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Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

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Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#211

Post by oh_sigh »

dieselz wrote: post #27

Before the pitchforks come out, keep this in mind: before Obamacare increased access to affordable individual plans, employers were the typical purchasers of health care plans. When you have a 100+ person company, the company pays a rate that averages out their employee pool's healthcare needs. Now we have a situation where more people can more efficiently participate in the healthcare market. Individuals who are you…

> Individuals who are young and healthy will opt for a lower cost plan,

This doesn't jive with the Obamacare marketing: They specificially needed to get a lot of young healthy people to sign up, because their fees would pay for the older generations who have higher health care costs.

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#212

Post by mathattack »

seibelj wrote: post #2

Can anyone succinctly explain the benefits of having a market for private health insurance companies, rather than a single provider of health insurance (government, aka "public option")? Can a capitalist case be made for their existence? Does the lack of a large private insurance market in countries with government-provided health insurance cause lots of inefficiencies and waste?

I'm not well enough informed to give a complete opinion on what's better, because it's a complicated solution. I do know some reasons why a public option might not be good. (This doesn't mean it's the wrong option - just considerations)

1 - When you eliminate competition, you lose innovation and smart cost control. Look at most monopolies for evidence of this.

2 - You wind up forcing a "one size fits all" on everyone. What if some people prefer a bare bones service, and others prefer an advanced one?

3 - How many things does the government really run well?

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#213

Post by maxxxxx »

eridius wrote: post #34
VonGuard wrote: post #9

Earlier quoted context omitted.

There is no benefit. The benefit is for the legislatures who passed the law. There was no way that we'd get single payer here in the US because our Congress is very much in the pocket of the health care industry. As such, the markets were a compromise measure enacted by congress to make it easier for people to choose health care. Before Obamacare, it was sort of a black box where only HR people could figure out prici…

There's no way that we'd get single payer here because the Republican party has convinced their base that single-payer health care is socialism and that socialism is evil, which leads to the situation where poor people who desperately need health care and can't afford it still oppose single-payer even though they stand to gain the most from it.

I am still waiting for the Republicans vote for abolishing Medicare and the VA. Those programs are pure evil and seniors and vets must be liberated from them.

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#214

Post by jessaustin »

gozur88 wrote: post #193
seibelj wrote: post #2

Can anyone succinctly explain the benefits of having a market for private health insurance companies, rather than a single provider of health insurance (government, aka "public option")? Can a capitalist case be made for their existence? Does the lack of a large private insurance market in countries with government-provided health insurance cause lots of inefficiencies and waste?

If the government is going to be making all the decisions there's no benefit. But I doubt we would have had Obamacare at all if he'd proposed a single-payer plan. Insurance companies, which have a lot of clout in Washington, helped push it through because they expected to make more money. Which, quite frankly, was stupid. It was pretty clear from the outset the ACA would break the US health care system so badly singl…

Do you think that was as clear to the sponsors of the ACA as it was to you?

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#215

Post by ashark »

Randgalt wrote: post #191
ashark wrote: post #185

Earlier quoted context omitted.

> "'Rights' are basically just freedoms we've decided we like a whole lot and want the government to guarantee" - as I said below, the logical conclusion of that argument is not a world you'd want to live in. How is that not the world we live in? What is the alternative? At some point someone's deciding what's a right and what isn't. Other people may disagree. Rights aren't a law of nature, they're a fuzzy category,…

"What is the alternative?" - a system of rights based on the nature of human beings. Human beings survive by producing the things we need to survive. We need governments to protect others from initiating force against us in opposition to our primary needs of living. Will we ever see this in reality? No. But, the closer humans have gotten in history the better off they've been.

> "What is the alternative?" - a system of rights based on the nature of human beings. Human beings survive by producing the things we need to survive. We need governments to protect others from initiating force against us in opposition to our primary needs of living.

I'm having trouble figuring out how this doesn't still boil down to people making judgement calls on what is and isn't a right, just with a level of indirection, so maybe this other question will help me see what you mean:

> Will we ever see this in reality? No. But, the closer humans have gotten in history the better off they've been.

Do you have an example in mind of when and where we've come especially close to this ideal?

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#216

Post by Randgalt »

parasubvert wrote: post #179
Randgalt wrote: post #82

Earlier quoted context omitted.

1. Try getting an MRI in Canada. Canada rations care via wait lists. 2. Your argument implies that there wouldn't be low cost schools in the absence of public schools. The evidence is overwhelming that the opposite is true. 3. I live in Panama. When I need something mailed here I use FedEx or DHL. The USPS is unreliable and takes far too long. If there weren't laws against private first class mail in the US they'd be…

Canadian here. Firstly, diagnostic care is often privately managed throughout the provinces, so if you don't want to wait, you can often pay to expedite. It's about $900 for a joint MRI. Secondly, if you really need an MRI for a critical diagnosis, as I once did in 2012 as a hospital inpatient, I got it within 2 days. Canada's health system is a point of national pride.

