|
Post by swurveman on Aug 1, 2017 12:36:47 GMT -6
Generally speaking, when people participate in a "group plan" there are a couple of factors that create a lower premium for the employee, 1. yes, the plan is rated on a group basis vs. individual basis, 2. many (but cannot say all) employers share in the cost (pay part) of the health plan for their employees. As far as subsidies go (which I find to be a sore subject), this is something that a government uses for participants that could not afford the program on their own (which should say lots about the program to begin with). The problem is governments only have revenue from its citizens through taxation so in essence you are paying additional for those entitled to a subsidy or the government just magically prints that subsidy (money) out of thin air otherwise known as the 8th wonder of the world (sarcasm) and an entire subject in and of itself. Group plan is easiest when all parties live in one geographical area. Trying to build a plan across state boarders isn't easy. Unions do it nationally. We live in the 21st centruy where data and medical records are easily transmitted. However, I know it's a pipe dream that engineers could negotiate a national policy, but it would be nice to lower health care costs. I'm hoping that when this current repeal/replace effort goes nowhere we'll get one step closer to national health care. The insurance bloat, the cronyism of not being able to negotiate drug prices and the amounts surgeons make today is outrageous. I knew surgeons when I was a kid and know them now. Surgeons have gone from being well off to living like kings. There is so much fat that can be cut. I think there will be a tipping point where - as premiums continue to grow- people will want the kind of system that all the western democracies already have. What we have is unsustainable and will only get worse in time.
|
|
|
Post by EmRR on Aug 1, 2017 15:07:24 GMT -6
Needing Rabies shots (touch a bat at all) in the USA will bankrupt most people without insurance, and possibly with. There was an LA Times piece that looked at it, and came up with prices as high as $5K/shot (6 needed?). Many other countries it's around $40/per. Guess what, we don't stock that particular version. One example.
The wife had a benign cyst removed from her wrist today. Even with insurance, they demanded up front payment of $3K to SCHEDULE the surgery. She was told the operation was billed at $15K. I think it took 20 minutes actual, we were there about 3 hours total. After deductibles that's gonna be around $6K with insurance coverage, which is an individual policy as she's a freelancer too.
Were we in a medical emergency across state lines, insurance would cut the payment rate by a very large percentage. So don't go anywhere too far from home. That must be a fun thought for those living in Jersey and working in NYC.
|
|
ericn
Temp
Balance Engineer
Posts: 14,937
|
Post by ericn on Aug 1, 2017 16:05:22 GMT -6
Group plan is easiest when all parties live in one geographical area. Trying to build a plan across state boarders isn't easy. Unions do it nationally. We live in the 21st centruy where data and medical records are easily transmitted. However, I know it's a pipe dream that engineers could negotiate a national policy, but it would be nice to lower health care costs. I'm hoping that when this current repeal/replace effort goes nowhere we'll get one step closer to national health care. The insurance bloat, the cronyism of not being able to negotiate drug prices and the amounts surgeons make today is outrageous. I knew surgeons when I was a kid and know them now. Surgeons have gone from being well off to living like kings. There is so much fat that can be cut. I think there will be a tipping point where - as premiums continue to grow- people will want the kind of system that all the western democracies already have. What we have is unsustainable and will only get worse in time. Unions are normally clustered in specific areas and have the power to get some employer contribution. If you haven't noticed the states are trying to cut the power of unions.
|
|
|
Post by joseph on Aug 1, 2017 16:28:58 GMT -6
Risk pool needs to be large for insurance to work. This is why a public option with automatic enrollment and minimum level of preventative care makes sense.
Course, unlike with most industries such as software, energy and pharma R&D, the profit motive in the private insurance industry seems to have no added value, only costs.
|
|
|
Post by Bob Olhsson on Aug 2, 2017 15:33:52 GMT -6
All recording engineers' income plummeted when the majors shut down most of their studios in the mid '70s. I was never in a union but it was a real eye opener about the impact of unions on all wages. Many started calling themselves "producer/engineers."
|
|
|
Post by jazznoise on Aug 2, 2017 16:44:03 GMT -6
The cross-borders stuff is nonsense. I have a European healthcard, meaning I get the same access to healthcare everywhere in the EU. That's places with different laws, different languages, different medical practices. Not having insurance in Ireland, however, is increasingly unwise but I can't afford it so..
|
|
|
Post by sean on Aug 3, 2017 6:22:27 GMT -6
~ $40-$50,000 this past couple years, if I had to guess. Some weeks you make $500, some $1000, some $3000...
