OBAMA/TRUMPCARE MEGATHREAD

[StrangeSox]

Yikes. She'd be f***ed if she ever wanted to see a doctor or actually got sick. I take a medicine that is $400/month without insurance; I'd never get by on something like that.

 

Yeah her particular "insurance" plan sounded like a straight-up con job. She was paying over $50/month for them to throw in a few bucks here or there.

[StrangeSox]

It makes no sense to me that a health young person who doesn't use health care as often needs to pay MORE for coverage. If anything, they should pay the least amount out of anyone.

 

I just wanted to add that, for the majority of (non-Medicare/aid) Americans that get their health insurance through group plans provided by their employer, this is already how things work. The healthy 22 year old fresh out of college will pay the same premiums for an individual plan as the 65 year old who's already had a bypass surgery.

 

More from the Incidental Economist (quoting Josh Barro)

 

Redistributive public policy is even more of a theme in the group health insurance market, which is nine times larger than the individual market and the dominant source of “private” health coverage. […]

 

Employers are also limited in their ability to pick and choose whom they offer insurance to. You can limit coverage to full-time workers only, but you have to offer it to all of them on approximately the same terms, without premium adjustments for claims or health status. […] [T]hat benefit ends up being much more valuable to people with high health costs than with low ones.

 

Some 90% of people with private insurance receive it through an employer, and those plans are generally priced using “pure” experience-rating. This means the company serves as one giant risk pool, and a firm’s youngest employees have the exact same insurance premium as their eldest colleagues. The practice has roots in tradition and history; unions started negotiating these kinds of contracts after World War II, and other plans followed suit. But it’s also a matter of law: HIPAA and the ADA prohibit premium variation by health status. Age rating is constrained somewhat—though not entirely—by the Age Discrimination in Employment Act.

[cabiness42]

Here are the nationally available options for Federal employees for 2014:

 

http://www.opm.gov/healthcare-insurance/he...npostal-ffs.pdf

 

Not accounting for the part the employer pays, individual plans range from $360-701 per month and family plans range from $781-1652 per month. I don't know what kinds of prices people are being forced to pay on the national or state exchanges. If it's higher than the $360 self or $781 family plans here, then I think it's fair that everybody should get these options as well. $360/month is not a ridiculous amount to pay for health insurance, and if you can't afford that then you probably qualify for some sort of subsidy.

[Texsox]

There is no "fix" to this problem. It's insurance companies being forced to comply with the mandatory minimums of the law. This has nothing to do with the website issues.

 

Which of the mandatory minimums are you against?

[Jenksismyhero]

No, not "this." Are you really under the impression that health insurance premiums have, in aggregate, held steady over the past 6-7 years? People have been seeing substantial yearly increases (5-15% or more) for a while now. If insurance companies are using ACA as an excuse to extract even more rents from the rest of the economy, well, that's even more damning evidence against their existence.

 

 

edit: steadily increasing health care costs are a major impetus behind the PPACA in the first place. Now, it will be interesting to see what happens with prices over the next several years (though I think we've already started to see a reduction in premium increases in the last few years?), and it could very well be that Obamacare is a poorly designed policy. And, undoubtedly, some portion of people are going to be stuck paying more for "better" plans that they won't actually use because they won't need healthcare. But, really, every story I've seen that's had even a minimal amount of detail, with the exception of Crimon's claimed cost increases, has turned out to be vastly overstated or just ridiculously incorrect.

 

edit2: as a kicker, my premiums for my pretty awesome, relatively inexpensive plan are dropping by 1% this year! Obamacare works!!!

 

No, i'm saying that I don't think insurance companies increase premiums willy nilly or for some nefarious profit-driven motive. Yes, they obviously seek as much profit as possible, but competition doesn't allow them to jack up prices or get rid of plans for profit motives alone.

 

I'll wait and see what my insurance company says, but I find it odd that they'd send out an email warning their insureds that they won't have the same options and prices will rise. I can't imagine that's just catastrophic plans since they're probably the least popular that is offered.

[Jenksismyhero]

Which of the mandatory minimums are you against?

 

Any? You should have the freedom to shop around for the insurance plan you want.

[Jake]

The problem with assuming people will act like rational consumers, as Duke said long ago in this thread, is one's life doesn't have a price. My parents, who are still several years away from Medicare, have to have medical insurance. The risk is way too great to go without. In the past 10 years, the price they've paid for this coverage has tripled while their deductibles (they're on separate plans because that ended up being cheaper) went from 1000 to 5000 dollars. They pay out of pocket for routine checkups and preventative care like colonoscopies, mammograms, etc. where those used to be covered like anything else. Pretty much the only aspect that hasn't gotten worse is the prescription plan, but only one of them takes medicine regularly and it is a single, inexpensive generic. I'm thrilled for them that they'll be spending much less now. One had been on a casualty plan for a long time because they had a pre-existing condition (being around 60 years old and being overweight with a bout of high blood pressure in the past that has since dissipated). I'm glad the other one quit smoking 15 years ago or they'd be completely f***ed

[Texsox]

Any? You should have the freedom to shop around for the insurance plan you want.

