Affordable Care Act

[Perfection]

So other people should subsidize your choice of career? Can't you just charge more for your contracts to pay for benefits? I mean total compensation has to be figured into any job contract. Yes it's unfortunate, but it's been happening in the employer provided health care arena for years as well, premiums skyrocket, employees pay more, benefits shrink.

I am willing and able (and currently do) to pay rates comparable to what large companies do for decent health insurance policies. (I pay about $550 a month, single 31) I think that is reasonable. The problem is that Trump's actions threaten to destabilize the individual insurance market by providing low cost plans with very limited benefits and eliminating subsidies that make higher benefit plans affordable. This is likely to cause the "death spiral" everyone is talking about where all the healthier people flee the market and leaving only those with medical conditions in the market for high benefit plans. That could mean substantial premium increases for me.

The reason I would then want to join a large employer is not because I'd be earning more or be more productive, but because the risk pool for my insurance wouldn't just be people with health conditions and thus the risk is more evenly distributed and my premiums aren't likely to skyrocket come 2019.

 

[Lexicus]

I mean sure, health insurance shares some similarities with other types of insurance. But the purpose of it is different, the reason for paying claims is totally different, and the risk structure is necessarily very different. Saying that you should charge people more for insurance if they have a higher likelihood of incurring medical costs, under the rationale that, "it's insurance and therefore you charge people more based on risk!" is asinine. It totally ignores the reality of how health care is provided and paid for, and literally boils down to an argument that because it's called insurance, we ought to treat it like all other types of insurance.

Oh, of course, I totally agree with you. And my point is that only those who don't really need it can afford to treat it like insurance (and I suspect that those who think of it as insurance, to the extent that they really do so and are not just trying to win some internet points, do so precisely because they don't have serious, expensive health problems). Treating it as just like any other insurance is a recipe for people who really need health care to be unable to afford it. The insurers make free money "insuring" people who are largely healthy while the public is saddled with the bill for the behaviors you describe later in your post.

 

[civvver]

I am willing and able (and currently do) to pay rates comparable to what large companies do for decent health insurance policies. (I pay about $550 a month, single 31) I think that is reasonable. The problem is that Trump's actions threaten to destabilize the individual insurance market by providing low cost plans with very limited benefits and eliminating subsidies that make higher benefit plans affordable. This is likely to cause the "death spiral" everyone is talking about where all the healthier people flee the market and leaving only those with medical conditions in the market for high benefit plans. That could mean substantial premium increases for me.

The reason I would then want to join a large employer is not because I'd be earning more or be more productive, but because the risk pool for my insurance wouldn't just be people with health conditions and thus the risk is more evenly distributed and my premiums aren't likely to skyrocket come 2019.

My point is you have options. Joining a large employer you would be earning more, just like how contractors have to charge more cus they also pay the employer portion of payroll taxes (depending on the contract type). Healthy people are already fleeing the individual market and just opt'ing to pay penalties cus it's much cheaper.

 

[Perfection]

My point is you have options. Joining a large employer you would be earning more, just like how contractors have to charge more cus they also pay the employer portion of payroll taxes (depending on the contract type). Healthy people are already fleeing the individual market and just opt'ing to pay penalties cus it's much cheaper.

I would not be earning more if I was an employee, I am factoring in the tax differences in my analysis. I know what I'm talking about, thank you very much.

The reason I would need to get an employee position has nothing to do with my productivity or earnings but because I could get into a risk pool with a mix of people with conditions and healthier people and thus my rates aren't likely to jump come 2019.

All I want is to have the same sort of insurance available to me as is available to a larger employer at a similar cost. Trump's actions threaten to take that away and that is likely to limit my career options.

 

[civvver]

what did you do pre obamacare?

 

[Perfection]

Suffer mostly

 

[FriendlyFire]

Suffer mostly

Its Republicans thinking it will punish those smokers, drinkers, obese and people with unhealthy lifestyles which are a drain on the healthcare system / costing healthy people higher insurance cost
Most of the aged Rual poor are on Medicare anyways, the health services have been leaving these areas since Reagan. The good news was the young mexican immigrants brought back new revitalization to many areas
Along with the opiode epidemic its almost a perfect storm

 

[onejayhawk]

I mean sure, health insurance shares some similarities with other types of insurance. But the purpose of it is different, the reason for paying claims is totally different, and the risk structure is necessarily very different. Saying that you should charge people more for insurance if they have a higher likelihood of incurring medical costs, under the rationale that, "it's insurance and therefore you charge people more based on risk!" is asinine. It totally ignores the reality of how health care is provided and paid for, and literally boils down to an argument that because it's called insurance, we ought to treat it like all other types of insurance.

