More Obamacare prognostications
Ever since Obamacare was proposed and then passed there has been rampant speculation on what its actual effects will be. It would almost be funny, if it weren’t so sad, how little anyone actually knows about precisely how this new system—one that will affect all of us in ways that are likely to be major—will actually work. We are almost certainly in for some surprises.
But there should come as no surprise that the current prognostication is that a great many individuals and small businesses will find their rates going up, sometimes a great deal (doubling in some instances).
Of course, the least affluent among us will receive subsidies and will probably come out ahead. And those with greater incomes will be paying more twice over: once in unsubsidized premiums and again in taxes to support the others. No surprise there, either. And some larger businesses may see premiums fall.
We just don’t know, but what I do know is that there’s no reason to call the system “insurance” any more. Insurance is based on assessment of risk, and under Obamacare insurance companies will no longer be allowed to issue policies and set premiums on the basis of health status, which is a huge part of the way risk is evaluated:
Starting next year, the law will block insurers from refusing to sell coverage or setting premiums based on people’s health histories, and will reduce their ability to set rates based on age. That can raise coverage prices for younger, healthier consumers, while reining them in for older, sicker ones.
I don’t know what you call that, but it’s not insurance as insurance has usually been defined.
It remains insurance but extended so as not to discriminate; as is ‘marriage’, ‘citizen,’ ‘victim,’ ‘poor,’ ‘rich,’ ‘equal,’ ‘opportunity,’ ‘merit,’ ‘winner,’ ‘sex,’ ‘gender’ and ‘J.D. – magna cum laude’.
Obamacare: I call it a goatscrew. I’m more concerned with what it is actually going to do the quality of healthcare. It would be one thing if we were going to have to pay a lot more for something better. The merits would even be debatable if things didn’t get better but were more “fair”. But, we’ll be paying a lot more, for less quality.
Sure, more people may get to see a doctor for a common cold (and clogging up the waiting rooms); but in the not too distant future our healthcare system will be like Britain’s.
Health insurance has never really been insurance in the classical sense. Insurance is there to spread the cost of rare catastrophic events over time and clients. Our health coverage has been more like a service contract which not only covers the rare catastrophic event, but also the routine maintenance. As the machine – the human body – gets older, the cost of the maintenance goes up as does the cost of the maintenance contract.
Obama care upsets this. I believe what is going to happen is that the costs for young and old are going to skyrocket as more and more people pile on for every little thing. The medical cartels – the major hospital corporations, the drug companies, and other major medical suppliers – have no incentive to cut costs and reduce their prices either – it’s all free – paid for by the government, don’t you know.
” . . . [T]here’s no reason to call the system ‘insurance’ any more.”
I’ve believed this for decades.
The idea underlying insurance is to let someone else (the insurer) take the risk, and the large pool of insureds takes care of the math — but only if we’re insuring against risk of genuinely unlikely events coming to pass.
The more likely the insurable events, the more expensive will be the insurance. Finally, once the events tend towards the more or less likely, it becomes a health plan of sorts, hardly “insurance”. (This is my roundabout way of agreeing with neo.)
Health insurance, with the word “insurance” properly understood — or at least understood as M J R and neo understand it — would be for catastrophic illness. Accidents might be folded in, or kept separate as it is now, in AD&D (accidental death and dismemberment) insurance.
The issues of subsidies for certain insureds I see as a pollutant to the pure insurance, and, whether they’re right/compassionate or wrong/mean, they are more properly classified as social engineering.
“”We have to pass the bill so that you can find out what is in it.” The upside is 11 months after all of the Obamacare rules, regulations, and costs crash down on us come 1/1/14 we will have an election. BTW, I had my annual physical a few weeks ago and asked my doctor his opinion of Obamacare. He smiled and told me he was going to retire in 2014 when it came into full effect. (He’s 56.)
There may be alternatives to retirement for physicians who don’t want to go along with Obamacare:
The Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health Care
1 In 10 Doctor Practices Flee Medicare To Concierge Medicine
I’m about due for a checkup, and I plan to talk to my doctor about this, and hopefully send her the links.
Thanks rickl, I’ll pass this along to my doc as a FYI. The reason article reminded me of my childhood. We paid the doctor with eggs, meat, and vegetables over the course of months if some serious medical problem happened. Cash in the bank was a bit scarce in the 1950s.
