NYC is all I needed to know, New York is one of the most regulated States in America pertaining to insurance, most insurance companies don't even do business there as a result.
Would you be surprised that private insurance premiums makes up only 3% of all healthcare spending... Overview National Health Expenditure Data
Back to New York, an article that you may like.
Massachusetts may have a universal health insurance mandate, but it is New York state that has experimented for the longest time with key components of the new federal health care package, most especially with a mandate that insurers must offer coverage to all comers, and also that insurers have limits on how much they can vary the price of a policy for different demographic groups. Whether the feds can figure out how to avoid all of the pitfalls that have plagued this system in New York remains to be seen.
New York enacted a health reform package with these two mandates - known as guaranteed issue and community rating - in 1993, making it unique among the states (only five others have both mandates but none has requirements as strict as New York's). Back when the state instituted the reforms about 752,000 residents were buying health insurance directly from insurance companies in the individual market. But premiums immediately started to soar, and as residents realized they could purchase insurance at any time, even after they got sick, New York's individual health insurance market disappeared, shrinking by 95 percent all the way down to a mere 34,000 individuals. Meanwhile, the ranks of the uninsured spiked to 20 percent by 1997.
New York's response to its vast increase in uninsured residents was to offer more state-subsidized insurance. When the price tag on these plans began to weigh down the state budget, New York slapped new taxes on residents and businesses to pay for them, including a new $275 million assessment against insurance companies on top of some $3 billion in assessments they already pay in the state. All of this so that the state's uninsured rolls would soar as costs spiraled upward and then declined again as government stepped in with subsidized coverage.
Moreover, the profile of the uninsured changed. Today, according to a recent Manhattan Institute study, about one-third of all the uninsured in New York earn $50,000 a year or more. Many would be able to afford insurance in most other states, but not in a place where a monthly premium for a single person ranges between $500 and $700, while a family policy costs between $1,400 and $2,600 a month.
The new federal legislation, of course, aims to fix the problems that New York has experienced by requiring that everyone carry insurance, which is a controversial mandate now but will be so much more so if costs spike as they did in the Empire State, or if taxes must rise further to subsidize premiums and keep them affordable. Those without insurance will face a federal fine that has been set at either $695 annually or 2.5 percent of your taxable income, whichever is greater. But that might be a small price for many people to pay for the privilege of not carrying pricey insurance.
To understand how this will work, look to another state, Massachusetts, the first to begin fining people for not having health care coverage. Massachusetts defines acceptable insurance as a policy with a deductible no greater than $2,000 a year. But policies at that level can be very expensive, so taking the fine is worth it, as Massachusetts resident Wendy Williams found. In a Wall Street Journal piece last October, she described how she and her husband were threatened with a $1,000 fine because they had given up their gold-plated and expensive health plan and were paying about $3,600 a year for catastrophic care policy that protected them from big hospital bills but didn't qualify as acceptable coverage in the state. For Williams the choice was easy. To increase her coverage to acceptable limits would have cost her about $6,000 a year more in premiums, because costs jump sharply as the deductible on a policy declines even moderately in a highly regulated place like Massachusetts. So she paid the fine instead and stuck with her "unacceptable" coverage.
RealClearMarkets - Health Care Reform: Welcome to NY, America
I enjoy chatting with you, you seem to be a very nice and civil person
i would not be surprised about the percentage of private insurance spending since most insurance is linked to employment. (or am i misunderstanding?) Is it a bad thing for companies to be required to provide coverage? At some point don't here have to be choices made about what benefits society in that regard?
I understand the Williams' choice and still the Massachusetts system has been, from all reports, pretty successful, no? It received support by a margin of 68-27% when the issue came up in january...
FiveThirtyEight: Politics Done Right: Massachusetts Liked Universal Health Care Before It Voted Against It
As for the mandated coverage, it is curious to me that costs would *increase* if the insurance pool is expanded with younger, healthier users who wouldn't normally purchase insurance. The only reason I can see that the costs would increase would be intentional acts by the insurance company to increase the cost of insurance.... like a big temper tantrum. Am I wrong?
Ultimately, perhaps the answer really is a single payor system... that obviates all of the other problems. (while creating some new ones, yes....).
