Health Insurance Degeneration Continues

[vern_humphrey]

Let’s see the difference between an MSA and a 401K:

1. You put money into both on a pre-tax basis.
2. The earnings on both are not taxed when they accrue.
3. The main difference is that with a MSA you can take the money out tax free, with a 401k the money is subject to tax. However, many people over 65 pay no income tax, so for them, there is no significant difference between the two. Many who do pay taxes, pay very little. Certainly it would be better to pay a 15% tax rate and negotiate 25% of the cost of your medical bill.

And you can have a MSA and a 401k.

But the big differences are:

• You pay on the spot, eliminating paperwork
• You pay on the spot, eliminating the cost of slow pay.
• You keep the money you don’t spend, giving you an incentive to bargain for health care.
• You keep the money you don’t spend, giving you an incentive not to overconsume

 

[stinkcat_14]

And you can have a MSA and a 401k.

But the big differences are:

• You pay on the spot, eliminating paperwork
• You pay on the spot, eliminating the cost of slow pay.
• You keep the money you don’t spend, giving you an incentive to bargain for health care.
• You keep the money you don’t spend, giving you an incentive not to overconsume

Why can’t these be done with a 401k? The worst case scenario is you whip out your credit card, make your medical payment and request a check from your 401k.

 

[vern_humphrey]

Why can’t these be done with a 401k? The worst case scenario is you whip out your credit card, make your medical payment and request a check from your 401k.

Because:

• You can’t do that from a 401k without paying a pentalty.
• You don’t have a full-blown program where millions of people are bargaining for health insurance.
• There is no system where those who cannot save enough can get assitance with their MSAs

 

[LCMS_No_More]

By tomorrow?

Awe, look. How cute. A snarky, immature response.

You, on the other hand are for the “government” to magically solve all problems through some magical “free health care” scheme.

Snarky responses are not responses.

I’m not for a “free health care” scheme. I believe that we should pay for our health care. Second, I don’t view the government as some entity that is “out there” scheming to do us wrong at the first opportunity. I view government as the agent that acts on behalf of the people…a servant government…kinda like the Founders intended. Finally, I believe that with a 2-3% overhead rate, Medicare (which is accountable to the people) can do it cheaper. Like I said, private “competition” has resulted in overhead rates up to 35% for profit and massive CEO salaries and NO accountability.

 

[vern_humphrey]

Awe, look. How cute. A snarky, immature response.

It takes one to know one.

Snarky responses are not responses.

By George, I think your’e learning!

I’m not for a “free health care” scheme. I believe that we should pay for our health care. Second, I don’t view the government as some entity that is “out there” scheming to do us wrong at the first opportunity. I view government as the agent that acts on behalf of the people…a servant government…kinda like the Founders intended. Finally, I believe that with a 2-3% overhead rate, Medicare (which is accountable to the people) can do it cheaper. Like I said, private “competition” has resulted in overhead rates up to 35% for profit and massive CEO salaries and NO accountability.

Riiiiight. You want a system that will have all the efficiency of the Post Office and all the compassion of the IRS.

Tell me, how will you get around the monopsony problem?

 

[ribozyme]

It takes one to know one.

By George, I think your’e learning!

Riiiiight. You want a system that will have all the efficiency of the Post Office and all the compassion of the IRS.

Tell me, how will you get around the monopsony problem?

Gee… what’s wrong with a government monopsony? You support corporate monopsony’s such as Wal-Mart.

 

[vern_humphrey]

Gee… what’s wrong with a government monopsony?

It’s a monopsony, of course!!

Look at what happened when we created a government monopsony to control the purchase and distribution of vaccines – most US vaccine makers got out of the business, leaving us dependent on foreign suppliers. And when one of those foreign suppliers contaminated their vaccine, we had no alternate source.

You support corporate monopsony’s such as Wal-Mart.

They’re also the Anti-Christ, the Keeper of Xibalba, and the Worm, Uroboros.

 

[LCMS_No_More]

It takes one to know one.

By George, I think your’e learning!

Riiiiight. You want a system that will have all the efficiency of the Post Office and all the compassion of the IRS.

Nice talking point. Where did you get it? Hannity? Limbaugh? Savage? How about something with some substance. Medicare isn’t in the business of making money, it’s in the business of paying for medical services…period.

Tell me, how will you get around the monopsony problem?

Considering that almost everything is a monopsony of one sort or another (especially when you speak of any large organization – even Disney, my favorite corporation), it’s not necessarily a problem.

Why haven’t you answered my question about what the money placed in your magical medical savings accounts will be doing while it waits to be spent? Is it true that you’d want to have it invested in the stock market and be subject to the whims of funds managers who charge hefty fees, whether or not they make you money? Perhaps you have some vested interest in this coming about?

 

[daeve]

When my wife had knee replacement surgery, a very pleasant lady came by and chatted with us. She later submitted an enormous bill.

So we tried to challenge it. It turned out there was a “service” which handled billing for hundreds of doctors, and they had no idea how we could contact her or challenge the bill.

We simply sent the “service” a letter saying we challenged the bill and demanded further documentation of the “treatment” provided, together with a copy of a signed document where either of us authorized such “treatment.”

