Toyota and pays $18 per hour in benefits. That's $21 per hour more that the U.S. auto makers pay in labor costs. That translates into $43,600 per FT worker per year. GM has 145,000 employees, GM has 74,000 active UAW workers. Thats over 3.2 billion per year in additional wage costs. Geez, no wonder we're bailing out GM. Oh, you should not drive a foreign made car if you think healthcare in the form of unrestricted "care is given as needed" is a basic right, where "needed" is determined by the patient. This is so because GM and the UAW have better health benefits than Toyota, and thus, prescribe to the beleif that "needed" should be determined by the patient.
Here is the UAW health care package: (click)
note that the UAW uses the Blue Cross network, Blue Cross based insurance is NOT FOR PROFIT. If you don't like private for profit insurers, you can always purchase blue cross insurance. Although blue cross sometimes denies claims, even though they are not for profit.
I don't have access to benefit levels for Toyota, but here's a review from an employee. Also: (Autospies.com article)
Now bringing this information back on point, who defines "needed healthcare"? When this argument reaches it's logical conclusion and we ignore costs since we outlaw putting a monetary number on human life; We outlaw the practice of using statistics, actuarial methods, mortality and morbidity tables, and like vehicles to determine risk and set prices for health care, who pays for the care, what will it cost? The U.S. auto industry is being crushed by healthcare costs, would our U.S. government do the same? How can we ignore costs? We cannot since costs are directly tied into what you consider the "care is provided as care is needed" concept.
For example, both Toyota & the UAW offer the HMO format that some people believe is full of collusion and corruption. The UAW also has the fee for service option with 30% and 50% co-insurance options. That means that if you choose the 50% option at your beneftis meeting and go to a hospital and get an MRI, you'll probably have to pay about $750 since the bill the hospital will send you will be around $1500. God forbid that the UAW didn't buy into the Blue Cross discount network...your bill would be about $5000. Anyway, is that co-pay of $750 for the MRI acceptable? Who determines what's an acceptable copay?
Donna, your suggestion that all care should be covered at 100% and that any care option is available to anyone at any time would be a disaster. The U.S. government would declare bankrupcy. Heck, I think I would go get monthly MRI, CAT, and PET scans. For fun, I would get functional MRI's of my brain to satisfy my curiosity of how my brain works in comparison to others. Do I need it to stay healthy, probably not, but I would get it have it done since its paid for. Donna, you dislike the talk about "discount networks", "tiered benefits" and all the other terms. But how do we implement an effective solution without that conversation?
In PA, there was a blocked merger between two non-profit insurers Independence Blue Cross and Highmark Blue Cross. Although I respect Ms. Shenk and her opinion as a nurse practitioner, her numbers and reasonings I do not I agree with. Did you know that doctors in PA would have been greatly affected by this merger? My example of the MRI earlier with "god forbid the UAW didn't buy into the Blue Cross network" comment is applicable here. Without a provider to network negotiation, your cost per procedure would be astronomical. Insurance companies provide a network discount via their own network done with in-house negotiators or via some other network. The Independence and Highmark discounts that they FORCE onto providers is REAL. I have seen them, you don't have to belive me, but they are REAL. If your a hospital in southeastern PA, the conversation is as follows: We need a 10% increase in MRI reimbursments. IBC says, no, you'll get 3% or we'll remove you from our network. We insure 80% of the population down here. Take it or leave it.
If you self fund healthcare costs in south eastern PA, you buy into the Independence Blue Cross network. Anyway, despite Ms. Shenk's contention that it was blocked by grass roots causes, the AMA had a lot to do with it. Doctors cried MONOPOLY! They will FORCE even lower payments onto us. And we will have to accept them because they insure 80% of the PA population! We will have to take it, and companies will be forced to use this MONOPOLY network, and all the bad things that happen with monopolies! Hence, the insurance commissioner said they could merge, but would lose Blue Cross status and the network competition advantages that comes with that Blue Cross tag.
The fact of the matter is, you have to set limitations and the conversation in setting these limitations MUST use these terms/concepts that you dislike. How would you do so otherwise?
As for the 3rd point in my introduction, that it's been suggested that folks with chronic and terminal conditions set these limitations and guidelines, how are they qualified? I've heard the saying "suffering imparts wisdom", but I do not feel comfortable using that as my measure for qualification. By that measure, you should have a 3rd world person whose had a rough life set all U.S. policy.
Anyway, how is having 5% of the population that use the most healthcare services make the decision for the other 95% fair? Sure they use more of it, but why, life choices or bad luck? Why should I subsidize their usage? If you use more of it, you should pay for that use. If you ran into bad luck, such as being hit by a drunk driver with no assets to her name, then I'm fine paying some tax money into a fund to help you out. One thing I don't want to do is bail out your bad behavior of eating Big Macs, smoking cigarettes, and never exercising. Just like most employers don't't want to bail out your bad behavior..and the UAW is being forced to do the same.
How would you respond to someone who says: I use a lot of gasoline because I work 50 miles away. That gasoline is essential to my survival. Its getting expensive. I want you to pay for my gasoline usage.
How is this different from:
I use a lot of health care services. That healthcare service is essential to my survival. Its getting expensive. I want you to pay for my healthcare usage.
Now if you mean "right to treatment" in relation to "denial of treament option X". Thats a different story all together. I ask how you maintain a benefits platform that will NEVER have a situation where "denial of treatment option X" would occur? Remember, I want a monthly MRI, a quarterly functional MRI for my brain so I can have some fun with it, and I also want some cosmetic surgery. I need a nose job because I have trouble breathing at night.
