Report: Sears To Offer Cash Rather Than Health Insurance Plans

[Newsjock]

Source: CBS Chicago

Two big employers, including one based in the Chicago area, are changing the way they provide health insurance to their workers.

As WBBM Newsradio’s Regine Schlesinger reports, Sears Holdings Corp., headquartered in Hoffman Estates, and Darden Restaurants Inc., which owns the Olive Garden and Red Lobster chains, reportedly are making a radical change that will be watched closely by other employers.

The Wall Street Journal reports the companies will give employees a fixed amount of money, then let them choose their health insurance from an online marketplace.


Read more: http://chicago.cbslocal.com/2012/09/27/report-sears-to-offer-cash-rather-than-health-insurance-plans/

[antigop]

1. and that fixed amount of money probably will not grow even as health insurance rate go up.

They are placing health care inflation risk on the employees.

[dixiegrrrrl]

4. It is essentially the voucher system

that so many Repugs want us to live with.
Only difference is that a business is paying for the "voucher" with cash to the employee
instead of government paying for it.

[antigop]

6. yep. that's exactly what it is...and the company decides how big that voucher is n/t

[antigop]

7. and unless the employees belong to a union, they have no control over the amount n/t

[Jeff In Milwaukee]

101. They vote with their feet.

If an employer doesn't offer a health plan, or any other desired fringe benefit like a retirement plan, workers are going to leave in favor of companies that do offer the benefit. The highest-performing employees are going to bolt for someone who pays them what they're worth. This is a losing strategy over the long-term (and let's face it, I'm not sure Sears Holdings HAS a long term).

But am I misremembering, or doesn't the ACA require large employers to provide a plan - I would assume that part of the definition of "a plan" would be the cash equivalent to purchase insurance off one of the state exchanges.

[antigop]

103. the article said other companies will be watching..and if they all do it, where are you going to go?

n/t

[antigop]

104. just like companies shifting their pension plans to 401(k)'s... n/t

[hamsterjill]

37. That's exactly right.

And these giant corporations still take solace in the fact that if an employee can't/won't/doesn't use the money for healthcare, that person can still "go to the emergency room".

[Bandit]

15. IMO it should be either on the employee or the Government, but it sure should not be required of the

Employer...Why should your employer be the one to make such decisions about your health care? It certainly is not that way in any other country in the world.....

[antigop]

16. especially when the companies see health care as an expense they want to minimize n/t

[Sekhmets Daughter]

56. It's not

Companies began offering health insurance after WW II to attract the best employees....This could actually be good if employees demand that at lest part of the savings show up in their paychecks...

[harmonicon]

73. I agree.

Healthcare is the government's responsibility. Why place that burden on companies that have actual work to do?

[mike_c]

2. this is one of the outcomes of the ACA that I feared might happen....

Increasingly, look for employers to drop employee insurance plans in favor of making them buy into the private market because the ACA mandates it. Employers get the benefits of an insured work force-- healthier workers, higher productivity-- without the cost of providing group plans. Workers lose.

Single payer universal health care NOW!

[antigop]

3. not directly tied to the PPACA according to WSJ

http://online.wsj.com/article/SB10000872396390444549204578020640220260374.html

The approach isn't directly tied to the federal health overhaul law, which largely goes into effect in 2014. That law will make it easier for employers to funnel workers toward purchasing plans in the individual insurance market, perhaps aided by an employer contribution. The exchange used by Sears and Darden still involves employer-backed group plans, not individual insurance, however, so it doesn't rely on the law's changes. [

[riderinthestorm]

12. While that may not be stated, its going to be the latest trend.

One in ten US Employers to drop health insurance coverage this year....

http://online.wsj.com/article/SB10000872396390443437504577545770682810842.html


I don't necessarily think this is a bad thing. While the short term pain will be demonstrable, once workers (especially middle - senior management) find they can't afford to purchase real policies the pressure will intensify rapidly for a public option (dare I say single payer??)

It will take pressure from the corporations to bring about real health insurance reform (along with other factors). Everything that works to bring pressure to reform our terrible system will move the ball farther along, faster.

