Yup. Small (<200 re’s) company in SoCal and our total family premium for '17 is $21,105/yr. (80/20 PPO, with $500 deductible.)
The fact that costs are high means that any attempt to solve any problem in medical care or insurance involves a lot of money being reallocated somehow – which means that someone will complain.
I didn’t say those 100k families didn’t exist. I just said the ones I know get them through employers. I don’t pretend that my experiences are generalizable.
Just personally, I’d still rather be a 100k family that has to pay 25k in healthcare than a poor person pre-ACA who didn’t have any options. Not that either is ideal, of course. I’ve just been uninsured and there isn’t much I wouldn’t pay to keep my insurance because, you know, the last time I almost died and money’s no good to you if you’re dead.
Our premiums have gone from $14,000 pre-ACA to $26,000 in 2017. Lots of people I know are in the same boat. Time to kill this system and replace it with something designed to cut costs instead of shifting the cost to those who did not vote for the people writing the law.
I don’t know if what you are saying is true. Do you have a study that says that employers pay about the same as ACA exchange rates for equally good plans?? I have precisely one data point, but for our company the COBRA rate is about 50%-60% of the individual market rate and the plan is much much better. (My friend jokingly(?) asked me to hire him for minimum wage for a month and then fire him just so that he could get our COBRA coverage). On the hand, our employees skew heavily towards young, very high SES, very highly educated males, so we’re an insurance underwriter’s erotic dream.
Because insurers know what they are doing and they are allergic to losing money. I’m gonna bet they charged the actuarial correct price for the individual pool at the time.
There’s one straightforward question that needs to be answered: does the post-ACA individual marketplace skew very disproportionately towards people who have very high medical costs? If so - and based on what I’ve read I think it does - then the healthy unsubsidized people in the individual market are shouldering a lot of the burden. This burden should be spread out evenly among the taxpayers.
I have no idea why this is controversial. This is what a lot of backers of the ACA are proposing in order to fix things … they want to increase subsidies (or economic equivalents like boosting the proportion of healthy people or the risk corridor reimbursements) in order to stop the death spiral from occurring. Even if you think that individual plans cost the same as employer plans (controlling for quality), then the fact that the individual market is spiraling down but the employer market is not probably tells you the answer.
I really don’t think your argument is with me. It’s with the Obama administration’s own analysis. I’m just parroting what they are saying.
You’re not the first person to want to reduce health care costs. What’s your proposal?
People are very bad at distinguishing between care they don’t really need, and care they do really need. Assuming we want people to keep on getting care they really need, “skin in the game” has been shown to fail. That is, you want people to avoid unnecessary trips to the emergency room, but if you impose extra costs they’re just as likely to skip diabetes checkups.
I, because I am a bleeding heart liberal, think we should make a nationwide list of treatments that aren’t cost effective, and not pay for them. This, by the way, was in fact included in the ACA, for Medicare. It was massively unpopular.
Blue Bayou, what if you took a higher deductible? You’re paying for that $500 ded.
And Zin, again, it’s not only the bottom line, as if all plans were created equal and simply the price almost doubled. It’s the particulars of what plan you choose from whatever selection there is, in your area. Some with higher deductibles or etc. Just to throw out the total (which we’ve seen across several threads now,) can be only part of the picture. Just saying.
Therein lies the political problem (which is now one for the “repeal and replace” politicians to try to figure out). People want many of the goodies in ACA like guaranteed issue, but do not want to pay for it.
NYS had guaranteed issue since the '90’s but without a mandate. It was outrageously expensive - so much so that the cost for those in the individual market after ACA dropped 50%. And in all of NYS only about 10,000 people had policies - that is how expensive it was.
There is no way you can have guaranteed issue without a mandate that every one has insurance (or a very weak penalty if you don’t like there is under ACA.)
No insurance company will write if there is guaranteed issue but no mandate. I don’t care what kind of voodoo plan anyone comes up with, insurance wouid have to be required of everyone. The insurance companies are not dummies.
