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It has some of the same problems of promising "cannot be denied insurance", but assuming you can have control over coverage. Once you say - you cannot be denied, you also have to specify some level of coverage. Otherwise you have race to the bottom and forcing enclaves of patients that have a condition into high risk pools that are significantly more expensive. Or even no insurance options for that high cost population.
Also removes: "benefit mandates that often force Americans to pay for coverage they don’t need and can’t afford"
This link gives a ranking of those high cost items as an a-la-cart view of spend/condition.
The fundamental problem is the high costs of healthcare at ~$10,000/person spending. Unless you remove the "can not be denied/dropped" clause (which is really important to keep), it changes the economics of the insurance given the high cost of healthcare.
I suspect it would be hard to reduce the insurance premiums much w/o reducing coverage (total claims or limit covered conditions) of some of these high ticket items. Again if you can move to another policy later (no denying coverage) that then covers these high ticket items better, you are not making healthcare affordable, just moving the burden to a different part of the population at more expense.
You can google search by the title for pro/con opinions on this plan.
Until we fix the cost issue, we are not going to fix coverage whether it be for those who are not insured, for pre-existing conditions or for high-cost items.
So we need to start by understanding why we are paying so much more on a per-capita basis than other developed countries and what measures can be taken to bring our costs more in line with them.
The 10K per person quote is the new term to take into consideration all of the healthcare costs consumed by the entire nation. The average family spends far less than that, about $2500 per year.
A small percentage of people consumes the vast majority of healthcare costs.
We are paying more partly because we are doing more than other nations. We have a very unrealistic view of life in this country. We spare no expense even where there is little chance of it actually working, particularly among our very elderly patients.
We need to start looking more at quality of life versus quantity. We need a right to die movement similar to the right to life movement that a person who has had enough and just wants to be let go can do so voluntarily with dignity and without legal or financial reprocusions.
C. Everett Koop said it best. We expect to live forever and have someone else pay for it.
Jaggy001, I agree it is about controlling cost. Until that happens, most plans have to be subsidized.
NSHL10 - do you have a link to that info $2500. As an example, Employer healthcare rarely covers the elderly or likely the extreme cases. It averages now ~$15k (2012) for a family, $18k in 2016. Given the health insurance model, this is mostly averaging out claims vs premiums.
There are other links that show the same magnitude numbers.
While I do agree with you there are smaller segments of the population that have higher costs, but any condition now a days is expensive. Your family of $2500, dad could have a heart attack or just an issue. Cardiac cath is about $20k (screening test), stents add another $10k, bypass $70-100k. Insurance is about the unpredictability of those events and covering them. 27M people have heart disease, 21M diabetes. These are not small segments of the population, all are expensive.
The ACA actually attempted to manage this better by taking some of that extremely high cost population out of the risk pool and having congress pay insurance companies separately. Great idea, reduced the premiums for the larger population, but Congress only paid back 12% of that cost for the 2014 year, partly causing increases in rates in later years. Bit more in the following years, but still maxed out at 55% in 2016 from what I remember.
Last edited by norm42; 01-28-2017 at 02:25 PM..
Reason: added year for the premium data
Until we fix the cost issue, we are not going to fix coverage whether it be for those who are not insured, for pre-existing conditions or for high-cost items.
So we need to start by understanding why we are paying so much more on a per-capita basis than other developed countries and what measures can be taken to bring our costs more in line with them.
Jaggy001, I agree it is about controlling cost. Until that happens, most plans have to be subsidized.
NSHL10 - do you have a link to that info $2500. As an example, Employer healthcare rarely covers the elderly or likely the extreme cases. It averages now ~$15k (2012) for a family, $18k in 2016. Given the health insurance model, this is mostly averaging out claims vs premiums.
There are other links that show the same magnitude numbers.
While I do agree with you there are smaller segments of the population that have higher costs, but any condition now a days is expensive. Your family of $2500, dad could have a heart attack or just an issue. Cardiac cath is about $20k (screening test), stents add another $10k, bypass $70-100k. Insurance is about the unpredictability of those events and covering them. 27M people have heart disease, 21M diabetes. These are not small segments of the population, all are expensive.
The ACA actually attempted to manage this better by taking some of that extremely high cost population out of the risk pool and having congress pay insurance companies separately. Great idea, reduced the premiums for the larger population, but Congress only paid back 12% of that cost for the 2014 year, partly causing increases in rates in later years. Bit more in the following years, but still maxed out at 55% in 2016 from what I remember.
Norm I was talking about out of pocket expenses, not premium costs. Sorry for my confusion. Including premiums yes I can see that cost of 10 K per person as an average, but then again premiums do not equal health care given.
I am looking for data though - I worked in data anlyatics in healthcare, so if you have any info it would be much appreciated. You can pm me if you have some good links
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