[magical thyme]

75. Agreed, 100%. nt

[BREMPRO]

8. one way to look at it but..

this may be a blessing in disguise. may be the beginning of an evolution toward single payer... we are the only major industrialized nation that ties health care to having a traditional job...that method keeps people in jobs that they may not find rewarding and limits their mobility and ability for self employment.. if that bond is separated then the likelihood of a single payer system or public option being demanded and enacted increases in my view, and the job mobility, entrepreneurship and creativity of our workers and economy will increase and benefit as well!

[antigop]

9. I think there is merit to your remarks. I think part of the problem people had with single payer...

is that people who had good health insurance through their employer weren't interested in changing.

I always thought that the way we have to get to single-payer is for the people with decent healthcare coverage to start feeling the pain and start demanding something else..like single payer.

I don't think enough people were hurt by the present system to demand change. (Not that I want people to be hurt...but I think this is the only way single-payer is going to happen.)

[tavalon]

95. Yep, I consider it a form of wage slavery

[valerief]

14. Single Payer Now is right. We first need a Dem House, Senate, and Prez. Only then do we

have chance. No guarantee, certainly, but a chance.

[antigop]

17. I agree...now is the right time...but will the Dems have the backbone to stand up to the insurance

companies?

[valerief]

18. Who knows? But it's a guaranteed NO without the Dem trio. nt

[harmonicon]

74. History shows that it's a likely NO with "the Dem trio."

They could have passed it a few years ago, but they didn't even try.

[valerief]

85. Conyers' Medicare for All was introduced in 2003 and again in 2009.

With all the DINOs in the House, it had no chance.

Trying to clean the DINOs from the House is like trying to clean the trolls from DU. You can only manage an infestation. You can't eliminate it.

[harmonicon]

86. The problem isn't DINOs its Ds.

As a party, the Democrats are too far to the right of folks like you and I. It's the minority who would support single-payer. I liked Obama's proposal of having a government plan, but it's still far from having a first-world healthcare system. He didn't even fight hard for that. He went in looking for compromise, compromised, and got almost no votes for it. No one was asked by the Dems to compromise towards the left; their default position was compromising towards the right, and it got them nothing - no support, no accolades, no good will.

[cr8tvlde]

89. Remember what happened to Hillary right after Bill's initial election?

It was brutal and until that element ... and it was Ds and Rs ... dies off, literally, it will be hodge-podge. And we'll be in the health care basement of "civilized nations". Notice, the main difference is the "Defense budget" we must prop up...that the rest of the them don't have to bother with.

IMHO, we trade being the Global Policeman with the health and well-being of all of our citizenry.

[Sekhmets Daughter]

59. All in good time.

[goclark]

5. The Sears in our area is "closing" the salesperson told me

I was shocked when I went in there a few months ago - few customers, stock that would have been easy to select from -- not there and they would say, " we can't even order it for you."

Huge store and maybe I saw 10 customers searching for products
that they probably would not be able to locate.

[BlueStreak]

10. Why should ANY employer provide ANY health insurance?

What does that have to do with employment? Bullying employers to provide coverage just makes the system way more expensive, complicated, and restrictive than it needs to be.

We need universal coverage. Has nothing to do with employment.

Employers need the flexibility to hire and fire. Employees need the flexibility to change jobs throughout their career. Putting insurance in the middle of that harms both employers and employees.

Remember, the only reason we started that stupid tradition was because there were pay caps in effect during the war and companies turned to fringe benefits as a way to get around the pay caps. Big mistake.

[antigop]

11. agreed...but maybe this is moving in the right direction... n.t

[Hassin Bin Sober]

21. Where are you getting that health insurance is a result of pay caps during the war?

Do you have a credible link? I looked. I would like to read it.

[antigop]

22. Here....

http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=7

During World War II, the federal government froze wages and prices as a means of controlling wartime inflation. To attract workers, employers began offering health insurance as a fringe benefit since the coverage wasn't subject to wage restrictions. For workers, these benefits also had the advantage of not being subject to federal income or payroll taxes, a situation that has prevailed over time. There is consensus among economists that the tax exclusion has contributed to the growth of employer-provided health insurance as a result.

