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I feel that I should be building full time but health insurance is a huge issue. My day job provides group BCBS full coverage for $102/month for my wife and I. I would expect that to cost upwards of $1000 in the private sector. Would like to here some of y'all's experience with health insurance.
Nelson

NAMM has been talking about a group health plan for a long time. Don't know the current status as I have all that covered in my retirement, but you could contact them to find out. There membership dues are around $175 if I remember correctly, and that will also get you four passes to the NAMM convention each year.

Health insurance is a MAJOR disaster. My company's premiums have gone up by a minimum of 20% per year and they tell us that these annual increases are hard to hold in check. Outside of payroll this is my highest cost.

My family (wife, 3 kids) is about $1,100 and some of my older employees are in about the $1,400 - $1,500 range for their families.

This is with a $2k deductable and $1,600 coinsurance.

This is a real problem.

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Brock Poling
Columbus, Ohio
http://www.polingguitars.com

I can only IMAGINE the costs for health insurance for a group of luthiers.. running table saws, breathing nitro fumes....

forget about it.

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Brock Poling
Columbus, Ohio
http://www.polingguitars.com

I've got privat BCBS coverage. I think I pay $350 every quarter. $2k deductable per occurance so it doen't even touch regular doctor visits. But it's there if something bad happens to me.
I checked on disability insurance and it was $1500 a month based on the risks of our occupation.

Disability is very expensive anyway.

I think the kind of insurance you have Paul is where it is heading. I have also looked at those new employer funded spending accounts. Those look interesting too, but not a real cost savings.

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Brock Poling
Columbus, Ohio
http://www.polingguitars.com

My wife went back to school after raising six little ones and now works as an LPN at the local hospital. The hospital doesn't have a very good health insurance program for it's employees.
Go figure.
Nelson

But the nurses get to bring home band-aids so no health insurance is needed.

Here's a solution: CANADA--lutherie capitol of the world!!! Let's all go!

No. I don't think that is the answer either.

No offense to our Canadian friends... but America is still the engine of innovation -- the whole world benefits from our research (or our ability to productize research). I think a large part of that has to do with the formation of our capital markets.

I don't think we should start monkeying with that end of it.

What I think we need are incentives (and disincentives) at the individual level to make us more consciencious CONSUMERS of healthcare. I think this should be our first priorty. Then to turn our attention on more creative ways of pooling risk to limit the individual exposure for insurers.

This is a real snake pit.

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Brock Poling
Columbus, Ohio
http://www.polingguitars.com

There are some doctors out there who run cash only businesses. $20 for a 15 minute doctors visit. I honestly think that this is the way to go. Get insurance like paul has for the BIG stuff and find a doctor who charges reasonable rates. Now, prescription drugs are a whole other matter. I could go on, but then this could really get political too.

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Joe Breault
Merrimack, NH
Perpetual novice

[QUOTE=Brock Poling]
No. I don't think that is the answer either.

No offense to our Canadian friends... but America is still the engine of innovation -- the whole world benefits from our research (or our ability to productize research). I think a large part of that has to do with the formation of our capital markets.

I don't think we should start monkeying with that end of it.

What I think we need are incentives (and disincentives) at the individual level to make us more consciencious CONSUMERS of healthcare. I think this should be our first priorty. Then to turn our attention on more creative ways of pooling risk to limit the individual exposure for insurers.

This is a real snake pit.

[/QUOTE]

It's probably not wise to post this, but I'll do it anyway:

None of that has diddly to do with the practice of medicine. Healthcare, biotech, pharmaceutical research is a seperate issue. The day-to-day practice of treating patients has nothing to do with innovation, and introducing a national healthcare system that would put America on par with the rest of the industrialized world, instead of at the bottom of the list (when it comes to access to and affordability of care, not the quality of care which is generally above average).

To my mind, access to healthcare should be, especially in countries rich enough to afford it, a basic right. I'm not advocating nationalized health systems (because I don't believe they provide optimal quality, or function terribly well for patients or doctors). But a mixed system, with private companies providing insurance and care itself, but government regulation of basic health insurance packages, to be paid for by individuals, with potential additional coverage if desired, and subsidised if appropriate (low-income families), defining a basic standard of insured care for the entire population would be a good thing all-round. Profit margins may go down, but market size would go way, way up, and the additional freedom it would give would-be entrepreneurs is not to be discounted. In my opinion, accessible, quality healthcare for everyone is the benchmark of a civilized society. Not free, but (financially) accessible to all. And MediCare doesn't cut it, in my book.