Nashville has been good to me and I feel very fortunate. I wouldn't want to do anything else anywhere else. I've been able to buy a house and a new car and while I always think about money, who doesn't?
|
|
|
Post by indiehouse on Aug 3, 2017 8:16:11 GMT -6
~ $40-$50,000 this past couple years, if I had to guess. Some weeks you make $500, some $1000, some $3000... Nashville has been good to me and I feel very fortunate. I wouldn't want to do anything else anywhere else. I've been able to buy a house and a new car and while I always think about money, who doesn't? Guess? Is this gross or net (before or after taxes)? Is this before or after overhead/operating expenses? Do you have children?
|
|
|
Post by sean on Aug 3, 2017 8:59:40 GMT -6
Before taxes. I don't have children. I guess if I were to break it down my living/operating expenses (mortgage, car loans, utilities and bills) is around $2000 a month? It was a lot less before my wife and I both got new cars...about $700 a month goes to that. Insurance is about $200 a month for the two of us, utilities average around $200 (seasonal with electric), mortgage/home owners is $900. I think if you asked most people what they make after living expenses it would be very little...I guess I don't make very much when you ask how much I make after I've paid for everything
|
|
|
Post by indiehouse on Aug 3, 2017 9:09:23 GMT -6
Before taxes. I don't have children. I guess if I were to break it down my living/operating expenses (mortgage, car loans, utilities and bills) is around $2000 a month? It was a lot less before my wife and I both got new cars...about $700 a month goes to that. Insurance is about $200 a month for the two of us, utilities average around $200 (seasonal with electric), mortgage/home owners is $900. I think if you asked most people what they make after living expenses it would be very little...I guess I don't make very much when you ask how much I make after I've paid for everything Cool, thanks. Do you run your own studio or work for someone else? I guess that's what I really meant by overhead. How much you're paying to operate your studio.
|
|
|
Post by jimwilliams on Aug 3, 2017 9:21:32 GMT -6
If I offer a few bucks sometimes folks will let me record them.
Back at Cal State in 1973 I heard this gem:
"Plenty of mixers, not enough fixers".
|
|
|
Post by sean on Aug 3, 2017 9:23:54 GMT -6
I run a studio with another engineer. We both pay into the studio rent when we have sessions, which is about $1000 month (rent and utilities). We are very fortunate to have such low overhead. But I'm also hired to work at other studios around town.
I'll do the occasional local live sound gig (really just the Station Inn)...I've also done a few festival dates with artist I've worked with in the studio (Telluride, Hardly Strictly Bluegrass, Merlefest) I'm not the worlds greatest live sound engineer (I couldn't actually get those stages up and running) but I think the artist is more comfortable having someone familiar with the music there, and at those festivals there's always someone from the sound company there.
I also have a mix room in my house, a converted spare bedroom, where I will do mixing/editing/work that doesn't require a tracking studio. It doesn't really have any operating cost expect another Pro Tools license, and the initial $3000-$4000 I spent on an interface, speakers, and a lot of room treatment. I tried to not bring work home for a long time but so much stuff is done over email it just make it easier to upload sessions to Dropbox or put them on a hard drive so I'm able to make changes or edits without having to hope into the car.
|
|
|
Post by sean on Aug 3, 2017 9:29:58 GMT -6
If I offer a few bucks sometimes folks will let me record them. Back at Cal State in 1973 I heard this gem: "Plenty of mixers, not enough fixers". I wish I knew more about electronics, I did a few studio installs and console recaps for producers/studio owners and while soldering a bunch of cables and replacing 1,000 capacitors isn't the most fun it's been a nice skill to have...but I'm more of a guy who can replace it or build you a kit, but not the guy you want diagnosing it. If I were I'd have a lot of side work
|
|
|
Post by wiz on Aug 3, 2017 15:20:40 GMT -6
I run a studio with another engineer. We both pay into the studio rent when we have sessions, which is about $1000 month (rent and utilities). We are very fortunate to have such low overhead. But I'm also hired to work at other studios around town. I'll do the occasional local live sound gig (really just the Station Inn)...I've also done a few festival dates with artist I've worked with in the studio (Telluride, Hardly Strictly Bluegrass, Merlefest) I'm not the worlds greatest live sound engineer (I couldn't actually get those stages up and running) but I think the artist is more comfortable having someone familiar with the music there, and at those festivals there's always someone from the sound company there. I also have a mix room in my house, a converted spare bedroom, where I will do mixing/editing/work