The Pharmacy Chick

Flying the coup in retail

Paying the premium

Filed under: Uncategorized — pharmacychick at 6:45 pm on Wednesday, July 20, 2011

In PharmacyChickville newspaper, the recent hot item, (other than the weather) is the fact that a huge union-based employer group is having a war during their contract negotiations.  Apparently, despite the sagging economy, rolling furloughs, layoffs, and cutbacks,  THIS group has managed to preserve (til now) its FREE health insurance.  Its the kind of job we all would love to have.  Once you get hired, its awfully hard to get fired, and the benefits are pretty nice….kinda rare in todays world.  No wonder everybody lines up 10 deep to apply.  Since I write anonymously, I cant reveal the employer but suffice it to say its still the bastian of golden parachutes.  It is a government based employee group.

Now however, this group can no longer fly under the radar.  If you worked for the govt you got the best of the best, with regards to benefits. It was said at one time that the wages may be slightly less than the private sector but the benefits couldn’t be beat.  True statement if what my employee friends say is accurate.

Now the hammer is coming down.  Money is short and if everybody else is having to pay for health insurance then is reasonable and rational to expect that THIS group should be paying part.   Mr Chick and I pay close to $400/month in “premiums” for our employer based health insurance.  $4800 per year for our anual tooth check and OB exam.  wow.  At least we know that if we crash and burn, we are covered….at 80%  Yea, even with health insurance we could be bankrupt by a catastrophe.  This particular group pays nothing.  nada.  zippo.  Tax dollars pay them all.  MY Tax dollars.

the union is having a fit because they may have to pay a small percentage of the premium. 

I thought about it for a while and came to this conclusion.  They should pay. No, I am not being sour grapes.  Its just the fact of the economy.  Times are lean and if you are gonna keep the most jobs, then something has to give. I did a mental looksee over the last 15years of my employment benefits and this is what I found.

        1.  When I was first hired.  we had free health insurance.  Both Mr chick and I happened to work at the same employer (tho in different jobs) and because we were “double” covered, we had our expensed paid at 100% because what 1 didn’t pay, 2 did.  it was nice.

      2.  later on the policy changed.  Each employee had to have his/her own plan, even if you worked for the same company and you could NO longer be double covered, which means that Mr C couldn’t be a dependent on my policy if he worked for the same company as I did, he had to carry his own…AND we had to start paying a small “premium” around 15 bucks a week.

      3.  Mr chick eventually moved to a new employer.  Chick’s employer group wouldn’t even cover him IF he could receive ANY benefits from his new employer, and if I did add him, it was a $200/month fee.  Yes folks…two hundred dollars a MONTH .  Thank good ness his new employer had health benefits.

      4. fast forward thru no deductibles, fixed copays and ceilings to 1000 dollar deductibles,  percentage copays and no stop loss.  currently the first thousand bucks of all medical expenses are on me each and every year.  For the last few years, I haven’t had to file a single claim, because I have had to pay for everything up front.  Everything the Dr billed was rejected “subject to deductible”. 

And I get to pay $400 per month for the priviledge ..of paying for it myself.

Do I feel bad for this union for being forced into the reality of 2011.

Not so much.  Ive been doing it for years.


Comment by WarmSocks

July 20, 2011 @ 7:36 pm

Yep. My SIL works for the state and is all in a huff about the possibility that she might have to pay a tiny fraction of her family’s premium.

No sympathy from me when she whines about maybe having to cough up a couple hundred dollars. My family pays $1200 per month as our insurance premium and has a $1500 deductible (per person).I have a customer who is paying over $1500 a month for he and his wife’s private insurance. Next month he is finally elig for medicare. He said it will be like getting a thousand dollar a month raise.

Comment by AX

July 20, 2011 @ 8:18 pm

Maybe instead of being upset that the union is trying to preserve good benefits for their members, we should be asking why we’re so complacent about getting royally f*cked ourselves.

If they can buck the trend and leverage their way into decent benefits, why on earth should the rest of us be upset that they’re not getting screwed like we are by this terrible, broken system?

Having managed to maintain reasonable health care costs for years shows that they’re doing something right and I, for one, hope they don’t just give up and roll over.

Maybe if they can’t keep foisting increased costs off on people who can scarcely afford it, we might see realistic solutions.

