"Obamacare"

[K-S-U-Wildcats!]

1.  Of course premiums went up in the last 20 years.  Healthcare costs went up in the last 20 years.  Insurance companies view themselves as mere middlemen between the consumer and the service providers.  If the cost for the service goes up, the cost of the premium goes up.  They are in the unique position of determining their profits because, in short, they know how to project how many people are going to get sick.  But their profits are neither high or low relative to the healthcare insustry.  They target the middle.  That's where they are.  It's by design.  It's so they don't get in trouble.

2.  I don't know how healthcare providers could increase their profits by charging higher rates to people who can't afford insurance in the first place.  They don't get any payment at all in many of those cases.  They get a tax write off. 

3.  Preventive care is a pretty small part of the complex issue of rising healthcare costs.  The amount of coverage added for new preventive services under typical health plans in the past 15 years is negligible compared to how much overall healthcare costs have increased in that time.

4.  Price shopping really has nothing to do with anything.  Rising healthcare costs, again, is a complex issue.  Costs increased a crap ton for all healthcare providers for many reasons.  They all had to respond by charging more.  The bigger issue on the consumer end of things is that they could often go to the doctor  as much as they wanted with little to no costs to themselves.  They didn't have to think about the bill.  Their employers who were paying it did.  And that's why dedutibles are now increasingly being applied to covered services.  It's to force people to think about whether or not they really need to go to the doctor because they have a cough.

I think I agree with all of the above. And again, it demonstrates how Obamacare is going make an already messed up system much, much worse. The reason health insurance premiums increase year after year significantly more than inflation is because the insurer "middle man" has distorted the efficient operation of a free market. If you want to make insurance more affordable, start by treating it as insurance. This is why HDHP/HSAs are so great. Obamacare works in exactly the opposite direction, compelling employers to offer bloated insurance policies to their employees. It then floods the market with millions of new taxpayer subsidized policies, which are in turn supposedly paid for by higher taxes, and strain our already short-staffed healthcare system. It requires insurers to insure those who are already sick (guaranteed issue), and supposedly compensates for this by forcing young people who don't need insurance to buy it anyway.

Obamacare is a trainwreck. It is potentially one of the most destructive pieces of legislation in history.

[OregonSmock]

http://www.forbes.com/sites/rickungar/2013/05/24/unexpected-health-insurance-rate-shock-california-obamacare-insurance-exchange-announces-premium-rates/

Cohn is saying that, despite the political naysayers, the healthcare exchange concept appears to be working very well indeed in states like California, Oregon and Washington—the first states to publish the expected health exchange prices for purchasing coverage. These are also states that are actually committed to seeing the program work as opposed to those states whose leaders have a vested political interest in seeing the Affordable Care Act fail.

Keep in mind that the entire idea of the exchanges is to require health insurance companies to compete openly with one another by offering identical coverage programs in the three created classes—each offering insurance coverage that actually delivers meaningful protection to customers—and then openly disclosing the price each insurance company will charge for that policy.  Thus, shoppers can clearly see which company has the best price on an apples-to-apples basis.

For all the negative chatter about how including older and sicker Americans in the health insurance pools would drive up the price for younger participants in the pool less likely to be ill, what we are now seeing in states like California is that the desire on the part of the health insurance companies to increase market share—thanks to the large influx of customers as a result of Obamacare—is driving prices downward.

That is precisely what the President said would happen.

[sonofdaxjones]

Any specifics on the actual coverage provided by these plans which now have lower premiums?

[OregonSmock]

Any specifics on the actual coverage provided by these plans which now have lower premiums?

 

[sonofdaxjones]

So, no specifics then?

I ask because I saw an article headline about "skinny plans". 

[OregonSmock]

So, no specifics then?

I ask because I saw an article headline about "skinny plans".

No specifics.  I've heard that the more fluid exchange of health care information has led to better coverage, though.  Hospitals/clinics are spending less time doing repetitive preliminary exams and whatnot, thanks to the accessibility of patient's health information.  The investment in HIT from the 2009 stimulus has really improved coverage in places that have taken advantage of it.

