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The Health Insurance Marketplace is coming soon

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Re: The Health Insurance Marketplace is coming soon

#31

Earlier quoted context omitted.

300bps is complaining about the fact that as a person with a low actuarial cost, he is being forced to subsidize others with a high actuarial cost. I too share this complaint - I wake up and hit the gym from 8-9:30 every day - as a reward for taking care of myself, I'm obligated to subsidize diabetes treatment for people who wake up and eat donuts. How would a public insurance option change this?

You've got it backwards: fat people and smokers cost less to cover because their bodies tend to fail more quickly and the most costly health care centers around slightly prolonging the lives of healthy people. Economically speaking, you should be penalized for your healthy habits. Of course, that doesn't fit in to the "we care about your health" line that insurers like to toss around, so they often just lie about wha…

You are conflating the overall cost with the per-year cost. Per-year, fatties and smokers cost more.

Since insurance premiums are also paid on a per-year basis, per-year is the relevant point of comparison. Of course, in a single payer system which only receives payments from people while they work, it would in fact be beneficial to induce people to die earlier.

Re: The Health Insurance Marketplace is coming soon

#32
post #27
post #23

Earlier quoted context omitted.

Conversely, if you had a preexisting condition, you may have just seen your health bills plumet.

Group plans were/are always forced to cover pre-existing conditions. It's only if you have a pre-existing condition and no group insurance that you will see your prices drop. This is also exactly what is going to eventually bring down the existing US privatized health system, btw. The accounting doesn't add up when you force a cap on premiums and allow unlimited ~10M treatments. People will pay the yearly fine until…

The markets appear to disagree with your hypothesis. Market valuations of the health insurance companies have zoomed to new highs.

Re: The Health Insurance Marketplace is coming soon

#34

We have a health insurance marketplace already. The headline should read: "Government run insurance coming soon".

This is a common MISUNDERSTANDING, unfortunately. The insurance in the exchanges is still "run" by HEALTH INSURANCE COMPANIES. Where government enters is:

(1) To allow people to compare apples to apples by having, in the exchange, groups of plans that offer the same coverage.

In the current individual insurance marketplace, it is basically impossible to compare policies because they all differ on many different details, and finding out those details is a laborious, unrewarding, and confusing slog.

(2) To make sure that the plans in the exchanges would be considered insurance to a rational person. Right now, the individual market has a lot of low premium plans (i.e., plans for which you don't have to pay very much per month) which are next to useless when you actually NEED the insurance, because they don't cover very much at all. The idea is to maintain minimum standards of coverage so if you ever are in a situation when you really NEED insurance, you actually will HAVE insurance.

Re: The Health Insurance Marketplace is coming soon

#35
post #16

Earlier quoted context omitted.

That's one of the reasons why subsidising and regulating private health insurance is not a good approach. If the government worked the way it was supposed to (rationally), then they would have voted for a public insurance option. They went half-way, and everyone will now pay the price.

300bps is complaining about the fact that as a person with a low actuarial cost, he is being forced to subsidize others with a high actuarial cost. I too share this complaint - I wake up and hit the gym from 8-9:30 every day - as a reward for taking care of myself, I'm obligated to subsidize diabetes treatment for people who wake up and eat donuts. How would a public insurance option change this?

> How would a public insurance option change this?

Because when the guy who eats donuts has some numbness in his foot due to Type 2 diabetes, he's going to go to a doctor for advice since he has insurance. The doctor could catch him early enough to prevent the most devastating parts of diabetes and saving you more money than had he woken up one day unable to walk and called 911 and received an amputation that the state picked up the tab for.

This applies for everything. Poor people regularly never see doctors in their offices. They go to the ER when it's nearly too late and rack up huge bills in the most expensive facilities. We don't turn away patients with emergencies. The hospital will bill you and the state will cover you if you don't pay.

Edit: Here's a public health idea: tax sugar (or crops such as corn turned into sugar). We tax cigarettes; it's only fair in my opinion. And the tax on cigarettes makes e-cigarettes very economical.

Re: The Health Insurance Marketplace is coming soon

#36
post #27
post #23

Earlier quoted context omitted.

Conversely, if you had a preexisting condition, you may have just seen your health bills plumet.

Group plans were/are always forced to cover pre-existing conditions. It's only if you have a pre-existing condition and no group insurance that you will see your prices drop. This is also exactly what is going to eventually bring down the existing US privatized health system, btw. The accounting doesn't add up when you force a cap on premiums and allow unlimited ~10M treatments. People will pay the yearly fine until…

People will pay the yearly fine until they have a major health problem, and then join up after the fact.

