Private Health Insurance

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so let's talk about private health insurance and I find the one of the
easiest ways to understand it
is to go ahead and take a little bit about historical you
let's go back almost a hundred years but sometime
before that nineteen twenties and before the nineteen twenty months
there is a group adopters they got together and they started tuning
say what looked we want people to be able to get to us
let me care and so what we're gonna do you
is we're gonna go ahead and offer essentially like them membership bar
so will have us possible asians
out there and think and go ahead
and send us CA small regular subscription

the so I'll send us money and then for that small see
Phyllis sensually have a subscription almost like a host club membership or
something along those lines
within your services they'll be able to get it when the
this is one the earlier attempts what's caught risks
cooling between people to make sure that they were protected
against a larger extent need to see the doctor at some points
then in the nineteen thirties
this there wasn't interesting twist so there were
again a group of workers in fact there were teachers networking
outside Dallas Texas and their school
on their behalf said look we really like our workers we want to take
good here of our teachers state across school building here
her little a tower near maybe clock
and that's cool said we are going to me

Gushi causes the hacker March teachers so we already pay our teachers
wages what we want to do is to offer them this new
benefit so Rs school system is gonna go ahead
and also hey you this
Center actually when you're Taylor hi
near Dallas Texas and we are going to
in addition to offering wages and salary
also gonna bite them health insurance those exit times roughly about six
dollars
a penny which got their teachers that right about 20 days in the hospital
the this is probably won't. earliest examples
what is today called in claw your all
sponsored sure sir the
s hi which his really
the car that dominant waded many people United States get
orchards and in fact this system about getting
all a group I'll and
workers together through their employer later became that basis it wants to the
Blue Cross she
however that's two lists really help us understand what that was it
that's it interesting I D that those in warriors that school was getting
insurance to their teachers but how is it that that's how
most Americans get health insurance so understand that we have to go to that
ninety
words and as you're probably aware 1946 when
the United States was in Grotal World War two
and because if that seems war effort that was it time
rationing it was not really widespread
access to all goods and services that people wanted
and were the things that government did it that time was thinkin Institute
very I tight system we each control
school in other words if you were a business owner
I'll hi you could not really offer
or increase it matter we just keep each workers and this is sort of a way to
control
economy by federal government despite the inclusion a little bit
on if you really want it grew workers you want better workers
you were allowed to offer more money so how'd you get so what the it was the
start to offer
strange benefits so yeah
you could offer more money but hey maybe we can offer workers other goodies
like watched and backed it turned out the biggest grin you all
you guessed it was health insurance so what happened in the nineteen forties
was
employers started to compete for better employees
the store these benefits it based are
quality and the quantity health insurance that they offer
so this got to be very popular way to recruit workers
but there was one other thing that happened which really kind
accelerated strand and that happen really pretty much in nineteen
Inc or and its unclear today whether the federal government
even realized what was happening but they made a decision
they said those fringe benefits that me to that health insurance
tell you what if you buy your or use health insurance
that is gonna be considered a tax
sry a benefit for that
in other words think about it this way let's say you hacked
%uh in pool whilst so you gave that employees hundred dollars
for work that they did well their take-home pay
is going to be less than a hundred dollars because they have to pay taxes
on
so even though the earned a hundred dollars what they're gonna take her was
on getting you got
ito snout let's look into how's this look
if you got health insurance that was
tax-free suppose that seeing worker heard a hundred dollars
and it because this was used to buy
employer-sponsored insurance occurs at hundred dollars
that entire hundred dollars was
value to the employees because they got a hundred dollars for
outage you happy any tax that so look at that comparison
you can see that economist
government said that these benefits would be taxed
re that was essentially wait for dante
you workers extra money that was not
tax was essentially a subsidy that the federal government
he for purchase health insurance starting in nineteen
the or and that continues to this day
this series the Excel arena switch to you
employer-sponsored insurance by
and 1960s while
almost three-quarters 75 percent
american workers were getting employer-sponsored health insurance
because it really easy you know should be great and that
even to this day the majority of Americans get health insurance
through their employer written agreements
let's talk a little bit now about what does that private health insurers
action look like so this ten few minutes now
describing general structure I'll private
sure it's while employer-sponsored
insurance generally takes wanna to force
the first is called the who or
certs some tend to agree it is
s at s in this is a type but what is called
in dan needle well
the other broad find private insurance
is referred to as managed here or
you all talk about what each in the skies health insurance are
in for shirts what happens is that you may see
a doctor
for a health care provider sometime and then health care providers is OK when
you
we're going to do an xray so that's gonna cost money Senate bill
they were going to do an operation that's going to school in the Senate
bill for that
maybe we are doing all so other
test this city built for that and they generate all these bills
these stills kits sent to your sure
and your insurer then goes and benches
pays that money now so they said that back to you
any got here for each these
or bill Center centel all

and that is what's called your shirts so pretty simple
in concept jazz/nu you got to seize you they perform a service
he said the bill thing pain that ox
turns out this year's many problems at this
tight up arrangement this first you can imagine
is that if you're unsure just pays whatever bill
get they get sent think about what the health care system and you
so say hey was sent bills are a lot of money
know he's checking they're just paying whatever we charge
so this is a set up for very high
health care costs so

if you had Ieper servicer indemnity system
there's a tendency for the health care system start charging hi
crisis because know you gotta pay cell
the screen and so the cost may go higher higher over time
the second problem is that because
you might see different doctors are all sending different bills
they're all getting paid that type but here at you get
me very fragmented hope your doctors your health care
providers meet up talk to each other know it's senator them to talk to each
other
and as a result quality hearing yet
may not be as good

the next thing that the third proper
with eat for services that overtime
as those fees go up you
increasingly have to patients
happy hey more soon at risk cost
shearing increases overtime
so cream use me go I'll York lawyers have to pay more and more
and overtime what that does that money comes
how did your wages sue your wages every tendency to be
even who lower over time you purchase the
ward where that money is going into paper your health care
so those are problems with that need research assistant
and it's actually led is to become much less popular
in fact its est me that if you wouldn't I percent are
all people who work private health insurers are
pure the sure is tightly its instead
is really been the rise what's called managed
here and bench here as couple

court futures so what happens is it when
package here your insurers happening actually
creamy he who they find in Google doctors
and hospitals and they make a contract with them
we'll see we'll hang you should arrange that we're gonna penny
if new one in get access to the patients were gonna send
you have to agree to this demand schedule
subway and so that should reverse assorted
me checkpoint cost that will be charged in addition they might say will
we might even had disease management grew
school because we manage people's
here from re don't want them to get sicker because the
seeker they get that wasn't hostess we're gonna have all these programs to
make sure that

you get better here yet diabetes asthma heart
E disease estimate mitigate the risks
or hopefully cost is less money gonna managed people's
hell little bit more hooks on what we might do
is we want to keep those costs low so some who were doctor struck to charge
more money
we're gonna start shearing doctors in other words we're gonna change that cool
its so if you go to a high
cost doctor you may have to pay a higher deductible
him if you go to a lower cost doctor
then you might have to pay a lower deductible so what they do is they
manage

what doctor sheep goats you and the are much more aggressive and making sure the
patients at lower cost there's as a result with the
you then is the also have very specific networks
or groups have doctors much like me per
her doctors what to so in this way
many insurers try and eggs sure
a little bit more control all the bills it repeats said
and how much those insurance well spay
and most people today now the steps that manage
here programs Private Health Insurance