And, finally, I’ve seen conflicting reports, but I was under the impression that pharmacists make quite good money. Paying $400/month for (poor) coverage is annoying at $100k per year. It’s downright crippling at $40k per year. Comparing your situation to that of those who earn closer to the median wage in this country is hardly fair.You make several good points, but the point that I want to make and reiterate is this: It is TAX dollars that are paying for all their health insurance costs. YOUR tax dollars and MY tax dollars. Im paying my own premiums and I am paying theirs. I am not complaining about paying my $400 share of my insurance. But I am not so thrilled about paying theirs.

Comment by chewyf

July 20, 2011 @ 8:52 pm

Did govt workers somehow bring down the economy? Did 4th grade teachers or cooks at state prisons cause the bad economy? I am with AX. Why are you OK with this race to the bottom? Why aren’t you asking why the private sector is screwing workers at all, rather than arguing that govt workers should get screwed too?write me a post, I’ll paste it in and give YOU all the credit. but just so you know, its NOT the teachers or prison cooks in this group. But Yes the govt is bringing down the economy. But its coming down to this: if the benefits are kept as they are: 100% paid, they will lay off more workers to offset increased health costs. You like that option better? fine. We aren’t living in the land of milk, honey and unlimited money anymore. Health care expenses are skyrocketing and the govt wants them to pay a token amount for premiums. Its not huge but spread over the population helps the situation. Its not unreasonable. there is a lot of scrambling. Today I took an unpaid day so a relief pharmacist could get some hours. If he doesnt’ work enough hours this month, he gets NO insurance next month. 2 years ago we could write our own paychecks..want 60 hours a week, fine. Now some of our floats are begging. There shouldn’t be any sacred cows.

Comment by CPhT Girl

July 21, 2011 @ 3:59 am

Well said, Chick, well said!

Comment by Bluetowelboy

July 21, 2011 @ 6:30 am

While I can agree with you that a small premium is a tiny price to pay maybe they are looking at your situation, and many others, and see it as just a first step down the path you have already traveled. A small premium increase this year then more increases next etc.

It is your tax dollars that are paying for these benefits but unfortunately you don’t get to decide how your tax dollars are spent. I don’t like the war in Afghanistan but I don’t really have a say as to whether may tax dollars pay for it. It is just a fact of life that some jobs in this country are done by the government. They have a right to collectively bargain in some places just as you do at your employer. Why should they give that up? Because you don’t like that they get good benefits? If you could have stopped the companies you worked for from raking you over the coals for health coverage wouldn’t you have done that?

The government did not create the financial melt down. It was created by investment greed plain and simple. Enough blame to go around to each party but the facts are pretty clear. Borrowers were given the opportunity to take out mortgages they couldn’t afford. The banks knew they couldn’t afford them, the borrowers knew they couldn’t afford them but both were looking to make a quick buck. The banks rolled the mortgages into mortgage backed securities and sold them as AAA investments even though they were worthless. The investors took out default swap insurance on the mortgage backed securities and then the whole thing started to unravel. Banks ended up owing billions to one another and investors. Trillions of dollars vanished from the market in a matter of weeks.

Government workers are not the problem. They are people just like you and me trying to eke out a living. All these cuts in government spending cut real jobs of real people, increases unemployment, and drives us deeper into the hole. IMHO

Comment by CHEWYF

July 21, 2011 @ 7:38 am

“We aren’t living in the land of milk, honey and unlimited money anymore.”

Really? Seems like it still is for the people who caused the mess.

Comment by JS

July 21, 2011 @ 9:36 am

Back in the day, when I started teaching (1991) our benefits were paid by the district. We had co pays for RX’s and MD visits and that’s all. However, because it was a NO CHARGE as part of our contract we had to sign up for the insurance (because it was at no cost and the more signed up the bigger discount we get on premiums). That caused problems for families who also were on a spouse’s policy. I know double coverage tends to be an issue now with hospitals.

During a contract negotiations year, there just wasn’t money in the budge anymore and we started having to pay part of the yearly premiums (it was a minimal amount; the more you made the more you paid) per pay period (more for family coverage). Keep in mind our salary is based on nine months NOT twelve (it’s just broken up into 26 paychecks). When that happened, it could NO LONGER be mandatory. I felt that the little we were asked to pay was understandable, and I hated to see student programs cut because we refused to “give and take!”