There are some limitations on this, though not airtight ones. If you don't enroll in the initial open-enrollment period from October 1, 2013 — March 31, 2014, you can't enroll completely freely after that. Subsequent enrollments are allowed only when you have a "qualifying life event", such as a change in employment situation, or a move between states. The main one that's clearly health-linked is that you can enroll upon pregnancy or childbirth (the argument for that appears to be based on the desirability of the child having health coverage, even if the father and mother were previously remiss on the subject). But it doesn't appear to be the case that you could just wait until you have a motorcycle accident, and then enroll for treatment.

Re: The Health Insurance Marketplace is coming soon

#37
post #16

Earlier quoted context omitted.

That's one of the reasons why subsidising and regulating private health insurance is not a good approach. If the government worked the way it was supposed to (rationally), then they would have voted for a public insurance option. They went half-way, and everyone will now pay the price.

300bps is complaining about the fact that as a person with a low actuarial cost, he is being forced to subsidize others with a high actuarial cost. I too share this complaint - I wake up and hit the gym from 8-9:30 every day - as a reward for taking care of myself, I'm obligated to subsidize diabetes treatment for people who wake up and eat donuts. How would a public insurance option change this?

Diabetics who wake up and eat donuts is an ignorant stereotype. There are many paths to diabetes, some of which involve donuts.

As for subsidizing people, younger people are also subsidizing their older future selves, so it's not entirely win-lose.

Re: The Health Insurance Marketplace is coming soon

#38

Earlier quoted context omitted.

300bps is complaining about the fact that as a person with a low actuarial cost, he is being forced to subsidize others with a high actuarial cost. I too share this complaint - I wake up and hit the gym from 8-9:30 every day - as a reward for taking care of myself, I'm obligated to subsidize diabetes treatment for people who wake up and eat donuts. How would a public insurance option change this?

It wouldn't change that and this is a good thing. Part of being in a society is shared responsibilities. I subsidize the education of other peoples' children by paying taxes that fund k-12 education. I have no children of my own. But I'm not being cheated because a society that has universal, free k-12 education is better than one that doesn't. Similarly a society that has free, universal healthcare is better than on…

I agree with the shared responsibilities, but you make it sound as if you are voluntarily subsidizing other peoples' children when in fact you are forced to. If you would contribute to the education and the health costs of others, why do you need to be forced to do it? And if people agree with you, they will do so without a gang of people coercing them to. So cut out the middleman.

> Similarly a society that has free, universal healthcare is better than one that doesn't.

That's a pretty broad, unsubstantiated statement. And how is it free? Nothing is free; that's just propaganda.

Re: The Health Insurance Marketplace is coming soon

#39
post #27
post #23

Earlier quoted context omitted.

Conversely, if you had a preexisting condition, you may have just seen your health bills plumet.

Group plans were/are always forced to cover pre-existing conditions. It's only if you have a pre-existing condition and no group insurance that you will see your prices drop. This is also exactly what is going to eventually bring down the existing US privatized health system, btw. The accounting doesn't add up when you force a cap on premiums and allow unlimited ~10M treatments. People will pay the yearly fine until…

Stop. Never compare health market with anything else. This is the error that the country has to fix.

Re: The Health Insurance Marketplace is coming soon

#40
post #14
post #10

This looks a lot nicer than the websites I had to deal with last time I bought individual insurance on the open market (2010). Will be interested to see how the presentation of plan information is when it becomes available, since that was the second-worst part of the old experience [1]. Hopefully they'll get it right and lay out the choices in some kind of understandable and transparent way. [1] The worst part was th…

It looks nicer than my.company's website for open enrollment. Since Obamacare was enacted, I've gone from a PPO that pays for just about everything to a HDHP that only pays for catastrophic things. But at least the price of the coverage only went up 28% for the vastly inferior coverage. Two of the provisions that are in place already that really raised the cost of the vast majority's health bills are having to cover…

My anecdote refutes yours, since the Obamacare vote, my employer provided insurance went from costing me ~$200/mo on a regular PPO for me and my wife to $150/mo for both of us on a high deductible plan (with employer provided $3k per year in an HSA account), to no cost for me at all and $70/mo for my wife on her employer's plan.

Coverage is about the same for me and much better on my wife's plan.

My mother, who couldn't get insurance for less than about $2300/mo because of preexisting conditions now has insurance that runs about $300/mo with decent coverage.

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