<p>Steve, there is nothing in that survey which I can see that shows that US citizens pay less for health care than those in other countries. </p>
<p>If you wouldn’t mind can you post the figures you found in this survey?</p>
<p>MaineLonghorn–“group” rates are more expensive than individual rates. Did your broker quote both for you? Yes, having a small group like that–2 people, you don’t get some of the advantages of larger group plans–but larger group plans are not always less expensive either. I just did an online quote with BC/BS (Anthem) in Maine for a family of 5 (2 parents, 3 kids) didn’t know your actual situation. Put the parents being born in 1960 and kids in 1992, 1994, 1996. Came up with a plan what was a $3000/7000 plan–so $3000 individual up to a family max of 7000 out of pocket for $1109.39/month. This number will change with family size and your age. Also, BC/BS around here is the most expensive plan but I don’t know who else has plans in your area but you can check them out. With a national plan, your taxes will be at least double that–are you prepared for that? Which would you rather have. None of this is going to be free. </p>
<p>Emily–your link shows health care costs in relation to GDP since 1960 when the cats meow in medical care was an x-ray and the life expectancy of a cancer patient was 10%.</p>
<p>tom–page 9</p>
<p>“Assuming a medium-range regional cost factor, the premium for a 50-year-old policyholder — in a family of four, with a household income of $92,200 — could be $16,858, according to the subsidy calculator. But that family might also qualify for an $8,099 subsidy, leaving them to pay $8,759. That estimate is close to the average subsidy of $8,290 that CBO projects exchange participants would receive in 2023.”</p>
<p>"… in a family of four, with a household income of $92,200 — could be $16,858, according to the subsidy calculator. But that family might also qualify for an $8,099 subsidy, leaving them to pay $8,759. That estimate is close to the average subsidy of $8,290 that CBO projects exchange participants would receive in 2023."</p>
<p>And most highly salaried people will still have their employer subsidized insurance plans.</p>
<p>“Emily–your link shows health care costs in relation to GDP since 1960 when the cats meow in medical care was an x-ray and the life expectancy of a cancer patient was 10%.”</p>
<p>You obviously missed the part at the end which estimated the costs based on HR 676 which was a House bill introduced in 2011 and which I quoted in my post.</p>
<p>“tom–page 9”</p>
<p>That page doesn’t show it either. </p>
<p>It shows we have the highest expenditures as a percentage of GDP and our per capita spending is the highest. </p>
<p>“In 2009, national health care expenditures reached $8,086
per capita, or 17.6 percent GDP – one of the highest rates of health
care spending in the world (Figure 4)”</p>
<p>The only statistic were we are lowest is in the amount of public expenditures and that is because we don’t have universal health system. Public expenditures is what the government pays for heath care - not what the % an individual person pays for heath insurance/care.</p>
<p>RE: small group plans vs individual plans.</p>
<p>Seems we have the same structure as MainLongHorn. H and I are employees of our own company and are in a group plan. Yes, premiums for an individual plan might be less although with H’s pre-existing conditions I doubt that. The benefit of being in our particular group plan is the ability to switch between insurance providers without having to requalify. If, for example, someone were to become ill and it was clear this was to be a long term and costly illness, we have the option of switching into a plan which would be better suited to that particular situation. Right now we have a $2500 pp deductible with pretty hefty co-pays and a high out of pocket max. I’ve run the numbers and if one of us (or a covered kiddle) needed expensive ongoing health care it would be better to switch into a higher premium 100% coverage minimum deductible plan at that point.</p>
<p>As to the current increasingly rising costs to those who choose to purchase insurance…as I’d mentioned in a previous post…my understanding of the ACA and associated penalties for employers (us) is that it’s financial very advantageous to simply pay the 2k pp fine. That’s 4K out of pocket a year instead of the current 14K.</p>
<p>
</p>
<p>SteveMA, I don’t know where you are getting your information, but I think it’s more helpful to look at statistics than anecdotal observations. The Kaiser Family Foundation has a lot of information on the uninsured here, but everything I’ve read is pretty consistent:
[Health</a> Coverage & the Uninsured* - Research, Public Opinion, Facts & Analysis - Kaiser Family Foundation](<a href=“http://www.kff.org/uninsured/index.cfm]Health”>Uninsured | KFF)</p>