Charging "higher risk" people more money for health insurance has many problems, starting with the fact that if they don't have access to coverage they can afford, they'll get ER care that those very young and healthy people will end up footing the bill for. They'll also probably skimp on or forego treatments altogether, racking up larger bills in the long run due to the lack of preventive care. Without even getting into the moral arguments, the economic arguments tend to run in favor of spreading costs more evenly to provide affordable insurance to more people, versus less even costs to people providing insurance that fewer people can afford.

So if there is an argument to be made in favor of charging higher cost patients more for their insurance, that's fine. But the argument needs to be more than, "because it's called insurance." Or it will deservedly be ridiculed.

Thanks so much.

All insurance is the same. If it isn't the same, you not talking about insurance, which is common. You, for example, conflate insurance, subsidies and entitlements under the umbrella term health insurance, then claim health insurance is different. It isn't different. The excess baggage is what is different.

I can see why you chose to analyze statistics, because you sure as hell fail at analyzing anything else.

I can tell when you haven't a clue and are faking it.

J

 

[Perfection]

I think in general the idea that our health care system should be based on the idea of insurance is kind of the wrong way of going about it. There's an insurance aspect to it, because mitigating financial risk due to unforeseen health events is important, but many health events are foreseeable in a way auto accidents are not. If a person has a chronic illness they know they will have chronic expenses, that sort of screws up the whole system.

 

[Azem.Ocram]

Health insurance drives up prices vs universal healthcare and results in overall worse health than either universal healthcare or free market health care (everyone paying out-of-pocket). We should transition away from private health insurance towards one of those two extremes because the golden mean doesn't exist in this case and compromise is on average worst. It's a good thing that other countries health care isn't technically health "insurance" because that is a horrible way to provide healthcare.

Reagan's economic ideas have been proven to be wrong. Wealth trickles up but not down, lowering taxes takes away more money for services than it encourages economic growth by businesses, thus making the economy worse.

 

[Arakhor]

Moderator Action: This is an RD thread. Knock off the personal attacks and the sniping one-liners, otherwise there will be repercussions for all involved.
Please read the forum rules: http://forums.civfanatics.com/showthread.php?t=422889

 

[metalhead]

All insurance is the same. If it isn't the same, you not talking about insurance, which is common. You, for example, conflate insurance, subsidies and entitlements under the umbrella term health insurance, then claim health insurance is different. It isn't different. The excess baggage is what is different.

I already pointed out the many ways in which it is different, and you refuted none of them. Why are you so fixated on the name? Are you really incapable of understanding that calling something "insurance" doesn't automatically make it exactly the same as other things which are also called "insurance?" Your fixation on the name is nuts, man.

 

[onejayhawk]

I already pointed out the many ways in which it is different, and you refuted none of them. Why are you so fixated on the name? Are you really incapable of understanding that calling something "insurance" doesn't automatically make it exactly the same as other things which are also called "insurance?" Your fixation on the name is nuts, man.

I pointed out that you were in error all along. Insurance has to do with spreading risk of financial obligation. It does not matter the nature of obligation. In fact, the obligation is often abstract, such as for life insurance. The obligation is the families future living expenses. Property, medical, and casualty insurance are more direct in the nature of the obligation. There have been cases where things that were not intended to be insurance, famously the New York Stock exchange, were ruled to be insurers, thus subject to regulation.

These are basic definitions such as you would get as a freshman in business school. Why is a fixation on the correct use of a core term difficult to understand? I thought it was a necessity in law.

J

 

[Perfection]

I pointed out that you were in error all along. Insurance has to do with spreading risk of financial obligation. It does not matter the nature of obligation. In fact, the obligation is often abstract, such as for life insurance. The obligation is the families future living expenses. Property, medical, and casualty insurance are more direct in the nature of the obligation. There have been cases where things that were not intended to be insurance, famously the New York Stock exchange, were ruled to be insurers, thus subject to regulation.