The RX co pays increased as well. Many complained that we went from an RX co pay of 5/5/10 to 10/10/20 and then over the years 15/15/25 and then finally capped off at 20/20/40 and then a mere $15 for all medical co pays. Several had a fit. One pounded her fists, screamed and yelled. She was a severely, morbidly, obese women who kept saying that she was going to be paying SO MUCH more for her monthly medication (I pulled her aside and tried to explain things more privately; it was NO WIN for her).

Since I was the messenger, I had done some research. I picked some drugs that I was fairly certain that staff members were taking and explained to them the cash price and the price with insurance. I know for certain several were on statins, diabetes medication, inhalers, and the newer more expensive antibiotic (we work with germ infested little people all day long). At that time, I had started having many health conditions and used some of my own medications as examples as well. Showing them that without insurance I would be paying more than $1000 a month for medication and with insurance I am paying less than 10% of said amount and without the insurance I would not be able to take some of my medication. Also, BC was always covered. I always turn down samples and ask MD’s to save them for patients that have NO INSURANCE (often some MD’s would push a few weeks on my just in case they made me sick or didn’t work).

Many understood that, but she continued to go on and on and on some more. Knowing where she fell on the pay scale……………25+ years in, with a Master’s +30 (highest education wise) and her husband was making a fair amount as well, she was the last one that should have been complaining. We had a staff member whose husband was dying of cancer and she was the only working person in the family (there were four kids too). She was new to teaching and at the very bottom of the pay scale and she was just thankful to have a job, with affordable benefits. When it came time to vote the change in benefits passed 98% (yes) to 2% (no).

When I left the district due to medical issues, I stayed on COBRA for the first 18 months at $500+ per month. Now, that I am on different insurance I am paying $400+ along with quite a lot of out of pocket expense before the 80/20 kicks in, and then finally the 100%.

The alternative is NOTHING!

I think anyone that has insurance should be thankful to have what they have. I know I am! My fiscal year started on 7/1/11 and by 7/13/11 I made my out of pocket deductible (though it will take me many months to pay off the hospital who did the procedure). At least my upcoming surgery and hospital stay will be covered at 100%.

Great, through provoking post (sorry about the rant)!


Comment by JenRPh

July 21, 2011 @ 9:58 am

I find that those who do not have to pay anything for their coverage tend to value it (and the services it covers) much less. Cost sharing is part of the program now. Maybe those who want everyone in the country to be covered without any cost sharing should foot the bill rather than using tax dollars. I would much prefer to have everyone pay something rather than some pay everything and others pay nothing.

And, Bluetowelboy, we do get to decide how tax dollars are spent…we can vote and we can write our representatives to express our opinions.

Comment by JustADoc

July 21, 2011 @ 10:30 am

Try paying the entire premium when you are the employer.
Health premium for family of 3: $1200/month
Deductible: $7500/year

That’s right. I pay the first $21,900 of medical care a year before insurance pays one penny. you win. that sucks the most!

And that doesn’t include dental insurance.

In addition to that, I(and my fellow owners) pay 100% of the employee’s premium as well. They have to pick up the extra cost if they want to cover spouse/kids.

And I am relatively thankful for it for what is possible in today’s world.

I would absolutely love a policy that was true catastrophic coverage and cost much much less, but such is just not possible in this country at this time. And with current law, it will not ever be.I have a couple of customers that are business owners of small businesses. a few of them have told me that buying health insurance for them darn near bankrupts them each year.

Comment by Bluetowelboy

July 21, 2011 @ 11:44 am

And, Bluetowelboy, we do get to decide how tax dollars are spent…we can vote and we can write our representatives to express our opinions.

That is true but it doesn’t change the fact that we live in a representative democracy so you still don’t get to choose how your tax money is spent. Expressing your opinion on tax policy is a wonderful freedom we have in this country but ignoring your opinion is still an option for your representative. Unless you are the policy maker you have very few options to decide where your tax money is spent.

Comment by jen

July 21, 2011 @ 3:40 pm

Jeez…I am so glad I live in Australia. I pay $163/month for top health insurance. I get the majority of my scripts for $5.60. I am having a regular medical procedure including a general anaesthetic in a private hospital every 2 weeks… I pay nothing. I recently upgraded my health insurance and have no copay or excess for private hospitalizations. Things not covered by private are generally subsidised by medicare/public health care. Things like glasses, I pay a small amount but the rest is picked up by insurance and Medicare. Yes..I am very lucky!

