<p>You say that in jest, but of course it’s not as simple as that. Euthanasia is a felony in all states, and assisting someone in committing a suicide is also unlawful, usually a felony, in all but a small handful of states where it is permitted but strictly regulated. Taking your own life is one thing; expecting someone to help is quite another. But even apart from the question of assistance, I certainly don’t think we want a public policy predicated on the idea that suicide is the answer if your medical bills are too high.</p>
<p>And your $6 million lifetime cap was probably on the high side of what was out there. The 2007 Kaiser Family Foundation employer survey found that 23% of people covered by employer-sponsored health insurance had lifetime caps of less than $2 million; 32% had lifetime caps of $2 million or more, but my guess is these skewed heavily toward the lower end of that range. In the individual market it’s likely that most caps were quite low. A 2009 PriceWaterhouseCoopers analysis for the National Hemophilia Foundation found that while caps had been increasing over time, the increase had not kept pace with health care inflation, such that a $1 million cap in 1988 would be the equivalent of a $3.6 million cap in 2007–yet relatively few policies had lifetime caps as high as $3.6 million in 2007. </p>
<p>Uhm, when you get into health care costs in excess of 6-million dollars isn’t it usually about prolonging life? Suicide would likely not be needed.</p>
<p>Exactly. Most (unless they are in the states with no expanded medicaid) now have access to insurance, but it does not mean they have access to health care. </p>
<p>People here pick on GP, but he does have a valid point regarding narrow networks. I personally do not need insurance to pay for my family doctor visits. But if I do get something complicated, I would like to have a choice of doctors. </p>
<p>I also think that those at the lower spectrum of income, but not on Medicaid, will probably still not be able to access health care, even if they now will have insurance. People in that situation probably do not have money for co-pays, even if they are subsidized. </p>
<p>I kind of think that ACA created more problems than it solved.</p>
<p>“I kind of think that ACA created more problems than it solved.”</p>
<p>It’s hard for me to see any problems that it created that are worse than – or even in the same ballpark as – the problem of millions of people without access to any decent insurance, and millions more unable to change jobs or start businesses for insurance access reasons. It’s already made a huge dent in that problem in the states with working web sites.</p>
<p>The way I remember it in Ca is that prior to 2010 almost all BS polices had the $6 million lifetime cap and Anthem had a $5 million cap. I suppose there were polices with amounts less than these thresholds, but all the ones I was looking at had either the $6 million or the $5 million cap. None of the polices I ever shopped had an annual cap. Maybe Ca was different from the rest of the country.</p>
<p>It’s easy to say, until one of your kids gets sick or hurt and it 's going to cost $10million to get him through. Then they have you by the ying yang.</p>
<p>This is also a point that the people fighting against the caps were making. The PriceWaterhouseCoopers analysis for the Hemophilia Foundation estimated that by 2009, 20,000 to 25,000 people per year were exhausting their lifetime caps–and that number was expected to grow, as caps were not rising fast enough to keep pace with health care inflation. That may seem like a trivial number, but it’s a life-changing deal for those 20,000 or 25,000 people–and for the additional tens of thousands who had already exceeded their lifetime caps in previous years and in most cases were excluded from re-entering the individual market by pre-existing conditions. </p>
<p>But the PriceWaterhouseCoopers analysis said the caps could be raised to $5 million or $10 million at a relatively trivial cost, well under 1% of the cost of the average policy. Of course, eliminating the caps entirely is bound to have a somewhat higher pricetag than merely raising the caps, but still, when you spread that cost across the entire risk pool, the cost per policyholder is fairly trivial, and the benefit to those who eventually will have multimillion dollar medical bills is staggeringly large. </p>
<p>It’s as if we were running our health insurance system like a reverse lottery–chances might be only 1 in 10,000 that you’d exceed your lifetime cap, but if you were that unlucky one in 10,000, the financial and health care consequences would be devastating. All so the average policyholder could save maybe a dollar or two per month in health insurance premiums. Or perhaps so the insurance company could fatten its bottom line with that dollar or two per month per policy.</p>
<p>BTW, I am not opposed to lifting the lifetime caps, although I still think if people want to purchase a policy with a cap because it is more affordable, they should be allowed to do so.</p>
<p>I see your point, but as I stated in my post, health insurance does not equal health care. My point was that it appears that IN SOME WAYS health care might be less accessible now then it was before.</p>
<p>“I personally do not need insurance to pay for my family doctor visits. But if I do get something complicated, I would like to have a choice of doctors.”</p>
<p>“I also think that those at the lower spectrum of income, but not on Medicaid, will probably still not be able to access health care, even if they now will have insurance. People in that situation probably do not have money for co-pays, even if they are subsidized.”</p>
<p>Ours, on an employer based plan, was $1 million cap, then it went to 2 for a year or two before ACA came into play. </p>
<p>We were some of the few concerned. It wouldn’t have been that difficult for my D to meet it. I always wondered–the cap was for that policy–so wouldn’t have getting a new job with a new employer have eliminated that problem? Not saying that’s easy or advisable, but wouldn’t the cap start over with the new policy? I’m assuming no greater-than-60 day loss of coverage, so no using the pre-existing clause.</p>
<p>"BTW, I am not opposed to lifting the lifetime caps, although I still think if people want to purchase a policy with a cap because it is more affordable, they should be allowed to do so. "</p>
<p>And then when they need an increased cap, what happens? They have preemie twins. That’s good for a few million right there. I knew a bunch of women who had home births, and they insisted they needed no maternity/obstetric coverage and very little in the way fo pediatric coverage as well. Premie twins one of them had, and then it was a whole other story. She got air vaced to a major hospital which jacked up the costs and then the two little ones cost milllions for the first year alone. That family might as well not have had insurance for the drop in the bucket it provided, and they certainly could not pay out of pocket. Let the kids die? Can’t do it. Not at this time in this country. So we all pay. Had she and all of the others with her philosophy paid, it would have been that much more money in the pot. To allow so many to go without that kind of coverage but still be able to access the benefits when a catastrophe occurs voids the whole concept of how insurance works. We all pay. so when the one in a million shot occurs, there are enough paying to take care of the problem.</p>
<p>lerkin, the wonderful thing about America is that you are allowed to make choices in your life, which does not come with any guarantees. I could lose all my money tomorrow and no one is going to magically appear with a do-over. I know this concept is hard for some people, but having run a business for many years, it is actually something I welcome.</p>
<p>Yes, that was my understanding. Between the two of us working spouses and changing jobs every few years, we must have enrolled in at least 10 different employer plans over the past 25 years.</p>
<p>It is also my understanding (confirmed by bclintock’s PW report), that people who exceed their lifetime caps often go on medicaid.</p>