Upset about not getting an acceptable pay raise the last few years?

[mailin 0]

Found this interesting...

http://www.gao.gov/docdblite/details.php?rptno=GAO-06-285

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Because most workers rely primarily on their employers to provide both wages and benefits as part of a total compensation package, the trends in the costs and availability of employer-sponsored compensation have a significant bearing on workers' well-being. Through tax preferences and payroll taxes, federal government policy also has a bearing on employees' access to benefits and on the costs carried by employers. The federal government provides significant tax subsidies for both health insurance plans and qualified retirement plans. In addition, workers and employers are required to pay taxes that fund Social Security and Medicare, programs intended to help provide for workers' economic security and peace of mind in retirement. In this report, GAO examined federal data on private employers' costs for active workers and sought perspectives from 17 experts to identify (1) recent trends in employers' total compensation costs; (2) composition of the trends; (3) whether employees' costs, participation, or access to benefits changed; and (4) possible implications of the changes for private systems. GAO received technical comments from the Departments of Labor and Health and Human Services and from some of the experts GAO consulted. These comments were incorporated as appropriate.

Private employers' average real cost of total compensation (comprising wages and benefits) for current workers grew by 12 percent between 1991 and 2005. The real costs of benefits grew by close to 18 percent, while real wages grew by 10 percent. Wages and benefits increased by about the same percentage for most of the period until 2002, after which time real wages began to stagnate and real benefit costs continued to grow. The increase in the cost of a total benefits package from 1991 to 2005 was largely composed of increases in health insurance and retirement income costs. Paid leave had been the most costly benefit to employers, but by 2005, the cost of health insurance equaled that of paid leave. In comparison to paid leave and health insurance, retirement income was the least costly, but it grew by an estimated 47 percent. During the time under review, employees' access to most benefits remained stable, but participation rates declined for health benefits as the real dollar amount of the premiums increased. Between 1991 and 2003, roughly half of all workers participated in employer-provided retirement plans. Holidays and vacations were generally available to most workers, but a smaller percentage of workers had access to personal and sick leave. A panel of experts from a variety of backgrounds agreed that rising benefit costs are forcing private employers and their employees to make increasingly difficult trade-offs between wages and benefits. They noted that the employer-sponsored system of benefits in its current form may be unsustainable, largely because productivity growth is unlikely to support the rising costs of some benefits, especially escalating health insurance costs.

How do you fix it?

Arianna Frances

[billvon 2,426]

>How do you fix it?

I think the two effective options are an unofficial two-tier system (which is what we have now) or a more socialized one. I fear that the 'default' option (which is to do nothing) will result in more and more non-payer ER visits, which bumps the cost up on everyone else - which is effectively socialized medicine, but without any controls whatsoever.

[mailin 0]

But does that solve the issue of rising health care costs or just how the consumer should have to pay for it?


Jen

Arianna Frances

[sfzombie13 307]

i am a member of the carpenters union in wv and we get a pay raise every year. this year it was $0.75 an hour. then they told us that the health insurance went up $0.72. we pay $675 a month for health insurance without dental or eye care. the only way to fix the present system is to set a limit on what doctors can charge, or hospitals. we had an issue recently that some doctors were pissed about not getting their on call pay. 7 of them went on strike because they didn't get their $3000 per shift for just being on call for a shift. it's bullshit like this that push up the cost of medical attention in this country. if doctors say they need it to pay malpractice insurance, you can safely call bullshit. if it's to pay for the medical degree, then they should fix the cost of the colleges, upwards of $100,000 for a degree is totally ridiculous. i say that it's time to fix this crap, socialize health care, subsidize insurance instead of big industry who only need it to make more money, something.

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Si hoc legere scis nimium eruditionis habes

[jkm2500 0]

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i am a member of the carpenters union in wv and we get a pay raise every year. this year it was $0.75 an hour. then they told us that the health insurance went up $0.72. we pay $675 a month for health insurance without dental or eye care. the only way to fix the present system is to set a limit on what doctors can charge, or hospitals. we had an issue recently that some doctors were pissed about not getting their on call pay. 7 of them went on strike because they didn't get their $3000 per shift for just being on call for a shift. it's bullshit like this that push up the cost of medical attention in this country. if doctors say they need it to pay malpractice insurance, you can safely call bullshit. if it's to pay for the medical degree, then they should fix the cost of the colleges, upwards of $100,000 for a degree is totally ridiculous. i say that it's time to fix this crap, socialize health care, subsidize insurance instead of big industry who only need it to make more money, something.

