Defending Obamacare (Page 3)

My husband could make a lot more money if he were to contract his job. But because of health insurance costs, no can do. If I were to add him and my son to our plan it would cost me over a 1000 a month. 

As a self employed business owner I pay just under that for a family of 4.

A thousand dollars a month is a lot of money for most people. 

Yep.  I'm on a separate plan from my wife and kids because of kidney stone I had 5 years ago.  I called to ask due to Obamacare if I could get put on the family plan and if they would cover my pre-existing condition.  They said yes.  For $800 (if I recall correctly) more a month.  It was about double.

So much for pre-exisiting condition exclusions.

I agree with this if everyone were covered, but unfortunately most healthy people will just end up paying the fine and not enroll until they need to enroll.  This will skew the costs drastically and reduce/eliminate this benefit.  Yes the government still gets the "fine" money, but it's a lot less than if they were buying insurance on the exchange.

I read recently that the IRS is projecting the cheapest family plan in 2016 to cost around $20k a year, but the fine in 2016 is only $2,085 or 2.5% of income for the same family.

There's gonna be a lot of ticked off young couples if they have to pay a mandatory $1,600/mo. for healthcare or a $174/mo. fine for nothing.

Oh, and guess where the uninsured penalty people will go for healthcare?  The ER, and they won't do preventative care.

What is the average cost of one night in the hospital where you work?

I know they haven't finalized the cost of the plans on Obamacare yet, but I suspect most of them will be quite a bit over $1000/mo. for a family with deductibles on the high side.  Obviously there are subsidies that will make this cost less for lower income families but I'll be curious how it all shakes out with deductibles and such.

Agreed. Healthcare coverage is an awful mess. Honestly, I am a lifelong Democrat, but I have little faith in our ability to come up with a public health plan that is workable in this country. 

I read that that statement, which had been reported by CNSnews.com, was an inaccurate claim. 

Yeah, it's hard to really put a number on it because they are all estimates.  I know the IRS put out the $20k number and it went a little viral, but in their defense it was an example rate because the real costs aren't out yet.

Any idea what the real numbers are?

That $20K number freaks me out.  That's like 4x what we're paying now.  Please give me hope that it's less...

I was thinking about this the other day and I'm not sure using the ER for primary care if they have a good triage staff is not somewhat efficient.  People who don't have money can go there and use their time instead.  The ER has to be staffed at all times in case something big comes in.  When it's not busy you can see the people who value money more than time.  You see the doctors when they have time.  If you took all of the sniffle case away from the ER would the doctors just sit there waiting for a car crash and getting paid to do nothing- might as well hand out some tamiflu.  Just a random thought.

Nobody really knows because the insurance companies that are going to participate in the exchanges haven't published their rates yet.  I did do a quick google and found a glimpse of at least one CT company's rates.  They have the average monthly for an individual at $427.  So, I would guess the family rate would be well north of $1000/mo. which really isn't any different than standard insurance prior to Obamacare.

http://www.ctmirror.org/story/first-clue-obamacare-insurance-cost-arrives

Here's a quote from the article:

Health plans sold on the exchange will be offered with several variations, based on “actuarial value” -- that is, how much of the health care costs the plan covers. The lowest-value plans will cover 60 percent of a person’s costs, leaving the customer to pay the rest. Those plans would likely require lower premiums than higher-value plans that cover more.

So, it could be possible that you're paying $427/mo. and still have to pay 40% of your annual healthcare out of pocket.  Also, the healthcare costs aren't going to go down at all, so that 40% could be HUGE.  As I mentioned before, I'm curious how they'll subsidize (if at all) the deductible for lower income folks that have the premium subsidized.

Another interesting tidbit is that the rates are going to be different for every state because Obamacare didn't really fix one of the underlying problems of every state being different.  So, NE insurance may be really cheap and CA insurance may be very expensive or vis versa.

I guess we're ultimately still waiting to see what's in the bill...

Only with COJ!  But THANK YOU for asking! 

Throws $20,000 at Left Brain

I just like to think that I've convinced everyone that I'm right and everybody agrees with me now. 
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Bwahahaha, clearly you're not from California.  But we're off to a great start, so far.

http://www.huffingtonpost.com/2013/05/09/california-health-exchange-secrecy_n_3247617.html

I know it's a hot button topic on both political sides, but an issue that needs to be addressed. The current system is broken. The proposed system is full of unknowns, risks and painful to even consider. But it is something. 

How do we continue as a society with our heads in the sand, ignoring those who go through the nightmare of being denied coverage. Watching someone being completely bankrupted by medical bills, or like my husband experienced, a friend who watched her 20 something daughter die because she could not qualify for medicare, and no cancer doctor would treat her.

Why? 

x3.

I will say two things though.

1. Calling it Obamacare rather than the Affordable Care Act is setting the tone for a partisan discussion.

2. Having spent some time in the ER and seeing that there were two people in the entire evening who actually were there for emergency treatment, it is clear that most trips to the ER could have been covered by with preventative care and access to affordable healthcare. Certainly my $10k bill was, in part, underwriting those who use the ER as a source for uninsured healthcare.

