Part of Obamacare Delayed a Year

[red321]

AIR isn't always wrong

[halobob]

Easy for the person using others to provide their safety net to say

You know nothing of my situation so no need to make assumptions. 

[red321]

I thought this was your situation

 

I agree, I'm young and healthy and don't currently need health insurance.  BS that I have to pay high premiums to cover the unhealthy population or I get fined....I know I am not indestructible.  But I also value my money.  In the last 5 years I have been to the doctors office twice.  Once for stitches for a gash I got under my eye (cost $350) and once for a stomach ailment likely caused by the recall of frosted mini wheats cereal ($125).  If I had been paying for insurance throughout this time I would've spend much more money.  I will get health and life insurance when I am ready to have kids as that is when I feel the cost will actually be worth what it provides for me.

[nate]

Under ACA people are no longer underwritten so people who are healthy are paying much more for their insurance than they were.  You can be a fat, out of shape, chain smoker and pay the same as someone with less than 10% bmi, non smoker, etc.  It is ridiculous.

[red321]

Under ACA people are no longer underwritten so people who are healthy are paying much more for their insurance than they were.  You can be a fat, out of shape, chain smoker and pay the same as someone with less than 10% bmi, non smoker, etc.  It is ridiculous.

 

And under the current law companies can fire you for things like smoking, taking contraceptives, having premarital sex...but freeeeedom?

 

It's an interesting debate. Where do you draw the line, if someone is out of shape do you charge them more? How do you decide that? Each person submit themselves to a health check that determines their rates for the next year? And what is the line...drinking? smoking? eating?  high cholesterol run in the family? family history of breast cancer? genetic defects?

[Mudville]

Easy for the person using others to provide their safety net to say

That safety net was in place long before this health care bill was passed and never overburdened the public nor did it fine anyone for not participating. It was an as needed emergency fund instead of a full time everyone on board plan. Somehow we were all better off with Halobob betting against disaster.

[nate]

And under the current law companies can fire you for things like smoking, taking contraceptives, having premarital sex...but freeeeedom?

 

It's an interesting debate. Where do you draw the line, if someone is out of shape do you charge them more? How do you decide that? Each person submit themselves to a health check that determines their rates for the next year? And what is the line...drinking? smoking? eating?  high cholesterol run in the family? family history of breast cancer? genetic defects?

 

 

There are lots of things we pay for in life because of genetic, etc.  IMO smoking and over weight both should be charged much more.  Something like 75% of all ER visits are a result of smoking.  Coincidentally, ER bills are the highest of all.  I should not be paying for that as a non smoker.  What the govt really should have done was create a high risk pool for people who are grossly over weight and smokers, pay for it with a tax on cigarettes and soda/unhealthy foods.  So the same people that are spending the money are also paying for it.

[red321]

There are lots of things we pay for in life because of genetic, etc.  IMO smoking and over weight both should be charged much more.  Something like 75% of all ER visits are a result of smoking.  Coincidentally, ER bills are the highest of all.  I should not be paying for that as a non smoker.  What the govt really should have done was create a high risk pool for people who are grossly over weight and smokers, pay for it with a tax on cigarettes and soda/unhealthy foods.  So the same people that are spending the money are also paying for it.

 

I don't necessarily disagree with you...I'm just trying to imagine how you would implement something like that. Who sets the bar and how do you manage it? Hell, look at the commercials being run by the soda manufacturers right now...can you imagine if you tacked huge sin taxes on soda like we already do with cigarettes and alcohol? People complain about the evils of government now, what happens when you have them setting health guidelines that change what you are charged for medical coverage? Death panels won't have nuttin on that.

[nate]

How is that any better than the healthy and active paying for the unhealthy sloth?

 

Just implement it for anyone that gets rejected by health insurance companies for underwriting reasons.

[halobob]

I thought this was your situation

 

I agree, I'm young and healthy and don't currently need health insurance.  BS that I have to pay high premiums to cover the unhealthy population or I get fined....I know I am not indestructible.  But I also value my money.  In the last 5 years I have been to the doctors office twice.  Once for stitches for a gash I got under my eye (cost $350) and once for a stomach ailment likely caused by the recall of frosted mini wheats cereal ($125).  If I had been paying for insurance throughout this time I would've spend much more money.  I will get health and life insurance when I am ready to have kids as that is when I feel the cost will actually be worth what it provides for me.

Yes, but you know nothing of my situation if I do happen to get into a serious accident.

[red321]

So you are going to create a high-risk pool, regardless off whether or not it's genetic or self inflicted, in essence a dumping ground so insurance companies can dump only but the healthiest most profitable individuals? Who the hell is going to underwrite that? How does that model work when you have no low cost individuals spreading the risk. What happens if I'm perfectly healthy in the low risk pool but the second something happens suddenly I get kicked off and now I'm dumped in to the high risk pool...or I can't afford insurance. Do we end up with the situation we have now...millions of people one job loss away from loving their health coverage and being forced in to bankrupcy if someone gets ill?

[red321]

Yes, but you know nothing of my situation if I do happen to get into a serious accident.

 

You are right...I don't...maybe you are one of the lucky few with a rich family...you got yours, right?

[nate]

Absolutely.  You keep mentioning genetics.  Those are the breaks.  Why should we pay for other peoples maladies?  I just don't get it.

 

The government would underwrite those plans.

 

Anyway none of this really fixes the biggest problem of all.  Everyone blames the insurance companies but we have very small profit margins.  Doctors and hospitals charge insane amounts of money for their services.  None of that is regulated under Obamacare... which is why premiums are skyrocketing in 1/1/14.  The whole thing as implemented is pathetic and flawed.  We were much better off before.

