why we have to pressure President Obama, the media and Congress to fight for an affordable strong, affordable Public or Government Option (and be properly armed). The fight is not over! No matter what concessions Obama or the Democrats make (or the GOP suggest), the Republican’s won’t support it; and when it fails they’ll blame Obama anyway. It's a set up. They want to destroy your credibility in both parties, by making you appear weak in one and un-authentic in the other.

So President Obama, you might as well go down with a good plan, instead of a failed compromise and then lose your base and the many new GOP, Independents and white converts who wouldn’t have normally voted for a "liberal" Democrat or a black President in the first place. All those people voted for change and not more of the same! Do you really think you got almost 70million votes, and beat McCain by almost 12million votes, just because people liked you, your family and because you appear to be a nice guy (which all appears to be true, by the way)? Not exactly; that was a bonus. We voted for you; because we wanted true change! Now it’s time to pull up those boot straps, fight and deliver!

Ultimately; many of us at Kos know the issues and its components. But many of our friends and neighbors don’t! Let’s teach them and clarify/simplify the message. We need a strong, affordable public option (not a blasted Coop) that covers all Americans. If we don’t get it; then this will just be a giant, near trillion dollar give a way to the Managed care business/industry. But it won’t help American’s or American Corporations pay their bill, heal their sick, lower their deductibles, re-direct cost and re-invest in better a workforce, technology and American future, when so many dollars are being spent/wasted on health care. Hey; single payer or a Strong Public Option is something not to back down from after all! Let’s all make it happen!
Now! Can I get my President from the November election back?

Originally posted to Excelscior1 on Tue Aug 18, 2009 at 12:33 PM PDT.

Poll

Will we get a strong, affordable public option passed in Congress this year?

16%6 votes
43%16 votes
5%2 votes
13%5 votes
13%5 votes
8%3 votes

| 37 votes | Vote | Results

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Comment Preferences

    •  Have you considered large companies that (0+ / 0-)

      "self insure"?  I have NO idea how that works, though I suspect the company pays a smaller % based the theory that people who can show up to work 40 hours a week are somewhat healthier than uninsured, unemployed people.

      From what I understand (they don't explain these things at work).  They then have BC/BS or some other health insurer administer the plan (for a fee, of course.)

      May be worth exploring because for employed people the public option might not be cost efficient.  For self employed, people with 'pre-existing conditions' or the unemployed who've run out of their Cobra eligibility, the public option might be the only option.

      The land was ours before we were the land's...Robert Frost, The Gift Outright

      by HylasBrook on Tue Aug 18, 2009 at 01:30:52 PM PDT

      [ Parent ]

    •  Not neccessarily. I posted late last night (0+ / 0-)

      And the people who read it, wanted to "rec it up", so I thought I'd clean it up a little (sadly, didn't have time to shorten it though), and post. Lol.

      I could of changed the title; but didn't want to.

      I know everyone is mad about what's going on in the White House, but I thought I'd go in another direction, since I can't be a news hawk at the moment (as I have been in the past). But thanks for asking.

  •  I pay an incredibly small % (0+ / 0-)

    My employer contributes something like 96% of my premium.

    They've already announced that the employee contribution will increase next year, however.  Instead of $26 per month, I'll have to put in $41.  That will raise my contribution to almost 6% of the premium.

    Ain't working for a state government entity grand?

    grok the "edku" -- edscan's "revelation", 21 January 2009

    by N in Seattle on Tue Aug 18, 2009 at 12:49:03 PM PDT

    •  I hear ya! And I'm glad you know! Lol. (1+ / 0-)
      Recommended by:
      N in Seattle
    •  Hubby and I pay 100% (0+ / 0-)

      Employer simply provides us an opportunity to access group health care.

      Costs about $430 a month for both of us.

      I want a public option!

      My dogs think triciawyse is smart and pretty.

      by martydd on Tue Aug 18, 2009 at 01:01:59 PM PDT

      [ Parent ]

    •  Yes, but ... (0+ / 0-)

      The fact is that we all pay 100% of our insurance premiums under the employer-based system.    I also am a state employee.  Ohio pays $9600.  I pay $500.  Except the $9600 is actually compensation that is "given" to us in lieu of salary.  Over a period of decades we have negotiated it away in exchange for lower salary increases.  

      To really get the point of how un-free your insurance is, you need to notice how much you pay if both you and your spouse work for the state (or other employer who "gives" "free" insurance).  The state of Ohio pays $19,200 per year to insure my wife and me.  No one seems to notice or calculate this huge overpayment for those of us who have "free" insurance.

