The PPACA Thread Part III - Let's have a healthy debate!

[dxmnkd316]

Re: The PPACA Thread Part III - Let's have a healthy debate!

Insurance deductibles at work jumped from $1,300 to $1,500 for next year. Premiums flat for high deductible plans. PPO premiums went up.

Very high deductible plans saw their deductibles also jump $200.

Sounds like we have new prescription drug limits now. Could be interesting to see what those are. They said the letter was coming in October.

[St. Clown]

Re: The PPACA Thread Part III - Let's have a healthy debate!

Insurance deductibles at work jumped from $1,300 to $1,500 for next year. Premiums flat for high deductible plans. PPO premiums went up.

Very high deductible plans saw their deductibles also jump $200.

Sounds like we have new prescription drug limits now. Could be interesting to see what those are. They said the letter was coming in October.

One of the TV stations ran a report stating that MN gov't market rates are going up anywhere between 27% (forget which provider) to 49% (BCBS). You're likely seeing the group plan response to that same situation.

[FreshFish]

Re: The PPACA Thread Part III - Let's have a healthy debate!

One of the TV stations ran a report stating that MN gov't market rates are going up anywhere between 27% (forget which provider) to 49% (BCBS). You're likely seeing the group plan response to that same situation.

One thing that is very frustrating about those kinds of news stories is that they don't provide any link between a change in prescription drug prices and the consequent change in healthcare costs down the line.

Effective medication for hypertension might easily be worth the increase in Rx costs if it works better and there are fewer side effects. Similarly with diabetes: people who have other health complications that result from ineffective management of their condition incur huge medical bills; a better diabetes medicine might well be worth it.




I am reminded of the old brain teaser which shows an apparently bad outcome at first glance which is really a fantastic improvement when you look at the overall big picture.

The British Army in WWI introduced an innovation. Head injuries increased by 2,000% as a result. They were elated at how well the innovation worked. What is the innovation?

Answer in white: Helmets. All those head injuries occurred to people who would otherwise be dead.

[joecct]

Re: The PPACA Thread Part III - Let's have a healthy debate!

Coops are in financial trouble.

https://www.washingtonpost.com/natio...f92_story.html

[burd]

Re: The PPACA Thread Part III - Let's have a healthy debate!

One thing that is very frustrating about those kinds of news stories is that they don't provide any link between a change in prescription drug prices and the consequent change in healthcare costs down the line.

Effective medication for hypertension might easily be worth the increase in Rx costs if it works better and there are fewer side effects. Similarly with diabetes: people who have other health complications that result from ineffective management of their condition incur huge medical bills; a better diabetes medicine might well be worth it.

[/COLOR]

Possible. As of several years ago anyway, 70 - 75% of health care costs were for treatment of chronic diseases.

[DrDemento]

Re: The PPACA Thread Part III - Let's have a healthy debate!

FreshFish: Interest post of yours pointing out the changes in prescription drug coverages. The insurers (and the government) hasmade some major changes in the past couple years and it appears will be doing even much more of it in the coming year. In addition to simply raising the cost of the insurance (most seniors have not seen the increase in Part D Medicare premiums yet for 2016). By having a tier structure for copayments for drugs that they can change at any time, there are lots of ways to alter costs. This coming year for example, across the board or Medicare part D coverage is raising the copays for almost each tier. Although the numbers in some case seem small (from $8 to $11) the percentage increase is massive when viewed against the backdrop of the government claim of inflation being so tame that no one will receive a COLA on the Social Security for only the third time in recent history. However there are other more massive increases hidden in this. Tier 4 drugs (which are most of the more expensive Brand name or newer drugs) will no longer have a dollar amount copay but have been moved to a 50% of cost copay. And the list of drugs in Tier 1 (inexpensive generics) has been shortened to the point of making it ludicrous.
A second interesting development has been in the generic drug industry. When brand name drugs lose their patent protection status, often multiple companies jump in with much cheaper (but questionably truly equivalent) medications. That has been some help for the past years. But we are now seeing a very interesting development as after a while, most of the competing generics stop or the companies merge or they simple decide not to make them. This leaves a market in which only one remaining company makes the so called generic pharmaceutical. They then have the ability to charge almost whatever they please . I am sure most have seen the headlines recently in which some drugs (generically produced) have increased by 500% to 7000% virtually over night. It has made part of the practice of medicine like working through a maze in trying to find medications to treat a disease for a patient without putting them in financial jeopardy or in many cases, made them simply unaffordable. Trying times to be sure. Physicians are put into a position of being unable to prescribe appropriate medications that have been used for decades, simply based upon outrageous costs.

