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When they lose their job, they lose their incomes AND their healthcare insurance...devastating. Unemployment is grossly inadequate.
Americans will have on average 11.7 jobs in their lives. Some of these jobs will be lost unexpectedly, so most Americans will be w/o healthcare coverage at least once. How so?
Some can afford COBRA...some can't. Some can afford subsidized ACA...some can't. Some qualify for medicaid..some don't.
The #1 cause of bankrupcy (62%) in the U.S. is medical expenses, & 78% of those had insurance, but were underinsured...some through employer-provided plans.
Employer provided insurance premiums rise ~5%/yr, or ~40% since 2013, far outpacing inflation.
Conclusion: tying jobs to healthcare insurance does not attain the objectives of; continuous, affordable, & adequate coverage for all.
~1/2 don't get coverage at work.
Many in this group can't afford subsidized ACA coverage, some make too much to qualify for subsidies, but can't afford insurance elsewhere either (gappers). Those who do have ACA coverage are seeing annual premiums skyrocket, and deductibles are too high. This group has unexpected job losses too...
...Pre-ACA, we had 18% uninsured, in 2018 we had 14% (& rising), but with 23M losing healthcare coverage due to C-19 job losses, we are back above the pre-ACA rate of 18%. ACA failed to cover all as promised, and now LESS are covered.
Many places in America are down to just 1 or 2 ACA providers. The ~50% who do NOT get coverage at work, have seen their private market insurance rates (including ACA) more than DOUBLE since 2013 (see CMS link above).
Conclusion: ACA insurance does not attain the objective of; universal, continuous, & affordable coverage.
Summary
Today, we have MORE uninsured Americans than we had pre-ACA, & ~1/2 of those who are insured are paying 100% (2x) more than they were paying 7 years ago, & the other 1/2 are paying 40% more.
The rate of premium increase is much higher in the private insurance sector (including ACA) than in the employer provided sector (100% vs. 40%) which amplifies the failure of ACA.
If the trend lines on all of this indicated improvement, we could ignore it all, but they're not. The trend line shows every metric worsening. The goal of universal, continuous, adequate, & affordable coverage for all is not being met for the overwhelming majority of Americans in either group.
Employer based insurance worked because of risk pools. A large corporation might have thousands of employees -- some older, some younger and for the most part healthy during their working years.
Everyone paid in a portion for the insurance which was cheaper than they could have gotten from an insurance company as an individual.
Some NEVER used the insurance at all during a given year. Some would get sick but maybe only 3 or 4 times in several years to the extent they required surgery, hospital stay or expensive testing. Some, unfortunately got sick and required a larger percentage of the healthcare but that was ok -- it was covered.
Because of the large risk pool costs could be kept reasonable for everyone.
Countries with universal health care have a huge risk pool: EVERYONE in the country.
Now the sticking point -- how is it paid for?
Taxes? If so is it taxes from individuals, taxes from companies or both.
If it is taxes from individuals is it ALL individuals or just 'some' of the people. Who decides and how.
Will current health insurers still be part of the equation? Current health care corporations like HSA or Kaiser permanente? What about Catholic, Baptist, Jewish supported hospitals?
Who decides how much Drs, nurses, and other health care workers get paid?
And how will pharmaceutical costs be held in check?
Employer based insurance worked because of risk pools. A large corporation might have thousands of employees -- some older, some younger and for the most part healthy during their working years.
Everyone paid in a portion for the insurance which was cheaper than they could have gotten from an insurance company as an individual.
Some NEVER used the insurance at all during a given year. Some would get sick but maybe only 3 or 4 times in several years to the extent they required surgery, hospital stay or expensive testing. Some, unfortunately got sick and required a larger percentage of the healthcare but that was ok -- it was covered.
Because of the large risk pool costs could be kept reasonable for everyone.
Countries with universal health care have a huge risk pool: EVERYONE in the country.
Now the sticking point -- how is it paid for?
Taxes? If so is it taxes from individuals, taxes from companies or both.
If it is taxes from individuals is it ALL individuals or just 'some' of the people. Who decides and how.
Will current health insurers still be part of the equation? Current health care corporations like HSA or Kaiser permanente? What about Catholic, Baptist, Jewish supported hospitals?