That was two years ago, and we haven’t heard from them since.

Vern, if you haven’t taken a look at your credit report, you should. It could be living there as a collection or even judgement and you might not know about it. Maybe not, but find out before you need credit.

 

[daeve]

We had our 3rd baby in July and I’m just now figuring out the last of the paperwork. I’ve got a pretty good PPO insurance plan at work. We followed the rules, picked an OBGYN on the PPO list, made sure the hospital was on the preferred list and asked the doctor to coordinate benefits prior to being admitted. So far, so good.

Trouble comes at the hospital. All the specialists aren’t hospital employees, they are outside practices with hospital contracts. Go have a baby and you will see the OBGYN, an anaesthesiologist, a pediatrician and possibly a contract doctor intern. You have no say on who the others will be, but if they happen to be NOT in your PPO network, you get stuck paying the out-of-network fees (which are large!).

I used to think a PPO was better than an HMO. Not anymore. The in-network hospital used to require their contract doctors to honor the PPO committments the hospital had made. Not anymore.

Somebody had better get busy with some reform ideas with real teeth or the socialists are going to be getting more and more traction on this issue all the time!

I worked in benefits administration at a great big bank for several years. We were actually SELF-FUNDED, meaning that a third party insurance company administered their plan for us, but we actually made all the pay outs. So, when someone had a problem like yours, I could call this nice lady named Diana, and say, “Go ahead and pay for this”, and they would.

I considered myself an advocate for the people on the plans I administered (long and short term disability), and would go to bat for them. Be nice, don’t start yelling at anyone about crummy insurance or compare your benefits to what your union friend gets. You’ve probably already done this, but if not…

Call your benefits department and find out if they self-insure. If so, Mr. Wheel, start pleasantly squeaking. Be nice but persistent. At my company, if you could get to the head of the HR department, he would cave under even a tiny bit of pressure. We paid for all kinds of stuff that shouldn’t have been covered, including one guy’s dental implants – about half a mouth’s worth. It’s worth a try.

 

[vern_humphrey]

Nice talking point. Where did you get it? Hannity? Limbaugh? Savage? How about something with some substance. Medicare isn’t in the business of making money, it’s in the business of paying for medical services…period.

And it’s assuredly not in the business of serving the customer.

Considering that almost everything is a monopsony of one sort or another (especially when you speak of any large organization – even Disney, my favorite corporation), it’s not necessarily a problem.

Either you don’t know what a monopsony is, or you’re being less than open in this discussion.

Why haven’t you answered my question about what the money placed in your magical medical savings accounts will be doing while it waits to be spent?

Because it’s a question that a 6-year old could answer. It’s doing what YOU want it to do. It’s your money, and you control it. Personally, I’d have it in a guarenteed interest account.

Is it true that you’d want to have it invested in the stock market and be subject to the whims of funds managers who charge hefty fees, whether or not they make you money? Perhaps you have some vested interest in this coming about?

My, aren’t we quick with the nasty, unfounded accusations?

 

[LCMS_No_More]

And it’s assuredly not in the business of serving the customer.

What a willfully ignorant statement. The only purpose of a government agency is to provide services to its intended constituency. It has no other purpose.

Either you don’t know what a monopsony is, or you’re being less than open in this discussion.

Perhaps not on the purest sense I don’t know what a monopsony is. I have a high-school level education relative to economics…and since I plan on becoming an ENGINEER and working in public service, I don’t have any plans to become a businessman or involve myself too deeply in economics. Perchance thou, oh Wise One, canst explain it to my lowly, unworthy self?

Because it’s a question that a 6-year old could answer. It’s doing what YOU want it to do. It’s your money, and you control it. Personally, I’d have it in a guarenteed interest account.

Surprising considering what most Republican proposals are about (enriching corporations at the expense of working people).

My, aren’t we quick with the nasty, unfounded accusations?

I just can’t see any right-winger having anything less than selfish motivations, so I wouldn’t necessarily call it unfounded.

 

[vern_humphrey]

What a willfully ignorant statement. The only purpose of a government agency is to provide services to its intended constituency. It has no other purpose.

What a willfully ignorant statement. The major purpose of every government agency is to provide services to itself.

Perhaps not on the purest sense I don’t know what a monopsony is.

Not on any sense at all – but that doesn’t keep you from preaching to the rest of us, does it?

I have a high-school level education relative to economics…and since I plan on becoming an ENGINEER and working in public service, I don’t have any plans to become a businessman or involve myself too deeply in economics. Perchance thou, oh Wise One, canst explain it to my lowly, unworthy self?

No, if you want to learn, you’ll do your own research.

Surprising considering what most Republican proposals are about (enriching corporations at the expense of working people).

More bile, bitterness, and unfounded accusations and innuendo.

I just can’t see any right-winger having anything less than selfish motivations, so I wouldn’t necessarily call it unfounded.

just can’t see any left-winger having anything less than selfish motivations, so I wouldn’t necessarily call it unfounded.

See how easy it is to spew this hatred?

Now actually contributing to the discussion – as I have done in explaining MSAs – that’s hard.

 

[daeve]

This discussion is taking a nasty turn.