[HiPointDem]

97. Which doesn't explain why it continued after the war. In fact, it was a way to compete for

employees in a booming economy with tight labor markets -- while not having to pay out as much real cash.

[BlueStreak]

99. True, but my point remains

In today's world, it is a ridiculous way to deliver health care. People change careers on average once every 7 years. This isn't like the 1960s when people might have expected to work for the same company their entire life.

And companies are no longer competing with the business down the street. Competition is worldwide, and the fact that our health care costs twice as much as it should is a MAJOR competitive disadvantage for American businesses.

We need to get employers out of the health care business and let them get back to doing what they do best.

[HiPointDem]

105. I agree universal coverage is optimal. But it was no less optimal then. Employer health care was

just more optimal for the ruling class then.

[radhika]

13. With Single Payer, healthcare is not tied to a specific employer

I've long thought it was time to decouple that relationship. It arose naturally back in the Progressive labor days when a company could provide a major medical policy to workers for a few dollars a month. I am amazed that employers and aspiring entrepreneurs didn't jump on the Single Payer or Medicare-4-All bandwagon years ago.

The current approach has limited the mobility of labor (stay with a dead-end job for benefits); created Cadillac benefits for some (large corporations) and not others (small companies or self-employed); skewed the pricing structure of products like cars, technology.

[antigop]

20. a thought as to why employers (especially large companies) didn't push for single-payer

Maybe they were making money off of the employees? Health care was a profit center for them?

[BlueStreak]

31. It certainly gives leverage to large corporations

They can get the best group insurance rates, so this allows them to get their employees more cheaply than smaller businesses.

I'm not sure the CEOs go through that much thought, but maybe it is a factor.

And all businesses see this as a way to retain employees. "If you walk out that door, your wife and 3 babies won't have any health coverage for 90 days or more. Think about that."

[antigop]

34. most (if not all) large employers are self-insured. Only use ins cos for billing and admin. n/t

[radhika]

62. Employer self-insurance rates are up 15% - you are correct....

There are many companies now that specialize in administering the details of a self-insured plan for corporate clients. They often use industry-standard adjudication software and reporting. They are known as ASOs: Administrative Services Only. The rules and procedures of ASO work is not much different than in a commercial plan - the difference is the employer carries the financial risk. And the employer defines key limitations of service - guess what kind?

In my years in healthcare IT, only very large companies assumed that risk, now more do. As this article in the NYT shows, the incentive is often to bypass regulations and mandates for care set by states and/or ACA. Not surprisingly, reproductive services are also a factor for some companies.

snip...

Incentives for Self-Insurance

The major incentives for self-insurance include exemption from potentially costly benefits that are mandated by the states, exemption from state taxes on insurance premiums, and the ability of the self-insurers to design their own plans and invest the money previously paid as premiums until it is needed to pay health expenses.

end snip

http://www.nytimes.com/1990/08/03/business/more-companies-choosing-to-self-insure-benefits.html?pagewanted=all&src=pm

[antigop]

68. thanks, radhika n/t

[BlueStreak]

78. Interesting. And I would guess there are hybrid plans (i.e. reinsurance)

where a company can be self-insured for the routine things, but has secondary insurance to protect them in the event of really expensive illnesses.

I don't know that to be the case, but that is what I would expect.

[radhika]

81. Absolutely, reinsurance is even used by health plans....

I've been out of the field a while, but it was quite common for plans and even participating medical groups to have some strategies to limit underwriting losses.

That is a staple of ASOs.

[mangermerdeRWfreaks]

19. What is the big deal, this process has been around for a while

I even had a plan like this before and I really liked it. You get a chunk of cash each year to buy your benefits. We got enough money for good coverage but what was nice is the flexibility. The only thing you had to do was either buy the most basic med plan or prove you are covered under another plan.

Everyone like it, we had 3 different med plans with various levels of coverage from high to no deductable, 2 dental plans, various other insurances and savings plans, including discount auto and home owners.