Who decides how much Drs, nurses, and other health care workers get paid?
And how will pharmaceutical costs be held in check?
Sounds simple doesn't it?
It's so simple that the United States is the only nation among all the rest of the first world developed nations that hasn't yet figured it out even though the working examples are easily visible to all.
Employer based insurance worked because of risk pools. A large corporation might have thousands of employees -- some older, some younger and for the most part healthy during their working years.
Everyone paid in a portion for the insurance which was cheaper than they could have gotten from an insurance company as an individual.
Some NEVER used the insurance at all during a given year. Some would get sick but maybe only 3 or 4 times in several years to the extent they required surgery, hospital stay or expensive testing. Some, unfortunately got sick and required a larger percentage of the healthcare but that was ok -- it was covered.
Because of the large risk pool costs could be kept reasonable for everyone.
Countries with universal health care have a huge risk pool: EVERYONE in the country.
Now the sticking point -- how is it paid for?
Taxes? If so is it taxes from individuals, taxes from companies or both.
If it is taxes from individuals is it ALL individuals or just 'some' of the people. Who decides and how.
Will current health insurers still be part of the equation? Current health care corporations like HSA or Kaiser permanente? What about Catholic, Baptist, Jewish supported hospitals?
Who decides how much Drs, nurses, and other health care workers get paid?
And how will pharmaceutical costs be held in check?
Sounds simple doesn't it?
Very simple....let the free market reign, & mandate transparency...problems solved.
ALL small businesses should be able to pool their employees into 1 massive risk pool that is larger than any other, & yield the lowest rates in America. Gov't regulations smother the free market by prohibiting this. Trump's trying to nix the regs, but the swamp creatures have taken too many insurance company bribes to agree...so the fight goes on.
Companies don't ultimately pay any taxes, they pass the tax costs through to the price of their goods and services. This is called "embedded taxes".
Pharma's must proportion R&D costs out to sales by country (not take all the costs here to lower profits & thus taxes) or make U.S. corp tax rate lowest on Earth...Pharma's checked.
It's so simple that the United States is the only nation among all the rest of the first world developed nations that hasn't yet figured it out even though the working examples are easily visible to all.
ALL small businesses should be able to pool their employees into 1 massive risk pool that is larger than any other, & yield the lowest rates in America.
The larger the pool, the lower the rates? Interesting. Let's pursue that idea to its logical conclusion...
No, just a group plan to leverage economies of scale like any other large group plan that new exists....such as General Motors healthcare plan, Delta Airlines healthcare plan.
Small businesses (and anyone not part of a large group plan) are being forced to pay MUCH higher rates than people who are part of a large group plan at work. This is due to political corruption. Swamp creatures taking bribes from Insurance Industry lobbyists.
Current medical financing practices make it impossible for people to withdraw from healthcare plans. We couldn't afford it. It's the distorted economics that needs to be fixed first.
Current medical financing practices make it impossible for people to withdraw from healthcare plans. We couldn't afford it. It's the distorted economics that needs to be fixed first.
Agreed, before we can fix healthcare insurance, we must first fix healthcare costs:
-significant tort reform including loser pays all legal costs.
-eliminate useless excessive testing to protect Doctors from Lawyers.
-transparent costs and retail prices to eliminate multi-tiered pricing, and to encourage competition.
-remove excessive new Hospital regulations to increase competition amongst hospitals.
-expedite FDA approval for medical devices, and drugs.
-have the lowest corp tax rates to attract big pharma & medical device makers, & lower embedded costs.
-bring medical manufacturing back to America to insure quality & supply chain protection, lower transport costs & time-in-transit, & eliminate import tariffs/costs.
-make medicare, medicaid, VA patients bid out non-emergency procedures to get 2 quotes if over X$'s.
-allow insurance companies to compete across state lines.
-mandate all procedures over X$'s have a written quote in advance, and no surprise billing afterwards.
It's so simple that the United States is the only nation among all the rest of the first world developed nations that hasn't yet figured it out even though the working examples are easily visible to all.
Strange, eh?
For a while, there was a plethora of posts about how Canadians didn't care for their health care system. However, every Canadian I know personally is quite happy with it.
Definitely, none have expressed any interest in trading it for the U.S. mess.
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