Got a Pre-Existing Condition? Your Premium Could Rise Sharply Under New GOP Plan

[Amica Nostra 4,803]

14 minutes ago, bcking said:

In general I agree with you. Obamacare isn't working as intended, and there are many reasons for that. I do believe strongly it is better than what we had before, but I also have specific definitions for what I consider to be "better" that others may not agree with.

 

The new plan isn't going to fix any problems. We will have less people with insurance, either because they are healthy and think they don't "need it", or they are sick and can't afford it.

 

While a "cash system" may make certain things cheaper overall (doctor's visits perhaps), obviously that isn't tenable for the entire healthcare system. A hospital stay or ED visit, paid in cash, wouldn't be cheap enough for people to afford.

I don't agree that it is on the verge of imploding though.  Instead of repeal and replace we need renew and reform.

[Teddy B 17,252]

1 minute ago, ccneat said:

I don't agree that it is on the verge of imploding though.  Instead of repeal and replace we need renew and reform.

If the single payer option is out of the question, then yes I agree, renew and reform.

[Dashinka 25,211]

2 minutes ago, ccneat said:

I don't agree that it is on the verge of imploding though.  Instead of repeal and replace we need renew and reform.

What are your suggestions?

[bcking 3,157]

8 minutes ago, Teddy B said:

I know this is your area of expertise so I'd like to hear your opinions on the followin.

 

Do you think it would be a big help to the financial side of the ACA if the penalties for not having were made more expensive than if you did have it?

 

Do you think adults over the age of 21 should be required to carry their own health coverage and not allowed to ride on their parents health care coverage to the age of 26 (I believe it's 26 could be wrong)?

 

I personally think that changing both of these things would make the ACA much more solvent and stable.

The financial aspects are in no way my area of expertise, since doctors are notoriously clueless about the cost of the things we provide. There is almost a conscious effort to keep doctors out of the loop. 

 

1. I think the fact that the penalty ends up being cheaper than getting the cheapest insurance does sort of defeat the purpose of the penalty. The point of getting everyone onto some sort of plan is so everyone contributes some amount of money to the pot to protect everyone when they get ill. I think the problem with the ACA is that the insurance rates exploded because insurance companies didn't like that their bottom line was changed. I agree that there should be a "minimum" type of coverage so that you don't end up with some false sense of "security" and then are ruined when you actually need care that your cheap insurance doesn't cover. However that meant that insurance companies were having to cover more, so of course they charged more. There needs to be limits to what they charge as well, and if that alters how much they make in the system so be it. The cost savings will have to come from making the system more efficient, cutting out more middle men, and renegotiating with all parties involved (including Doctors, though we aren't the only problem. Salaries are a lot less now then they used to be, but they could still drop even more when compared to other 1st world countries).

 

2. This is hard because I think realistically many "adults" between 21-26 would not be able to carry their own health coverage. Perhaps if instead it was adults up to 26 who were enrolled in full time education are allowed on their parents plans, but adults who are not have to pay? I wouldn't want to stiffle education, and honestly I also think just having coverage no matter where it comes from is the most important. 

 

EDIT:

 

In my opinion every system has problems and nothing is perfect, but I believe that a single payer system is a better STARTING PLACE. Yes it isn't perfect, but I think it is the best place to start. However I value universal coverage extremely highly because I think it should be apart of the social contract that a government/society makes with its citizens. The problem with a private insurance industry is they DON'T want to cover everyone. They never will. They want to cover the healthy people who they know they will make money off. They don't want to cover the "bad investments" and the more we force them to do it the more they will charge because they are a profit driven industry.

Edited May 4, 2017 by bcking

[Amica Nostra 4,803]

Just now, Bill & Katya said:

What are your suggestions?

My suggestions?  Tell congress to quit fighting and fixit.  There are many possible solutions but as long as there is a strong enough block in congress who do not believe health care is a fundamental right, no solution will pass. 

 

[Dashinka 25,211]

8 minutes ago, Teddy B said:

I know this is your area of expertise so I'd like to hear your opinions on the following.

 

Do you think it would be a big help to the financial side of the ACA if the penalties for not having coverage were made more expensive than if you did have it?

 

Do you think adults over the age of 21 should be required to carry their own health coverage and not allowed to ride on their parents health care coverage to the age of 26 (I believe it's 26 could be wrong)?

 

I personally think that changing both of these things would make the ACA much more solvent and stable.