It was great because you could tailor what you wanted and needed and pocket any extra money or come out of pocket, pre tax, for lots of coverage.

[antigop]

23. Republicans should love it....it's a voucher plan n/t

[mangermerdeRWfreaks]

27. Vouchers were not mentioned in the article

in fact no details were provided on the plan at all.

Where do you get voucher plan from?

[antigop]

30. the employees will be given a fixed amount of money ...just like a voucher.

From the article in the OP.

The Wall Street Journal reports the companies will give employees a fixed amount of money, then let them choose their health insurance from an online marketplace.

Just like Romney's Medicare voucher plan.

[mangermerdeRWfreaks]

45. That is a DEFINED Benifit Plan not a Voucher Plan

As long as the amount given to the employee is enough to buy medical coverage each year it is not a big deal.

If the amount given to the employee stays static over time, then yes it will become a voucher plan, which is what that ahole Ryan and the Pukes want.

[antigop]

51. No, it's a DEFINED CONTRIBUTION plan...company only gives fixed amount...

You get a FIXED AMOUNT OF MONEY...from which you have to go buy a plan.

[leftyohiolib]

53. just like paul ryans DEFINED CONTRIBUTION plan. paul ryan only gives fixed amount

You get a FIXED AMOUNT OF MONEY (in the form of a check some might call a voucher)...from which you have to go buy a plan.

[antigop]

58. yes...that's EXACTLY what it is. The "fixed amount of money" is your voucher. n/t

[antigop]

57. defined contribution health plan...

http://www.bloomberg.com/news/2011-12-07/defined-contributions-define-health-care-ahead-commentary-by-peter-orszag.html

Over the next decade, we are likely to see a shift in health insurance in the U.S.: So-called defined-contribution plans will gradually take over the market, shifting the residual risk of incurring high health-care costs from employers to workers.

The market today is dominated by “defined-benefit” plans, under which companies determine a set of health-insurance benefits that are provided for employees. These will gradually be replaced by defined-contribution plans, under which companies pay a fixed amount, and employees use the money to buy or help pay for insurance they choose themselves.

<edit to add> That's EXACTLY what Sears and Darden are doing.

It's a DEFINED CONTRIBUTION plan.

[highplainsdem]

25. How "great" it is depends entirely on how much money is offered (and how much of that is taxed)

and how high premiums are.

If they're offering the same amount of money to young, healthy employees as to older employees with pre-existing conditions, there will be a huge variance in the quality of insurance coverage they can buy and whether any money is left over.

[antigop]

29. one very frightening statement from the WSJ article

http://online.wsj.com/article/SB10000872396390444549204578020640220260374.html

The exchange used by Sears and Darden still involves employer-backed group plans, not individual insurance, however, so it doesn't rely on the law's changes.

Does that mean this plan doesn't have to adhere to the consumer protections in the healthcare law?
Rescissions, limits on deductibles, no exclusion for pre-existing conditions, etc....?

[mangermerdeRWfreaks]

39. These are also called cafeteria plans in some places

Yes it CAN be abused but the devil is in the details and the details are not available.

FYI many LARGE companies have multiple providers for insurance to comply with all the state and federal laws that currently exist.

I worked for a large multinational before and we had 6 Med Insurance Plans and companies to choose from each year.

[antigop]

40. FYI...most large employers today are self-insured. Ins cos used for billing and admin only. n/t

[mangermerdeRWfreaks]

47. Self Insured Plans Suck

I had one for a year it was horrid insurance and a PITA to do anything or resolve problems. Avoid Self Insurance if you can.

[antigop]

48. self-insured plans are like single-payer -- no insurance company for underwriting. n/t

[mangermerdeRWfreaks]

49. I beg to differ

I know that when I wored for the self insured company I had to deal with the Company Managing the Medical Bills and My Company to resolve anything.

Single Payer is what they have in Canada, get sick go to Dr, get fixed, pay your share, end of bills.