[K-S-U-Wildcats!]

http://www.forbes.com/sites/rickungar/2013/05/24/unexpected-health-insurance-rate-shock-california-obamacare-insurance-exchange-announces-premium-rates/

By Rick Ungar, Contributor

I write from the left on politics and policy

[OregonSmock]

http://www.forbes.com/sites/rickungar/2013/05/24/unexpected-health-insurance-rate-shock-california-obamacare-insurance-exchange-announces-premium-rates/

By Rick Ungar, Contributor

I write from the left on politics and policy

 

[Dugout DickStone]

I think transparent pricing is a pretty good idea.

[kim carnes]

here is an eye opening statement: people who can't afford to pay for health insurance can't afford to pay for health insurance

let that sink in for a moment

[Rage Against the McKee]

Since we are talking about rising health care costs, I'm going to throw in the single talking point I always add in.  I'm not saying it's a significant driver in rising costs, but it still bothers the hell out of me. 

Part of the rising cost of health care is due to the number of machines/equipment/resources that exist and need to be paid for and the quantity of these capital resources vs the population base they serve.  A lot of America is rural, like western Kansas.  There are a lot of towns with populations from 8,000 to 25,000 all between 45-70 miles apart, and they all have the exact same equipment.  You go to the hospitals in Garden City, Dodge City, Liberal, Great Bend, Hays, Emporia, Pittsburg, Newton, McPherson, Pratt, Colby, and probably Concordia & Norton.  They all have the same very expensive MRI machines.  Why?  So that when someone has strange pain they don't have to drive two hours round trip to get scanned.  Salina probably had 5 and Wichita probably has 20+ MRIs between the hospitals, cancer centers, and other "surgical arts" complexes.  Those things need to be paid for.  We have the ability to create amazing technology, but we can't afford it at the level that we can produce it.  However, since its in the name of health, we do it anyway and need to create reasons/ways to pay for it. 

Example: I live in a city of 30,000 people, 6 miles north of Tulsa.  We have two competing hospitals that are one mile apart from each other.  Both are full service, three story hospitals full of the same, expensive pieces of equipment.  One night I woke up at 1:00 am with a pretty bad kidney stone.  It was the throwing up from pain kind, so I knew my Loritabs weren't going to do it.  I finally broke down and went to the hospital.  I get to the hospital and they don't believe I have a kidney stone, even though I've had 15 before.  I pee blood to show them I have a stone.  Now they believe me, but they "want to be sure" it's not my appendix.  They say screw it and send me for an MRI anyway.  What do they care, the machine and tech are sitting idle at 2:00 AM, so it's an easy $2,000 they get to bill out.  All I needed was a little morphine (so I could keep down the gallon of water I was trying to drink) and a couple bags of fluid.  If they didn't regularly send people for unnecessary MRI's to charge the insurance companies, I'm sure they'd just raise the price on something else so they'd hit their budgeted revenue.  However, the citizens of my town (and their insurance companies) have to pay for two MRI machines and two of everything else.  Both need to hit their target revenue to pay for their redundant resources.  It's insanely stupid overkill, and this is going on all over the country in towns like those I listed in the paragraph above.  That's part of the reason health care costs are going up. 

/hamburglar-health-care-cost-rant

If your appendix had ruptured and you died, your family may have sued the hospital for several million dollars. This is the reason poor people can't afford health insurance today.

I'm pretty sure the hospital just wanted hamburglar's money here.

[K-S-U-Wildcats!]

here is an eye opening statement: people who can't afford to pay for health insurance can't afford to pay for health insurance

let that sink in for a moment

Would they be able to afford it if the insurance were cheaper? What if they cut out the cable, smart phone, fast food, etc.? Below what level of income should taxpayers subsidize (pay for) somebodies health insurance?

[Rage Against the McKee]

I think we should just eliminate insurance completely. Health care costs would drop very quickly.

[Institutional Control]

I think we should just eliminate insurance completely. Health care costs would drop very quickly.

But unemployment in the Philippines and India would skyrocket since that's where 90% of their claims are processed.

[Rage Against the McKee]

I think we should just eliminate insurance completely. Health care costs would drop very quickly.

But unemployment in the Philippines and India would skyrocket since that's where 90% of their claims are processed.

Those guys can get by. They just need to cut their cable and get rid of their smart phones. They are a resilient people. They will persevere.

[wetwillie]

I think we should just eliminate insurance completely. Health care costs would drop very quickly.

Agreed, then we eliminate mortgages and the price of houses gets cut in half.

