Cadillac Plans: Since When is Good Coverage a Luxury?

[Blue State Blues]

Cadillacading this article in the New York Times, and I was struck by the references to a “Cadillac tax” on "gold-plated insurance plans."

The plans referred to as "Cadillac plans" are typically plans that have low or no deductibles, low or no co-payments, and they require less in out-of-pocket costs for those fortunate enough to have them. In short, they provide good coverage.

Strange, isn't it, that we would think of good coverage as a luxury. Coverage that encourages preventative care and actually pays the costs of illness, that's a luxury now.

Isn't access to health care the reason we purchase health insurance in the first place? Isn't that what it is for?

According to the article,

Most economists’ favorite idea for slowing the growth of health care spending was ending the income tax exemption for employer-paid health insurance to make lower-cost plans more attractive.

So let me get this straight, their brilliant idea for lowering health care spending was shift more people onto lower-cost plans? Lower-cost, for-profit health insurance plans with higher deductibles, higher co-payments, and higher out-of-pocket costs?

But you know, the reason these plans cost less, is that they're worth less. And, at the extreme end of the scale, they are practically worthless.

The best idea for slowing the growth of health care spending was to shift more of the costs onto the patient?

Which, I guess makes a certain amount of sense. If you have to pay more of the cost of going to the doctor, you'll be less likely to go to the doctor. Money saved, right?

Except that it's wrong. If you put off preventative care, if you don't catch something early when it's treatable, if you don't effectively monitor and manage a chronic condition ... we know how this ends.

The problem with low-cost plans, as implemented in our for-profit health insurance industry, is the plans are designed to shift more of the burden for paying for health care onto those who can least afford to pay.

If you can't afford to buy good insurance, you can't afford to have bad insurance. The goal isn't to make sure everyone in the country has an insurance card, it's to give everyone access to health care. Bad insurance takes money in premiums without providing health care.

Good coverage isn't a luxury, it's a necessity.

But as long as we are stuck in a predatory system of profit-driven insurance companies, good coverage that is also affordable coverage will be an impossibility.

[endless october]

1. "Cadillac" plans, my ass.

i wonder what jackass came up with that talking point.

rather than taxing good insurance plans, here's a thought :

end the drug war and bring home all of the troops immediately.

that will free up enough money to bring EVERYONE into medicare.

[stray cat]

2. The idea is to have employers pay less by offering only crappy plans

[pdxmom]

3. We have one of those so-called "Cadillac" plans, and I've never

thought of it as such, until this whole debate. What it is, for us, is the plan that we need to have, based on our medical needs, most specifically my husband's needs. It's offered through his employer and we pay quite a bit as our portion, compared to other plans that his company offers. But for us, it is medically necessary, because without it, we'd be so swarming in bills that we wouldn't be able to afford treatments and medical hardware that he requires. Now, we will probably end up being punished for it, despite the literally thousands and thousands of dollars we've already invested in our insurance through the years.

[debbierlus]

16. I don't think it will go through

[The_Casual_Observer]

4. Since they have targeted them for some kind of taxation, that's when.

[bain_sidhe]

5. I see this as being part of the resentment

that people in unions with good plans get from people who aren't in unions. My answer to that has always been, hey, if you want the benefits a union brings, join a union. But too many people would rather take away what somebody else has than do the work of getting it for themselves. The rally cry seems to be "Why should YOU have it if *I* don't??"

[gratuitous]

10. That resentment gets fomented somewhere

Whether it's health plans, pensions, a living wage or paid leave, there are always short-sighted greedheads who need to put another dollar in their own pocket by filching it out of the pockets of the workers actually creating the wealth. And one of the ways they get away with it is to convince their victims that things are unfair. Not that it's unfair that the greedheads are stealing from their workers, but that some workers don't get as much as other workers. Workers who choose to hang together and bargain collectively against other greedheads.

[Blue State Blues]

6. Why I should never post before coffee ...

1st sentence should read:

Reading this article ...

I don't know how I missed that cut-n-paste snafu, must've had my eyes closed.