[Mudville]

The you got yours argument is usually one reserved for those practicing capitalism and the jealous socialists that want a share of it.

 

 

You are right...I don't...maybe you are one of the lucky few with a rich family...you got yours, right?

[halobob]

You are right...I don't...maybe you are one of the lucky few with a rich family...you got yours, right?

I'd say my family is very rich in love. 

[halobob]

Red, I just don't understand why I should contribute to a whole bunch of unhealthy people who are at a very high risk (essentially using me as a safety net).  Then you scold me for the very very slim possibility of something bad happening to a fit, non smoker because, as you put it, "Easy for the person using others to provide their safety net to say".

[red321]

Absolutely.  You keep mentioning genetics.  Those are the breaks.  Why should we pay for other peoples maladies?  I just don't get it.

 

The government would underwrite those plans.

 

Anyway none of this really fixes the biggest problem of all.  Everyone blames the insurance companies but we have very small profit margins.  Doctors and hospitals charge insane amounts of money for their services.  None of that is regulated under Obamacare... which is why premiums are skyrocketing in 1/1/14.  The whole thing as implemented is pathetic and flawed.  We were much better off before.

 

Because I don't believe "those are the breaks" is an acceptable answer.

 

The government...e.g....the taxpayer? That will go over well.

 

 

http://money.cnn.com/magazines/fortune/fortune500/2012/snapshots/3147.html

 

In 2012

 

United Healthcare, Fortune 22, had profits of 5 billion dollars

 

Wellpoint, Fortune 45, had profits of 2.6 billion

 

Humana, Fortune 79, had profits of 1.4 billion

 

 

I think the payers are doing just fine. And I totally agree we should be addressing on provider/hospital costs. We should be looking at bringing down pharma costs (government direct negotiation would be awesome), wasteful and unnecessary tests/treatments, better managed care for chronic conditions, etc. etc. etc.

[red321]

I'd say my family is very rich in love. 

 

You are very lucky, and I sincerely hope you don't have to bankrupt them

[red321]

Red, I just don't understand why I should contribute to a whole bunch of unhealthy people who are at a very high risk (essentially using me as a safety net).  Then you scold me for the very very slim possibility of something bad happening to a fit, non smoker because, as you put it, "Easy for the person using others to provide their safety net to say".

 

Because one day, most likely sooner than you imagine, you will be the old/unhealthy person. And maybe that oh so slim possibility you talk about...happens..and I want to make sure you and your loved ones, and kids, could have the coverage they need and deserve...and that you don't have to go in to bankrupcy because the unimaginable...becomes your worst nightmare...and that you don't have to worry that you may lose your job, and healthcare coverage you so desperately need, or you can't pursue you dream job or a small business because you can't afford to lose your healthcare coverage.

[nate]

Because I don't believe "those are the breaks" is an acceptable answer.

 

The government...e.g....the taxpayer? That will go over well.

 

 

http://money.cnn.com/magazines/fortune/fortune500/2012/snapshots/3147.html

 

In 2012

 

United Healthcare, Fortune 22, had profits of 5 billion dollars

 

Wellpoint, Fortune 45, had profits of 2.6 billion

 

Humana, Fortune 79, had profits of 1.4 billion

 

 

I think the payers are doing just fine. And I totally agree we should be addressing on provider/hospital costs. We should be looking at bringing down pharma costs (government direct negotiation would be awesome), wasteful and unnecessary tests/treatments, better managed care for chronic conditions, etc. etc. etc.

 

Those profits are tiny compared to other similar sized companies.  In fact if you look back to the H1N1 outbreak those margins were nothing.  Such small margins don't give much room for risk.

 

United Healthcare has a total membership of about 128 million.  That is a 38 dollar profit per member.  Again, margins are tiny.  Just because the dollar amounts are big doesn't mean the profit is...  percentage wise it is tiny.

[red321]

Regardless of how slim those margins are...5 billion dollars is a huge friggen profit. Allowing payers to cherry pick who they cover and allow them to cover only the most profitable will not only increase their margins...but profit as well. At the same time costs for the government high risk pool (aka taxpayers) goes through the roof. 

[Spirit]

If we were going to do government health care, I think single payer was the only way to do it right.  Anything else, including this piece of crap Affordable Care Act, was (is) going to be a goat rodeo.

[arch stanton]

Where can I buy insurance that protects me from being legislated into oblivion?

[nate]

Regardless of how slim those margins are...5 billion dollars is a huge friggen profit. Allowing payers to cherry pick who they cover and allow them to cover only the most profitable will not only increase their margins...but profit as well. At the same time costs for the government high risk pool (aka taxpayers) goes through the roof. 

 

Pharma and Physicians have 10x that profit.  It is small, like I said, if a bad year comes the companies could be losing money, you have to have a margin.

[red321]

Pharma and Physicians have 10x that profit.  It is small, like I said, if a bad year comes the companies could be losing money, you have to have a margin.

 

Don't all companies run that risk? Or is this another case of privatizing the profit and socializing the losses ala Wall St?

 

And I agree...we should be looking at Pharma and the Provider sides of the house. Allow government to directly negotiate prices for drugs...take a closer look at the shenanigans that allow companies to drag out patents. Lots of room to allow companies to make a healthy profit and help bring down/maintain costs. On the provider side we could be taking a page from Europe, using a common fee schedule. Our costs per procedure outpace most every other country, why is that? 

 

In 2010, our healthcare costs were 17.6% of GDP, approximately 1.5 times more than any other country.