The PPACA Implementation Phase II - Love it or Lose it!

[ericredaxe]

Re: The PPACA Implementation Phase II - Love it or Lose it!

Getting back to daxe's point, lets break it down. $480 a year higher premium. If he's in Mass, but not knowing who he's covering, lets say he's paying 6K or so a year for his insurance. Applying the 3-4% typical cost increase, he'd be paying half that $480 anyway regardless of the ACA. So, a $240 increase, or 20 bucks a month for presumably better insurance (no annual limit of something really bad happens, lower deductible, etc).

I'll play... if rates had increased by the 3-4% you mentioned, my share of the annual premuim would have gone up by about $122... instead it has gone up appx 16%. Everything is the same. The only thing "better" about it is the lower deductable (which my family has never come close to approaching). We have had a few extra trips to the Doctor and ER over the years (beyond routine visits/checkups etc) but we have not ever come close to the $6000 (now $5000) deductable. Over the years our rates did increase by minimal ammounts. However the plan worked well for us and we liked it a lot. In fact we deliberately picked the plan with the higher deductable because of it's lower cost and I am prepared to pay the full $6000 out of pocket if something major were to happen.

As I said below, the extra $40 per month is relatively minor in the grand scheme of things... but it illustrates the point that plans are being canceled because of Obamacare.

Do you acknowledge that Obama was being untruthful when he said many times that "If you like your plan you can keep it"?

 

[ericredaxe]

Re: The PPACA Implementation Phase II - Love it or Lose it!

Food for thought:

Would we be better off with higher deductables or slightly higher co-pays and lower base / annual costs for insurance plans?

If people still have some "skin in the game" each time they go in for something not considered routine would there be fewer people running to their Doctor to ask for antibiotics when they have the sniffles, or going to the ED with every little boo boo they get because it is "free" with the insurance?

 

[BassAle]

Re: The PPACA Implementation Phase II - Love it or Lose it!

Food for thought:

Would we be better off with higher deductables or slightly higher co-pays and lower base / annual costs for insurance plans?

If people still have some "skin in the game" each time they go in for something not considered routine would there be fewer people running to their Doctor to ask for antibiotics when they have the sniffles, or going to the ED with every little boo boo they get because it is "free" with the insurance?

I think in general we are better of with lower co-pays for any kind of preventative care. Its a lot cheaper for someone to go to their PCP and be diagnosed with hypertension and treated early vs developing some other condition like kidney failure or cardiac problems.

Then again, we could avoid a lot of cost simply through healthier lifestyles. Prevention is the most cost effective, and that starts at home at the dinner table and through physical activity...

 

[FreshFish]

Re: The PPACA Implementation Phase II - Love it or Lose it!

Food for thought:

Would we be better off with higher deductables or slightly higher co-pays and lower base / annual costs for insurance plans?

If people still have some "skin in the game" each time they go in for something not considered routine would there be fewer people running to their Doctor to ask for antibiotics when they have the sniffles, or going to the ED with every little boo boo they get because it is "free" with the insurance?

What we really need in this equation is the ability to set aside money on a tax-deferred basis, sort of like the existing Flexible Spending Accounts, but then roll the money over year after year if we don't use it. Then as you get older you can keep raising your deductible in a commensurate manner.

Ideally, just like there is "whole life" insurance (not the specific product type, a generic concept), which builds reserves every year so that, as the rate per thousand of insurance increases, the amount of "pure risk" insurance declines, so that the premium can remain level and affordable for your entire lifetime, we need a "whole health" insurance that operates in analogous manner: part of the premium goes into a cash reserve and the rest covers "pure risk" and the risk compenent goes down as the cash reserve goes up.

There's no denying that many of the objectives are PPACA are laudable, the problems lie almost entirely in the methods.

the problem with individual FSA or HSA is that, once you do use it, it's gone and you need to rebuild it. If insurers were able to develop and market a pooled group product along the lines suggested above, we'd have something that keeps premiums affordable for people without any of the cross-subsidies and mandates and penalties and taxes and everything else. It's just silly to charge post-menopausal women for obstetric care, or charge men for maternity care, even if it does in theory help "spread the cost around," because while idealistically it might sound good on paper, in practice it's just not how people in the US want to do things. It goes against the grain of our nature.

 

[FreshFish]

Re: The PPACA Implementation Phase II - Love it or Lose it!

The other thing that grinds my gears in these discussions is the implicit assumption that rising expenditure on health care must necessarily be a problem.

Perhaps it is, but then again it might just as easily be a sign of prosperity (though not in the 0baconomy, it seems, sigh). Many people would choose to pay more on health care voluntarily out of a growing disposable income. The most obvious examples are psychological counselling and cosmetic surgery (I'm not talking necessarily about boob jobs, more like having a facial scar repaired or a mole removed).

