Employers rethink their role in healthcare

[Teamster Jeff]

>>>
Healthcare and employers - inseparable? Maybe not. With the Supreme Court ruling to uphold the Affordable Care Act and the president's re-election, employers have never had a better opportunity to re-examine their long term role in providing healthcare coverage. The year 2013 will likely be the turning point for how healthcare benefits evolve over the next decade.

Employers may decide to transition out of healthcare altogether or elect to move toward a defined contribution approach with the exchanges.
>>>

http://www.pwc.com/us/en/health-industries/top-health-industry-issues/employer-healthcare-coverage.jhtml



And the beat goes on

[Dyedinthewoolliberal]

1. Many employers are moving to the

Catastrophic Health Care plan model. Pushing a large chunk of the cost back onto the employee. This is where we need to reintroduce single payer...........

[Teamster Jeff]

2. Yes!

[patrice]

3. The problem with that is that it is an anti-Prevention model, right? TTE, "We'll pay for only

the worst stuff", so maintenance and prevention get "put on the back burner", so the system ends up only treating the worst, most likely non-recoverable conditions, which will drive the poor out of the market, which will drive the price of everything up for those who do have the resources to pay and who can and WILL pay ANYTHING since they are under mortal threat, so prices will go up and up and up . . . .

You'll have people dying in the darkened cold corners of what is left of the middle-class and in the streets.

[patrice]

5. Another problem with Catatastrophic: Authentically collaborative & integrated health care teams

will suffer from the rising costs and that's something that will reduce the effectiveness of catastrophic care, while also increasing the need for catastrophic care, since fracturing those teams is also anti-Prevention, so the costs keep going up both inside and outside of your catastrophic model.

[enlightenment]

4. The government is doing their best to force

employers to offer insurance coverage for employees. For example - recently, the IRS told universities and colleges that must not try to avoid offering adjunct instructors coverage by failing to count preparation hours. Presumably, the idea is that all these schools will happily recalculate the amount adjuncts actually work, which will bring many over the mark where they are eligible for employer subsidized insurance.

What it will actually do is make things even harder for part-timers, as the schools cut back on the number of courses they offer to each adjunct to avoid having to offer the coverage. A few years ago, my state decided to absolutely make sure that adjuncts couldn't sneak in enough hours by combining all the institutions in the state under one umbrella for employment purposes (not budget, just employment). That way, an adjunct can't sneakily cobble together more than the three (3-credit each) courses allowed by teaching at more than one institution.

Of course this memo from the IRS means that they will cut back even more since they'll have to rate each course at a higher percentage of full-time pay (not that the pay will change - just that magic percentage number on the contract). Right now, employees who work more than 50% FTE (full time employment) are eligible for coverage - so they rate each three credit course at 15% for adjuncts. In order to satisfy the IRS that they are considering preparation hours in addition to instructional hours, they'll probably increase that percentage - but then make sure adjuncts still don't get coverage by refusing to give them more than two courses in a semester.

A single payer, nationalized, non-profit system is the only reasonable answer.