that doesn't require a tracking studio. It doesn't really have any operating cost expect another Pro Tools license, and the initial $3000-$4000 I spent on an interface, speakers, and a lot of room treatment. I tried to not bring work home for a long time but so much stuff is done over email it just make it easier to upload sessions to Dropbox or put them on a hard drive so I'm able to make changes or edits without having to hope into the car. When I was in Nashville two years back, I went to the Station Inn with Randy and Cowboy and Jo (my wife) ... it was one of the best gigs I have ever been to. The venue, the crowds behaviour, the sound... Randy Introduced me to the band and they were all truely lovely generous people... great night. If you were on the board that night, kudos... cheers Wiz
|
|
|
Post by viciousbliss on Aug 3, 2017 20:53:54 GMT -6
The healthcare debate is interesting. I don't look at it through partisan glasses and I had some hope for the 2009 Dem supermajority to pass something better than we got. Too many DLC Dems blocking a public option or anything useful. At the time, Democratic base websites were calling it the "Insurance company profit protection act". Puzzles me why they talk about it like it's a national treasure nowadays. The Dem base and the Alt-right both want single payer. The Alt-lite is more into a free market solution championed by people like Peter Schiff and Rand Paul. I think some of Rand's ideas were about people forming associations to negotiate. Supposedly some of that is happening now via executive order. Trump himself said something about bringing back drug importation if I'm not mistaken. I'd be surprised if anyone in Congress save a handful of members would support a bill that results in insurance and healthcare companies making less money. The Trump base almost unanimously hated the most recent proposals. Starting next year, the insurance policy we have will be pretty bad. An HSA with a $5000 deductible for anything beyond preventative care. We're probably a few years away from removing enough establishment politicians to enable the passage of something that puts people first. Hopefully a lot of this real revolutionary stuff in Nanotech and Biotech starts becoming more widely available.
|
|
|
Post by Guitar on Aug 5, 2017 18:35:06 GMT -6
I made $26 from my rich friend buying my discography on Wednesday. My mom made a good dinner. I am at the absolute bottom of the barrel, but I do have good healthcare. LOL. caveat: I work for myself, I am not properly a 'full-time engineer' other than my own materials. Really enjoying this thread as well.
|
|
ericn
Temp
Balance Engineer
Posts: 14,937
|
Post by ericn on Aug 9, 2017 10:52:12 GMT -6
The healthcare debate is interesting. I don't look at it through partisan glasses and I had some hope for the 2009 Dem supermajority to pass something better than we got. Too many DLC Dems blocking a public option or anything useful. At the time, Democratic base websites were calling it the "Insurance company profit protection act". Puzzles me why they talk about it like it's a national treasure nowadays. The Dem base and the Alt-right both want single payer. The Alt-lite is more into a free market solution championed by people like Peter Schiff and Rand Paul. I think some of Rand's ideas were about people forming associations to negotiate. Supposedly some of that is happening now via executive order. Trump himself said something about bringing back drug importation if I'm not mistaken. I'd be surprised if anyone in Congress save a handful of members would support a bill that results in insurance and healthcare companies making less money. The Trump base almost unanimously hated the most recent proposals. Starting next year, the insurance policy we have will be pretty bad. An HSA with a $5000 deductible for anything beyond preventative care. We're probably a few years away from removing enough establishment politicians to enable the passage of something that puts people first. Hopefully a lot of this real revolutionary stuff in Nanotech and Biotech starts becoming more widely available. As much as I am pro a basic universal Health plan, you have to look at the fact that you suddenly legislate a huge part of the country's employed out of work you do as much damage as good! No politics but think about this simple fact: If health care in the US were even now truelly free market nobody could afford it but the 1% because if free market truelly ruled the needs for nurses would mean Nurses would make MD money! In Buisness if one single customer is 60% of your business you bend over for that customer, he gets what he wants !
|
|
|
Post by Bob Olhsson on Aug 9, 2017 14:15:05 GMT -6
When corporations and other government imposed limits on liability exist, there is no such thing as a free market because unlimited liability is what regulates it. By definition limited liability requires government regulation to replace the people's unlimited right to sue the owners. Most talk of a "free market" is utter BS that misleads people.
