scrubbedexpat099

Seems like the 21's will go for skinny policies, or stay on their Parents policies. Not that I care much, I and the majority of those who I know and who I have talked to about this are way past 21.

I am not that interested in what opposition politicians say, I have noticed that often bears little correlation with what they do when they get a chance. More interested in current reality and its consequences.

Michael

Tomorrow's consequences could possibly be worse than today's consequences.

The problem are the politicians that they let health care costs get totally out of control. We could continue doing the same thing over and over again and costs will only get worse until most employers drop coverage, very few will be able to afford health insurance, and people won't be treated unless they can pay.

There is no easy solution to the problem since the problem has been developing since the 1940s.

Michael

The 21 year olds seem to care just as much as you do. Staying on their parents policies isn't a big advantage anymore since ACA is available. That policy was implemented when insurance companies would drop 18 year olds because they had medical problems. Now it doesn't make much difference since the additional cost is through ACA or through the parents policy.

You are not required to purchase health insurance if the cost is greater than 8% of your income. If it is less than that and you don't purchase health insurance, the penalty is $95 per adult or 1% of your income whichever is greater in in 2014. In a sense by paying the penalty, you are buying catastrophic health insurance since the government will likely pay the bills if you have major health problems. Then possibly by next year, the prices will drop as insurance companies realized that they charged too much and are required to give refunds.

scrubbedexpat099

The cynical may think that is the plan. Anybody who can add up or has access to a calculator should be able to work out that this makes no sense.

Michael

What do you mean? What doesn't make sense? If you are paying more than 8% of your income and you want to take a chance, there is no penalty but you could get hit with high medical bills. You'd be no worse off then you were last year without insurance.

scrubbedexpat099

The whole system seems designed to fail.

Michael

It's been failing for the last 60 years. Is your issue with the cost or what is your issue other than you don't like it at all? You complain about the cost and I try to help by pointing out that if you liked the old way of doing things, there may possibly be an option. Would you rather have it the way it was?

Switzerland has a very similar program where a family can pay up to about 10% of their income for health insurance but in Switzerland, they must carry health insurance even if it is 10% or more of their income.

I sometimes have a hard time understanding what you want other than you appear to want health care and not pay for it by increased taxes or by paying premiums.

If you have a better solution. please advise and see if you can get 51% of the country, the house, and 60 votes in the senate to go along with it. I think I have a better plan but I couldn't get the 51%, the house, and 60 votes in the senate.

Bob

But it's in better shape than it was, when it was designed not to allow sick people to even play.

Michael

Just to elaborate, if it was my plan, I'd go to a single payer system, forbid employers from providing health insurance, everybody gets health insurance equivalent to Medicare coverage (100% hospital coverage and 80% outpatient coverage except the poor which get 100% Medicaid coverage), limits would be placed on end of life treatments unless the person pays extra for that coverage through private insurance, the government would use it's bargaining power to drive costs down, and taxes on corporations and individuals would be increased to pay for the coverage.

If all of that was put in place, health care costs as a percentage of gdp would likely fall below the health care costs as a percentage of gdp of Switzerland within a year.

However maybe only 20% of congress would vote for such a proposal. Actually part of my plan would satisfy conservatives since it reduces the burden on corporations of providing health insurance since they believe that corporations are carrying too large of a burden. If corporations didn't provide health insurance, either pay would rise so increased taxes on individuals wouldn't hurt that much or corporations would pay increased taxes but they would have savings by not providing health coverage.

So what is your plan?

Michael

There are flaws in the system. Initially it appears that a healthy individual or family may possibly be able to find health insurance on the open market cheaper than through the exchanges and much like "Medicare Advantage", some insurance companies took advantage of the government by covering Medicare recipients with a 14% subsidy but when the patient got sick, there was fine print in the policy that specific procedures were not covered so many sick patients returned to traditional Medicare during the next open enrollment. By doing this, the insurance companies kept the healthy patients making big profits and the government got the sick patients with added expenses.

Similar things could have occurred under ACA where companies will keep open market rates low until someone in the family gets sick and then raise the rates forcing that family to the exchanges. The exchanges would then have a higher percentage of sick patients than open market insurance making the exchange rates higher than they should be and insurance company profits high.

That sounds like a major flaw in ACA but because of what insurance companies did with "Medicare Advantage", congress wrote into ACA that the insurance company payout must be equal or greater than 80% of the premiums collected for open market insurance, the exchanges, and "Medicare Advantage". Now it is not as tempting for insurance companies to dump sick patients back on the government or the exchanges.

However I am a believer that insurance companies won't give up that easily and will hire a team of lawyers to look for loopholes in ACA to see if there are some tricky accounting practices that they can use to reduce the payout percentage and increase profits. But that is what the free market system is about when there is no real competition in the health care industry. In any other industry, if a company doesn't provide a cheaper and/or better product than other companies, they go under but in the health care industry, it is all about fine print that no one can understand until someone gets sick and then policies are cancelled or rates are raised.

