<p>“My daughter used to work for United Healthcare.”</p>
<p>Isn’t that like those cases of US soldiers defecting to North Korea?"</p>
<p>:)</p>
<p>If healthy young people don’t sign up, will the rules change so that the young can stay on their parent’s plans until they are 40? :)</p>
<p>The young millenials already are burdened by student debt, low wages and bad career prospects. Those that are making over the subsidized amount, are now forced to buy a product that’s more than they need or want and which they cannot afford. </p>
<p>The death spiral is coming.</p>
<p>Trying to understand why anyone would think it odd that dstark’s daughter, an actuary, worked for a health insurance company.</p>
<p>“Trying to understand why anyone would think it odd that dstark’s daughter, an actuary, worked for a health insurance company.”</p>
<p>CF, some people have very strong feelings about health insurance companies.</p>
<p>There is no excuse for the website glitch. Those ■■■■■■■ contractors and government supervisors should be fired. But this not all about ACA and it should not be used as a propaganda for attacking ACA. I am ready to go back to do consulting work because I can buy health insurance now. Anthem denied my application 8 years ago. Now they send me mail to offer insurance.</p>
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<p><a href=“https://developers.google.com/open-source/projects[/url]”>https://developers.google.com/open-source/projects</a></p>
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<p>[Is</a> Facebook The World’s Largest Open Source Company? ? ReadWrite](<a href=“Is Facebook The World's Largest Open Source Company? - ReadWrite”>Is Facebook The World's Largest Open Source Company? - ReadWrite)</p>
<p>Maybe businessweek knows what source code is.</p>
<p>Calmom is right. With three years to set in place, it is a wonder that this common sense approach wasn’t put into place on the site. </p>
<p>I looked at that Kaiser calculator back in first ACA thread in July. That is when I realized I wouldn’t be eligible on exchanges based in family income. Or maybe we would depending on what is figured in MAGI. With self employment wages that fluctuate, it seems to be too big a risk to get a subsidy and then maybe owe it back at end of year. Still, I figured I would give it a go and price some plans. I was shocked at how much more my own plan is for level of service. I am one of those losers in the ACA, like many here. </p>
<p>Some will be winners. </p>
<p>The thing that gets me is simply how complex this problem is. For most folks, they are not spending hours reading a discussion board about the merits of doing one thing or the other. Many people I know do not have an emergency fund to pull a family deductible of nearly $13,000 if it is a bad year, plus monthly premiums rivaling our mortgage costs. </p>
<p>The medical system in the US was a mess, but for all the good things in ACA, there are many unintended consequences, too. </p>
<p>In my opinion, we should have all had the option to buy a basic plan, and add on riders. Is is fair for the woman who will never have children to have to pay extra costs every month of her life because others want to have maternity care? I doubt if the insurance companies would have gone along with a basic plan with riders fir additional coverage. They need healthy people to pay for sick ones. </p>
<p>When you buy a new appliance. the sales reps always push you to buy extended warranties. They make money off of this practice. The odds are good that if something goes wrong with your dishwasher, it happens in the limited warranty period. If you buy the extended, you are taking a gamble. Most consumer products experts tell you it is a waste of money. </p>
<p>Not everyone has a dishwasher. Everyone has to have health insurance, now. And lots of people are goi g to be paying more for less. Lots of people are going to pay less for more. The insurance companies win, again.</p>
<p>Coolweather, I am happy for you.</p>
<p>Google’s core business code is not open source. And they may have “inspired” Hadoop, but Google’s own map-reduce code is not open source. You bet “some” would take exception to classifying Google as an open-source company. “Most” would be a better characterization.</p>
<p>Moreover, the exchange software’s failure has nothing to do with the code not being open source.</p>
<p>Samurai:</p>
<p>+1</p>
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<p>If the existence of a Cat plan and a Comprehensive Coverage Plan in the market are incompatible, then how come both have existed in marketplace for decades? The logic is suppose to be that Cat plans force out other plans because only the sicker would choose them. But that isnt true because apparently a great number of people favor a known, fixed cost over the possibility of greater variable costs. </p>