It could get worse. What if they got sick? Under the ACA, they could then buy insurance for the next year. Under the brave new ACA-repealed world they voted for, they couldn’t. Gosh, wouldn’t it be a pity if the same terrible consequences they are trying to impose on other people backfired and hit them instead?
Just saying that the $14,000 plan had a wider number of doctors, lower co-pays and lower deductibles. The $27,000 plan is described as a “silver” plan, so it does not have all the bells and whistles of the gold plan.
The ACA was passed with a promise to lower costs by $2,500 and keep your doctor. Instead, they have risen by $2,500 per year and provider networks have dramatically shrunken.
Start with tort reform.
The USA has relatively low tax rates for all income groups. Getting enough money to pay for universal health care means tax rises on the middle class, which just won’t put up with it.
@al2simon, when I asked whether pre-ACA premiums were right and just, I wasn’t asking whether the actuaries could do their jobs. I know they could do their jobs. That’s why 18% of people, and about a third of people over 60, were rejected when they tried to get insurance. Of course you can offer cheap insurance if you reject people who need insurance! That doesn’t mean it’s right and just to say that people who are sick shouldn’t be able to get insurance; it means it’s profitable to offer insurance only to healthy people.
People currently in the individual market are a lot sicker than they were when sick people couldn’t get insurance. They’re probably sicker than the average person eligible for individual insurance, although the sickest group is the new Medicaid subscribers in the expansion states. On the other hand, people over 55 on the individual market get substantial subsidies from younger people.
I don’t see why it should be spread evenly among taxpayers. Unlike people in the individual market, people in the employer market have always had to pay for sick people. Employers offer insurance to everybody. I haven’t seen any evidence that people eligible for the individual market (people over 100%/133% of poverty, under 65) are sicker on average than people who get insurance from their employers.
The burden should be spread over people eligible for the individual market. That’s what the individual mandate is for, but it isn’t strong enough.
Tort reform, zinhead? Congratulations! You have now saved one tenth of one percent (0.1%) of American health care costs. What is your next proposal?
http://theincidentaleconomist.com/wordpress/meme-busting-tort-reform-cost-control-2/
“Start with tort reform.”
LMAO
@Cardinal Fang - Snarkiness aside, other researches have found larger potential saving from tort reform. For example:
Whether it is 0.1%, or 1.0% or 10%, tort reform would generate 1000% more savings than ACA did.
@zinhead. We are in the same boat. We are clinging to our small family group policy inspire of going from $1150 for four people to $1850 for two with an big increase in OOP costs.
The first year of the ACA our policy was extended for another term - with associated premium increases.
The the website began showing a message along the lines of ‘this is a non-compliant plan. If you are not grandfathered, it will be discontinued at the next enrollment period’. The message disappeared before the renewal time frame. Turns out we were ‘grandmothered’.
Turns out no one (least of all my State) wanted to fully implement all of the ACA measure because the reality of its costs and pitfalls would have been evident sooner.
The SHOP system - which is supposed to be for small businesses - has never materialized.
We were renewed again this year - but with a reset of the ‘plan year’ date. This policy terminates 9/30/17.
I’m hoping the repeal/replace will include a continued allowance for small family businesses to maintain group policies.
H is Medicare eligible in two years.
At that point I’ll probably just get the catastrophic plan and put the rest of the $$ towards a concierge practice.
It’s worth asking: exactly how many of the single payer, universal health countries allow their doctors to be sued? In a fashion that’s comparable to the US court system?
If none - or even some - then… malpractice costs are much greater than 0.1 %. It isn’t just a co-incidental, non causative correlation.
We’ve already had tort reform in 24 states. Those potential savings should be actual savings by now, if they were going to exist.
As to ACA savings, most occurred in Medicare. Here is one example:
http://www.cnbc.com/2015/05/04/obamacare-program-generates-substantial-medicare-savings.html
I’m impressed we made it 50 pages without the tort reform talking point. Bravo, everyone!