The free market is a wonderful thing, but frankly, the US is a perfect case study of how it fails miserably at handling healthcare provision on a population level. That its perfect, and the best of possible systems for every area of human interest, is and remains a myth.Mattia Valente38644.7797453704

This is one of the main reasons I have a day job with great benefits.
I pay 25% of my family health insurance which is about $300. a month.The nice thing for me is that it's the same price if you have 1 kid or 6 (We are having our 6th).
But it has been going up at an alarming rate.

Whoa. Those numbers are quite frightening.

for the record: right now, as a 25 year old student, I'm paying about 50 bucks/month for full healthcare insurance (no dental). As of January 1st, NL will have a single form mandatory health insurance at a state-defined level, insurance provided by private companies, care largely by private hospitals, clinics and GPs (save the academic hospitals, which are at least semi-state funded) to the tune of roughly (IIRC) 1500 dollars per year, per person, with a variable rebate according to income levels of up to 500. This covers basic costs, but not dental, and children under 18 are (if I understand it correctly) insured for free. The standard of care here is at least equal to that in the US. The Netherlands also has the advantage that it's fairly small, which makes some things easier to organize.

What we do have, however, is a shortage of doctors and qualified nurses. As ever. I guess that means I won't have much trouble finding a job, but still.

It's sad that we Americans think we have the best of everything, yet we can fool oursleves on such an enormous scale. It sure is a snake pit. And as always, the driving force behind it all isn't concern for humanity, but the Almighty $. Somehow as a people we've lost sight of what is really important. It's systemic. It goes to the very core of our socio-economic belief system. It's a pervasive lust for profit, and grabbing as big a share of the pie as we all can. Unfortunately, a lot go without.Don Williams38645.3990162037

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"I want to know what kind of pickups Vince Gill uses in his Tele, because if I had those, as good of a player as I am, I'm sure I could make it sound like that.
Only badly."

Mattia, very well said and I couldn't agree with you more. We are one of the richest countries on the planet (if not THE richest) yet a very large percentage of people living here can't afford to go to the doctor. Even in some of the poorest countries, that's a "right" that people are given.
Yes, we have the most innovation, best drug research, blah, blah, blah...but very few of us can reap the benifits of this technology. Pretty sad really.

My family was one of those that was going without insurance until earlier this year. It was scary, but we've basically been pay-as-you go for over 10 years.

We found that doctors would frequently give us discounts when they found out we were having to write a check for the full amount. But we were very fortunate in that none of us had health difficulties that required hospitalization. Hehe. I'll never forget the $2,000 visit to the emergency room when my daughter was 2yo, cuz she busted her eyebrow open on the coffee table, requiring stitches.

My advice to a luthier? If you don't work a job that provides you with health insurance, try to talk your wife into getting one. My wife got hired at Costco last year and one of the best things about that job is that we finally have health insurance for the family. Yeah, it costs quite a bit, but it sure takes a load off the mind, lemme tell ya.

Anyway, this is a very complex issue, and finger-pointing can be done from all sides. I personally believe health care costs are totally out of control, but the reason for this situation is complex. It is overly simplistic, albeit convenient, to blame lawyers for causing doctors' malpractice insurance rates to rise to such heights that their costs of doing business are almost unbelievably high (try several hundred thousand dollars per year in malpractice premiums for surgeons). And I also believe that, since medicine has become a non-competitive environment where the patients do not see the cost of care until after the fact (if they have insurance, that is), this further encourages increases.

Case in point regarding the latter. Last year, I managed to nick one of my fingers pretty well with a chisel when splitting some brace wood. The cut went entirely through the cutaneous layers, down into the meat. As soon as I saw it, I knew I needed stitches. So, I wrapped the cut up tight with a damp paper towel and drove myself down to the local emergency room.

The nurse asked me when my last tetanus shot was. I had no idea. I wasn't given a choice; I got one. Some time later, a doctor came into the room, and when I showed him the finger, the cut had already closed (I'd kept pressure on it with the paper towel the entire time).

I told the doc that it looked to me like I didn't need stiches after all. He agreed (surprisingly), saying as long as it stayed closed, I should be fine. So, I went home.

