According to several talking heads (a mix of political philosophies) the individual market ‘only’ affects 6% of the population. And it IS in a heap of trouble.
Now, the original numbers said there were 30 million uninsured which, given a population of 350 M, makes that about 8.5% pre ACA. So the entire scrambling of the system was to address a problem for 8.5%.
Is it a ‘success’ that we’ve managed to reduced the obvious number negatively affected to ‘only’ 6%. I say OBVIOUS because that doesn’t even calculate the percentage of those negatively impacted like the @Midwest67. In fact, according to ACA math - they are a success.
It appears we’ve just rearrange the deck chairs on a non-sea worthy vessel.
What if the current folks in the bridge just let the danged thing run ashore? They didn’t set the course and obviously ‘most’ don’t want to adjust the course. Given the premium increases and continued decline in choices, one more renewal year should make it even clearer how quickly this is unraveling.
Pre-ACA there were 47 million uninsured Americans. That is 18%, not 8%. About 22 million more people have health coverage than did before the ACA was enacted.
However, some people were / are concerned about the possibility in the future of being outside employer (or government) group plans, due to potential job loss, switching to self employment or contract jobs, early retirement, etc., particularly if they have pre-existing conditions.
HSA accounts were designed to allow people to meet deductibles and copays – they were never intended to be a way of saving to cover major health care expenses. That is why from the start, HSA’s were only available for high-deductible plans.
The idea was that that insurance companies pay a lot in dribs and drabs for low end routine health costs, and premiums can be reduced somewhat if those costs are shifted to the patient. Additionally – for that routine, low end stuff, there are incentives for a person to make more economical choices if they are paying out of pocket. On the patient end, if the patient is the sort who rarely needs medical care, then the HSA lets them save the dollars that are meant to cover deductibles/copays if they don’t need to be spent during any given year.
If you do the math, the difference in premium costs tends to be roughly equivalent to about 75-80% of the deductible. (I haven’t done this for a couple of years, so maybe the percentages have changed a little, but the point is the same). So basically the insured can opt for a lower deductible, higher premium – or save some money on the premiums and optionally bank the difference. Really good deal for someone like me who rarely spends more than a few hundred dollars each year on medical costs, especially since ACA came in and required that insurers provide preventive services for free. But not so good for someone whose anticipated costs will exceed the available premium savings available by opting for the higher deductible plan.
It is a complete corruption of the whole idea of health insurance to suggest that the HSA is something to be offered as some sort of alternative to insurance.
It also is insane to advocate HSA’s when a good deal of people’s distaste for ACA is they don’t like the deductibles – essentially it’s trying to sell a system that drives up deductibles even more. (I do like the HSA because of the control it gives me – for example, I have every right to use my HSA dollars to get a second opinion from an out-of-network doctor if I choose – but it only works for someone with the discretionary income to put into the HSA account in the first place.)
My employer offers a high deductible PPO with HSA and a lower deductible PPO from the same insurance company. The way the employee contribution is priced, the HD with HSA ends up not much different from the LD plan in costs for a heavy user, due to the lower employee contribution and the employer giving free HSA money. But a low user comes out ahead on the HD with HSA plan.
But I would not be surprised if there were still many choosing the LD plan due to the aforementioned distaste for deductibles.
The scarier thing is that this woman in raw story (post 465) was a teacher of kids! People entrusted her to educate their young children! It’s sad to know that she and her family have no idea of what will happen to them and no sense.
Just out of idle curiosity…seems she’s now the admin asst at a cosmetology school (that may be family owned.) Her son was “pursuing a golf career.” Guy with the same name is listed in financial aid at the school (as is the dau.)
LF, it’s definitely true that the strongest non-Dem opposition is the faction which feels AHCA isn’t strong enough. The trouble for leadership is that there are also a small number of moderates who feel it goes too far, and a larger number who are barely OK with it now and will jump ship if it goes even a skosh further. The only hope of its passage in the House IMO is if moderates become convinced that bucking the party will hurt them more with their own constituents back home than taking away healthcare will, but that is NOT what they’re hearing back home. Just the opposite; “Save our healthcare!” has completely drowned out “Repeal Obamacare!” and these guys/ guys are exquisitely sensitive to that kind of thing.
Another force pushing against passage is majority-party Senators, of whom an increasing number are expressing outright opposition. The last thing that moderate House members want to do is go on record with a vote taking away their constituents’ healthcare, knowing that the Senate will probably leave them twisting in the wind. I don’t think the House leadership is going to be able to convince them to commit political suicide, especially when they’re squeamish about it in the first place.
Each day I am more grateful that I moved to a country with “socialized” medicine. Don’t have to worry about paying for prescriptions either. I used to live near Massachusetts General Hospital. Brilliant place…so long as you had insurance (and they approved your treatment).
I’m in the same boat, @exlibris97 , but someday I may want to repatriate–my parents aren’t getting any younger–and I can’t imagine doing so unless the US decides to do healthcare like a developed country rather than a banana republic.
That was their plan (at least some with whom I spoke). Way less expensive in-home care. Am guessing also true for assisted living and nursing facilities.
Btw, the Mass General annual reports can be found online and, by intention, they are quite charitable. A hardship, but so far, a commitment. It’s one thing that concerns me, as the powers that be talk of cutting back expenses at the source.
Less expensive is one reason my mother moved to AZ.
In home care may be less than SNF or other options, but is still cost prohibitive to many families. And it’s not equivalent to having an RN or doc on call. Nor the focus, in a setting where they specialize. It’s not an automatic better. What I suspect the PTB envision is you taking care of your elderly. Something Victorian.