L-- a monopsony is kind of the reverse of a monopoly. With a monopoly you have only one seller. A monopsony has just one buyer. That’s a simplistic explanation, but it’s what sticks in my head. I’m not sure I spelled it right.

 

[LCMS_No_More]

What a willfully ignorant statement. The major purpose of every government agency is to provide services to itself.

Not on any sense at all – but that doesn’t keep you from preaching to the rest of us, does it?

No, if you want to learn, you’ll do your own research.

More bile, bitterness, and unfounded accusations and innuendo.

just can’t see any left-winger having anything less than selfish motivations, so I wouldn’t necessarily call it unfounded.

See how easy it is to spew this hatred?

Now actually contributing to the discussion – as I have done in explaining MSAs – that’s hard.

All you’re doing is the “I know you are but what am I” game.

First, as I work for a governmental agency, I can tell you that if we don’t have people using our services, our agency doesn’t have any reason to exist.

Second, I chose my area of study based on my actual abilities. Economics is of no interest to me beyond some basics. On the other hand, engineering is one of the most fascinating and stimulating fields of study I can think of. We’re all different, you know.

Finally, you really need to stop thinking like a protestant. I thought you were a Catholic but you seem stuck in this either/or mentatlity. I am only opposed to the right-wing ideology that the Republican party represents. That does not automatically mean that I am supportive of a left-wing ideology. There are other options.

 

[vern_humphrey]

This discussion is taking a nasty turn.

You got that right!

L-- a monopsony is kind of the reverse of a monopoly. With a monopoly you have only one seller. A monopsony has just one buyer. That’s a simplistic explanation, but it’s what sticks in my head. I’m not sure I spelled it right.

You’re right.

Both are exploitive – in a monopoly, the sells sets the price – because from whom else can you buy? In a monopsony, the buyer sets the price – because to whom else can you sell?

The most recent example of a monopsony is the US Government’s decision to take over distribution of vaccines. The monopsonistic practice of the government put vaccine manufacturers in the US out of business, and left us dependent on foreign suppliers. And when foreign supplier contaminated his batch of flu vaccine, where did that leave us? Up the creek without a paddle!

Another example is the flight of doctors from Canada. The government (the only buyer for most healthcare services) sets the price so low that doctors come to the US. We’ve had Canadians on this forum call us “poachers” for “allowing” that.

In a system such as I have described (MSAs), we have millions of buyers, each making his own decision in his own best interests. In addition, we have set up real competition – the consumer is rewarded for bargaining and not over-consuming, something the present system doesn’t do.

 

[vern_humphrey]

All you’re doing is the “I know you are but what am I” game.

First, as I work for a governmental agency, I can tell you that if we don’t have people using our services, our agency doesn’t have any reason to exist.

But that doesn’t mean you have the same motivation an open market service would have – your customers are your captives.

Second, I chose my area of study based on my actual abilities. Economics is of no interest to me beyond some basics. On the other hand, engineering is one of the most fascinating and stimulating fields of study I can think of. We’re all different, you know.

Then why come here and preach on economics to the rest of us?

Finally, you really need to stop thinking like a protestant. I thought you were a Catholic but you seem stuck in this either/or mentatlity. I am only opposed to the right-wing ideology that the Republican party represents.

Ah, more nasty, unfounded name-calling, eh?

That does not automatically mean that I am supportive of a left-wing ideology. There are other options.

No comment. None needed.

 

[LCMS_No_More]

But that doesn’t mean you have the same motivation an open market service would have – your customers are your captives.

Considering the government is there to enforce LAWS, well, DUH! If someone breaks into your house, who do you call? The police.

If you saw a Mexican in your neighborhood, who would you call? ICE.

Government agencies. Duh!

Then why do come here and preach on economics to the rest of us?

This is my Scooby-doo moment of the day. Huh!?

Ah, more nasty, unfounded name-calling, eh?

I didn’t call you anything. I said you think in either/or terms…just like a protestant does.

No comment. None needed.

Snarky and nasty much? More of your either/or thinking.

 

[vern_humphrey]

Considering the government is there to enforce LAWS, well, DUH! If someone breaks into your house, who do you call? The police.

No, I shoot.

Rememer, when seconds count, the police are only minutes away.

If you saw a Mexican in your neighborhood, who would you call? ICE.

“ICE?”

Government agencies. Duh!

Government agencies. Duh!

This is my Scooby-doo moment of the day. Huh!?

If you say so.

I didn’t call you anything. I said you think in either/or terms…just like a protestant does.

That’s two insults.

Snarky and nasty much? More of your either/or thinking.

And another one.

Don’t you have anything positive to say?

 

[LCMS_No_More]

No, I shoot.

Rememer, when seconds count, the police are only minutes away.

After the fact, Mr. Happy Trigger. You come home from a nice night on the town with your wife.

“ICE?”

Immigration & Customs Enforcement.

That’s two insults.

And another one.

I didn’t realize you southerners were so thin-skinned. Wow.

And before you go off half cocked, I’m not a northerner, I’m California born and bred.

Don’t you have anything positive to say?

Sure, when I speak to people who aren’t snarky and rude.