[bain_sidhe]

7. Ha! I don't open my eyes before coffee!

OK, a bit of an exaggeration, but not much! And besides, I'm posting mostly just to give this a :kick:

[Blue State Blues]

9. Without coffee

I am barely functional. But I can stop anytime I want. Really. It's just the whole being awake thing.

(and thanks for the kick).

[inna]

8. KR, excellent post.

Meanwhile, I'm starting to think of this health care reform in terms of health care DEFORM.

[midnight armadillo]

11. yet another attack on unions

Not being satisfied with pushing union membership to a fraction of what it once was, conservatives now want to actively punish people's actual bodies by attacking the good-quality health plans that many unions have negotiated on behalf of their members.

[paulsby]

13. rubbish

i am a proud union member. and i have, what any rational person would admit, is a cadillac plan.

my union fought long and hard to get it, and i love it.

but it would be a lie to call it anything else than what it is.

i have already posted my benefits and am willing to do so, if you want.

it's a cadillac plan.

and my union helped me get it!

kick ass!

[paulsby]

12. i have a cadillac plan. they exist. and people deny this reality

i have had 2 major surgeries in the last 20 months. cost to me: $5

my entire copays for any given year max out at $350

i pay $0 for my insurance. my employer pays 100%.

i get 60 massages a year. 30 chiro visits. 60 physical therapy appointments. FREE (my coverage is 90%. once i pay out $350 in copays, it goes to ONE HUNDRED PERCENT)

my recent surgery involved: one x-ray, one MRI, and major surgery, followed up by 2 physical therapy appts a week: cost: $0.

my copays for drugs (different insurance than my primary medical) are average $7 (depends on whether is generic or not).

i CLEARLY have a cadillac plan.

and i'm all for discussion of my benefits. if you think i don't have a cadillac plan, then discuss...

this is just the tip of the iceberg. i also have coverage for everything from mental health stuff, anti-aging treatments, etc. etc.

it's CADILLAC PLAN!

[debbierlus]

15. Everything but the massages & anti-aging treatments sounds about right

Everything else is how it SHOULD be...

So, no. I don't think you have a cadillac plan except for the caveats noted above.

[paulsby]

22. oh, it's not JUST massages and anti-aging

also, it covers acupuncture lol.

and even i think 100% coverage is kind of excessive. but i LOVE it. i just admit it's a cadillac plan.

[debbierlus]

24. Acupuncture should be covered. This is what everyone SHOULD have....

The fact that health care is considered a luxury shows how depraved this country really is....

I would enjoy 60 massages a year as well.

Damn, that sounds GOOD

[paulsby]

26. the point is

that any benefit of the plan is something that (given universal coverage) everybody is going to have to pay for. in the case of universal coverage, do i think it should cover massage? no.

my plan pays $96 per massage.

so, if i get 60 in a year, that costs them almost 6k.

that's greater than 3/5 of my premium the dept. pays.

add a few more doctor visits, etc. and the insurance co. barely breaks even. for me, they are WAY in the red, i've cost them 30k+

the reason my plan is so extravagant is that we were able to negotiate for it because our history is that the VAST majority of officers don't take advantage of stuff like massages (i have talked to over 2 dozen of my fellow officers. none of them do), and as a rule tend to have relatively low illness/injury rate.

i personally do not think health care (basic) should be a luxury. that's why i believe in universal health care.

i certainly do not think the universal plan should be NEARLY as extravagant as the cadillac plans are.

[debbierlus]

27. Cadillac plans such as yours are virtually non-existent and they are a distraction from the debate

Yes, a tiny percentage do exist.

I don't have any friends or family that has one, or near one.

The cadillac plan is a diversion and a false talking point to keep people from discussing the real problem with the entire system.

Industry profit. That is the problem. Yes, we need to manage costs in responsible ways. However, before those step can be effective, we need to excise the tumor that is the health insurance industry that suck almost a third of all health care dollars into profiteering.

The rest is simple stuff. i think we can all agree that cosmetic procedures aren't necessary, although I know massage would make my chronic pain, a more liveable situation. We can get rid of those too.

