Another point to mention is that what proponents in GA and CA are failing to share are the increased premiums for the same small groups they are comparing to. They are using 2014 IFP premiums to compare to 2013 small group premiums. From what I am hearing from small business owners in my market is that small business premiums are increasing going into 2014 about 20-30%. Not only are they comparing bicycles to mopeds, but they are comparing next year's bicycles to this year's mopeds.
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If this Actually Works, then What?
- Thread starter RayNY
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Another point to mention is that what proponents in GA and CA are failing to share are the increased premiums for the same small groups they are comparing to. They are using 2014 IFP premiums to compare to 2013 small group premiums. From what I am hearing from small business owners in my market is that small business premiums are increasing going into 2014 about 20-30%. Not only are they comparing bicycles to mopeds, but they are comparing next year's bicycles to this year's mopeds.
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The question at hand is this - so O'care gets repealed. Great - isn't gonna work. But with group premiums doubling every 7 years (per Kaiser Foundation) and individual premiums doubling every 10 - how was that gonna play out over the next 20, 40 years?
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That's the $1MM question.
I think the closest thing that would work is the old/current structure combined with PCIP groups that are subsidized on a tiered system of health and finances.
But until health, not insurance, is tackled in this country, we won't have a solution.
No doubt the current system is unsustainable. However, this new system is unsustainable too.
I agree with Stuy119 that you don't need a multi-billion dollar law to tackle basic issues. A high risk pool for the uninsured/uninsurable would go a long way. Price transparency, tort reform, change in consumer health issues, etc. would also lead us to controlling root drivers.
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The old system never worked because the free market never presented a solution for the uninsured without group coverage. In theory state risk pools could have picked up the uninsured but we don't have to go over how that worked out.
So long as health insurance is "required" to get health care services, then everyone is this country must have access to that system. Note that I said "access" to that system and not necessarily health insurance.
It's probably a fair statement to say that nothing will "work" and we're only looking for the solution that sucks the least.
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The closest we're going to get is a market system where no copays exists except for "the poor." That'll turn everyone into shoppers and will go a long way to fixing many issues.
The downside is people might avoid care - especially preventative due to OOP costs.
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I think the exchanges if they are up and running could be a huge success for the working poor.
Fully insured groups will get destroyed under the law.
Upper Middle class and high income will get devastated if they do not have access to large group.
Fully insured groups will get destroyed under the law.
Upper Middle class and high income will get devastated if they do not have access to large group.
Turning the current system into true Private Market will definitely require consumers to be shoppers. Some transparency, and some skin in the game will go a long way toward that goal. However, the high costs must be brought down to truly make that work. When medical care can bankrupt a family, insurance must be a vehicle to provide financially. And that muddies the waters when consumers should be shoppers. In my utopia (hehehe), health care is budgetable, consumers are responsible shoppers, and insurance just covers and unforseen catastrophic loss.
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Still puts us all back to where we are - which is a long as a system exists where providers demand that their patients have insurance, that system must provide everyone with a means to obtain it.
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So, from what I gather, whether this is a roaring success or a complete failure, we don't see a scenario where it all works as planned. We (Americans/Government) are just waiting to see what breaks down first so we know where to start making fixes, and will continue to do so either A) into perpetuity or B) until the law is rescinded. We also all agree that the climbing healthcare costs are unsustainable, something must be done about it, and that this law isn't the solution.
Where do you think the major hangups will be? Enrolling millions of insurance-illiterate citizens? Subsidy caclulation? Obtaining care? Claims? Spreading the word that the marketplaces are law and are working? Premiums? Networks? "Loopholes"?
Personally, I think the biggest hurdle is getting the enrollment/subsidy systems working. I know enough about programming and databases to know what a massive headache that is. The scale of the project is near incomprehensible, and as far as I know, it really hasn't been started yet.
Where do you think the major hangups will be? Enrolling millions of insurance-illiterate citizens? Subsidy caclulation? Obtaining care? Claims? Spreading the word that the marketplaces are law and are working? Premiums? Networks? "Loopholes"?
Personally, I think the biggest hurdle is getting the enrollment/subsidy systems working. I know enough about programming and databases to know what a massive headache that is. The scale of the project is near incomprehensible, and as far as I know, it really hasn't been started yet.
True.
Just look at Medicare, Medicaid, NHS and other government run health care financing programs. NONE of them are effectively controlling costs.
speaking of . . .
Zócalo Public Square :: Smacked to the L.A. Pavement, Without Health Insurance
And whose fault is this?
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