Rationing Medicare

[Quantum Windbag]

You're right that your proposal would control health care inflation... by making services so expensive for the average person that they would die.

Think about that. Are you really saying that people paying more of their health care bills out of pocket would make health care prices go up? Have you ever really thought about the way insurance affects the health care market?

I doubt he has, because many people have explained it to him many times and he keeps talking about everything else being the problem.

 

[Polk]

And to give another example about misleading claims, a lot of businesses are saying they'll drop their insurance coverage because of the ACA. Have any of you ever stopped to think how little sense that makes? If you offer health insurance to your employees today, what's the logical rationale for dropping coverage in a world where you'll be provided with incentives to provide coverage and disincentives if you don't?

 

[Quantum Windbag]

Self-insured plans aren't subject to the qualified health plan requirements in the ACA, meaning they don't have to offer the essential benefits package you seemed to be referencing earlier. Perhaps you're not using the word the way the rest of the universe does?

As for political connections for annual limit waivers, you're the one who posted the GAO report that showed there was no political favoritism in the waiver process. Who could've guessed you didn't bother reading it?

Whatever.

The company no longer offers the policy, and tells me, and everyone else, that is because of the PPACA. The news is also full of stories about insurers that have been selling similar policies no longer offering them. That means that I have to choose between every insurer in America lying to me, or you lying to me.

Guess who I believe.

It's not like health insurers have any incentives to oppose the ACA. O wait...

Remember this?

[ame=http://www.youtube.com/watch?v=1LRcLMScEqo]YouTube - ‪Obama You can keep your doctor‬‏[/ame]

I do.

 

[Polk]

That video does nothing for your argument. He never said he was going to force insurance companies to keep offering products they don't want to offer.

 

[dblack]

Really? I'm looking at policies in my state and while the cost of a high-deductible plan is cheaper than your previous post, the out-of-pocket costs are also significantly higher (deductible of 10k, plus 20% of everything beyond that).

Right. And here's what I found for the traditional policy:

Average family health insurance policy: $13,375

Assuming the premiums on the catastrophic policy you found were $300/mo (which honestly seems high, given the deductible), that works out to almost exactly the same total cost.

People don't think of health care in the same way they think of shoes. A lot of people have no problem wearing a pair of shoes from a dollar store to cut costs. I doubt you'll find anyone willing to have major surgery in a back alley to cut costs.

That's a silly example and has nothing to do with what we're talking about. People don't want to think about health care in terms of dollars and cents. They want it to be gift from god or some non-sense - but it's not. It's a service we have to pay for. The sooner we come to terms with that, the better.

 

[dblack]

It's not like health insurers have any incentives to oppose the ACA. O wait...

Wait, are you implying they do???

Why on earth would they? For all intents and purposes, they wrote it.

 

[Quantum Windbag]

And to give another example about misleading claims, a lot of businesses are saying they'll drop their insurance coverage because of the ACA. Have any of you ever stopped to think how little sense that makes? If you offer health insurance to your employees today, what's the logical rationale for dropping coverage in a world where you'll be provided with incentives to provide coverage and disincentives if you don't?

What's the incentive? Are you actually that stupid, or do you just play it on the internet?

It currently costs around $6,000 per person for an employer to offer the basic coverage they already do. That cost, as we have seen, will go up under the new mandated plans in Obamacare.

Obamacare will charge any employer who does not provide insurance $2000 per employee, and exempts the firs 25 employees from that fine.

Even a partisan idiot should be able to see the incentives to drop coverage in that formula.

 

[Polk]

Right. And here's what I found for the traditional policy:

http://www.usatoday.com/money/industries/health/2009-09-15-insurance-costs_N.htm

Assuming the premiums on the catastrophic policy you found were $300/mo (which honestly seems high, given the deductible), that works out to almost exactly the same total cost.

It works out to be the same cost if and only if your total healthcare costs are the amount of the deductible.

People don't think of health care in the same way they think of shoes. A lot of people have no problem wearing a pair of shoes from a dollar store to cut costs. I doubt you'll find anyone willing to have major surgery in a back alley to cut costs.

That's a silly example and has nothing to do with what we're talking about. People don't want to think about health care in terms of dollars and cents. They want it to be gift from god or some non-sense - but it's not. It's a service we have to pay for. The sooner we come to terms with that, the better.

It is absolutely what we're talking about. The end result of your proposed solution is to tell people who can't afford treatment tough luck. People don't think of health care in dollars and cents. If you told the average American that their mother or their child was going to die unless they have treatment X, they'd do it no matter the cost.

 

[Quantum Windbag]

That video does nothing for your argument. He never said he was going to force insurance companies to keep offering products they don't want to offer.

You really are an idiot.

Quite a few plans that used to be available are illegal under Obamacare, why do you think they have been issuing waivers to keep people insured?

 

[Polk]

It's not like health insurers have any incentives to oppose the ACA. O wait...

Wait, are you implying they do???

Why on earth would they? For all intents and purposes, they wrote it.

Of course they oppose it, because it represents a long-term threat to their business model.

 

[Polk]

And to give another example about misleading claims, a lot of businesses are saying they'll drop their insurance coverage because of the ACA. Have any of you ever stopped to think how little sense that makes? If you offer health insurance to your employees today, what's the logical rationale for dropping coverage in a world where you'll be provided with incentives to provide coverage and disincentives if you don't?