1) Obama himself said he liked the nickname in the Denver debate, also, how is that partisan? The Eisenhower Interstate System isn't partisan is it?

2) agree. But how best to prevent that? Maybe have the triage turn more folks toward the urgent care place.

You most certainly can.  You'll need good insurance after you see the price tag too... because you'll either faint and hit or your head, or you'll have a heart attack.

The problem is that there is an extremely small market for individual plans because *most* people have health insurance provided by their employer.

Also, you don't seem to have a good grip on the concept of "free."

Finally, healthcare costs are currently ~18% of our GDP.   So a 5% consumption tax isn't going to cut it.    Current figures are that consumption is about ~70% of our economy.   So you'd need a (are you ready?) 30% consumption tax to cover health care at its current levels.

What do you think a 30% consumption tax will do to our consumption, and therefore our economy?

I couldn't agree with you more on the bolded part Kate.  There's no question the current (or pre-ACA stuff) was broken badly.

My opinion and I've stated it before is that health insurance is the reason that it's broken, so by giving more people health insurance like the ACA does is inadvertently throwing gas on the fire and making it even worse.

When I was in college, we had an entire chapter that studied the economics of healthcare insurance.  It described how healthcare has a supply and a demand and the costs of healthcare were based on that supply.  Many years ago when you went to the doctor you paid the doctor your $100 or whatever and you were done, but you went to the doctor when you needed to go to the doctor and not every time you had the sniffles.  It wasn't super cheap, but pretty much anybody could afford to go when they needed to.

With HMO's and PPO's and all the other insurance options that gradually became available the working folks started getting either free or subsidized insurance from their employers and now every time they wanted to go to the doctor it only cost them a $20 copay.  Because of the reduced cost the demand increased drastically because the true cost was hidden from the consumer by insurance.  Now that there's an increase in demand the costs on the supply side naturally go up (simple economics) and now that $100 visit costs $200.  The insurance company now has to pay the $200 and passes the cost increases onto the employer.  Maybe the consumers copay goes up to $30, but his demand is still skewed and the costs keep going up and up and up for both the doctors and ultimately the insurance.

Fast forward several decades and you now have an environment where the individual who has no insurance has to pay hundreds of dollars out of pocket to see a doctor or $10k to go to an emergency room.  If the individual wants to buy insurance she has to pay $1000/mo. or more.  The system is now "broken" and we blame the greedy insurance companies or the greedy doctors, or whatever, but it's really nothing more than simple economics.  Throw in the gazillion government regulations allowing every state to have their own insurance minimum mandates and the inability for companies to offer insurance in multiple states and it just compounds the mess.

So, what's my solution?

• Get rid of HMO and PPO programs and regulate insurance companies to only offer high deductible health plans similar to HSA's.  For example If everyone has to pay the first $1500 (single) or $3000 (family) out of pocket with 80/20 or whatever coverage for everything above that then people won't be hitting the doctor for every sniffle they have.  Everyone also has catastrophic coverage for the bad stuff and you could even eliminate pre-existing conditions.
• Allow companies to sell plans nationwide which will increase competition and lower prices.
• Stop allowing employers to directly pay for healthcare insurance.  Individuals should all have to write that check every month to their insurance company.  Companies can still give employees extra money to subsidize their insurance, but make them cut the check so they know the costs.  My understanding is that America is one of the few countries in the world that does this due to some weird World War II price controls law or something.  I can't remember the history but I think it was a way for employers to "pay" employees more by giving them fringe benefits when the govt. said they couldn't pay them more.
• For lower income folks they could get a subsidy to pay the insurance premium and help with the out of pocket.

Obviously I'm overly simplifying the tuwoodcare program, but it's a proposal that IMHO addresses the actual problem with our healthcare system.

If it was textbook economics all those years ago in college, why do all these smart people out there seem to ignore the economics of what actually caused the problem.  They in stead come up with more and more solutions that skew the supply/demand curve further and further and wonder why it keeps getting worse.  /facepalm

So, yes Obamacare does do "something" it gives people free insurance.  However, this "free" insurance will add tens of millions of new people to the already over stressed healthcare system which will result in the costs skyrocketing even more.  These costs will cause insurance premiums to go atomic and even if the government tries to limit payouts to hospitals it simply doesn't work that way.  Economics 101 law of supply and demand tells us this will not work.  The government can continue to print money to cover the increased costs, but that only helps the poor who are on the subsidized insurance.  The non poor will get rocked on premium increases, which is already starting to happen.

Sorry for the long post, but I'm really passionate about this topic.  It's easy to say I don't like Obama so I of course hate Obamacare, but that's not the case at all.  I truly feel it's a band-aid being put on a finger when the actual problem is a broken ankle.

http://ww3.startribune.com/projects/exec_comp/topNonCeoView.php

Here in MN, the CEO of United Health Group is the highest paid CEO in the state at $48M and two non-CEOs make about $14M each.