Comment by Longhornpharm.d

July 21, 2011 @ 6:45 pm

Ax – Just because the public sector unions can negotiate better deals doesen’t mean they are managing health care costs any better than any other union or business. They are just shifting more of the cost to the employer, which in this case happens to be the taxpayers. I don’t mind paying taxes for passable roads, running water, and all the other services that the government provides including providing a living and benefits for the government workers. However, whenever times are tough and everyone is having to make hard choices, it really irks me when certain groups are COMPLETELY unwilling to participate in the give and take!which precisely was my point! well said Longhorn

Comment by J

July 21, 2011 @ 11:57 pm

It looks like they have conceded and will be paying a small percentage of healthcare premiums along with some some other surcharges linked to healthy living…the economy is hurting…changes are needed.

Comment by RxBoy

July 22, 2011 @ 7:53 pm

I think the problem is that some people have it so good at their jobs that they are spoiled and don’t understand what it’s like for most workers. Up until five years ago we did not have to pay anything for our benefits where I work. Then one day they announced that we would have to start contributing $10 per week. Long time employees were up-in-arms just complaining about how horrible the company we work for is.

Last year they raised it again. Now we pay $13 per week for our benefit package. Our benefit package includes medical insurance with a $500 deductible then we must pay 20% of expenses until we’ve paid an additional $250 out-of-pocket. Then the insurance covers 100% of everything for the rest of the year.

I should also add that we get two raises every year until we reach the top of the payscale for our job category. Then you get an annual bonus check. Not too shabby.

We also have dental insurance that covers two exams per year plus a good portion of other dental work. We have a $50,000 life insurance policy and our prescription copay is $4 for generic and $25/$50 for brand drugs.

Yesiree, we get all of this for $13 per week and so many employees complain about how horrible our company is. Some people really need a reality check. After reading this, the only thing I want to say to my employer is “thank you”.

Comment by Marci

July 26, 2011 @ 12:59 pm

I disagree with you. The reality of 2011 is that insurance companies are making out like criminals. I think we all need to collect and push for insurance at a reasonable price, or free health care for all citizens. No one should accept $1000 deductibles as a norm! Especially when you pay $400/mo.! That’s ridiculous!

Comment by The Redheaded Pharmacist

July 26, 2011 @ 10:55 pm

I’m very thankful for health insurance and the coverage available to me through my employer. It would really help me in the event of a major illness or surgery. And as a pharmacist I’m also fortunate to make a very comfortable salary as well. But a lot of people are hurting right now and they can’t afford these increases in premiums or deductibles. And factor in the energy and food cost increases and you can see why the average individual or family must make some difficult choices in this economy.
I think there is room for improvement with our healthcare system and how we pay and use healthcare goods and services. The problem is our government is busy tackling other major problems at this time. We’ve really got to find a way to try and curb these increases in costs but there is a lot of different factors that contribute to those rises in healthcare costs.
And yes, I do have some problems with unions. I’ve written about my displeasure for unions at length. They seem to have more power and money than sense. And they tend not to represent the people they are meant to protect in the first place.
And having health insurance for free is a dangerous idea. If people are handed something for free they do not value it or use those services appropriately. If there is at least a nominal out of pocket fee for healthcare goods or services then people will think twice about what they are getting and use healthcare services more appropriately. That is just a reality we all must accept.

Comment by loveinmyjob

August 5, 2011 @ 11:59 pm

I believe there is alot of “entitlement” thinking in this country. Certain groups feel they are entitled to certain benefits for one reason or another. Whether it’s “I’m entitled because I work for the governemnt” or “I’m entitled because I don’t work” or “I’m entitled because I belong to a certain minority”, etc. If asked, we could ALL come up with some reason why we are entitled to something more than someone else. That kind of thinking is what causes division and animosity. That kind of thinking is self-centered and doesn’t solve any problems.
I for one am very grateful for the benefits I get from my employer. Some I pay for and some I don’t. My health insurance runs just over $200 per month for myself and my husband. I think it is an awesome deal. I have an out-of-pocket max of $2500 per year which I usually meet about this time of year. With $4500 per month Remicade treatments and $1500 every 6 weeks for Botox-medical I feel blessed to even have the option to buy medical insurance through my employer. Everyone needs to stop and realize that they don’t HAVE to offer this to us at all so it they ask that you pay a small percentage of the premium be thankful and do it. Or not, it is your option to not have insurance (so far anyway).

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