[Rage Against the McKee]

I think we should just eliminate insurance completely. Health care costs would drop very quickly.

Agreed, then we eliminate mortgages and the price of houses gets cut in half.

That sounds amazing. Just think about how cheap rent would be.

[john "teach me how to" dougie]

I think we should just eliminate insurance completely. Health care costs would drop very quickly.

Agreed, then we eliminate mortgages and the price of houses gets cut in half.

Same with eliminating college grants and loans. Imagine how cheap tuition would be! Everybody would be able to afford it again.

[Rage Against the McKee]

I think we should just eliminate insurance completely. Health care costs would drop very quickly.

Agreed, then we eliminate mortgages and the price of houses gets cut in half.

Same with eliminating college grants and loans. Imagine how cheap tuition would be! Everybody would be able to afford it again.

I agree. It really is just doctors, bankers, and politicians standing between us and utopia.

[K-S-U-Wildcats!]

http://www.forbes.com/sites/rickungar/2013/05/24/unexpected-health-insurance-rate-shock-california-obamacare-insurance-exchange-announces-premium-rates/

By Rick Ungar, Contributor

I write from the left on politics and policy

 

http://www.forbes.com/sites/theapothecary/2013/05/30/rate-shock-in-california-obamacare-to-increase-individual-insurance-premiums-by-64-146/

Last week, the state of California claimed that its version of Obamacare’s health insurance exchange would actually reduce premiums. “These rates are way below the worst-case gloom-and-doom scenarios we have heard,” boasted Peter Lee, executive director of the California exchange.

But the data that Lee released tells a different story: Obamacare, in fact, will increase individual-market premiums in California by as much as 146 percent.

Lee’s claims that there won’t be rate shock in California were repeated uncritically in some quarters. “Despite the political naysayers,” writes my Forbes colleague Rick Ungar [who writes "from the left on politics and policy"], “the healthcare exchange concept appears to be working very well indeed in states like California.” A bit more analysis would have prevented Rick from falling for California’s sleight-of-hand.

Here’s what happened. Last week, Covered California—the name for the state’s Obamacare-compatible insurance exchange—released the rates that Californians will have to pay to enroll in the exchange. “The rates submitted to Covered California for the 2014 individual market,” the state said in a press release, “ranged from two percent above to 29 percent below the 2013 average premium for small employer plans in California’s most populous regions.”

That’s the sentence that led to all of the triumphant commentary from the left. “This is a home run for consumers in every region of California,” exulted Peter Lee.

Except that Lee was making a misleading comparison. He was comparing apples—the plans that Californians buy today for themselves in a robust individual market—and oranges—the highly regulated plans that small employers purchase for their workers as a group. The difference is critical.

...

Read on...

[K-S-U-Wildcats!]

The article is just too good not to post in its entirety.

One of the most serious flaws with Obamacare is that its blizzard of regulations and mandates drives up the cost of insurance for people who buy it on their own. This problem will be especially acute when the law’s main provisions kick in on January 1, 2014, leading many to worry about health insurance “rate shock.”

Last week, the state of California claimed that its version of Obamacare’s health insurance exchange would actually reduce premiums. “These rates are way below the worst-case gloom-and-doom scenarios we have heard,” boasted Peter Lee, executive director of the California exchange.

But the data that Lee released tells a different story: Obamacare, in fact, will increase individual-market premiums in California by as much as 146 percent.

Lee’s claims that there won’t be rate shock in California were repeated uncritically in some quarters. “Despite the political naysayers,” writes my Forbes colleague Rick Ungar, “the healthcare exchange concept appears to be working very well indeed in states like California.” A bit more analysis would have prevented Rick from falling for California’s sleight-of-hand.

Here’s what happened. Last week, Covered California—the name for the state’s Obamacare-compatible insurance exchange—released the rates that Californians will have to pay to enroll in the exchange. “The rates submitted to Covered California for the 2014 individual market,” the state said in a press release, “ranged from two percent above to 29 percent below the 2013 average premium for small employer plans in California’s most populous regions.”

That’s the sentence that led to all of the triumphant commentary from the left. “This is a home run for consumers in every region of California,” exulted Peter Lee.

Except that Lee was making a misleading comparison. He was comparing apples—the plans that Californians buy today for themselves in a robust individual market—and oranges—the highly regulated plans that small employers purchase for their workers as a group. The difference is critical.