Do you get paid if you work overtime? Do you get paid if you work holidays or weekends? Would you prefer that a doctor not get paid what his profession calls for? There is a reason that an MD gets paid what he does. The difference between a plumber and a doctor is that you can call your brother in law to come over and help with a leaky toilet....you wouldn't call your brother in law to revive you after a heart attack(unless he is a doctor).

I have been charged up to $75/hr for calling a plumber after hours. The going rate for an Air conditioning guy off hours is higher in the heat of the year or cold part of the year. Add parts to that and you can pay quite a bit for the a repair call. The ER is different, you go there because there is no option.

If you want to socialize the healthcare system that will drive down the competition to get into medical schools and drive some very competent doctors from the business. Once again there is a reason that a heart surgeon makes +500K a year. If you dont like the cost visit Canada, they have socialized health care, and some of the longest waiting lists for care.

Maybe, the doctors accross the US should unionize and really drive up the cost of healthcare. Maybe that will solve the problem. Then as people continue to default on their bills, the doctors can go on strike. That seems fair to me.

The true cost of the healthcare industry is in the insurance companies. They keep the costs up, and then pass that onto the consumer, and for some reason they keep showing a profit. Maybe a solution is to get rid of the insurance industry, or regulate it, or even subsidize it.

I think that it is completely fair for someone who goes to scholl for close to a decade (15 plus for specialists) should have to settle on a paltry wage. Those people get into the industry for other reasons than to "help people", and money is a big one. Pay them what they are worth, or the next time that you go to the ER you might not make back out.

The primary purpose of the Armed Forces is to prepare for and to prevail in combat should the need arise.

[nathaniel 0]

We need to get the facts straight before we can solve healthcare, everybody has their favorite "solution" but not too many people (Congress included) have ever wrapped their heads around the full extent of the problem...

These are some parts I've learned about recently from articles online and in the Economist. Not saying I'm an expert or anything, but these are facts that I didn't quite understand until recently and I rarely hear other people talking about...
* the federal gov't already subsidizes healthcare via tax breaks to employers who offer health insurance plans to their employees
* employers pay health insurers on behalf of employees (this is starting to change tho)
* hospitals get paid by health insurers--large consumers--and by ordinary people--small consumers--who don't have health insurance
* consumers choose which healthcare they consume on the basis of what they thing they need if they have health insurance or on the basis of what they can afford if they don't have health insurance.

Before we can talk about gouging, there's a few supply / demand problems here.

People who have health insurance overconsume
Consumers who get healthcare from their employers don't have the right incentives--they don't see the costs from pursuing excess healthcare services because the bills get footed between the health insurer and the gov't. So they have every reason to overconsume. I'm talking about a class of individuals here, not necessarily every single one. Hell I'm in this group because I have employer-provided, govt subsidized health insurance.

Some consumers get shafted
Hospitals & healthcare providers have 2 types of customers, big (health insurers) and small (individuals). In most situations like this the big guy has better negotiating power & gets off with a better deal. In effect, healthcare providers raise rates on individuals who don't have insurance in order to keep the big customers. That's how business works.

Prices go up, even for people with health insurance
When there is excess demand, any market will respond in at least one of 2 ways: 1) prices go up 2) supply goes up. The supply of healthcare is hard to increase quickly since the amount of training doctors & nurses require is very high, compared to manufacturing or construction, for instance...but it has been going up. But there are few medical professions that are not in tight supply already. Since supply increases are constrained, the only place for excess demand to go is into the price of healthcare.

The taxpayer gets shafted
The result of employer-insured individuals' overconsumption is that the gov't ends up footing a huge bill. This is becoming an unbearable expense to the gov't, and there's every reason to think that the gov't will eventually turn off the flow of cash--at some point it will simply become unmanageable (2010 plus or minus a couple years). If the govt hasn't fixed it by then it will have no choice but to fix healthcare or to start printing money.

