Yes, I agree that would have solved the financial problem. You would instead have a different problem–more of an uproar about the high costs since everyone would have to pay it. But it would definitely solve the adverse selection problem.
there is ALWAYS golng to be an uproar when ANYTHING changes.
that is not a good enough reason not to make change happen.
Look…I’m never going to get prostate cancer. My husband is never going to be pregnant.
I don’t think we should be basing health care costs on gender…at all.
Let’s look at some other costs that add to healt care costs…salaries of the top folks at ALL of those health insurance companies. Let’s add that into the mix.
“For example, if I had gotten ACA for my family, my DSs and I would have been mandated to pay for coverage for mammograms, pap smears, birth control, and child birth? Huh?”
“But none of that changes reality. Women cost more for health services. But since both men and women are charged the same, men are being asked to pay more as a result, and some of them (particularly the young and unattached) rationally say “no thanks”.”
I choose to view healthcare as a fundamental right in this country much like I view, and society seems to view, K-12 education. Should we start charging individual families extra if their children cost the school district more to educate? Those utilizing special needs services and enrichment programs, or anything really beyond basic K-12 education? To me, the comments expressed above are proposing the equivalent to that.
This is why a one payor system is the only viable option IMO.
While executive salaries are everyone’s favorite target, the reality is that on a per subscriber basis, they are rather inconsequential. The much bigger impact is that many insurance companies are expected to make a profit.
“I choose to view healthcare as a fundamental right in this country much like I view, and society seems to view, K-12 education. Should we start charging individual families extra if their children cost the school district more to educate? Those utilizing special needs services and enrichment programs, or anything really beyond basic K-12 education? To me, the comments expressed above are proposing the equivalent to that.”
Very good point.
I chose to send S to private high school school and now I have no children school age. Should I not have to pay any school tax? The $7k/yr I pay to educate other people’s children I couid be having fun with! And why do I pay the same school tax when I only have one kid that couid use the school system as the person who has 4 kids going to school pays? And my kid didn’t go to an instate public college. I should get a reduction in the amount of my state tax that goes to public higher ed.
Of course, I believe that taxes are the price we pay for a civilized society - which is why I pay my taxes happily - and even vote yes every year knowing that means they will be going up.
^ and hospitals are more likely to be for profit now. Remember when many of them weren’t?
Of course the other elephant in the room is the cost of prescription drugs, how much is spent on development and marketing, and the disparity in what is charged for them country to country…
If we ask women (or men) to pay more, elderly people to pay more,… according to the benefits they receive then we may suggest that people with preexisting conditions to pay higher rate. Is this what we want? Does ACA work that way?
Thanks for mentioning drugs. There are plenty of drug abuse today, by both doctors and patients. And illegal drugs 100 times stronger to make people sick or die and to increase healthcare costs.
My earlier comments might not suggest it, but I am actually a proponent of universal health care.
But my comments reflect ACA doesn’t work, in the sense it is not financially sustainable. There was a time in 2013 when participation could have been made mandatory such that it would have been financially sustainable, although people would have howled about the higher initial cost if participation was mandatory. And if it was mandatory, the young and the men would not have a rational reason to opt out. A lost opportunity.
Agree that ACA is financially unsustainable in its current form.
However, I would also argue strongly that what we had before the ACA wasn’t sustainable. Costs cannot continue to raise at current rates, and we cannot as an a society afford to have an increasing number of citizens without affordable health care… I’m afraid many disagree with the latter though.
It’s not true that men cost more than women in every age cohort-- only ages 15-55. In the (expensive) Medicare years, men cost more. http://www.healthcostinstitute.org/files/Age-Curve-Study_0.pdf
@Jpgranier the reason we have our children in our employer family coverage is that it costs the same if we have one kid covered as having three covered, and is cheaper than covering them under individual plans.
Earlier you mentioned that premiums rose so drastically because a large percentage of the newly insured have high medical costs (which is understandable since they had no medical care) . And people left the exchange. Where did they go? Is there a way to get a non ACA policy from an insurance company? Or is there a large nbr of families self insured now?
People didn’t “leave the exchange.” They never entered the exchange. Post ACA, they chose to go without insurance, because they were healthy.
Thank you. I wouldn’t want yo take that risk. You never know when you might “get hit by a truck”
Not if one is forced to pay for services one cannot even use, want, or need. That is legalized robbery at that point - being forced to hand over money for something and absolutely getting nothing in return.
I would love to know posters who actually behave like that in their financial lives. i.e., buying stuff they cannot use, want or need AND lowering their family lifestyle and financial capabilities to do so. And if you do not do spend like that in your real life, why is it OK for government to make you spend hard earned dollars in a way you know is worst for your family?
Basic logic - if the product was so good for people and their families and priced appropriately, there would be no need to mandate it because people would automatically do it. Obviously, it was known to be huge negative for millions of people, thus the need to force it on people. That is just plain wrong to do to hard-working families, imho.
@coralbrook yes, you can get private health insurance OFF exchange directly from the insurance companies…with no subsidy. One of my kids already does that…and we are actually encouraging the other to do so as well.
"Not if one is forced to pay for services one cannot even use, want, or need. That is legalized robbery at that point - being forced to hand over money for something and absolutely getting nothing in return.
I would love to know posters who actually behave like that in their financial lives. i.e., buying stuff they cannot use, want or need AND lowering their family lifestyle and financial capabilities to do so. And if you do not do spend like that in your real life, why is it OK for government to make you spend hard earned dollars in a way you know is worst for your family?"
But we all do that, don’t we? We pay taxes for things in the common good - schools, roads, other infrastructure, the functioning of the government - in the form of income tax and property tax.
It was only considered unsustainable for people who thought they should not have to pay the actual costs of the services and get more services without paying more and also by people who thought they should be able to get healthcare for free. The system before ACA was very sustainable for people paying the actual costs of the policies they had.
Before ACA, my family of four policy was $440/mo with $2,500 per person annual deducible with one checkup covered annually and 2 million lifetime limit and it covered everything under the sun applicable for each family member.
After ACA, the somewhat equivalent policy was $3,680/mo with $18,000 deductible regardless of the person using the deductible, i.e, in my former policy after $2,500 by one family member, then insurance kicked in for that family member. With ACA, the entire $18,000 must be spent first.
Not difficult to understand why I never signed up for ACA. It would have been very stupid financially for me to do so.