[paulsby]

28. false

#1) i don't care if they are a DISTRACTION. if people would stop saying THEY DON'T EXIST (Which is a lie) , then i wouldn't be talking about them. the fact is they do exist, and MY plan is a perfect example
2) and saying they are virtually non-existent is hogwash. scores of thousands of police, firefighter etc. have them. i know this because during our negotiations in the union for a plan, we studied OTHER dept's plans. ours IS a cadillac plan and is similar to plans that literally scores of thousand police/fire share.

i have no problem with the other stuff you are saying, but i can't stand when people state falsehoods to emphasize a point, even when i AGREE with their main point

the statement that cadillac plans do not exist is FALSE.

your statement that they are "virtually non-existent" is also bogus.

accept that they exist, and many union members have them.

[Blue State Blues]

18. Wow. So my question is, would you care to trade with me?

Because my plan's benefits are, well, to put it mildly, crap. And I pay almost enough to qualify for the so-called Cadillac-tax even though my benefits are hardly luxurious. In fact, at the current rate of my premuim increases, I would be paying that Cadillac-tax in a few years on a plan whose benefits would better described as a Pinto.

So part of my skepticism about the structure of the tax is that it is based on the cost of the plan and doesn't appear to be linked to the value of the benfits or the profit margins of the company selling it -- so someone who pays a great deal for their coverage because of age or health issues might fall into the tax even though they simply cannot afford to pay it.

But what you have sounds like a wonderful plan, so I'm really curious about your perspective on this. Do you think that you should pay a 40% tax on your benefits?

Wait. Is this a trick? Are you perhaps a Member of Congress?

[paulsby]

23. uh, no

i do not think i should pay any tax on my benefits. nor does my union, or most unions whose participants have similar plans. it would be the functional equivalent of a HUGE tax hike for the middle class.

i support universal health care. this is not a trick. i have cadillac plan. admittedly one of the reasons my union was able to negotiate such a plan is that my coworkers historically have relatively low levels of usage of medical benefits. so, the insurance company thought it was a good risk.

i enjoy my (currently) 2 massages a week. i'm currently on disability insurance (another company - paid by my union dues. primary insurance is paid by my employer). my take home pay on disability is GREATER than my take home pay at work.

i will not trade w/you, but if you are considering a career in law enforcement... i can give you some tips, and you can have this plan too. :)

[debbierlus]

14. I have written about this before. It is disgusting

[MisterP]

17. these are the same economists who say that the problem is lack of "competition"

like we need to return to some unfallen, 1830s small-scale capitalism, and that would solve our problems

it wouldn't because "competition" would only mean MORE insurance companies

a robust public option would be subsidized, and thus UNfair competition--and that's the whole point, to provide something affordable and without unnecessary overhead

f--- the market!

[LiberalFighter]

19. What do those on Medicare, VA, federal employees and Congress have?

[kath]

20. What they call a "cadillac plan" here is what VIRTUALLY EVERY SINGLE GODDAM PERSON IN EUROPE OR

CANADA has.

Jeebus H. Christ. :banghead: :banghead:

And it costs far freakin' less than what it does here (if you consider what employer + employee pay_

[Brickbat]

21. I hate that it's considered a taxable luxury, esp. when our excellent coverage is a NEGOTIATED

BENEFIT that was AGREED UPON by the union and the employer. NO coverage should be taxed. It's bullshit.

[TheKentuckian]

25. The Max tax is a rip off squeeze play designed to screw workers

out of wages negotiated away to allow the worker to maintain quality affordable health coverage.

This will not just hose union workers but virtually EVERYONE. Very few people have any plan crappy or not that doesn't have a total cost of 8k. The only reason every alarm bell in the universe is going off is because most people don't realize their raise has gone into premiums and because the only thing they are counting is their portion of the cost.

Max is conniving to get more of your money back in your employer's pocket and as always to slide his masters at big insurance a few extra bucks too.

The plan is to give almost everyone crap coverage and make us pay as close as possible to the out of pocket maximum.