This is a little off the subject, but I should be honest and say that while I don’t like ACA, I am VERY thankful for how the government has treated my son. He is on MaineCare, our state’s version of Medicaid. His med co-pay is $3. He pays nothing for doctor’s visits (internest, psychiatrist, etc.) or hospital stays - which means WE don’t pay for these services. He gets $733 a month from Social Security, which is not taxed. His monthly rent is $379, which includes utilities and 24/7 staff presence on-site. He has a case manager who meets with him weekly and takes him to the food pantry every month. Most importantly, this degree of independence has made him happy! It’s not the life we pictured for him, but without the government’s assistance, his life would be pretty bleak.
When I recently spoke at the NAMI Texas conference, several people said, “Wow, we’re moving to Maine!” So I know we’re fortunate.
^ We’d have “that which shall remain nameless” so fast our heads will spin.
But, it’s quite apparent that business likes their role just the way it is - otherwise they’d have backed health insurance reform and most especially, “that which shall remain nameless.” But, they did not.
Nice try, but not close; both of my kids attended college on big time need-based aid.
Sure, you can cherry-pick all the anecdotes that you want, but multiple anecdotes are not data. This is one of those things where so-called conventional wisdom is wrong.
More importantly, like I posted earlier, the ‘non-partisan’ Congressional Budget Office disagrees with you. (And that was when both the House and Senate were under Democratic control, so conceivably if they did not like the Director’s views, Nancy Pelosi and/or Harry Reid could have replaced him.)
I have always been for improving Medicaid, and actually worked on California’s version of that program back in the dark ages.
bluebayou is right about whether the preventative services pay for themselves.
I suspect the birth control mandate would pay for itself, if you counted the cost of birth control versus the cost of pregnancies it prevents. But many of the women who get free birth control would have paid for it rather than risk an unwanted pregnancy.
This is a fallacy because it ignores the other logical option.
A business person talking here, and the reason my colleagues and I did not support the ACA is not because we liked things the way they were; it is because we know it would make things worse, which it did.
Specifically, business would rather have increased competition by being able to purchase across state lines, creation of high-risk pools, catastrophic insurance for the healthy, and heath saving accounts and a couple other things, i.e, just like cars - many different models available to service the needs of each consumer.
Business knew ACA would reduce number of carriers and reduce competition and thus raise costs and reduce the percentage of insurance pool that constituted actual paying consumers - a recipe for red ink.
For the record, the only business that supported the ACA were insurance companies because they underestimated the scope of the premiums necessary and thought that they would get millions of new customers by mandate. Now, they are stuck with ever-rising costs and cannot get out of the economic quagmire.
Because ALL COLLEGES are paid directly by a third party, they are effectively a cartel. A cost comparison of net price does not change the fact that the price is determined not by what the student has negotiated to pay (or refused to pay) in a real marketplace.
And we know this is the case because a private college that is not as good as say the Ivys to very top LACs essentially have the same tuition.
In a real marketplace, he lower ranked schools’ tuition would be lower because no one would equate them with the top schools, and thus would not pay the same price. However, these less-than-top colleges can charge students the same as an ivy degree because the student has no negotiating power and the government simply pays out what the college charges and hands the students this in loans.
To make a simple analogy, currently the third party payment system for college is making students pay the same for a Honda as a Mercerdes, which would never occur in a real free marketplace.
EDIT: Just to show how a third party raises costs, take a look at the tuition at Hillsdale and Grove City, two colleges that do not accept federal funding. Their tuition is some 45 - 55% lower than other private colleges. Now ask yourself this simple question - how in the world can they survive just fine charging that tuition when other colleges say they cannot? Hm…
Every time you pretend that high risk pools are anything but a figleaf to cover the fact that you are unwilling to pay for sick people, and are willing to see them die because they don’t get health care, I will call you on it. The rest of us don’t need to be fooled by your phony concern. We see you.