How high do you make the penalty?  I would think it would have to be higher than the annual cost of getting the insurance such as if the insurance costs $12k annually, the penalty would need to be more than that.  As to children staying on parents policies, I agree with you there.

[smilesammich 10,727]

i disagree with ending the children on parents plans until 27. this should remain. certainly until we fix the whole student loan/debt fiasco..

[Teddy B 17,252]

2 minutes ago, bcking said:

The financial aspects are in no way my area of expertise, since doctors are notoriously clueless about the cost of the things we provide. There is almost a conscious effort to keep doctors out of the loop. 

 

1. I think the fact that the penalty ends up being cheaper than getting the cheapest insurance does sort of defeat the purpose of the penalty. The point of getting everyone onto some sort of plan is so everyone contributes some amount of money to the pot to protect everyone when they get ill. I think the problem with the ACA is that the insurance rates exploded because insurance companies didn't like that their bottom line was changed. I agree that there should be a "minimum" type of coverage so that you don't end up with some false sense of "security" and then are ruined when you actually need care that your cheap insurance doesn't cover. However that meant that insurance companies were having to cover more, so of course they charged more. There needs to be limits to what they charge as well, and if that alters how much they make in the system so be it. The cost savings will have to come from making the system more efficient, cutting out more middle men, and renegotiating with all parties involved (including Doctors, though we aren't the only problem. Salaries are a lot less now then they used to be, but they could still drop even more when compared to other 1st world countries).

 

2. This is hard because I think realistically many "adults" between 21-26 would not be able to carry their own health coverage. Perhaps if instead it was adults up to 26 who were enrolled in full time education are allowed on their parents plans, but adults who are not have to pay? I wouldn't want to stiffle education, and honestly I also think just having coverage no matter where it comes from is the most important. 

I agree with everything you said including the part about allowin adults who are enrolled in full time education to stay on their parents plan.

 

I've never understood how a system that depends on young people enrolling to make it solvent, allows the penalty for not enrolling to be peanuts compared to what they'd pay for the insurance. Doesn't make much sense.

[Teddy B 17,252]

3 minutes ago, Bill & Katya said:

How high do you make the penalty?  I would think it would have to be higher than the annual cost of getting the insurance such as if the insurance costs $12k annually, the penalty would need to be more than that.  As to children staying on parents policies, I agree with you there.

Yes, I agree the penalty needs to be more, I believe I did say that in the bold below.

 

14 minutes ago, Teddy B said:

I know this is your area of expertise so I'd like to hear your opinions on the following.

 

Do you think it would be a big help to the financial side of the ACA if the penalties for not having coverage were made more expensive than if you did have it?

 

Do you think adults over the age of 21 should be required to carry their own health coverage and not allowed to ride on their parents health care coverage to the age of 26 (I believe it's 26 could be wrong)?

 

I personally think that changing both of these things would make the ACA much more solvent and stable.

[Teddy B 17,252]

2 minutes ago, smilesammich said:

i disagree with ending the children on parents plans until 27. this should remain. certainly until we fix the whole student loan/debt fiasco..

Damn slackers!

[bcking 3,157]

It wouldn't be very popular but I also think that an income-based "premium bracket" system would also be potentially helpful.

 

What I pay on my employer-based health plan is quite similar to someone working at the same hospital but making half my income or even less (at least to my knowledge, I've never asked). I wouldn't be opposed to paying more because I make more. But like I said I don't think that would be very popular amongst other people in my income bracket (or above me).

Edited May 4, 2017 by bcking

[smilesammich 10,727]

4 minutes ago, Teddy B said:

Damn slackers!

i guess i'm thinking in terms of young adults that have preexisting conditions. people in their early twenties today have a hard enough time finding part time jobs let alone jobs that will immediately offer health insurance..so a kid's preexisting condition would totally determine if they could enter the workforce straight out of hs or go to college...all these huge decisions have to be based on if you can get/afford health insurance. just seems like we'd be vastly improving our speed in our race to the first world bottom..

Edited May 4, 2017 by smilesammich

[yuna628 9,779]

2 hours ago, bcking said:

The financial aspects are in no way my area of expertise, since doctors are notoriously clueless about the cost of the things we provide. There is almost a conscious effort to keep doctors out of the loop. 