 

[LynahFan]

Are you channeling FreshFish?

Glad you took it in good humor - forgot the smiley!

 

[BassAle]

Re: The PPACA Implementation Phase II - Love it or Lose it!

The other thing that grinds my gears in these discussions is the implicit assumption that rising expenditure on health care must necessarily be a problem.

Perhaps it is, but then again it might just as easily be a sign of prosperity (though not in the 0baconomy, it seems, sigh). Many people would choose to pay more on health care voluntarily out of a growing disposable income. The most obvious examples are psychological counselling and cosmetic surgery (I'm not talking necessarily about boob jobs, more like having a facial scar repaired or a mole removed).

I wouldn't mind paying more for health care if it were actually benefiting my health. What many of us see though is our premiums going up much faster than inflation yet we receive no more healthcare than previous years (luckily my premiums haven't gone up in 4 years I think, thanks to a focus on wellness at my company). Lots of people see their insurance go up by 5-10% in one year, yet they might be fit and healthy and really their cost is going up because of the obesity epidemic and the chronic diseases so many people are living with (that were preventable).

 

[Rover]

Re: The PPACA Implementation Phase II - Love it or Lose it!

I'll play... if rates had increased by the 3-4% you mentioned, my share of the annual premuim would have gone up by about $122... instead it has gone up appx 16%. Everything is the same. The only thing "better" about it is the lower deductable (which my family has never come close to approaching). We have had a few extra trips to the Doctor and ER over the years (beyond routine visits/checkups etc) but we have not ever come close to the $6000 (now $5000) deductable. Over the years our rates did increase by minimal ammounts. However the plan worked well for us and we liked it a lot. In fact we deliberately picked the plan with the higher deductable because of it's lower cost and I am prepared to pay the full $6000 out of pocket if something major were to happen.

As I said below, the extra $40 per month is relatively minor in the grand scheme of things... but it illustrates the point that plans are being canceled because of Obamacare.

Do you acknowledge that Obama was being untruthful when he said many times that "If you like your plan you can keep it"?

Yes he screwed up and has already acknowledged as much about saying that. Not sure why we're beating the dead horse here...???

Next, your insurer could just be screwing you. Did you ever consider that? But, lets look at it in total.

Your premium is up 480 bucks. Some of that is natural heath care cost growth. Some of that is your insurer making a profit. Some of that is now having no limit on insurance coverage which benefits you personally if a calamity ever happened to you or your family. Some of it is the lower deductible. Some of that is more routine care that now needs to be covered.

The point being, you have little way of knowing what Obamacare did or didn't do to your policy, and be very wary of insureres chalking up increases to the new law. In fact as the law has been on the books for almost 4 years now, they would have most likely had a sense long ago of what was coming and reacted accordingly.

 

[ScoobyDoo]

Re: The PPACA Implementation Phase II - Love it or Lose it!

I like how the insurance companies are still in control of everything for the most part and it's Obama that's screwing everyone. That's awesome. Only a Democrat in the White House could hatch such a stupid scheme.

 

[busterman62]

Re: The PPACA Implementation Phase II - Love it or Lose it!

The point being, you have little way of knowing what Obamacare did or didn't do to your policy, and be very wary of insureres chalking up increases to the new law. In fact as the law has been on the books for almost 4 years now, they would have most likely had a sense long ago of what was coming and reacted accordingly.

Like our government has?

 

[Rover]

Re: The PPACA Implementation Phase II - Love it or Lose it!

Like our government has?

I thought da private sector was supposed to be superior to da gubmint???

 

[Tiggsy]

Re: The PPACA Implementation Phase II - Love it or Lose it!

The point being, you have little way of knowing what Obamacare did or didn't do to your policy, and be very wary of insureres chalking up increases to the new law. In fact as the law has been on the books for almost 4 years now, they would have most likely had a sense long ago of what was coming and reacted accordingly.

How? No one seemed to know what exactly was in this law and now it seems to be getting selectively enforced with waivers and delays. How could anyone predict that?

I like how the insurance companies are still in control of everything for the most part and it's Obama that's screwing everyone. That's awesome. Only a Democrat in the White House could hatch such a stupid scheme.

Not everything. Sure they still handle most of the logistics but there are lots of new rules they need to follow or risk running afoul with the government. They have a hand in it without a doubt, but they are not the ones pulling the strings behind the scenes. They can't delay parts of the law or grant waivers to themselves.

 

[busterman62]

Re: The PPACA Implementation Phase II - Love it or Lose it!

