CDZ Individual Mandate

[Onyx]

Eliminate it and cause millions to lose coverage. Keep it and you are screwing over young and healthy individuals.

Critics of the PPACA, this is your chance to argue why the individual mandate should not exist, which would cause premiums to skyrocket to unsustainable levels and cause those that most need it to lose coverage.

Proponents of the PPACA, this is your chance to defend why millennials should be penalized for not purchasing health insurance, when it would be more financially responsible to save money in a tax free account.

 

[debbiedowner]

HSA's tax free accounts normally draw only the high wage earner's.

There are cheaper compliant catastrophic plans for under 30 or someone who can make their case and fill out an exemption because they don't make that much money.

The penalty has something like 56 exemption's, you can get these exemption forms on healthcare.gov or I believe a CPA. When calculating the penalty and I haven't stayed up on this, but first year going without the govt took off $9500 from your income and then you paid the penalty on what was left.

In Ryan's plan the penalty was still there except it reversed to the insurance company and it was going to be about 30% more in premium if you did not have continuous coverage.

I also learned today that HHS is going to let insurance companies for 2018 enrollment that one that had coverage and then dropped it October (since you can go 3 months without penalty) to save premium's will not let that person enroll until all back premium's have been paid.

 

[usmbguest5318]

Keep it and you are screwing over young and healthy individuals.

My response is found here: CDZ - Understanding how the ACA's discounting provisions help people afford health insurance. It is there because the individual mandate, though I like "a la carte" as much as the next guy, is what makes O-care possible. Moreover, as was noted here -- CDZ - Analysis of the ACHA and ACA at the individual level -- the GOP's currently proposed 30% lapsing penalty provision has the same impact as the individual mandate, and actually costs noncompliant persons more than does the individual mandate.

 

[Fishlore]

The mandate is contentious because it bridges two sides of an ideological gap: the idea of healthcare covered by "insurance" and the idea of healthcare as an "entitlement."

The insurance model says you pay a premium based on the chances that you will need the insurance company to pay for medical costs this year. The older or sicker you are, the higher the chances and so the higher the premium.

But medical needs aren't like a car crash. With luck and careful driving you may never need your insurance, but you get older, sicker and, eventually, die no matter what. The premiums for your health insurance go up as you get older while the premiums for your car insurance go down. That's life.

Given your age, gender and history, we can predict how much healthcare you are going to need from now until you die. (About 1/3 of your lifetime costs will happen in you last few months.) Predicting how much care you will need this year is a lot tougher. Similarly, the amount of healthcare all America will need this year is fairly easy to predict, Exactly who will need what, that's a lot harder.

BOTTOM LINE: The car insurance model for healthcare is a bad one. Universal single payer is much easier to plan to finance. You pay more than you need when you are healthy and you get more than you pay when you are sick. It balances out over your lifetime.

 

[debbiedowner]

Yea the car insurance is a bad one I am approaching 70 no tickets or accidents and just received a huge rate increase on same auto simply because people text or talk while they drive. From like a good neighbor.

You must be an actuary?

 

[debbiedowner]

The mandate is contentious because it bridges two sides of an ideological gap: the idea of healthcare covered by "insurance" and the idea of healthcare as an "entitlement."

The insurance model says you pay a premium based on the chances that you will need the insurance company to pay for medical costs this year. The older or sicker you are, the higher the chances and so the higher the premium.

But medical needs aren't like a car crash. With luck and careful driving you may never need your insurance, but you get older, sicker and, eventually, die no matter what. The premiums for your health insurance go up as you get older while the premiums for your car insurance go down. That's life.

Given your age, gender and history, we can predict how much healthcare you are going to need from now until you die. (About 1/3 of your lifetime costs will happen in you last few months.) Predicting how much care you will need this year is a lot tougher. Similarly, the amount of healthcare all America will need this year is fairly easy to predict, Exactly who will need what, that's a lot harder.

BOTTOM LINE: The car insurance model for healthcare is a bad one. Universal single payer is much easier to plan to finance. You pay more than you need when you are healthy and you get more than you pay when you are sick. It balances out over your lifetime.

Oh, you edited this lol. Yes, Medicare in some form for all or certain ages and go back to underwriting for the younger crowd and if they are turned down or any stipulation's states should create a high risk pool. No more Medicaid, that money goes toward high risk pools.

 

[usmbguest5318]

Exactly who will need what, that's a lot harder.

It is, but that's at the "person" level, but getting it to that level isn't necessary for insurers to calculate premiums and spread the risk over a pool of people.

I'm sure my 99 year-old Aunt Petunia has "busted" the actuarial predictions, but the guy who dies in a car crash at 43 and others like him make up for her and others like her.

 

[debbiedowner]

BTW Anthem is going to pull out of some of these areas mentioned in link for 2018. Just a heads up.

About Us: Anthem Blue Cross Blue Shield | Anthem.com

 

[Onyx]

HSA's tax free accounts normally draw only the high wage earner's.

Maybe, but the vast majority of Americans could take the money they pay in insurance and save it, and have a better security net for much less.

Health insurance companies rely on the majority of those they cover to pay in more than they receive, which means the majority of people are always getting screwed.