This assumption is false, since federal direct loans for undergraduate are only up to $5,500, and Pell grants are up to a similar amount. Most college discounts off list price are from the college itself. The most applicable economic idea is price discrimination if you want to look at different net prices for different students, as well as high list prices for students with wealthy parents who are presumed to be willing to pay.
Of course, a given student can easily find different net prices at different colleges, so s/he can shop by price if desired or necessary.
The public option is not the same as Medicare for all. It’s completely different. Don’t confuse the two.
Medicare for all means that everybody would be covered by Medicare, just as everyone over 65 is covered by Medicare now. Medicare is funded primarily by the federal government, not by subscribers. Everybody’s taxes pay for Medicare, although subscribers pay a token premium.
The public option would be a non-profit insurer run by the government, with policies that would be available alongside private insurer policies in the exchanges that serve the private health insurance market. People would pay a premium to be insured by the public option insurer, and would pay co-pays and co-insurance, and would have deductibles, just as they do for private insurers. The public option policies might be cheaper than private insurance, or might not. The public option policies would have the same subsidies that private insurance now has.
Yes to eliminating employer-provided insurance plans because the employer is NOT the user of the insurance plan, the employee is the user - give the plan to the actual entity that would be using it. No one can explain why an employer should be in control of an employee’s policy. Silly.
Group insurance is exactly what you want to do. Just have different insurance product pools that anyone can join, totally disconnected from business, and the employee can choose the plan that is best for them. This way the employe can change jobs and states and their insurance coverage is unaffected. They may have to change doctors and networks because of proximity, but the insurance travels with the person.
Basically, there is no reason for a group policy has to be limited to the employees of one company; that is an artificial wall that does not need exist. A group policy can include employees of many companies in several states.
And if an employee just wants to be in a catastrophic coverage pool, then that is fine. See previous paragraph.
Unworkable. In essence, nonsensical. “The insurance” is a bunch of deals made by the insurer with local providers, and a deal made between the insured and the insurer. “The insurance” can’t travel with the person, because the doctors and hospitals don’t travel with the person, and the insurer might not even be in business in the person’s new location.
I’m surprised that a businessman doesn’t understand this.
Insurance plans vary in cost by state/geographical area largely because medical costs vary dramatically depending on the cost of living and to some extent competition. No way could a CA doctor survive on the benefits paid to a doctor in ND for example
If anyone can join these pools (i.e. no medical underwriting), how will adverse selection with respect to pre-existing conditions be handled? I.e. what is to prevent someone from going without insurance until s/he is diagnosed with something expensive, then buying insurance from one of the pools at that time?
The main reason large employer insurance “works” with respect to guaranteed issue without pre-existing condition limitations is that large employer employees are not self-selected by pre-existing conditions, and employees cannot decline coverage without proving other coverage (i.e. a kind of universal mandate within the employer pool). Attaching medical insurance to employment is generally undesirable, but it stays that way because of this type of thing.
Suppose I buy a policy in Des Moines, for $621/month. Now I get a job in Silicon Valley. A similar health policy costs $869, because Silicon Valley is an expensive place and doctors and hospitals command high fees. Why is my poor Aetna of Iowa liable now for my health care, Silicon Valley care at Iowa rates?
Say I crash my bike and break my collarbone. I go to Stanford Hospital. Aetna of Iowa says to Stanford, “Our negotiated price for broken collarbones and road rash is $X.”
Stanford says, “Whoa, whoa, whoa. We never agreed to that. Our price is $2X.” How is this supposed to work?
More likely, there was no successful negotiation (since the insurer and provider in question would not agree on a price), so the insurance would treat the provider as an out-of-network provider, where you would get a lower reimbursement and be subject to balance-billing.
The effect of selling across state lines may not actually be that much, since the PPO/HMO plans in lower cost areas would not be able to sign up many or any in-network providers in higher cost areas, so buyers in high cost areas would not find such plans desirable.