These are basic definitions such as you would get as a freshman in business school. Why is a fixation on the correct use of a core term difficult to understand? I thought it was a necessity in law.

J

You will note the "risk of" aspect. Healthcare plans as the exist today also cover things that are foreseeably near certain. For instance, continually prescribed medications.

I don't mean to meander too much into a hair-splitting exercise, but health plans as they currently exist are markedly different than other insurance because of the nature of the risk they insure against, namely they insure against expenses that are near certain.

 

[onejayhawk]

In the case of an individual plan, you would be correct. Where there is no uncertainty, there can be no insurance. In the context of group coverage, there is uncertainty, because different people will have different drug protocols. You will also see wellness items. The insurer will provide something free of additional charge, say gym membership, hoping it will reduce the likelihood of a serious medical issue, like a heart attack.

This is not insurance, though they are packaged together. It is, however, why various posters insist that health insurance is different.

J

 

[Perfection]

In the case of an individual plan, you would be correct. Where there is no uncertainty, there can be no insurance. In the context of group coverage, there is uncertainty, because different people will have different drug protocols. You will also see wellness items. The insurer will provide something free of additional charge, say gym membership, hoping it will reduce the likelihood of a serious medical issue, like a heart attack.

This is not insurance, though they are packaged together. It is, however, why various posters insist that health insurance is different.

J

The other thing about group coverage that makes it workable is that people don't self-segregate. At a company, everyone typically buys into a single plan regardless if they're healthy or not (that's not 100% true but is mostly true).

But for people outside of these large groups, which is a large portion of Americans, there isn't such a group to make the system work. So in absence of the ACA (which uses tax penalties to create a group) or single payer system, how should we manage these expenses effectively?

 

[metalhead]

I pointed out that you were in error all along. Insurance has to do with spreading risk of financial obligation. It does not matter the nature of obligation

This is just. Not. True. Warranties do this. Protection and maintenance plans do this. HOAs do this. Taxes do this. Government does this. THEY ARE NOT INSURANCE.

Insurance pools risk to cover finanical loss. If your risk pool is not covering financial loss - which health "insurance" mostly does not - then it is not insurance. You can't just make up a ridiculously broad definition to try to make it look like you're right. You were, and are, as always, just wrong on this point.

 

[Perfection]

This is just. Not. True. Warranties do this. Protection and maintenance plans do this. HOAs do this. Taxes do this. Government does this. THEY ARE NOT INSURANCE.

Insurance pools risk to cover finanical loss. If your risk pool is not covering financial loss - which health "insurance" mostly does not - then it is not insurance. You can't just make up a ridiculously broad definition to try to make it look like you're right. You were, and are, as always, just wrong on this point.

Don't warranties cover financial loss as well?

 

[metalhead]

I don't know. It seems more likely to me that companies would insure their warranties, rather than structure their warranties as a standalone insurance product, but if you're GM or something and already have a large financial services subsidiary, perhaps your warranty is a straight insurance product bundled into the sale price of the car.

When you sell your house and you warranty clean and clear title, that warranty is covered by a separate insurance policy even though the warranty is part of the contract of sale. The warranty is being made by one person to another, so there is no pooling of risk; the risk is pooled in title insurance that the buyer obtains to cover potential loss to their lender. If you buy a house with cash and the seller warranties clean and clear title (which is admittedly rare, you'd pay a lot extra for it), then they are on the hook for the full damages themselves if they didn't obtain a separate insurance policy to cover the warranty.

 

[onejayhawk]

This is just. Not. True. Warranties do this. Protection and maintenance plans do this. HOAs do this. Taxes do this. Government does this. THEY ARE NOT INSURANCE.

Insurance pools risk to cover finanical loss. If your risk pool is not covering financial loss - which health "insurance" mostly does not - then it is not insurance. You can't just make up a ridiculously broad definition to try to make it look like you're right. You were, and are, as always, just wrong on this point.

Let's agree to calling it a healthcare plan and not insurance. The plan is an umbrella with several aspects. Insurance is one of those. Then we will no longer have these instances where you misuse terms of art. Specifically, the ACA does not regulate insurance, the states do. ACA mandates certain types of insurance coverage and additional non-insurance provisions to the plan. Separate sections of the act cover funding, access, etc.

J