What's the incentive? Are you actually that stupid, or do you just play it on the internet?

It currently costs around $6,000 per person for an employer to offer the basic coverage they already do. That cost, as we have seen, will go up under the new mandated plans in Obamacare.

Obamacare will charge any employer who does not provide insurance $2000 per employee, and exempts the firs 25 employees from that fine.

Even a partisan idiot should be able to see the incentives to drop coverage in that formula.

If that was the case, why wouldn't they just not offer coverage today, since the fine for not providing coverage is zero?

 

[Polk]

That video does nothing for your argument. He never said he was going to force insurance companies to keep offering products they don't want to offer.

You really are an idiot.

Quite a few plans that used to be available are illegal under Obamacare, why do you think they have been issuing waivers to keep people insured?

The "plans" you're referring to weren't insurance plans in the first place. However, this portion of the discussion began with you complaining that your current policy can no longer be offered because of the Affordable Care Act. As Greenbeard already noted, if your insurance company told you that, they lied to you, because self-insured plans are exempted from the requirements.

 

[dblack]

It works out to be the same cost if and only if your total healthcare costs are the amount of the deductible.

OH, well, yeah, that's a good point. If costs are less than the deductible for the catastrophic plans, families can save a LOT of money. Beyond that it's about the same.

It is absolutely what we're talking about. The end result of your proposed solution is to tell people who can't afford treatment tough luck.

C'mon! Did you read what I've been posting? It's the roughly the same thing in terms of dollars - the difference is only in how much we choose to funnel through the insurance companies. Why is it so important to do that?

 

[Polk]

It's not like the issue is unexamined.

New regulations include rate bands that limit premium price variation, risk-adjustment policies that will transfer funds from low-actuarial-risk to high-actuarial-risk plans, and requirements that plans include “essential health benefits.” While the new regulations will be applied to all non-grandfathered fully insured policies purchased by businesses with 100 or fewer workers, self-insured plans are exempt from these regulations.

http://aspe.hhs.gov/health/reports/2011/LGHPstudy/EmployerSIDACA.pdf

 

[dblack]

Of course they oppose it, because it represents a long-term threat to their business model.

???

The whole point of the ACA is to preserve their business model. To do it by force, actually. I'm not sure how you could possibly imagine it differently.

 

[Polk]

It works out to be the same cost if and only if your total healthcare costs are the amount of the deductible.

OH, well, yeah, that's a good point. If costs are less than the deductible for the catastrophic plans, families can save a LOT of money. Beyond that it's about the same.

Sure, they can save a fair amount of money, but they're also exposed to much great downside risk. That wouldn't be a problem with the downside risks were low, but the reality of life is that barring a very narrow set of circumstances (like being shot in the head and dying instantly), that negative shock will occur at some point.

It is absolutely what we're talking about. The end result of your proposed solution is to tell people who can't afford treatment tough luck.

C'mon! Did you read what I've been posting? It's the roughly the same thing in terms of dollars - the difference is only in how much we choose to funnel through the insurance companies. Why is it so important to do that?

It's not the same thing in terms of dollars. It's the same thing in terms of dollars until you get critical ill.

 

[dblack]

Sure, they can save a fair amount of money, but they're also exposed to much great downside risk. That wouldn't be a problem with the downside risks were low, but the reality of life is that barring a very narrow set of circumstances (like being shot in the head and dying instantly), that negative shock will occur at some point....

It's not the same thing in terms of dollars. It's the same thing in terms of dollars until you get critical ill.

I feel like you're not actually reading what I post. The catastrophic plans are specifically designed to cover the critical problems. If anything, there's more risk on the low end - consumers would need to have the discipline to put the money they're saving on the premiums into savings to cover the deductible. On the high end there's no difference.

 

[Polk]

Of course they oppose it, because it represents a long-term threat to their business model.

???

The whole point of the ACA is to preserve their business model. To do it by force, actually. I'm not sure how you could possibly imagine it differently.

It preserves their form, but firms don't care about that. They care about the profit structure.

 

[Polk]

Sure, they can save a fair amount of money, but they're also exposed to much great downside risk. That wouldn't be a problem with the downside risks were low, but the reality of life is that barring a very narrow set of circumstances (like being shot in the head and dying instantly), that negative shock will occur at some point....

It's not the same thing in terms of dollars. It's the same thing in terms of dollars until you get critical ill.

I feel like you're not actually reading what I post. The catastrophic plans are specifically designed to cover the critical problems. If anything, there's more risk on the low end - consumers would need to have the discipline to put the money they're saving on the premiums into savings to cover the deductible. On the high end there's no difference.

They don't really cover critical problems though, at least to the same extent a standard policy does. They're a fig leaf.

 

[Polk]

Since I'm going to bed, I'll cut to the final point about insurers and the ACA. The law is only good for insurers if increasing the number of consumers make up for the implementation of the medical loss ratio. That may be true for now, but it won't be true if the ratio is increased in the future. The structure created by the Affordable Care Act could very likely result in a system where people have the choice of several different private insurers which are so tightly regulated that they're functionally public provisions.