 

1. I think the fact that the penalty ends up being cheaper than getting the cheapest insurance does sort of defeat the purpose of the penalty. The point of getting everyone onto some sort of plan is so everyone contributes some amount of money to the pot to protect everyone when they get ill. I think the problem with the ACA is that the insurance rates exploded because insurance companies didn't like that their bottom line was changed. I agree that there should be a "minimum" type of coverage so that you don't end up with some false sense of "security" and then are ruined when you actually need care that your cheap insurance doesn't cover. However that meant that insurance companies were having to cover more, so of course they charged more. There needs to be limits to what they charge as well, and if that alters how much they make in the system so be it. The cost savings will have to come from making the system more efficient, cutting out more middle men, and renegotiating with all parties involved (including Doctors, though we aren't the only problem. Salaries are a lot less now then they used to be, but they could still drop even more when compared to other 1st world countries).

 

2. This is hard because I think realistically many "adults" between 21-26 would not be able to carry their own health coverage. Perhaps if instead it was adults up to 26 who were enrolled in full time education are allowed on their parents plans, but adults who are not have to pay? I wouldn't want to stiffle education, and honestly I also think just having coverage no matter where it comes from is the most important. 

 

EDIT:

 

In my opinion every system has problems and nothing is perfect, but I believe that a single payer system is a better STARTING PLACE. Yes it isn't perfect, but I think it is the best place to start. However I value universal coverage extremely highly because I think it should be apart of the social contract that a government/society makes with its citizens. The problem with a private insurance industry is they DON'T want to cover everyone. They never will. They want to cover the healthy people who they know they will make money off. They don't want to cover the "bad investments" and the more we force them to do it the more they will charge because they are a profit driven industry.

The problem with increasing the penalty is that SCOTUS kind of made it that way. What I mean is, in order for the government to argue it's case they had to call it a penalty and not a tax, and that the penalty wasn't so high as to be a big burden to the point the person was 'forced' to buy a plan. I think when Roberts wrote his decision he spent a lot of time on that aspect iirc. As far as insurance companies go, they complain of course that they are losing money... and yet it seems as if they are raking in more money than ever before. I've yet to see an insurance company go bankrupt, they simply just leave the marketplace, but certainly would continue to sell privately. Whenever an insurance company asks for an increase in my state, they get it.. no matter how high it is. It's ridiculous. Smaller startup companies like Evergreen which had a more limited network jumped out of the market recently, leaving BCBS with a near monopoly.

 

While having young adults on parent's insurance may be helpful in some situations, I also disagree with it. I was one of those persons without insurance once, because of my situation. If I had decided to be more selfish and leave Mom without daily care I suppose I could have done that. But that was just my life situation, and one I didn't feel anyone else should pay for. When I was hit with the big hospital bill I paid it off very slowly. I know of a mentally disabled young man that has to work to receive benefits. I don't think he should be forced to, compared to many slackers out there these days. I think in some of these cases it should be based upon specific situations. I sort of feel like if you're a poor kid struggling to joggle work and a good education then health insurance is a good option... but if you're a slacker kid mooching off of the trust fund and breezing your way through rich-college and not trying to show you're making an attempt... well..

[elmcitymaven 9,712]

51 minutes ago, yuna628 said:

The problem with increasing the penalty is that SCOTUS kind of made it that way. What I mean is, in order for the government to argue it's case they had to call it a penalty and not a tax, and that the penalty wasn't so high as to be a big burden to the point the person was 'forced' to buy a plan. I think when Roberts wrote his decision he spent a lot of time on that aspect iirc.

It's actually the other way around -- in order for it to be constitutional, it had to be a tax and not a penalty (since Congress could only pass the legislation if it fell under an enumerated power, which here was the power to tax). If anyone's interested in the reasoning behind this in Nat'l Fed'n of Indep. Bus. v. Sebelius, let me know and I can post something I wrote on this topic.

[yuna628 9,779]

2 minutes ago, elmcitymaven said:

It's actually the other way around -- in order for it to be constitutional, it had to be a tax and not a penalty (since Congress could only pass the legislation if it fell under an enumerated power, which here was the power to tax). If anyone's interested in the reasoning behind this in Nat'l Fed'n of Indep. Bus. v. Sebelius, let me know and I can post something I wrote on this topic.

Doh!  That makes much more sense now. I do remember there being quite an argument about the tax or penalty thing. Always interested in thoughts on the subject. Is it true though that it's one of the reasons why the 'tax' couldn't be so high as to be too much of a burden as a way to force someone into buying a plan?