How will Obama Care handle this...

[Left Seater]

Obama Care is set up so that more people will be insured, therefore lowering the overall average cost per covered individual. Younger, healthier people will now be paying for coverage that they are much less likely to need. Further, costs of subsidizing the costs of the poor who can't afford the coverage will be somewhat offset by penalties charged to "Cadillac" plans.

But what happens to the costs of Obama Care when huge employers with Cadillac plans drop out of the insurance marketplace completely. Further what if it is a huge employer with a workforce that is very healthy and claims per employee put it in the top 5% of companies?

There are multiple companies that are currently considering this option, including my wives company. There are 17,500 employees of her company located here in SA at the corporate headquarters. They are actively looking to see about bringing health care in house. They would hire roughly 100 doctors from GP to specialists who would be company employees. These doctors would have their offices in a new health complex built on the company campus. This complex would work in partnership with the 4 teaching hospitals that are within 5 miles of the campus.

This would be appealing to Doctors who would take home more money at the end of the day because their costs are zero. The company would pay all the expenses from nurses to insurance. This works for the company because they aren't paying the huge costs for insurance premiums. It will also work for employees who will still have choices of doctors, will see their costs go to zero, and their insurance paperwork disappear.

This doesn't work for Obama Care, because it removes 45,500 healthy insureds from the overall pool. It also removes payments from the "Cadillac" plan penalties.

Now granted this won't work for all companies, but it will for large single city type companies. Look for large union shops and other large white collar employers to move to set something like this up.

[BSmack]

Single payer IS the most efficient and cost effective way to go. IMO, that will be the direction this trends towards. Eventually HMOs will be extinct. And not a moment too soon.

[Terry in Crapchester]

Now granted this won't work for all companies,

I think you just answered your own question. The percentage of people affected by an idea like this overall will be miniscule.

[LTS TRN 2]

Someone say Cadillac? On Kolob we call them Kadillacs. What?...

[Terry in Crapchester]

Having thought about it some more, I see at least two additional problems with this approach:

1. Assuming your wife's employer only hires a certain number of in-house doctors (and obviously, the more doctors they hire, the less cost-effective this option becomes), they've restricted their employees' right to choose their own physicians considerably.

2. I'm assuming that your wife's employer will hire exclusively GP's and maybe a handful of pediatricians, if they're covering children's insurance as well. Problem is, eventually you come to a point where someone needs to see a specialist. So of course, your wife's employer will still need to maintain some form of insurance covering treatment outside the house. At some point, this program could become too costly for your wife's employer.

So even for the relatively narrow class of employer who could pursue this option, it's probably not as attractive as it might appear to be at first glance.

[Mikey]

...my wives company.

How many do you have, and were they all assembled by the same company?
Any parts outsourced?

[Left Seater]

Terry,

The company is looking at having a large number of doctors, all the way up to specialists, and anything outside of that would be handled at the 4 teaching hospitals in the area under an agreement. Same with hospitalization.

While choice may go down, I would love to not have to deal with insurance each and every time.

Their insurance costs are already crazy. In order to help keep them down they changed the way they operate two years ago. Now the deductible is at $5,000 for the two of us, but the company puts $5,000 on a flexible spending card each year. In effect we still have zero deductible.

Yes, this will only be an option for some companies, but it will be the largest ones out there. Taking even a few percent of the healthier groups out of the pool, will have an effect on the rest.

Mikey,

Damn autocorrect. Who would want multiple wives? One is plenty.


88,

Is Medicare and/or Medicade insurance? Participants don't pay premiums and aren't subject to underwriting.

[Shlomart Ben Yisrael]

Obamacare isn't "national health care"...it's a bit fat cheque to the insurance industry.

I wouldn't go to an insurance adjuster if I broke my arm. Would you?

[Terry in Crapchester]

Yes, this will only be an option for some companies, but it will be the largest ones out there.

Disagree. Most of the largest employers are located in more than one area. Having a geographically decentralized employee base makes this option less cost-effective.

This is an option only for a very narrowly-tailored base of employers: those who have a large enough employee base to justify such a hefty expense, yet are limited to just one geographic area.