Pulaski

Not at the moment, but I have had in the past
You have (had) several options, apart from bellyaching about the choice you made. (Get a job with health insurance, take a high deductible plan, leave the country....).
So? Get a job with health coverage.
Sounds like it works for you. I was thinking about those currently uninsured, not the poorest, who'll get coverage free, or close to it, but those who are going to find paying the premiums challenging, and then find the cost of copays and deductibles impossible to meet. (That was the group that I was referring to in my previous post, sorry I didn't specify that, which meant it looked like I was talking more generally.)
I have no idea what that means. Are you a bad risk?
Well now my taxes are going to start subsidize your health insurance, so I guess that makes it fair then.
That's just silly, argumentative, or you have a major chip on your shoulder. .... Any of which would explain your usual belligerent and hate-filled posts!

scrubbedexpat099

You are talking about a bill which Pelosi famously commented that you vote for first, read later.

I have only skimmed the surface, having been in the Insurance Industry for 30 years and having some knowledge of how regulators work I can only start to imagine the loop holes, intended and unintended consequences, that will arise. Well quite a few have.

I am reasonably computer literate, mathematics was always my good subject, yet looking at this on Saturday morning made my head hurt!

I did meet a lady at a local Chamber of Commerce meeting recently who is one of the local sources for information. I really do not see how you can function in this role without an actuarial background. Which she clearly did not.

I just tried to log back in, now does not recognise my account again! This is really an aside, I dare say eventually they will resolve the IT aspect.

It is a boondoggle, probably the Germans have a better word for it.

Giantaxe

Cool, we can scrap the ACA now you've thought of that solution.

I'm happy that some of my taxes are going to go to subsidize the insurance of those who can't otherwise afford it, just as I was happy when I lived in the UK that some of my taxes were paying for others higher use of the NHS. And I can think of many things I'm less happy my tax dollars are going for.

Michael

If ACA is a boondoggle, then you must be paying a compliment because the Medicare Reform Act of 2003 would have to be described as a super totally incompetent outrageous boondoggle.

The CBO projected that ACA would cost $1.2 trillion over the first 10 years but primarily covered by increased revenues and reimbursement pressure on providers and and would produce a surplus during the 2nd 10 years. The same CBO projected that the Medicare Reform Act of 2003 would also cost $1.2 trillion over the first 10 years and $2.7 trillion during the 2nd 10 years adding $3.9 trillion to the national debt over 20 years.

Where was the outrage when the republicans passed Medicare Reform that had very little benefit to Medicare recipients and was bankrupting the country? If the republicans wanted to increase the national debt by $3.9 trillion over 20 years to accomplish literally nothing, they could have instead passed an affordable health care act that truly was affordable to the 50 million uninsured.

You are probably saying that the CBO is just playing with numbers and they don't reflect reality and the surplus during the 2nd 10 years of ACA won't actually occur. Partially you are correct because much of the surplus is created by killing one of the main provisions (Medicare Advantage) of Medicare Reform and that is a harder beast to kill then originally projected. The CBO made it's projections based on flawed data provided by the insurance companies. The CBO stated that since insurance companies claimed they needed a 14% government subsidy to offer a $0 premium for Medicare Advantage to compete with traditional Medicare, it assumed that by initially reducing that subsidy to 9%, insurance companies would need to charge seniors an additional $80 per month to offer a plan equivalent to traditional Medicare and therefore enrollment in Medicare Advantage would stabilize by 2014. What the CBO didn't take into consideration was that ACA kicked the inefficient plans out of Medicare Advantage leaving only the efficient plans and miraculously the efficient plans didn't need a 14% subsidy to offer $0 plans but could profit well with a 9% subsidy. So the government is saving 5% but unfortunately enrollment in Medicare Advantage plans is still increasing. The subsidy will continue to decrease eventually to 0% and even if Medicare Advantage enrollment continues to increase, the savings will be real since Medicare Advantage will be providing the same care as traditional Medicare costing the government nothing more than traditional Medicare but the projections will be slightly wrong since government subsidies will be for more enrollees for a longer time than projected.

In one sense the savings aren't real since ACA is only killing a very bad program developed by the republicans.

Unfortunately ACA didn't touch the other main provision (Prescription Drug Benefit) of Medicare Reform where the government provides a 75% subsidy but the Part D plans primarily only provides drugs at a cost that most people can get at prescription drug discount web sites and the insurance companies are pocketing most of the premiums.

scrubbedexpat099

In CO as that is the own site I am familiar with, it has nothing to do with whether you can afford it, which I guess is going to be subjective anyway, solely down to your estimated 2014 income.

The of course there is the cross subsidies within the system, the so called need to sign up younger people so their contributions subsidise the cost of those older.

Probably the biggest single cost is waste. Operating costs, overpaying for drugs treatment etc etc.