<p>If the adverse selection is as destructive as claimed, then the Bronze plan would quickly destroy the Platinum plan in a few cycles.</p>
<p>In reality people choose non-cat plans for all sorts of reasons- for instance having low deductibles. That isnt adverse selection. Based on the existing market, its possible to make viable risk pools for comprehensive policies. </p>
<p>What doesn’t make sense in ACA is baring people from affordable Cat policies they would have bought and then giving them subsidies to buy Bronze plans. They are nominally paying more into the system but in reality thats just the government pumping money in.</p>
<p>I think open source and open interface protocol are 2 different things. Some open sources don’t have open interface standards. Some private sources have open interface standards.</p>
<p>I like Samurai’s post also.</p>
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<p>It’s not the insurance people who object to this. Insurance companies have clever employees like dstark’s daughter to figure out how to price policies.</p>
<p>The problem is sick people. Under your scheme, healthy people will buy cheap policies that don’t cover the problems they don’t have. And then that leaves the sick people. Your system sounds just dandy for healthy people, but terrible for sick people who are left with unaffordable premiums. This problem is the essence of why ACA has “community rating” where everyone pays the same: because if healthy people pay less, sick people will pay a lot more. </p>
<p>Now maybe you think it’s fine that sick people will face ruinous health insurance premiums, if they can buy insurance at all, while healthy people can buy inexpensive insurance. But many people thought that was a problem, and the ACA is designed to fix it. And by the very nature of the situation, if sick people are paying less, healthy people have to pay more.</p>
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<p>Because we didn’t have community rating, so sick people couldn’t buy either the Comprehensive Coverage Plan or the Catastrophic Plan. If you want to have everyone buying insurance, and you want to have premiums that sick people can afford, you’re going to have to have healthy people subsidizing the sick people’s insurance premiums. You can’t skim off the healthy people into the catastrophic plans.</p>
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<p>Except that wasn’t what you said.</p>
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<p>Clearly wrong.</p>
<p>(I overstated my case on Apple. They didn’t fire everyone just the manager most responsible for the mistake. I would settle for that with this fiasco.)</p>
<p>[U.K</a>. Official Urges U.S. Government To Adopt A Digital Core : All Tech Considered : NPR](<a href=“U.K. Official Urges U.S. Government To Adopt A Digital Core : All Tech Considered : NPR”>U.K. Official Urges U.S. Government To Adopt A Digital Core : All Tech Considered : NPR)</p>
<p>“Not everyone is onboard with the reforms. For one, becoming “digital by default” means those who prefer a more analog relationship with government services are forced to adapt. And one of Bracken’s biggest critics is a man named Tim Gregory. He argues that putting technologists at the heart of government stifles business investment in the U.K. Gregory is the U.K. president of CGI, the global contractor whose American arm was the biggest contractor on HealthCare.gov. (Bracken calls Gregory’s complaint “beyond parody.”)”</p>
<p>A small fraction of people use a huge percentage of health care and cost the ‘system’ a bundle. I don’t remember the exact number but it’s something like 5% using 30% of all health care dollars. This is not just end of life care. My friend is an internist and she sees the same patients over and over. Have they followed their medication regimen? No. Did they follow the recommended diet plan? No. Do they get out for a walk once a day? No. Did they give up the booze or the cigarettes? No. Did they cut out the salt? No. Did they take the antibiotics for the full course? No. It’s very frustrating for her. </p>
<p>So yes, those who are sick because of genetics or just plain bad luck, I feel for and if I were king of the world, I wouldn’t charge them extra for insurance. </p>
<p>But good drivers get discounts. People who build a house surrounded by dry brush pay more for homeowner’s insurance. People who simply don’t take care of themselves should pay more.</p>
<p>The top one percent of people use 22% of health dollars; the top five percent use 50% of health care dollars.</p>
<p>[url=<a href=“http://kff.org/slideshow/health-spending-trends-and-impact/]Health”>Health Spending: Trends and Impact | KFF]Health</a> Spending: Trends and Impact | The Henry J. Kaiser Family Foundation<a href=“fifth%20slide”>/url</a></p>
<p>Addressing that problem would make far more sense than revamping the insurance system.</p>