I dont completely agree with this. The essence of insurance is the pooling of risk, which is still there. I do agree the essence of insurance rates is going to be totally screwed up.
“I don’t know what you call that, but it’s not insurance as insurance has usually been defined.”
Its the means to arrive at a single payer, statist healthcare system run by femi-nazi lesbians deciding who goes to the death camps. Isn’t that obvious? (I’m practicing at channeling artfldgr in less than 60,000 words.)
My brother works in healthcare. He is laying people off. Most of the clientele is elderly and medicare was paying the bills. New payment schedule, fewer workers. But he says the misery will be spread fairly since doctors in his community who were putting off retirement are retiring now because of obamacare… and people are going so far as to retire early because of it… gonna be a mess.
“because of it… gonna be a mess.”
That was what was in ‘it’ that they didn’t want the proletariat to discover before it came crashing down upon their uninformed heads. The elitists hold us in utter contempt, I mirror back utter contempt to 10E12 upon them. They are vermin. I look forward to no daily bag limit.
While we’re on the subject . . .
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Because it was a form of compensation and not true insurance, health coverage became ever more expansive and expensive. Employees were shielded from the true cost of what they were consuming and accordingly failed to economize. If food were provided as a fringe benefit of employment, we’d dine on Chateaubriand every night. States compounded the problem in response to lobbying from particular providers, passing laws that required all insurance policies to cover expensive services, such as in vitro fertilization, pregnancy services, weight loss surgery and alcohol and drug rehabilitation programs. Over the past 30 years, 1800 mandates have been adopted, driving up the cost of insurance. This was bad enough for those with employer-provided insurance, but it hit those purchasing insurance individually particularly hard.
The high cost of insurance drove many who were not covered by employers to rely on hospital emergency rooms when they got sick. The federal government ratified this by mandating that hospitals treat all comers. Hospitals in turn charged more to their paying customers (i.e. insurance companies and the government through Medicare and Medicaid) to cover the costs of treating the uninsured. Rube Goldberg would be proud.
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Here’s the link: (by Mona Charen)
http://washingtonexaminer.com/republicans-should-prepare-for-the-collapse-of-obamacare/article/2525107
The WSJ article says MY premiums — I’m one of the independent buyers, and I’m not dirt-poor — could go up by 116%.
DID I READ THAT RIGHT? Right now, it’s over $600 a month in the buggered state of New York: that’s an INDIVIDUAL policy. Combines the HMO restrictions with (as of last year) only 80% payout, not the 100% of yore.
God, how I LOATHE, EXECRATE, and ABOMINATE the PINKOS. Damn them all.
M J R Says:
A lot of it is also that we all want to see a real Dr every year (sometimes several times) for common colds (something they can’t do anything about).
I think we get very little for our money since if you have a more serious problem they don’t typically catch them (IMO). They didn’t mine and I’m told by other doctors that my experience is the norm (oh they never get that; you end up in the ER and they do… of course ending up the ER means it progressed a lot….).
We already know what Obamacare is going to do. We have two examples. Tennessee enacted Hillarycare in 1995 and the first year budget was 2.5 billion. In 2004 the budget was 8.0 billion. The cost more than tripled in less than a decade. Hillary care became the largest line item in the Tennessee budget and was well on the way to bankrupting the state. They had to vastly scale back the program to stay solvent. Romneycare is bankrupting massatuches according to the state treasurer.
Many countries, like Australia where I live, have health outcomes much like America – life expectancy etc. What is unique to America is that the cost for those outcomes is about double – 16% of GDP in the US, 8.5% in Australia. The first time I have seen this problem openly discussed in US media is in a recent Time magazine article entitled Bitter Pill. It is not just Obamacare that is doomed. Hilariously, it LIMITS medical costs to 17% of GDP by 2017. The US medical system was unsustainable before Obamacare. Now it is significantly less so. I am an American, by the way who has spent about half my life in Australia. Like Neo I am a former liberal, but this issue is beyond ideological stance. The US has been so rich for so long that it has run the cost of Health Care (and higher education by the way) out of sight. If you have more money than most countries for 70 years such obviously good things as health care costs spiral out of control. I don’t know how it will work out, but there is pain ahead. One thing I learned from Bitter Pill was that the heath care industry spends more on lobbying than the defense industry. Good luck with getting those snouts out of the trough!