Obamacare to double individual-market premiums

If you’re a 25 year old male non-smoker, buying insurance for yourself, the cheapest plan on Obamacare’s exchanges is the catastrophic plan, which costs an average of $184 a month. (That’s the median monthly premium across California’s 19 insurance rating regions.)

The next cheapest plan, the “bronze” comprehensive plan, costs $205 a month. But in 2013, on eHealthInsurance.com (NASDAQ:EHTH), the average cost of the five cheapest plans was only $92. In other words, for the average 25-year-old male non-smoking Californian, Obamacare will drive premiums up by between 100 and 123 percent.

Under Obamacare, only people under the age of 30 can participate in the slightly cheaper catastrophic plan. So if you’re 40, your cheapest option is the bronze plan. In California, the median price of a bronze plan for a 40-year-old male non-smoker will be $261. But on eHealthInsurance, the average cost of the five cheapest plans was $121. That is, Obamacare will increase individual-market premiums by an average of 116 percent.

For both 25-year-olds and 40-year-olds, then, Californians under Obamacare who buy insurance for themselves will see their insurance premiums double.

In the map below, I illustrate the regional variations in Obamacare’s rate hikes. For each of the state’s 19 insurance regions, I compared the median price of the bronze plans offered on the exchange to the median price of the five cheapest plans on eHealthInsurance.com for the most populous zip code in that region. (eHealth offers more than 50 plans in the typical California zip code; focusing on the five cheapest is the fairest comparator to the exchanges, which typically offered three to six plans in each insurance rating region.)

As you can see, Obamacare’s impact on 40-year-olds is steepest in the San Francisco Bay area, especially in the counties north of San Francisco, like Marin, Napa, and Sonoma. Also hard-hit are Orange and San Diego counties.

According to Covered California, 13 carriers are participating in the state’s exchange, including Anthem Blue Cross (NYSE:WLP), Health Net (NYSE:HNT), Molina (NYSE:MOH), and Kaiser Permanente. So far, UnitedHealthCare (NYSE:UNH) and Aetna (NYSE:AET) have stayed out.

It’s great that Covered California released this early the rates that insurers plan to charge on the exchange, as it gives us an early window into how the exchanges will work in a state that has an unusually competitive and inexpensive individual market for health insurance. But that’s the irony. The full rate report is subtitled “Making the Individual Market in California Affordable.” But Obamacare has actually doubled individual-market premiums in the Golden State.

How did Lee and his colleagues explain the sleight-of-hand they used to make it seem like they were bringing prices down, instead of up? “It is difficult to make a direct comparison of these rates to existing premiums in the commercial individual market,” Covered California explained in last week’s press release, “because in 2014, there will be new standard benefit designs under the Affordable Care Act.” That’s a polite way of saying that Obamacare’s mandates and regulations will drive up the cost of premiums in the individual market for health insurance.

But rather than acknowledge that truth, the agency decided to ignore it completely, instead comparing Obamacare-based insurance to a completely different type of insurance product, that bears no relevance to the actual costs that actual Californians face when they shop for coverage today. Peter Lee calls it a “home run.” It’s more like hitting into a triple play.

That Obamacare more than doubles insurance premiums for many Californians is especially ironic, given the political posturing of the President and his administration in 2010. In February of that year, Anthem Blue Cross announced that some groups (but not the majority) would face premium increases of as much as 39 percent. The White House and its allies in the blogosphere, cynically, claimed that these increases were due to greedy profiteering by the insurers, instead of changes in the underlying costs of the insured population.

“These extraordinary increases are up to 15 times faster than inflation and threaten to make health care unaffordable for hundreds of thousands of Californians, many of whom are already struggling to make ends meet in a difficult economy,” said Health and Human Services Secretary Kathleen Sebelius. “[Anthem’s] strong financial position makes these rate increases even more difficult to understand.” The then-Democratic Congress called hearings. Even California Insurance Commissioner Steve Poizner, a Republican running for governor, decided to launch an investigation.

Soon after, WellPoint announced that, in fact, because of lower revenues and higher spending on patient care, the company earned 11 percent less in 2010 than it did in 2009. So much for greedy profiteering.