[antigop]

52. It's like single payer that it gets the ins cos out of the underwriting. n/t

[antigop]

54. definition: self-insured plans

http://www.fairhealthconsumer.org/reimbursementseries/insured.aspx

What is a self-insured plan?

If you are in a self-insured plan, your employer pays for all your care directly instead of paying an insurance company to handle it. If the cost of care ends up higher than your employer predicted, your employer must cover the cost.

Your employer may hire an outside company – sometimes called a “Third Party Administrator” or TPA - to handle the day to day work, like processing claims or sending out ID cards. The TPA may also run the provider network for your employer. For example, some commercial insurers serve as TPAs for self-insured plans, and rent their own provider networks to employers for a fee. The cost of hiring a TPA and renting a provider network will also figure into your employer’s healthcare costs.

Some groups of employers – for instance, some plans that cover union workers - administer the benefits themselves and manage their own provider networks, instead of hiring an outside TPA.

[antigop]

55. the reason large cos go self-insured is BECAUSE IT'S CHEAPER. n/t

[mangermerdeRWfreaks]

32. Well my plan was tiered by salery

less then 50k got more money to spend then those that made between 50k - 100k who got more then those who made over 100k.

It was a pretty progressive plan in many ways.

People who made less then 50k with 2 or more kids could get a $1500 family deductable 80/20 coverage for abot $100 per month. Perscriptions were 5/10/15/25.

[Lasher]

38. Everyone doesn't like cafeteria benefits.

It looks like free money but that's an illusion. Over time you end up with shitty choices where your employer pays less and you end up paying more.

[antigop]

42. the only thing you will eventually be able to buy is a (very) high-deductible plan. n/t

[antigop]

44. but Republicans love "consumer-driven" health plans n/t

[eridani]

98. Of couse you do. It's a wonderful way for the healthy majority to fuck over sick people

In every age demographic, 5% of the population accounts for half of all health care costs, and 15% for 85% of costs. That leaves the vast majority of 85% accounting for only 15% of costs. Naturally they think crappy cheap insurance that doesn't actually help you if you get expensively sick is a wonderful thing, because the odds are that they won't be one of the ones getting expensively sick.

[kysrsoze]

24. Sears has long been a horrific employer. This may be their death knell

Just see how many employees stay there and how many new ones are attracted.

[Mopar151]

41. Sears current management could fuck up toast. n./t

[Lint Head]

26. Wonder how much cash they will give when a person has a $100,000 bill for cancer treatment?

[matt819]

28. I don't have a big problem with this

There should never have been employer-based health insurance. There was an opportunity after WWII to take the same approach as the British with their NHS. There was another another opportunity with Medicare to create a single payer system. These were opportunities lost.

The move toward a single payer system should continue, but it's not going to happen overnight, for all the reasons that any number of posters here can offer. In the meantime, it's worth considering other options within the context of the ACA.

Of course, there are a bunch of caveats with the proposals noted in the OP. Here are just a few:

-- Insurance companies need to step up to the plate and provide plans to cater to individuals. The state exchanges mandated under the ACA should go a long way to addressing this issue.

-- And then there's the question of ensuring that these cash amounts will track with the cost of health insurance. If not, then it's bogus.

-- There's also the tax treatment of this cash payout. If the federal government is going to penalize - tax - individuals on this additional income, then it's bogus.

-- If these payments do not account for insurance requirements for families, then it's a fraud.

[PuppyBismark]

33. I just sent this to a Repub friend who gets his health care from his wife who works at Sears.

I love it when the GOP gets to learn a lesson first hand.

[antigop]

35. well...he should love it. It's the Republican "consumer-driven" health plan. n/t

[Shitty Mitty]

79. If not, he'll blame it on Obama

.

[Exultant Democracy]

36. Our companies will never be competitive in a global market if they keep paying health care.

That is a simple fact. The solution is equally simple, single payers is the best way anyone has figured out so far to keeping cost low.

[leveymg]

43. Wanna bet it isn't nearly $15K/yr needed to pay for a family plan?

This was the anticipated outcome of ObamaCare. Shifting costs from employers onto workers.