 

[Onyx]

Universal single payer is much easier to plan to finance. You pay more than you need when you are healthy and you get more than you pay when you are sick. It balances out over your lifetime.

That's how private health insurance works too.

The main difference between state single payer and private insurance is that the former usually has no profit incentive. The state also generally has more bargaining power. Of course, there are a ton of problems with having the state control the healthcare of all its citizens.

 

[IsaacNewton]

It's far beyond time to just join the rest of the civilized West and have a single payer system. In such a system if you have money you can still go outside the single payer and have your own doctor and just pay for it.

The Republican party is hellbent on keeping as many people living in 1854 as is possible. But their backs will soon break. North Carolina got a glimpse of the true future of this society and now they are moving slowly to rejoin modern humanity.

 

[debbiedowner]

HSA's tax free accounts normally draw only the high wage earner's.

Maybe, but the vast majority of Americans could take the money they pay in insurance and save it, and have a better security net for much less.

Health insurance companies rely on the majority of those they cover to pay in more than they receive, which means the majority of people are always getting screwed.

Ok, so no insurance just take money and put away in a tax free account, correct? Maybe a single male could live like that for awhile, but what if that single male has a auto accident and exhausts his medical on auto policy and then uses his tax free account until depleted, should they throw him out of the hospital?

Anyone at anytime can be diagnosed with a dreaded disease and deplete their tax free savings account real fast. But all in all if one wants a tax free savings account without the insurance it should be allowed, but remember even Ryan's plan said you could not sign up just when you got sick.

 

[debbiedowner]

It's far beyond time to just join the rest of the civilized West and have a single payer system. In such a system if you have money you can still go outside the single payer and have your own doctor and just pay for it.

The Republican party is hellbent on keeping as many people living in 1854 as is possible. But their backs will soon break. North Carolina got a glimpse of the true future of this society and now they are moving slowly to rejoin modern humanity.

What's NC done?

 

[debbiedowner]

There really isn't an answer unless we went back to underwriting days. That would lower your premium's in about year 3 of it.

 

[usmbguest5318]

There really isn't an answer unless we went back to underwriting days. That would lower your premium's in about year 3 of it.

I wonder....As a former retail fashion industry colleague once informed me, "everything goes retro except the price."

 

[Fishlore]

Here it is! 58% of Americans support this Medicare for All legislation
This bill establishes the Medicare for All Program to provide all individuals residing in the United States and U.S. territories with free health care that includes all medically necessary care, such as primary care and prevention, dietary and nutritional therapies, prescription drugs, emergency care, long-term care, mental health services, dental services, and vision care.

Only public or nonprofit institutions may participate. Nonprofit health maintenance organizations (HMOs) that deliver care in their own facilities may participate.

Patients may choose from participating physicians and institutions.

Health insurers may not sell health insurance that duplicates the benefits provided under this bill. Insurers may sell benefits that are not medically necessary, such as cosmetic surgery benefits.

The bill sets forth methods to pay institutional providers and health professionals for services. Financial incentives between HMOs and physicians based on utilization are prohibited.

The program is funded: (1) from existing sources of government revenues for health care, (2) by increasing personal income taxes on the top 5% of income earners, (3) by instituting a progressive excise tax on payroll and self-employment income, (4) by instituting a tax on unearned income, and (5) by instituting a tax on stock and bond transactions. Amounts that would have been appropriated for federal public health care programs, including Medicare, Medicaid, and the Children's Health Insurance Program (CHIP), are transferred and appropriated to carry out this bill.

The program must give employment transition benefits and first priority in retraining and job placement to individuals whose jobs are eliminated due to reduced clerical and administrative work under this bill.

The Department of Health and Human Services must create a confidential electronic patient record system.

The bill establishes a National Board of Universal Quality and Access to provide advice on quality, access, and affordability.

The Indian Health Service must be integrated into the program after five years. Congress must evaluate the continued independence of Department of Veterans Affairs health programs.

 

[Fishlore]

It is easy to see why this ^^^ M4A bill is political dynamite! What a sad reflection on our democracy that this bill, which polls indicate has clear majority support, is smothered in secret by the paid lobbyists who are our elected representatives. If it is such a terrible idea, as conservatives insist, why isn't there a public debate in Congress? If it won't work or will cost too much, let's see the numbers and counter-arguments. We the people are being treated like naughty children by our elected representatives. It stinks!

 

[debbiedowner]

Haven't you noticed? Once one is elected to congress they no longer care who got them there it's all about shoring up contacts and money for when they get voted out of congress. Doesn't matter which party, you could have a legitimate poll that 98% of the people want Medicare for all and if there wasn't anything in it for our elected officials's they would ignore the people, just like they always have.

 

[usmbguest5318]

Haven't you noticed? Once one is elected to congress they no longer care who got them there it's all about shoring up contacts and money for when they get voted out of congress. Doesn't matter which party, you could have a legitimate poll that 98% of the people want Medicare for all and if there wasn't anything in it for our elected officials's they would ignore the people, just like they always have.

A People's History of the United States -- The Coming Revolt of the Guards