 

Have you really thought that through? Without minimums you could shop for a plan that does not offer hospitalization, perscriptions, routine care, physical therapy, etc.? It would only cover a chat with a nurse once a year. That would be "insurance" and it would cost $25 annually. Now I understand that would be the dream scenario for conservatives but isn't even close to the goal if the reforms.

[Jenksismyhero]

Without minimums you could shop for a plan that does not offer hospitalization, perscriptions, routine care, physical therapy, etc.? It would only cover a chat with a nurse once a year. That would be "insurance" and it would cost $25 annually. Now I understand that would be the dream scenario for conservatives but isn't even close to the goal if the reforms.

 

Obviously this is the disconnect in my thoughts on healthcare and the socialist version. I think if you're 20 or 30 years old, totally healthy, and really only need a check-up once a year, you should be able to buy an incredibly cheap plan with a large deductible for catastrophic stuff. I think it's bogus that someone who doesn't use healthcare is now required to pay a hundred or more dollars a month in order to cover someone else.

 

[Texsox]

Obviously this is the disconnect in my thoughts on healthcare and the socialist version. I think if you're 20 or 30 years old, totally healthy, and really only need a check-up once a year, you should be able to buy an incredibly cheap plan with a large deductible for catastrophic stuff. I think it's bogus that someone who doesn't use healthcare is now required to pay a hundred or more dollars a month in order to cover someone else.

 

Have you ever looked at the definition of socialism or do you just parrot what you hear?

 

I find it interesting that there are people that can't handle a hundred dollars a month but could suddenly pay a large deductable.

[Jenksismyhero]

Have you ever looked at the definition of socialism or do you just parrot what you hear?

 

I find it interesting that there are people that can't handle a hundred dollars a month but could suddenly pay a large deductable.

 

Why do you always assume i'm an unintelligent boob that can't think for himself and just listens to what Hannity tells me (note: I do NOTE listen to Hannity)?

 

I consider an "everyone pays into the collective pool regardless of how much you take out" system socialistic. The only thing that's missing is the single entity owning everything, but when every entity involved is forced to do something as mandated by the single entity, it's the same thing.

 

And the key is to that system is that 9 out of 10 people will NEVER need to pay the large deductible. You're saving money for those people that don't use it, money that could be better spent on other goods and services.

[Texsox]

Why do you always assume i'm an unintelligent boob that can't think for himself and just listens to what Hannity tells me (note: I do NOTE listen to Hannity)?

 

I consider an "everyone pays into the collective pool regardless of how much you take out" system socialistic. The only thing that's missing is the single entity owning everything, but when every entity involved is forced to do something as mandated by the single entity, it's the same thing.

 

And the key is to that system is that 9 out of 10 people will NEVER need to pay the large deductible. You're saving money for those people that don't use it, money that could be better spent on other goods and services.

 

9 out of 10? Do you have a link somewhere with that?

 

But more interesting how high of a deductable are you wishing for? And do you expect the person to actually pay the deductable if they are in an accident, get ill, etc?

[Balta1701]

I consider an "everyone pays into the collective pool regardless of how much you take out" system socialistic.

so...you disagree with the concepts of insurance in general.

[Y2HH]

9 out of 10? Do you have a link somewhere with that?

 

But more interesting how high of a deductable are you wishing for? And do you expect the person to actually pay the deductable if they are in an accident, get ill, etc?

 

Even if the deductible is 10,000$, that's just there to cover catastrophic hospital stay, which could exceed hundreds of thousands in mere days...versus 10,000, which they can pay over time.

 

You do realize that at any hospital, at any time, you can pay down your bill -- interest free -- over a span of years, right?

 

So yes, I expect them to pay it...since they can do so over a span of 5 years at a low low interest rate of nothing.

[Y2HH]

so...you disagree with the concepts of insurance in general.

 

I don't think so...I think he's saying that people who will use insurance the most should be the ones that pay the most, versus spreading it around like they're doing now.

 

Of course, you knew that's what he meant, but decided to play games with his words, instead.

[Balta1701]

I don't think so...I think he's saying that people who will use insurance the most should be the ones that pay the most, versus spreading it around like they're doing now.

 

Of course, you knew that's what he meant, but decided to play games with his words, instead.

That's not insurance then. That's having everyone pay for what they need. Insurance is by definition something you need to cover costs that are potentially larger than what you can afford. You can still conduct some weighting in costs based on details like age and smoking in this system, but if I find out next year I have cancer I'm suddenly using the most insurance and by your statement I should "pay the most". That's not insurance, that's a payment plan!

[Jenksismyhero]

9 out of 10? Do you have a link somewhere with that?

 

But more interesting how high of a deductable are you wishing for? And do you expect the person to actually pay the deductable if they are in an accident, get ill, etc?

 

Call it an educated guess mixed with an understanding of the economics behind insurance (the majority will never spend as much as they put in). How many people in college do you remember ever having a major surgery? Or someone who was involved in a major accident? I knew of probably 2 people out of hundreds.