Several days later, I got a bill for $120, which I thought was pretty outrageous for a tetanus shot and 5 minutes with the doctor. But then I looked at what my insurance had to pay. Over $700. So, that tetanus shot and 5 minutes with the doctor cost my insurance company and me over $820.

Now, them's good wages!

As far as the cut goes? It healed up so well (that was a scary sharp chisel) that I have to know exactly where to look to find the scar. Shoulda just stayed home.

Best,

Michael

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Live to Play, Play to Live

Hello, One And All--I'm not a luthier, but I hang around here quite a bit,
as I have a deep and abiding interest in the steel-string guitar. I have
bought guitars from several of you, all of which are gorgeous instruments
I might add, and I'm sure I will be back in the market before too long.
Anyway, this post on health care is interesting and timely. For the last
two years I have been the president of a teachers' union, dealing with all
these issues in detail. It had to be my business to learn about health care
and its delivery. Here's a statistic for you, which is true almost across the
board. 85% of health care costs are driven by 15% of a group's members.
I think Brock is exactly right. I was much more "collectively" minded
about health insurance until I really studied it. Until we incentivize good
health instead of poor health, we will never solve the problem. If you
smoke, if you drink too much, if you eat too much, if you don't exercise,
you pay the same insurance rates as everybody else; however, you use
the system at 3-to-5 times as much as everybody else. This is an
unsustainable system, mostly because the 85% of the population who are
healthy are going to figure out sooner or later that their health care
dollars are going to subsidize the poor health of others. I want my health
care dollars to insure me and my family, to protect the group against
catastrophic occurrences such as heart transplants, cancers, and
accidents; but I don't want my health care dollars to subsidize the poor
health choices of others. This is exactly what is happening now. And I
would wager, based on my experience, that one of the reasons reform is
so difficult is because the high users are more knowledgable and more
aggressive at protecting their interests. They like the system the way it
is. Put another way, in general terms, the only people accepting any
financial risk are healthy people. I just don't think this is a sustainable
system, for the long haul. Thanks for letting me spout off. And by the
way, this is a great forum. Luthiers are just too cool!!

I once went without insurance. I'm young and healthy. Then my apendix needed to be removed. $10,000 later, I learned my lesson.

My old boss was self employed, he was paying $1,200 a month for insurance. So, he sold his business and now works for someone else.

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Joe Breault
Merrimack, NH
Perpetual novice

My wife and I run a small "mom and pop" business. Our medical and dental insurance which covers the two of us is through Kaiser Permanente who charges us $520/month and is paid by our business. Each visit costs us $10.00 and we pay a minimal amount for our prescriptions when needed. I have always complained about this monthly fee but after reading some of these posts I don't think I'll be complaining anymore.

The reason I'm semi-retired is insurance. When I retired from teaching I lost the state's contribution and local contribution to our policy. The whole load shifted to me. I was paying around 300 a month for my wife and me. Upon retiring, the cost jumped to 1000 a month. So I'm still teaching half a day until I am old enough for social security. Then when I'm old enough for medicare, I hope I can relax a little.
I agree about the group thing. It costs a lot to insure a group because everyone is accepted regardless of health. I have high blood pressure now and can't get a decent individual policy, so I must stick with what I have. Fortunately my family is healthy, but the risk of financial disaster without insurance is scary.
A lot of the problem is driven by the gullability of the American people. Watch TV and see how many drugs we didn't know we needed, and how many lawyers are urging us to sue everyone.

Ron

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OLD MAN formerly (and formally) known as:

Ron Wisdom

Somewhere in the middle of Arkansas......