Eric, I also worry that changes to healthcare are being way oversimplified on all sides. It has been a train wreck since the Reagan Administration forced Wall Street to take it over from the non-profits. We pay lots more while doctors and hospitals earn lots less. Unfortunately nobody seems to be talking about how we got here.
|
|
ericn
Temp
Balance Engineer
Posts: 14,937
|
Post by ericn on Aug 9, 2017 14:45:58 GMT -6
When corporations and other government imposed limits on liability exist, there is no such thing as a free market because unlimited liability is what regulates it. By definition limited liability requires government regulation to replace the people's unlimited right to sue the owners. Most talk of a "free market" is utter BS that misleads people. Eric, I also worry that changes to healthcare are being way oversimplified on all sides. It has been a train wreck since the Reagan Administration forced Wall Street to take it over from the non-profits. We pay lots more while doctors and hospitals earn lots less. Unfortunately nobody seems to be talking about how we got here. Bob I think only those of us who have any real amount of time spent in the healthcare system understand the complexity and the balancing act any reform really entails! I'm not sold On what we have, but any real change requires all parties involved need to be at the table. Those who make the changes have to realize any changes effect people's lives and livelihoods. As a country we have to make a decision are the potential for profits more important than people's lives? If we do ever get to a real discussion of universal care will be an even rougher fight what extent of care do all deserve? I fear that fight will be even more fragmented, and freely admit even if we had universal coverage without Rolls Royce insurance I would not be to type this.
|
|
|
Post by joseph on Aug 9, 2017 14:56:38 GMT -6
The insurance companies seem to contribute nothing but bureaucratic waste. Not to mention, maximizing profits inherently conflicts with maximizing health outcomes for those already sick, those with completely unexpected catastrophic illness, children with disorders or perinatal injuries, or the typical ravages of old age.
This is why a public option that gives everyone an ounce of preventive care before costs spiral out of control (melanoma and colorectal cancers being prime examples) is a reasonable compromise proposal, because it preserves private insurance for "free market" worshippers, and leaves access to platinum umbrella healthcare for those that want it, while it increases risk pool to spread out cost per member and bring in healthy young people, and allows group negotiation of costs.
Other big problem in line with tort reform is that a doctor will always order an expensive test like an MRI with anesthesia, even if he or she believes there is a less than .5% chance of it helping diagnosis and treatment approach.
Anyone who has been admitted to a hospital knows that - aside from being awakened by a nurse every 4 hrs -- you are given a rotation of superfluous visitors, all charging an embedded hospital overhead on top of the usual professional fees. Similar to hospital mark up on over the counter pills like aspirin and medical devices.
|
|
|
Post by Bob Olhsson on Aug 9, 2017 15:57:15 GMT -6
Those of us who have actually cared for our parents at the end of their lives also know a lot about this.
|
|
|
Post by Bob Olhsson on Aug 9, 2017 16:04:03 GMT -6
Health insurance is more of a scam than most people realize. The heavy lifting is done by Medicare disability followed by Medicaid after co-pays have bankrupted the patient.
|
|
ericn
Temp
Balance Engineer
Posts: 14,937
|
Post by ericn on Aug 9, 2017 16:41:41 GMT -6
The insurance companies seem to contribute nothing but bureaucratic waste. Not to mention, maximizing profits inherently conflicts with maximizing health outcomes for those already sick, those with completely unexpected catastrophic illness, children with disorders or perinatal injuries, or the typical ravages of old age. This is why a public option that gives everyone an ounce of preventive care before costs spiral out of control (melanoma and colorectal cancers being prime examples) is a reasonable compromise proposal, because it preserves private insurance for "free market" worshippers, and leaves access to platinum umbrella healthcare for those that want it, while it increases risk pool to spread out cost per member and bring in healthy young people, and allows group negotiation of costs. Other big problem in line with tort reform is that a doctor will always order an expensive test like an MRI with anesthesia, even if he or she believes there is a less than .5% chance of it helping diagnosis and treatment approach. Anyone who has been admitted to a hospital knows that - aside from being awakened by a nurse every 4 hrs -- you are given a rotation of superfluous visitors, all charging an embedded hospital overhead on top of the usual professional fees. Similar to hospital mark up on over the counter pills like aspirin and medical devices. OK having spent over 2 years of my life in a hospital including last Thursday-Monday plus having hospital bills in the millions. 1 health insurance like any insurance spreads the risk over many rather than the individual covering it all, in other words that bureaucratic nightmare is why I can afford to eat! 2 We can't speak to what a public option would cover since no one has put one forward but there would have to be limits. 3. Malpractice isn't quite the big deal you think it is and like all of us doctors fuck up and when they do it can screw up somebodies life big time! My wife is currently involved in a lawsuit because a MD bit off more than she could handle and while it's a pain it's a great teaching moment. Also say you win a million dollar settlement, your lawyer takes at least a 1/3 then your health insurance wants what ever it payed out for the resulting care. Not much left . I'll put it at a MD ordering tests on a 10% chance , which is OK for what I'm mostly hospitalized for I'm 10 percent of 10 percent of the cases. 4 The interruptions, well if things worked like they should it can be a lot better organized, but there are rules and the rules are there because shit happens and when it's your loved one.... Also the nurse and the tech can cut down & combine trips to your room but, I just say over the years I'll just apologize for screwing that up, for instance Sunday night my blood sugar went low and the Nurse had to stay with me till it was back to normal took 40min. where she was just in my room, now the solution would be more nurses but there already is a shortage. I'm not saying your wrong just it's complex.