I thought da private sector was supposed to be superior to da gubmint???

“The most distinct thing in this report: ‘the team is operating with private sector velocity and effectiveness,’” Todd said. “That is an acknowledgement that this was a government operation for a long time, and it failed, and now we’re bringing in the private sector folks. That is an indictment of the whole idea of government as the solution.”

.

 

[ScoobyDoo]

Re: The PPACA Implementation Phase II - Love it or Lose it!

How? No one seemed to know what exactly was in this law and now it seems to be getting selectively enforced with waivers and delays. How could anyone predict that?



Not everything. Sure they still handle most of the logistics but there are lots of new rules they need to follow or risk running afoul with the government. They have a hand in it without a doubt, but they are not the ones pulling the strings behind the scenes. They can't delay parts of the law or grant waivers to themselves.

Delay? Waivers? They've known what's coming for over 3 years now. If anything they should have been implementing and changing things right away so they didn't have this massive cluster**** all at once. But here's your "private sector 'velocity and effectiveness'"

 

[Tiggsy]

Re: The PPACA Implementation Phase II - Love it or Lose it!

Delay? Waivers? They've known what's coming for over 3 years now. If anything they should have been implementing and changing things right away so they didn't have this massive cluster**** all at once. But here's your "private sector 'velocity and effectiveness'"

Then why is the government issuing all the waivers and delays? If that is really the case, they should take the stand that the insurers knew all of this and tell them tough cookies and deal with it.

 

[Rover]

Re: The PPACA Implementation Phase II - Love it or Lose it!

How? No one seemed to know what exactly was in this law and now it seems to be getting selectively enforced with waivers and delays. How could anyone predict that?

Insurers knew exactly what was in the law which is no lifetime limits on insurance coverage, pre-existing conditions, etc. The only delays have been for people/businesses to sign up, not for what is and isn't covered. In fact, some of these provisions have been in place for a couple of years. Are you really arguing that insurers have just gotten around to factoring in for example that there's now no lifetime cap on benefits....a provision that's already been in place for several years???

 

[walrus]

Re: The PPACA Implementation Phase II - Love it or Lose it!

http://www.kgw.com/news/Enrollees-report-erroneous-debits-by-WA-Healthplanfinder-235244701.html

Have to like a state exchange debiting money from your acct without you knowing it.

 

[Tiggsy]

Re: The PPACA Implementation Phase II - Love it or Lose it!

Insurers knew exactly what was in the law which is no lifetime limits on insurance coverage, pre-existing conditions, etc. The only delays have been for people/businesses to sign up, not for what is and isn't covered. In fact, some of these provisions have been in place for a couple of years. Are you really arguing that insurers have just gotten around to factoring in for example that there's now no lifetime cap on benefits....a provision that's already been in place for several years???

If that's all that's in this law, why is it several thousand pages? You just summed it up with a few sentences. Even after lawers get ahold of that description it should be less than 10 pages. You can't just gloss over everything else. Again, if it's that easy why can the government design a website to run it properly? Obviously there is way more to it than that and with the threat of the government over you for not complying I can definitely see it taking years to decipher everything.

 

[ScoobyDoo]

Re: The PPACA Implementation Phase II - Love it or Lose it!

If that's all that's in this law, why is it several thousand pages? You just summed it up with a few sentences. Even after lawers get ahold of that description it should be less than 10 pages. You can't just gloss over everything else. Again, if it's that easy why can the government design a website to run it properly? Obviously there is way more to it than that and with the threat of the government over you for not complying I can definitely see it taking years to decipher everything.

Oh, NOEZ. The law is too long we can't understand it in 3 FREAKING YEARS!!!!!!!!!!!!!

Give me a break.

 

[LynahFan]

Re: The PPACA Implementation Phase II - Love it or Lose it!

Insurers knew exactly what was in the law which is no lifetime limits on insurance coverage, pre-existing conditions, etc. The only delays have been for people/businesses to sign up, not for what is and isn't covered. In fact, some of these provisions have been in place for a couple of years. Are you really arguing that insurers have just gotten around to factoring in for example that there's now no lifetime cap on benefits....a provision that's already been in place for several years???

Well, it would be awfully hard to price that factor if you don't really know who (or how many) will be signing up. The whole idea is to spread costs over a larger pool, remember? Tallying up the cost is only one piece of the equation - knowing the pool is the other. If you don't know which people/business will be signing up when, then it does make calculating the appropriate price difficult. Oh, and don't forget that they're not allowed to get it wrong, either - if they don't pay out 80%(?) of premiums in benefits, they get fined. It's definitely a ticklish business and I think you're underselling the complexity by a whole lot.