[antigop]

46. and wanna bet the fixed amount of money won't be anywhere near $15k for family coverage? n/t

[Hoyt]

63. There are very few -- if any companies -- paying $15K a year for employee's families.

Most companies long ago shifted big portion of premiums for family members to the employee.

Hopefully folks will go to polls and elect Democrats who will significantly modify Obamacare to offer at least public option, real cost reforms, etc.

[Hoyt]

50. Right now employers cut back their premium share, increase deductibles/coinsurance, etc.

So not much difference in my view. If the level of cash -- and that is a big "if" -- is sufficient, I'd rather purchase my own insurance.

Sooner or later, government will be forced to offer private option or go single payer.

And this might be boost to unions -- unions will jump all over this to ensure level of cash is sufficient.

Yea, this could be bad -- but for some reason I'm feeling more optimistic today than normal.

[Raggaemon]

60. Sick employees too ?

What about employees with pre-exisiting conditions like hypertension, diabetes, elevated cholesterol ? This seems a lot like the old Kaiser shipyard workers healthcare plan that was intended as basic well-persons coverage. A typical pool of employees is expected to have mostly healthy people, so how does handing a limited cash amount to all employees work for those with on-going health issues ?

[Hoyt]

61. If it occurs in 2014 -- Obamacare to the rescue with no "pre-existing" exclusions.

That's not to say this is without concern, but having insurance tied to employment is foolish anyway.

[antigop]

66. I'm not so sure about that...see post #3

http://online.wsj.com/article/SB10000872396390444549204578020640220260374.html

The approach isn't directly tied to the federal health overhaul law, which largely goes into effect in 2014. That law will make it easier for employers to funnel workers toward purchasing plans in the individual insurance market, perhaps aided by an employer contribution. The exchange used by Sears and Darden still involves employer-backed group plans, not individual insurance, however, so it doesn't rely on the law's changes.

Have they somehow figured out a way around the PPACA?

[antigop]

64. Very good questions...there will probably different tiers of coverage

The healthy people will probably choose a high-deductible plan.

People with health conditions won't want a high-deductible plan...so they'll have to go with a plan that offers better coverage..but those plans will cost more.

So..what will probably end up happening is that less healthy people will end up paying more for the better coverage.

Inhumane, I think...to charge less healthy people more.

[Sekhmets Daughter]

65. Yesterday I saw an article

in 24/7 Wall that ranked the "least valuable employees" i.e. revenue per employee. The Ranking was from #11 best of the worst to # Lowest revenue per employee. Sears Holding ranked #11 and Darden Restaurants ranked #2.

Darden Restaurants has 180,000 employees, but you can bet your sweet life most of those employees don't have health insurance to which the company contributes a dime. I wonder if they will be giving this cash to wait staff, dis washers, bus boys etc.

[HughBeaumont]

67. Lots of optimists on here.

"This'll lead to single payer!!" No, it won't.

Are we under some assumption that the wealthy care if hundreds of thousands die? They don't. Elected representatives? In the pockets of the wealthy.

This is part of their grand plan for glacial acceptance of the "Every Person For Themselves" society. The "Big Club" isn't going to willfully sacrifice even a CENT of profit for your needs or the greater good. The "Big Club" doesn't step on one another's toes and they represent the handler class of our "government", so any hope of legislation isn't going to happen as long as we live.

We're not a progressive nation, even if circumstances force us to be.

[antigop]

69. Hugh, I think in a rather disastrous way, it can lead to single-payer because

what will happen is the companies are shifting the healthcare inflation risk to employees.

Eventually, employees who were used to having decent coverage, will no longer be able to afford coverage. The fixed amount that companies will contribute will be worth less and less each year.

Part of the problem, I think, with a single-payer is that there were too many people with decent health care coverage through their employers that didn't care about people who didn't have good coverage.

Now we will have more people with crummy coverage who will demand something else.

It will add to the chorus of single-payer advocates.

<edit to add> or at least it will to more people demanding change.