Hey Brock, ya have to know that Canada has a fair share of innovation as well! In luthiery alone think Laskin, Manzer, Larrivee and our very own Proulx, just to name a few. Regardless, our medical system is not the best either and it certainly is not free. Nothing works that way. It is just a matter of WHEN you pay. Our health care is federally mandated and provincially operated, the bulk paid through our taxes and the rest either subsidized (if you can't afford it) or typically covered by group insurance through work. I think my monthly bill for my family of four is about $75. But I probably pay close to 50% tax by the time the dust settles when you pay taxes on all you buy along with your income tax. I have had very recent experience with a major medical incident. Both my wife ad I are quite healthy and use the system very little. Our 1st son is the same. Then came number two, a thriving young lad that did great but would then all of a sudden plumet into a bad flu like illness that would land him the hospital for 6 to 7 days of IV to rehydrate the little gaffer. A few months of this and it was finally determined that his liver was failing. It turns he had a rare (as yet undescribed) gentic defect that resulted in the pre-programming of the genes in his liver to just shut down. So a year ago last March, he was 16 months old then, we were shipped to a hospital in Alberta, we live in British Columbia, where they took a chunk out of my liver and put it in him. Six weeks in the hospital for him and another two weeks of hanging around before we could start to head back home. I don't have clue what the costs would have been to have some of the worlds best surgeons open each of us up and start swapping organs around, but I bet it is more than my entire worth (in money anyways). Leith's ongoing medicine costs about the same per month as your insurance rates (about $12-1400/month) but is covered by Government funding somehow, we only pay to have it couriered to use every 3 to 4 weeks. The moral is, even if you are otherwise healthy, non-smoking, not entirely over-weight, somewhat fit, these things can still sneek up on you. Then on the woodwork side, 25 years in the shop, seen the doctor once. I am thankful for our Canadian system but it is also riddled with tremendous flaws that keep it as one of our countries great debates and a consistent election issue. But, hey, any Luthiers want to come to Canada, you are most welcome, especially if you are innovative! (Just throwing you a jab Brock! but it's a slow one...)

Shane

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Canada

Jack: I agree, it's a serious problem, but it's not one that's not happening right now, either. A small percentage of the population, usually older people (degenerative conditions) will amount for the majority of healthcare costs in an insurance system. In the US, and increasingly in other industrialized nations, there are alarming increases in high-risk behaviours (obesity being number 1, in my book, with disastrous effects across the board), such that siginificant portions of the population are due to have serious problems at younger ages than 'normal' (degenerative diseases more common at age 70 starting at age 30 or 40). Even now, a lot of these things aren't 'merely' a matter of 'eating less' and 'exercising', and a lot of these people need medical help now. Prevention is great, and should be pushed above all else, but solving public health issues won't happen by not insuring people with high-risk behaviours. Requiring additional premiums for risk behaviour is also a difficult choice, because, by and large, it's people from lower/socioeconomically disadvantaged classes that have the most health problems.

As always, with insurance, it boils down to the level of solidarity you're willing to put up with. What people often forget is that, at some point in their lives, it's all too likely that they too will have an extended stay at the hospital, and they too will 'cash in' on those premiums they've paid throughout their lives. And, lest we forget, uninsured people using healthcare only when it's gotten so serious they have to stumble into the emergency room means higher costs across the board, including for people with insurance.

Personally, one the new features of the Dutch system that does add an incentive is the no-claim bonus system. Usage of healthcare (excluding basic GP care) is divided into tiers, and at the end of the year, people get a rebate (up to about 1/6 of their annual premium, I think) according to their consumption. That's a fairly strong incentive to think about care consumption, without excluding those with weaker health from basic coverage (because frankly, not all of those high-care users are to 'blame' for their problems, lest we forget). Additional insurance is also up to insurance companies; its just basic (but full) care that's covered.

It's a big, tricky, messy snakepit, and it's not one that any country's solved perfectly, I fear.Mattia Valente38645.1236458333

I'm not going to get into the fray regarding government supplied heathcare. But I will say the reasons behind the current situation as regards health insurance is the result of government over-regulation combined with the advent of the third-party-pay systems. (And also the cost of supporting all those ambulance-chasing lawyers.)

There's a reason that NAMM has been talking for a long time about providing group healthcare for its membership — talk about it is pretty much all they can do, thanks to the rat's nest of regulations and laws that make it nearly impossible for associations to form healthcare groups across state lines.

The franchising company I work for has been talking about it for a long time, too. During the past ten years we've explored quite a few avenues and have found a dead end at each one. Our organization consists of about 250 small businesses with an everage of 3-4 people employed. That's large enough to form a pretty good group, but because of the insurance laws we've been prevented from forming a group for health insurance purposes.

There is hope, however. the U.S. House has passed a bill that would cut through the regulations and allow professional, fraternal and other organizations to set up group health plans. The Senate version of the bill (S 406) is still in committee and has been there quite a while. If you want to get involved in solving this particular problem, you could contact your Senator and tell him or her to get off the dime.

You can read much more information about this at the International Franchise Association Web site.

By the way, the bill is sponsored by Senator Olympia Snow. I'm so conservative, that I creak when I walk. This is the first time in my memory that I have ever agreed with her about anything.

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