So, to summarize: Supporters of Obamacare justified passage of the law because one insurer in California raised rates on some people by as much as 39 percent. But Obamacare itself more than doubles the cost of insurance on the individual market. I can understand why Democrats in California would want to mislead the public on this point. But journalists have a professional responsibility to check out the facts for themselves.

[K-S-U-Wildcats!]

Obamacare: Marginally better healthcare for the poor and those with pre-existing conditions. And for everyone else, pony up, assholes.

http://online.wsj.com/article/SB10001424127887323469804578523623272958456.html?mod=WSJ_Opinion_LEADTop

Liberals have spent years claiming that "rate shock" under the Affordable Care Act—the 20% to 30% average spike in insurance premiums that every independent analyst projects—is merely the political imagination of Republicans and the insurance industry. So they immediately claimed victory when California reported last month that the plans that will be available on the state's new insurance exchange next year would be cheaper than they are today.

Except now it emerges that California goosed the data to make it appear as if ObamaCare won't send costs aloft as the law's regulations and mandates kick in. It will, by a lot. And now liberals have suddenly switched to arguing that, sure, insurance will be more expensive but the new costs are justified. Needless to say that was not how Democrats sold health-care reform.

California reported that the rates would range from 2% above to 29% below the current market. "This is a home run for consumers in every region of California," said Peter Lee, the director of the state exchange. "These rates are way below the worst-case gloom-and-doom scenarios we have heard."

But Mr. Lee and his fellow regulators were making a false comparison. They weren't looking at California's lightly regulated individual insurance market that functions surprisingly well. They were comparing ObamaCare insurance to the state's current small-business market where regulations similar to ObamaCare have already been imposed.

In other words, California wasn't comparing apples to apples. It wasn't even comparing apples to oranges. It was comparing apples to ostriches. The conservative analyst Avik Roy consulted current rates on the eHealthInsurance website and discovered that the cheapest ObamaCare plan for a typical 25-year-old man is roughly 64% to 117% more expensive than the five cheapest policies sold today. For a 40 year old, it's 73% to 146%. Stanford economist Dan Kessler adds his observations nearby.

We wouldn't be shocked if California deliberately abused statistics in the hopes that no one would notice that in some cases premiums would more than double. In any case, the turn among the liberals who touted the fake results has been educational.

They now concede that individual costs will rise but claim that it is unfair to compare today's market to ObamaCare because ObamaCare mandates much richer benefits. Another liberal rationalization is that the cost-increasing regulations are meant to help people with pre-existing conditions, so they're worth it.

So they're finally admitting what some of us predicted from the start, but that's also the policy point. Americans are being forced to buy more expensive coverage than what they willingly buy today. Liberals also argue that some of the new costs will be offset by subsidies, which is great news unless you happen to be a taxpayer or aren't eligible for ObamaCare dollars and wake up to find your current coverage is illegal.

The Affordable Care Act was sold as a tool to lower health costs. In case you missed it, the claim is right there in the law's title. The new Democratic position is that the entitlement will do the opposite but never mind, which is at least more honest.

But we wonder how long this new candor will last. If the public reacts badly to these higher premiums, the authors of ObamaCare will soon be back to blaming insurance companies and Republicans.

[Big Sam]

Costs are soaring and will only continue.  It has pushed insurance rates up, and will get worse, and will lead to most leaving private insurance companies which will cease to exist (current estimate is 2/3 will fall into the federal system now as businesses drop insurance plans due to soaring rates as a result of new/adjusted mandates).

Now, that news may make some happy.  However, the lower middle class will be hammered.  The system admits that there will be a significant group out there who won't receive any subsidies, but won't make enough to afford the plans.  Plus, it will leave it in the hands of the government what will and won't be covered.  If you think there will be mercy in this regard, all you have to do is consider Sebellius's response to the kid who is too young to get a lung transplant in the Philly area today.  She says there is nothing she can do to intervene over the rule.  However, the rule was based under a past medical reality, and not current reality.  Also, the regulation allows the person in Sebellius's job to intervene and/or change the rule. 

Just remember, dealing with an uncaring, bureaucratic health insurance company sucks.  Dealing with a large federal department will make dealing with your insurance company look like child's play.

[Institutional Control]

The sky is falling!

[Rage Against the McKee]

If nobody had insurance, we wouldn't have to deal with the bureaucratic insurance company or the government, Big Sam.