 

What was wrong with the 10k deductible? Something that wouldn't be easy for most but also a figure that wouldn't leave you financially ruined either. And of course i'd expect them to pay back.

 

 

[Jenksismyhero]

so...you disagree with the concepts of insurance in general.

 

Yes, just like roads and police and fire service are dirty socialist ideals too.

 

When you start taking away my options as a consumer based on mandates from the government, yes, I have an issue with that. I'm all about the government providing a playing field where reasonable and affordable insurance is attainable. I don't care for the government telling me what I have to spend or what kind of coverage I have to have. We're not totally there yet, but that's the direction we're heading.

[Y2HH]

That's not insurance then. That's having everyone pay for what they need. Insurance is by definition something you need to cover costs that are potentially larger than what you can afford. You can still conduct some weighting in costs based on details like age and smoking in this system, but if I find out next year I have cancer I'm suddenly using the most insurance and by your statement I should "pay the most". That's not insurance, that's a payment plan!

 

I wasn't attempting to redefine what insurance meant, I was just pointing out what he was getting at.

 

Insurance is designed to spread the risk by spreading the premiums...but again, just as I said when this all started, you can't stop premiums from rising if you did nothing to curb WHY they're rising. And they didn't.

 

Maybe it's time they drop that first A off of the acronym ACA.

 

And there is no doubt the law did some very good things, but it came at a cost a lot of people are now balking at. Call it sticker shock, or what have you, but most of these people don't realize that the plans they had covered almost nothing, and they got lucky to never get sick with them, or they'd experience serious sticker shock.

[Y2HH]

Call it an educated guess mixed with an understanding of the economics behind insurance (the majority will never spend as much as they put in). How many people in college do you remember ever having a major surgery? Or someone who was involved in a major accident? I knew of probably 2 people out of hundreds.

 

What was wrong with the 10k deductible? Something that wouldn't be easy for most but also a figure that wouldn't leave you financially ruined either. And of course i'd expect them to pay back.

 

Of course, if anyone stopped for a second to think about that, they'd realize that more money MUST be going into insurance or there would be no profit margin to begin with.

[Jenksismyhero]

BTW Tex, I forgot to add one of the "minimums" I don't agree with in this law is that plans have to include mental health services and pregnancy/maternity/newborn services. That applies even if you are buying an individual policy for a male. Why on earth would a male need to pay for pregnancy/maternity services? Why should he have to pay for something he will literally never, ever use? Why should someone be forced to buy mental health services if they've never had a history of any kind of mental health problem?

 

SS said it yesterday - technically people are going to pay more for better policies with better coverage, but maybe people don't need that coverage? Maybe they don't want to spend the extra money on those things, so why are we taking that choice away?

Edited October 31, 2013 by Jenksismybitch

[Soxbadger]

Health insurance is also a very low profit margin business, contrary to popular belief.

 

And interestingly I believe that it should be a 0 profit business.

 

You can still have millionaire CEO's etc, they just dont get extra millions of profit on top of it.

 

http://www.chicagobusiness.com/article/201...past-16-million

 

Other Health Care Service executives also received significantly higher pay in 2012. Each of the company's 10 highest-paid executives got at least $1.2 million more than in the previous year.

 

I just have a fundamental problem with people getting rich off of other peoples sickness. I believe that we should live in a world where people can be guaranteed a basic level of medical treatment and not have to worry about being broke because of it.

 

Call it rose colored glass optimism, but what is the point of all this if we arent going to actually improve the human existence?

[Jenksismyhero]

And interestingly I believe that it should be a 0 profit business.

 

You can still have millionaire CEO's etc, they just dont get extra millions of profit on top of it.

 

http://www.chicagobusiness.com/article/201...past-16-million

 

 

 

I just have a fundamental problem with people getting rich off of other peoples sickness. I believe that we should live in a world where people can be guaranteed a basic level of medical treatment and not have to worry about being broke because of it.

 

Call it rose colored glass optimism, but what is the point of all this if we arent going to actually improve the human existence?

 

Should lawyers and doctors be in a 0 profit game too? They're involved as much as insurance companies.

[Soxbadger]

Should lawyers and doctors be in a 0 profit game too? They're involved as much as insurance companies.

 

Absolutely

 

Lawyers should make 0 profit. In fact if I really had my way lawyers would be far more regulated and their salaries would be fixed. That way we can ensure that everyone actually gets justice, not that one side has a lot more money so they have a disproportionate advantage.

 

 

[Y2HH]

And interestingly I believe that it should be a 0 profit business.

 

You can still have millionaire CEO's etc, they just dont get extra millions of profit on top of it.

 

http://www.chicagobusiness.com/article/201...past-16-million

 

 

 

I just have a fundamental problem with people getting rich off of other peoples sickness. I believe that we should live in a world where people can be guaranteed a basic level of medical treatment and not have to worry about being broke because of it.

 

Call it rose colored glass optimism, but what is the point of all this if we arent going to actually improve the human existence?

 

But despite these things, we HAVE improved human existence. A LOT.