[FreshFish]

Re: The PPACA Thread Part III - Let's have a healthy debate!

DrD: always like to hear your perspective, not many people these days appreciate how history dominates bureaucracy these days.....

There is always an ethical conundrum when dealing with healthcare and insurance. How do you best serve the interests of the many when a conflict arises with humanitarian instincts toward the needs of the few....

The biggest problem with "insurance" is timelines: sure, using a 'more expensive' preventative drug now might save hundreds of thousands of dollars later, but I won't be the insurance company covering 'later', so where is my incentive?" Harsh but realistic.

It would be really interesting to remove the employer sponsorship of group health insurance and replace it with affiliation-centric insurance instead. That at least would restore the appreciation of timelines!

When I first started in the insurance industry, affiliation-centric insurance ("association group plans") was widespread, popular, and effective. Any member of XYZ Association could be covered under their group plan. I daydream sometimes that this model might have become dominant instead. Insurance works best by extracting empirical trends from data, and association membership was a rich data source*. Employer groups on the other hand are transitory, given how much turnover occurs.

It just breaks my heart sometime how much of PPACA was delegated to amateurs. I know their intentions were good, but they never heard of unintended consequences, and they never researched what worked well.











* notice how AARP is a big-time player in association insurance: they derive amazing revenue from the sale of Medicare-supplement group health insurance.

[Rover]

Re: The PPACA Thread Part III - Let's have a healthy debate!

Like shooting Fish in a barrel....

http://www.cbsnews.com/news/obamacar...an-early-look/

[FlagDUDE08]

Re: The PPACA Thread Part III - Let's have a healthy debate!

What Grover ISN'T telling you... http://dailysignal.com/2015/10/14/an...op-goes-under/

[FlagDUDE08]

Re: The PPACA Thread Part III - Let's have a healthy debate!

Oops, there goes schools, too. http://www.washingtonexaminer.com/ob...rticle/2574159

[ScoobyDoo]

Re: The PPACA Thread Part III - Let's have a healthy debate!

Oops, there goes schools, too. http://www.washingtonexaminer.com/ob...rticle/2574159

Sure makes sense. We can afford Benghazi committees and Afghanistan war machines though. No problem there. Oh, and don't forget oil subsidies.

[joecct]

Sure makes sense. We can afford Benghazi committees and Afghanistan war machines though. No problem there. Oh, and don't forget oil subsidies.

The price of oil is low to force Russia to its economic knees. While I like cheap gas, I seem to remember when another country was cut off from oil, they got very angry.

[dxmnkd316]

Re: The PPACA Thread Part III - Let's have a healthy debate!

Russia isn't cut off from oil. I'm not sure how you can even make that comparison...

[St. Clown]

Re: The PPACA Thread Part III - Let's have a healthy debate!

Russia isn't cut off from oil. I'm not sure how you can even make that comparison...

I was wondering the same thing since they're a net exporter of the stuff.

[burd]

Re: The PPACA Thread Part III - Let's have a healthy debate!

The price of oil is low to force Russia to its economic knees. While I like cheap gas, I seem to remember when another country was cut off from oil, they got very angry.

You think OPEC"s decisions target Russia's oil economy but not ours?