<p>Over 3/4 of non-elderly uninsured are in working families–your concert-going slacker example notwithstanding, most work for companies that don’t offer insurance, are not eligible for what they have (e.g. work part-time), or make too little to afford the cost. The average cost of employer-sponsored healthcare in 2012 was about $4400–that’s a lot for many people. </p>
<p>According to the Kaiser Family Foundation, only 2% of adults say the reason they do not purchase health insurance is that they do not think they need it.</p>
<p>
</p>
<p>Yes, this is one of the big drivers of our escalating insurance costs, and one of the big problems which ACA addresses. ACA will bring tens of millions of new subscribers into the risk pool, new subscribers who are on average younger and healthier than the current risk pool. You work in insurance, as I recall, so you understand what effect that will have on premiums.</p>
<p>You said up thread that Americans pay less for their health care than Canadians, a statement which is wildly at odds with the facts. We pay far more than anyone else, and more than two and a half times the average:</p>
<p>
</p>
<p>[Health</a> Costs: How the U.S. Compares With Other Countries](<a href=“http://www.pbs.org/newshour/rundown/2012/10/health-costs-how-the-us-compares-with-other-countries.html]Health”>http://www.pbs.org/newshour/rundown/2012/10/health-costs-how-the-us-compares-with-other-countries.html)</p>
<p>You also said that “Health costs are NOT crippling our economy”, a statement which is contradicted by the facts:</p>
<p>
</p>
<p>[The</a> Economic Case for Health Care Reform](<a href=“http://www.whitehouse.gov/administration/eop/cea/TheEconomicCaseforHealthCareReform]The”>http://www.whitehouse.gov/administration/eop/cea/TheEconomicCaseforHealthCareReform)</p>
<p>If you have data to refute any of this, please post links.</p>
<p>“there is a public option in the ACA?? There are and will be state plans for those that don’t have access to a group plan.”</p>
<p>SteveMA, this is also incorrect information. There is no public plan and no public state plans being offered. The insurance exchanges will only offer private insurance plans. Each state can create their own exchange or have the federal gov’t create it - but only private insurance plans will be offered. </p>
<p>The only public plan is Medicaid which will be expanded under ACA but any state can opt out of that part.</p>
<p>Going to a single payer system will not in itself reduce the cost of insurance. The benefit of insurance companies is that they are the ones who keep the costs down by not fully reimbursing providers. They also try to limit receipt of services to those who may not need them. It is the insurance companies that are putting pressure on medical providers to reduce cost. </p>
<p>Medicare follows (not leads) insurance companies in setting reimbursement rates. If we go to a single payer Medicare process cost containment no longer exists. Reimbursement rates will be set by the political process of doctors etc lobbying Medicare to set their rates higher. The public will pay higher rates in the long term by using a single payer system as proposed by most people today. But there is a better system, in my view. </p>
<p>A better system would be a single payer system with costs payments set by funding of the system and nothing else. I would like to see a national sales tax (not an income tax) that everyone pays into based on ability to pay and the health care system is funded with those revenues. High deductibles and co pays would be necessary to prevent abuse. If revenues from the sales tax do not support an increase in reimbursement then providers will do without additional funding they claim to need. Under this system, our society has only the health care system it can afford and not the giant black hole continuing to suck money out of our economy.</p>
<p>“As to the current increasingly rising costs to those who choose to purchase insurance…as I’d mentioned in a previous post…my understanding of the ACA and associated penalties for employers (us) is that it’s financial very advantageous to simply pay the 2k pp fine. That’s 4K out of pocket a year instead of the current 14K.”</p>
<p>One would have thought given the cost to both small and large businesses that they would have been the biggest cheerleaders for single payer but alas, they were amongst the biggest opponents.</p>
<p>^^ Seems like employers have a pretty good deal with the penalty option in the ACA. What would single payer get them that’s any better? In the end SOMEONE has to pay into whatever bucket would support single payer. And, the only ones with money to extract would be businesses and individuals with any type of means or assets. So, again those currently paying for the system you deem so terribly broken would continue to pay for the single payer system you hold in such high esteem. At least now there a loophole which is financially attractive.</p>