It depends where you live. I know many Canadians who've had different experiences. This points to a major problem with socialized products - how they perform depend not on merit or ability to pay, but where you live, how good your representative is, etc. That is much worse.

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#217

Post by lemmsjid »

Frondo wrote: post #162
sweettea wrote: post #142

Earlier quoted context omitted.

I believe statistics say that expanding Medicaid added 8 million covered folks, about 15% of uninsured Americans, and otherwise Obamacare has only gotten an additional few percent of uninsured Americans to become insured. I don't think the norm is that everyone should have access to health insurance any more than it was before due to Obamacare's negligible increases in coverage. [ http://www.heritage.org/research/rep…

Oh, I'd agree completely that, as an implementation of universal health care, Obamacare falls far short. I always say, it's better than what preceded it, but that is a pretty low bar to achieve. (My own story: I had my gallbladder out in 2004, and from that time on was denied personal health insurance for BS "pre-existing condition" reasons...until Obamacare.) But while the implementation is pretty poor, the idea beh…

Same exact scenario here, except a kidney problem. It was a nightmare to get back into coverage and required ultimately working for a large company.

Since that happened I've always thought the lack of universal healthcare was a major cultural lever against entrepreneurship and small business ownership, because stable healthcare coverage is probably the number one draw of working a corporate job. It seems so culturally odd to me that employment and healthcare are so linked in the U.S.

Unfortunately I think some people don't understand how existentially frightening it is to get a bunch of rejection letters from insurance companies until it happens to them.

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#218

Post by random28345 »

zeveb wrote: post #201
seibelj wrote: post #2

Can anyone succinctly explain the benefits of having a market for private health insurance companies, rather than a single provider of health insurance (government, aka "public option")? Can a capitalist case be made for their existence? Does the lack of a large private insurance market in countries with government-provided health insurance cause lots of inefficiencies and waste?

> Can anyone succinctly explain the benefits of having a market for private health insurance companies, rather than a single provider of health insurance (government, aka "public option")? Government provision of health insurance means that every procedure covered is a political issue (e.g. abortion for the left, sexual-orientation counselling for the right). This means that there will be nationwide winners and loser…

> American governments are not capable of running efficient programmes, because to a first approximation American government employment is a make-work program for people who can't get hired at anywhere that cares about competence.

American governments are not capable of running efficient programs because to a zeroth approximation Americans keep electing politicians that not only promise that government can't do anything right, but also work to ensure it.

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#219

Post by Randgalt »

Randgalt wrote: post #191
ashark wrote: post #185

Earlier quoted context omitted.

> "'Rights' are basically just freedoms we've decided we like a whole lot and want the government to guarantee" - as I said below, the logical conclusion of that argument is not a world you'd want to live in. How is that not the world we live in? What is the alternative? At some point someone's deciding what's a right and what isn't. Other people may disagree. Rights aren't a law of nature, they're a fuzzy category,…

"What is the alternative?" - a system of rights based on the nature of human beings. Human beings survive by producing the things we need to survive. We need governments to protect others from initiating force against us in opposition to our primary needs of living. Will we ever see this in reality? No. But, the closer humans have gotten in history the better off they've been.

"I'm having trouble figuring out how this doesn't still boil down to people making judgement calls on what is and isn't a right" - at the end of the day we're ruled by people. But, there should be a standard by which decisions are made other than "whatever the majority decides".

Re: Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

#220

Post by harryh »

tptacek wrote: post #208
harryh wrote: post #168

Earlier quoted context omitted.

I don't know about single payer, but health care is tricky. What do we do (as a society) about this guy: https://news.ycombinator.com/item?id=12307526 He has his gallbladder out and all of a sudden he's a super risky person to insure. How do we get him in a risk pool where his premiums won't be unaffordable?

By shifting more of the group insurance market onto the individual market, perhaps mostly by eliminating current incentives for employer group coverage, to minimize the adverse selection problem. Incidentally: two members of my immediate family have the same problem he does. No history of serious illness, no current health problems, probably healthier than the median in both cases for their age cohort, but uninsurabl…

1) Can we make the individual mandate in the individual market strong enough to really eliminate (or at least minimize) the adverse selection problem?

I am unconvinced that we can. Perhaps though.

2) Are you really convinced that the pre-existing rules you encountered were bogus? Are insurance companies just dumb when it comes to this sort of thing? I tend to assume, absent other evidence, that insurance companies will be profit seeking so would only turn people down if they expected to (probabilistically) lose money on the deal. Perhaps they're just not smart enough to discern differences at this level though? I don't have much experience in this area.

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