      If my wife and I had a choice of a public option, we could purchase ONE (rather than two) policies for somewhere around $10,000 a year and increase our salary by almost $10,000/yr.

      •  well, yes ... but (0+ / 0-)

        This is true of all employer-based insurance.  

        The origin, as I assume you know, was in WWII, when employers weren't allowed to increase wages and thus added employee benefits instead.  At that time, it was a win-win, in that employers could deduct both wages and benefits from their taxable income, while employees did not pay income tax on the value of their benefits.

        It's quite true that the true price of health insurance is often hidden, or at least made difficult to determine, by most employers.  Governments and unionized businesses tend to make that information more easily known than other types of employers.

        grok the "edku" -- edscan's "revelation", 21 January 2009

        by N in Seattle on Tue Aug 18, 2009 at 02:01:08 PM PDT

        [ Parent ]

        •  Yes, I do know (0+ / 0-)

          about the origins of the employer-based system.  My point is that over time it has become a completely irrational system, leaving employees of small businesses largely uninsured and requiring employees of large businesses and government to pay (in the case of a working couple) twice as much as is reasonable.  

  •  Affordable..like beauty is in the eye of the (0+ / 0-)

    beholder. We need a % of income cap. Your idea of affordable is way too low. With insurance averaging 7000 per person, who is going to pay the rest?

    I think it ought to be capped at 10% of one's income.

    •  Hey Steve. That's my point. (0+ / 0-)

      I'm glad you gave your comments on affordable.

      Because every company I ever worked for, paid more than 95% of my premiums. That's what I'm used to, and I wouldn't settle for anything less. Why shouldn't the government subsidize our health care (or as the GOP; subsidize more expensive health care insurance).

      That's why single payer, would of been such a boon. It would of made health care so cheap, it would of put the insurance companies out of business. That's what they didn't want. And because of this, they don't want a cheap, strong Pub option either.

  •  I pay 100%. (0+ / 0-)

    I should clarify; I'm the employer and I pay 100%.

  •  Companies don't publicize the actual premium (0+ / 0-)

    I don't know why they don't but they don't. They only list the premium co-pay.

    When I administered benefits before I became a manager I got in a little trouble for telling people at an employee meeting what the actual premium was compared to their premium co-pay. People were very surprised at the actual premium.

    People also don't understand that in many companies, it is the company that is actually paying the medical bills. Those companies are self-insured but contract with an insurer for administrative services (enrollments, claims processing) and to remain at arm's length from coverage decisions.

  •  About 100% Over $1150 a Year (0+ / 0-)

    But of course that number varies year to year.

    Senator Inhofe? If you're still wondering? He's on my side.

    by TooFolkGR on Tue Aug 18, 2009 at 01:36:34 PM PDT

  •  Since the premium is being paid for YOUR work (1+ / 0-)
    Recommended by:
    wblynch

    YOU are paying the entire premium.  Employers are not charities.

  •  I'd like to find insurance (0+ / 0-)

    that meets these criteria: 1) affordable premiums, given that we make $1200 a month; 2) reasonable deductible, given our income; 3) widely accepted in our area; 4)will accept us given the multiple pre-existing conditions we have; 5)will actually pay out if something happens without jerking us around.

    Sounds like Medicare, only we're just 37 and 47. So we're fucked for a few more years.

  •  I'm a Fed (0+ / 0-)

    According to my quick check of the OPM website, they pay up to 75% of premiums, depending on the plan; for my plan they pay a shade under 70%. That's for health insurance. Of my dental and vision premiums, they pay zero but the rates are negotated based on a fairly hefty client base and they aren't, in and of themselves, all that expensive (for example my vision care plan costs me $5 every two weeks; dental is $19 every two weeks. And believe me, I use those benefits).

    I'm probably what you would term a moderately high-information consumer when it comes to my benefits though in truth I don't do detailed research on every single offering each open season. I will go with a plan that has good coverage for prescriptions because I'm HIV-positive and my meds are very costly. So $65 for a three-month supply of what would normally cost over $1,000 is a pretty good deal. I also go for a plan that's likely to cover my standard medical needs and one that most or all of my doctors participate in.

    Intrinsically I'm in favor of a single-payer approach. As a backup, I think it mightn't be a bad thing to (as some have suggested) open up the federal employee programs to everyone, though this would end up costing non-employees far more than employees pay and for that reason this might not turn out to be such a great option. But it would certainly be an improvement over what obtains for most people now. Cutting out the profit motive and the administrative cost of having all those folks working hard to deny claims based on pre-existing conditions and whatnot seems like the most pressing thing to accomplish.

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