Whenever the gov't gets around to doing something about it, the final shape of the system could be various. A few things will likely be a part of the final solution no matter how it's implemented
* Whatever benefit is subsidized, there will probably be some way to bank it so the current "use it or lose it" system is not perpetuated.
* nobody will have a "right" to the latest medical treatments. This concept, which I've heard among several people I've spoken to, is noble but unfathomably expensive. There's not nearly enough cash to make it happen.
* whatever health subsidy the gov't provides will probably be akin to the shift from pensions to 401k plans. ie, defined benefit -> defined contribution. It will be unfair in that wealthy people will get better healthcare than poor, but it will be "fair" in that it doesn't wreck the economy.
* people who have health insurance right now will end up "paying" more as the true costs are exposed to them

And then there's the whole bit about malpractice...long story short is that the current malpractice system makes healthcare more expensive and will probably get neutered somehow too. The money goes into the of lawyers and malpractice insurers and people whose medical treatment didn't quite succeed.

If there's anyone gouging the system right now, it's people like me who have cushy govt subsidized employer-provided healthcare plans, as well as lawyers (perennial favorite villain) and malpractice insurers. Pretty much everyone else gets the schnitzel, including doctors, hospitals, and health insurers.

And there's undoubtedly more to it than I know about...since what I just wrote is just about all I know about the subject.

My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

[Lindsey 0]

There's another part of this that has really surprised me over the past 8 months (intern year so far). You mentioned people with insurance over-consuming. While that's probably true, the people who "overconsume" the most are 1)people without insurance who use the ER as their primary care physician....so they never have to pay a bill and 2) people (and these may outnumber #1) who use the ER for a work excuse.

It is absolutely unbelievable. You want a day off work, so you call in sick. Go to the ER that night when it's not so busy and get your work excuse. The numbers of people who bring their well children into the ER late at night saying "he's been crying" when the child is obviously well....are there for a work excuse. Well, I'm a bitch where that's concerned. I DO give them a work excuse....for the hour that they were in the ER. And their discharge papers say under diagnosis: "Healthy."

There are lots and lots of healthcare dollars spent this way. It is so commonplace and acceptable to some that I've had a few people come in and actually TELL me that they were there for a work excuse. ARGGHHHHH!!!!

I recognize that this is only a small, small part of a much bigger issue. I don't know what the answer(s) are going to be. I think your list is pretty good though.

linz

--
A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

[nathaniel 0]

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1)people without insurance who use the ER as their primary care physician

edit to add: This bit is pretty remarkable. This is what HMO's were created to solve, the problem of how to make people go to the right healthcare provider. When forced to go to a PCP for non-emergency issues, everybody freaked out and called their congresscritter or negotiated with their employer for a non-HMO plan. The notion of choice seems to be both very valuable to consumers and very expensive to taxpayers. This is where the out-of-pocket aspect of any healthcare solution comes in...the idea is that if instead of paying the healthcare provider directly, if you pay consumers and the consumers pay the healthcare provider, consumers would have a reason not to pursue an emergency visit for $1500 if a $150 checkup would suffice, go with generics instead of brand name drugs, etc because they could keep whatever difference they could squeak out of the system.

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I recognize that this is only a small, small part of a much bigger issue. I don't know what the answer(s) are going to be. I think your list is pretty good though.

Medicare belongs in there somewhere...I don't have a good grasp of how medicare works... but it's a major factor that needs to be fixed too. Probably something along the lines of defined benefit vs defined contribution.

My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

[PhreeZone 15]

Could do what one of the large (5000+ employee) companies around here is doing to manage heath care costs. They are firing any employee that smokes. They gave a 1 year notice and are paying for all the stop smoking programs that the employee needs but if they are still smoking after the deadline given then the company has the right to move them automatically to a MUCH higher costing insurance plan or to fire them if the made no effort to quit or smokes on company property. Even with the cost factor of the quit smoking plans and everything else it looks like the employer is looking at a 24-36 month break even cycle. Their health insurance provider is agreeing to lower the company matching $ by a few % for getting them to stop smoking since it will reduce the annual costs. In return for the savings they are putting it back into benifit programs for the empolyees

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