I would imagine the hospitals would provide their students’ insurance rather than not have students. But early retirees like Mr. Fang and me would be out of luck.
“$15,000 would be seen as a catastrophic cost for many middle income households, particularly those who have not been saving for years before.”
While it is a lot of money, none of the things I needed to get diagnosed would be covered under any “catastrophic health insurance policy.”
I’m very sorry about what will happen but since it’s likely there will be no individual health insurance available to anyone, they have no choice but to try and save as much money as possible.
Tatin, there are unfortunately a whole bunch of people who believe that vaccinations are harmful. Are you OK with an American citizen being charged a higher fee, per the government, because of their beliefs?
Everyone should be vaccinated unless there is some medical reason why that individual cannot be.
But if you choose not to be vaccinated and then get measles, mumps, whooping cough, polio, TB, chicken pox, then you made that (bad) choice. I don’t like paying for other people’s bad choices. People need to take personal responsibility.
I agree with you that anti-vaxxers are beyond selfish, but that wasn’t the question. We’re talking about who gets charged more for insurance.
Should those people be forced to either pay a higher premium for their belief, or else undergo a treatment that they believe is harmful? And either way, how is that not government overreach on steroids?
I am as pro-vaccine as they get. I do not believe in exceptions unless you cannot get vaccines for explicit health reasons.
With that said, I think charging on a gradient for vaccines can be a slippery slope. There are vaccines that are technically considered safe for me to get but my doctor advised against them for a variety of reasons. Then there are others that are safe for me to get and I do. And then there are vaccines that not only can’t I get, but no one I live with can get with either.
Which of us, if any, should have to pay more? The amount of paperwork to get through all of this would again create even more bureaucratic bloat.
“Everyone should be vaccinated unless there is some medical reason why that individual cannot be.
But if you choose not to be vaccinated and then get measles, mumps, whooping cough, polio, TB, chicken pox, then you made that (bad) choice. I don’t like paying for other people’s bad choices. People need to take personal responsibility.”
Who is going to pay for vaccinations when individual insurance is no longer available and Medicaid is taken away from those who benefited from its expansion? Right now they are all covered at 100% because of ACA
The problem is the PARENTS choose not to vaccinate the kid. Should the kid suffer because of poor parental choices?
We could and should save a lot if all folks had a better understanding of what their choices include if they choose ALL possible medical interventions at the end of life. So much is spent for questionable benefit. My folks and two older sibs are convinced that is what my folks want and should get. I dread it and think it’s an awful choice and decision. I understand most providers will go with the squeaky wheel and provide care when in doubt to minimize lawsuit risk.
Exactly, romani. All of this slicing and dicing of the population in the name of punishment (sorry, but that’s what it is) only raises costs for all of us. And that includes those who thought their premiums were going to be lowered. The administrative costs would be enormous. How many forms would you have to fill out for your complicated situation? How many hours would be spent processing them? For someone who doesn’t have any of Tatin’s ennumerated “bad habits” they’d still have to fill out forms. How would we know they’re not lying about, say, how much exercise they get? How would this be certified? How much exercise is enough to pay the lowest premium, and who decides? Times 20 million people. Who’s going to pay for all of that?
The evidence in the Mckinsey link is weak. It only includes medical conditions that account for 35% of US health care spending. Of that 35%, the US does have a higher prevalence in some areas, and in the rest, the categories are often too large to be meaningful. Do all heart conditions cost the same amount to treat?
“If you do not smoke and do not abuse drugs or alcohol, exercise regularly, get routine vaccinations and checkups, etc. your health insurance premium should be lowered.”
Some of the people I know who have the highest medical bills do all that stuff - fit, exercise, don’t smoke, drink in moderation or not at all. What they do have is crappy genes. Should we start giving genetic tests so those at lower risk for the multitude of illnesses, ailments and conditions can get a discount? Or how about those weekend warriors or the runners/tennis players/ etc. with shot knees who need surgery? Maybe you shouldn’t get a discount for exercising. Maybe we should charge a premium for those kids who participate in contact sports because they have a higher risk for injuries. Lefties are more accident prone statistically - make them pay more. Get your tubes tied when you are 21 and get a huge discount. Once you open the can of worms on this kind of stuff, where do you draw the line?
Flip this around.
Other parents make good choices for their children, improving their children’s health, and resulting in lower health care expenses. If they could buy insurance with other like-minded parents, their costs would be lower. But instead, you are forcing them to subsidize parents who make poor choices.
Just as in encouraging safe driving, encouraging good health habits with a premium discount seems a good thing to me. Look at any CDC report on the costs of the chronic conditions caused by preventable behaviors.
TatinG, your analogies to auto and homeowner insurance don’t work. There is a direct correlation between having an operable smoke alarm and halting a fire earlier. There is a somewhat direct correlation between greatly over speeding, or running a red light, and car accidents.
Medical science has not advanced to the point where we can directly attribute many of the most expensive medical conditions to any particular behavior. There is correlation in some cases, but causation is a whole 'nother thing.
Your system would have the outrageously unfair result of punishing people who did not cause their condition in any reliably provable way.
Also, traditionally, auto insurance companies did not rate based on individual driving behavior (do you use your turn signal when turning or changing lanes, do you leave a safe following distance, do you lock your car and take your key when you leave, etc.), but on the results (crashes, citations, thefts) of such. It is only recently that some have gone to trying to determine the riskiness of individual driving behavior by offering discounts if data from your car’s OBD-II port does not show what they consider higher risk behavior (e.g. lots of hard braking or acceleration).
That is not too much different from pre-ACA medical underwriting, where your actual pre-existing conditions, not your health habits (other than smoking and obesity) are used.
People who start to smoke start to smoke when they are minors. It’s rare indeed for an American smoker to have begun in adulthood. And, as I remarked earlier, some people have what we might call a hard addiction to cigarettes, for genetic reasons they can’t control. Even faced with strong incentives they can’t stop.
Granted, starting to smoke when you are 14 is stupid. It’s an idiotic thing to do and no child should do it. But now we’re punishing them when they’re 40, for the stupid thing they did when they were 14?
This is ironic considering this forum. People obsess over college admissions because they think their kids career at 40 will be determined by where they got admitted to college at 17 based on grades they earned at 14.
The question, as it has been for most of a decade, is really whether you can get someone else to pay for you. That the current effort isn’t very popular doesn’t mean a way won’t eventually be found.
Fit, diet-conscious, healthy on the outside people do indeed need health care - they’re no more immune to genetics than the almost morbidly obese are. That they’re not at the same risk for Type 2 diabetes is also a fact.
I’d invest money in an insurer that pooled based on lifestyle.
And here we go with more bureaucratic bloat.
I can’t wait to figure out how we’re going to actually “catch” people who smoke. Because of course, you know, everyone will be completely honest when it means their rates will go up. 8->
Oh and smoking cessation programs? Forget it. Since trying them (and most people fail the first time) would prove that you’re a smoker.
^Going back to the pre-ACA individual health market, insurers could use rescission. You might lie about not smoking, and the insurer might never bother to try to catch you until you had cancer and large medical bills. Then they could use that as a reason to revoke your policy, so there was a lot of risk in lying on your health insurance application.