<p>“A better system would be a single payer system with costs payments set by funding of the system and nothing else.”</p>
<p>Wouldn’t that simply mean that the government would be the entity that is setting the reimbursement rates?</p>
<p>I don’t see why that would necessarily mean higher deductibles or co-pays. Other countries with single payer don’t need to do that - why would we?</p>
<p>emilybee–current state plans are run though private companies–the state is just another “employer” for those on a state plan. It’s no different. The state is just the pool of people using that plan, just like the people that work at Google are the pool of people using the plans at Google. The other point you are missing and continue to argue is EVERYONE WILL HAVE COVERAGE next year, EVERYONE…why are you so insistent on a national plan. I WANT a choice of plans. I WANT to be able to pick a plan that works for me and my family. Now, ask around to people that are over 24 and how much they like the increases in the plans they have over the past few years with the ACA changes—which I happen to agree with and like the changes they have made–but again, having a national plan IS going to cost EVERYONE more.</p>
<p>“Seems like employers have a pretty good deal with the penalty option in the ACA. What would single payer get them that’s any better?”</p>
<p>The employer would only need to pay for their own insurance, period. </p>
<p>If you are a small business person already and drop your group you will now also have to purchase an individual policy - which will likely be more expensive than what you pay for your coverage in the group. So, you will no longer get the benefit of being in the group either and on top of that you will have to pay fine on every person you dropped - something under single payer which would be unnecessary.</p>
<p>“emilybee–current state plans are run though private companies–the state is just another “employer” for those on a state plan.”</p>
<p>I honestly don’t have a clue what you are talking about but I don’t think you have any idea what a public option is if you believe that private insurance plans offered by a state is a public option plan. </p>
<p>A public plan is one in which the government is the insurer - like Medicare and Medicaid.</p>
<p>SteveMA, all I can tell you is what our broker found. They looked at ALL available plans, individual, group, etc. They said that one reason our rates went up so much is that I turned 50. DH is 58. For the last ten years or so, Anthem has been the most affordable plan. Quite a few companies pulled out of Maine when the coverage requirements were increased (no exclusion of pre-existing conditions, for example).</p>
<p>We were able to decrease the premium from $1,590 to $1,468/month by putting DH as an individual. The three kids are under me. Whoo hoo, what a break! Of course, it also means our family OOP max is increased since DH is now not under our “family.”</p>
<p>As I see it, I really don’t have much “choice” of plan right now, anyway, if I want to be able to pay the bill each month.</p>
<p>MaineLonghorn–in reality you actually have a “cheep” group plan if you consider that your “employer” would normally be paying 1/2 of that premium or more–it’s just hard when you are the employer too. I used to own my own business, I carried our health insurance under that business and while the month to month out of pocket costs were higher, when all was said and done, it was less expensive, a lot less, because of the tax deductions for the business. We are high users of insurance, our D has a chronic medical condition. She has 3 surgeries last year–the 3rd one was over $40,000, we paid zero because we had already hit our out of pocket costs (and Emily or Tom-had we had Medicare–that zero would have been over $4000 on top of everything else we paid…). Even with all those costs and our premiums, we STILL pay less out of pocket then our taxes would go up under a national plan----and I get to pick my doctors, don’t need referrals, I can make an appointment as needed, I don’t have to wait months and months and months for treatment. If I want the blue one vs the red one I can, etc. etc., etc.</p>
<p>Steve, as I’m sure you well know, there is NOTHING in ACA which prevents you from picking your doctor or self-referring. Some PRIVATE INSURANCE COMPANIES do limit self-referrals, but that’s a function of their profit motive, not current or proposed law.</p>
<p>Some of us have posted links backing up our statements. It would be really helpful if you would do the same, so we can see where you’re getting this wildly incorrect information (Canadians pay more than Americans, most uninsured choose to be so, illegal immigrants are the cause of most of the problem, etc.).</p>