Quote:
Originally Posted by Happy Monkey
Part of Obamacare is to get more people on private insurance.
Not everyone will take advantage of it. The people you'd rather not get into, perhaps. But many will. Once the hurdle (sometimes mental as much as financial) of getting enrolled is overcome, it's much easier to do it.
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Yes, many will (hopefully) take advantage of the chance to get private insurance and will behave as you expect. The mental hurdle you mention, though, is significant. The healthy 20-somethings who choose not to have insurance now, because they feel the odds of needing it are low, will resent paying premiums and copays. They aren't likely to take on that expense unless forced to, when they've been getting along without. (There are quite a few young adults in smalltown who work full-time, decline to enroll in the health insurance their employer offers because it would cost them $20/month although they choose to spend funds on smoking 2 ppd, and still expect to be seen in less than an hour at the local ER while fully intending never to pay for that service. This is very common in the smalltown area.)
Another part of Obamacare is expanding eligibility for MA. This sounds like a good thing on the surface; however, it will be a serious problem for hospitals. At the moment they can write off non-payment from self-pay patients. If the percent of MA patients they see goes up substantially they will get the MA rates (which are less than overhead for both private practices and hospitals), no copays even at $3, no writeoffs, and they'll go bankrupt. Especially when there are no limits to the number of ER visits on MA - there are individuals, and not just a few, who have 200 ER visits/year in smalltown.
Please understand, this isn't a rant at self-pay or MA patients. One of my sons is on MA and I see the system from his perspective as well as from that of a provider. But people don't always behave as you'd expect, and there are always unexpected results from programs that seem beneficial at first glance.