[HughBeaumont]

76. If recent history is any indicator, I'm not optimistic our requests are going to be met.

Millions demonstrated against the Iraq war, in 2003 and constantly after that. The War Criminal Administration and their rubberstamp congress pretty much gave the world a giant oily middle finger on their cries for peace.

OWS gathers daily and fights the good fight. Banksters give a diamond-encrusted middle finger to America because they have the government in their pockets and the militarized police on their side.

I haven't seen much in the way of any demonstrations for Single Payer, and there really needs to be. I thought Sicko would be the catalyst for a groundswell, but it was not to be.

Like it was said upthread . . . the only, and I mean ONLY hope of single payer happening is a Democratically-controlled House, Senate and Presidency (with more emphasis on progressive to center-left Democrats, not more Ben Nelsons and Mary Landreius). If any of those elements are missing or are in danger of being lost, forget it.

[antigop]

83. I don't think enough people have been hurt enough yet by today's health care system.

And I seriously don't think we will get the changes we need until more people have been hurt by the existing system.

As much as I don't want to see any more people suffer, I don't think we are going to see a change otherwise.

[CBHagman]

102. We have the additional factor of the health care time bomb...

...of obesity rates. Most news stories suggest a third of U.S. adults are overweight and another third are obese, and that obesity rates among children have been rising as well. That is going to translate into very serious long-term health issues, including for younger workers. Think type 2 diabetes, hypertension, and more.

"Everybody just try really, really hard, OK?" isn't going to cut it as a plan for dealing with health care costs over the long run.

[exboyfil]

70. Should we have a payroll tax

like the German system (8% employer/8% employee)? This assumes that we can get the per capita spend down to German levels (it is half U.S. spend). Another way to look at it is 11.6% GDP versus 17.4%.

[okieinpain]

71. seems like a great opening for unions. just allow people to join and access

their benefits from being in a large pool of workers.

[julian09]

82. This would this help portability.

Workers are tired of giving their raises to the insurance industry, should make ins more competetive.

[antigop]

84. The problem is these workers were probably in self-insured plans and now have to move to the open

market.

Self-insured plans should be cheaper than an open market group plan because they don't have the insurance company in the middle as an underwriter. They may use an insurance company for billing and administration.

This is why we need single payer...get the insurance companies out of the picture.

[rock]

72. I smell Republican Ass

It has a unque stench which is picked up by anything they rub it against!

[Shitty Mitty]

80. You have my sympathies.

.

[rock]

87. Thx but what is one to do

Like monkeys they like to smear their stink everwhere.

Ooh, I didn't notice. Welcome aboard!

[Safetykitten]

77. Oh, nothing to see here...move along. So sayeth the people with insurance.

You see, this was, expected, not a problem, there is no need for concern.

And so the results of this clusterfuck health plan begin

[mysuzuki2]

88. One word -

single payer!

[antigop]

90. You posted two words.

But I agree with you.

[mysuzuki2]

91. no sense being picky. But single payer is the obvious way to go!

[antigop]

92. Yes, as I said, I agree with you. n/t

[DeSwiss]

93. They have a lot of inventory backed-up in the warehouses too, I imagine......

...so maybe they could throw in some aluminum siding, or those decorative solar lights for your driveway. And you can't beat Sears' Craftsman drills, now can you? And have you heard about the doctor who trades in farm animals?? She's a TeaBagger, of course.

- We don't need no stinkin' Federal Reserve!!! Bring a chicken to the doctor!!!

[greymattermom]

94. state by state

Single payer will happen state by state. As a few more states have that option, businesses and free lance folks will start moving. When that happens, more states will start single payer systems to be competitive. At least that's what I think.

[HiPointDem]

96. Health care vouchers, one of the GOP's wet dreams.

[madville]

100. My brother's company is currently studying where to go with their health care benefits

He said the spend about $6,000 per employee annually for health insurance. They are studying now how they can transition the employees to these exchanges that are supposed to come about and just pay the $2,000 penalty per employee and save hundreds of thousands per year.

Could be good or bad for the employees, depends on what these exchanges offer. If the exchange is $1,000 a month for a family policy when they used to only pay $400 a month through the employer, that's going to suck.