|
|
|
Post by Tbone81 on Aug 9, 2017 19:04:01 GMT -6
The insurance companies seem to contribute nothing but bureaucratic waste. Not to mention, maximizing profits inherently conflicts with maximizing health outcomes for those already sick, those with completely unexpected catastrophic illness, children with disorders or perinatal injuries, or the typical ravages of old age. This is why a public option that gives everyone an ounce of preventive care before costs spiral out of control (melanoma and colorectal cancers being prime examples) is a reasonable compromise proposal, because it preserves private insurance for "free market" worshippers, and leaves access to platinum umbrella healthcare for those that want it, while it increases risk pool to spread out cost per member and bring in healthy young people, and allows group negotiation of costs. Other big problem in line with tort reform is that a doctor will always order an expensive test like an MRI with anesthesia, even if he or she believes there is a less than .5% chance of it helping diagnosis and treatment approach. Anyone who has been admitted to a hospital knows that - aside from being awakened by a nurse every 4 hrs -- you are given a rotation of superfluous visitors, all charging an embedded hospital overhead on top of the usual professional fees. Similar to hospital mark up on over the counter pills like aspirin and medical devices. OK having spent over 2 years of my life in a hospital including last Thursday-Monday plus having hospital bills in the millions. 1 health insurance like any insurance spreads the risk over many rather than the individual covering it all, in other words that bureaucratic nightmare is why I can afford to eat! 2 We can't speak to what a public option would cover since no one has put one forward but there would have to be limits. 3. Malpractice isn't quite the big deal you think it is and like all of us doctors fuck up and when they do it can screw up somebodies life big time! My wife is currently involved in a lawsuit because a MD bit off more than she could handle and while it's a pain it's a great teaching moment. Also say you win a million dollar settlement, your lawyer takes at least a 1/3 then your health insurance wants what ever it payed out for the resulting care. Not much left . I'll put it at a MD ordering tests on a 10% chance , which is OK for what I'm mostly hospitalized for I'm 10 percent of 10 percent of the cases. 4 The interruptions, well if things worked like they should it can be a lot better organized, but there are rules and the rules are there because shit happens and when it's your loved one.... Also the nurse and the tech can cut down & combine trips to your room but, I just say over the years I'll just apologize for screwing that up, for instance Sunday night my blood sugar went low and the Nurse had to stay with me till it was back to normal took 40min. where she was just in my room, now the solution would be more nurses but there already is a shortage. I'm not saying your wrong just it's complex. I'd like to add to your point Eric, if I may. I work in healthcare, it's my "other" profession and has been for 5 years now. There have been a lot of good points made here, by a lot of different people and I'd just like to say this: Healthcare is an incredibly complex system. There are hundreds of interlocking pieces. There is no one solution or one problem. It's not insurance premiums, or malpractice insurance or prescription drug prices...it's everything. There are FDA regulations, pharmaceutical interests, medical device manufacturers, insurance companies, hospital systems, kick backs and payolla, over regulation and under regulation (in different places), the education system, medical boards, unions and more. And that's just the tip of the iceberg. There's so much too it, and so many competing interests that few people are really qualified to come up with system wide solutions. I am not one of those people. I know just enough to realize I know very little. So what is the point of my post? I'm not sure, just food for thought. Just something everyone should think about in connection to this debate. Btw, we hate waking people at 4am too, but it's sometimes necessary. However, next time you're in the hospital ask your nurse to let you sleep, communicate that to the allied health folks taking care of you. Most of us are more than happy to skip less important tasks to let you sleep, and you do have the right to refuse treatment.
|
|
|
Post by Guitar on Aug 9, 2017 19:09:31 GMT -6
My heart goes out to everyone who's been there. I was in the hospital a few times. I have a distinct memory of the nurse coming in in the middle of the night to take my blood out of my arm. I had no idea what the hell, but I also didn't know until just now about the 4 hour rule. Haha! My sister is a doctor as well, it occurs to me I should ask her what she thinks about all this. We hardly ever talk about it.
|
|