Impeding changes to our Health Care system

[BigV]

Originally Posted by TheMercenary

Trying to figure out why you can't make the connection between overwhelming support for the Obama Admin and those who are getting waivers, all from the list you posted? There should not be a single Union on that list. As a group they have some of the best health care available in our market today.

I think this is a seriously mistaken oversimplification. Why wouldn't there be a single union-sponsored health insurance plan on that list? Really. why not?

The huge break are the people getting the waivers vs those who will still have to pay for insurance at ever inflating prices. Do you really think these will be limited breaks? I don't.

this is a good one. I do think there will be an end to these breaks, and here's why. All laws we make at the state and federal level have some kind of introductory period, usually in months. The PPACA has a lead in time where different aspects of the law are being phased in over different periods of time. I think this is appropriate. The instant and immediate introduction of such a sweeping would cause a huge amount of disruption, all of which is avoidable, by making the rules applicable in a gradual, but definite and finite manner.

Costs are transfered when one group of people have to pay while others do not. Under the mini-med plans who pays for the care when that care exceeded the value of the plan? Vs, people who are forced to get very expensive health plans as mandated by Obamacare?

there are no costs transferred when there are no costs. Imagine--I have a health plan, one that meets these kinds of requirements that would justify a waiver. "Mini-med" plans, ones that have a $750,000 lifetime cap on benefits. I seriously doubt that there is very much health care delivered to these folks ABOVE the cap that goes unpaid for, and presumably cost transferred to you. Who pays these costs? The patient incurs them, but who pays? the hospital? that then charges more for insured patients? Including the original underinsured patients? Where does that extra cost come out of? Ah, you discuss costs next. Good!

Why do you think costs are skyrocketing, and prior to some states intervening, in what were clearly abuses by insurance companies in anticipation of madated coverage by Obamacare, the rest of insurance companies are doing the same just not at increases of 50% but instead at increases of 25% or 35%, maybe that does not draw the same ire of the regulators. So you see the burden is still borne by those who do not get the waivers when the mini-med plans run out. This is the costs, albeit indirect to those who are not exempted. I do not believe for one minute that they will not be continually granted waivers. It is not the number that matters, it matters that they are giving waivers at all. McDonalds should be forced to pay like everyone else. They are getting the waivers because they have convinced the HHS that they cannot bare the costs. Bullshit. They don't want to bare the costs.

Soon, when the waiver period is over, there won't be any more waivers. The costs will be borne by the insured. I think this latest round of fucking insane increases is the last gasp gouge by the insurance companies. They're not regulated for profit, and tha's unfortunate, because I think most of the difference in the cost for equivalent healthcare in our system compared to equivalent health care in other systems is due to two main factors.

1 -- healthcare as a for profit enterprise is the main driver of making stuff expensive. If my margin is 5%, then I make more money if I make the basis for that 5% markup as huge as possible.

2 -- we have a healthcare payment system that is stupefyingly complex and that complexity adds friction and cost at every point of contact. As these points are reduced in number, the costs will be reduced as well.

Ah you say, so much more for the insurance company! Sure. Until another aspect of PPACA comes into play: the requirement that (don't quote me on this, it's not covered in my own feces, merely my own memory) 80% of a company's cash flow (or some such damn word) be dedicated to patient care.

No more CRANKING up the premiums, unless of course, they're paying more in benefits. This will put a natural cap on increases like the ones you describe. Now I'm a capitalist, yay money. I am. But there's a serious, a FUNDAMENTAL disconnect with insurance, it's like a bet. I bet I will claim, get my money back plus some, and the company bets I won't. this bet times one bazillion subscribers usually generates a profit for the company. the house edge if you will, paid to the people that have the actuarial tables. Limiting profits in this way is NOT unAmerican, not unprecedented. Healthcare is making the transition in peoples' minds today from something we can choose to have or not, to something that is considered more... intrinsic. more fundamental. more "inalienable". And some services we already enjoy being provided by FOR PROFIT companies is being regulated this way. think of Utilities. I think health care insurance providers occupy the same space as an electric company or the gas company or the water utility. It's not a perfect analogy, but it's apt. They can make a profit and still be regulated and still provide the service to a large diverse population. We're already doing it.

Not a single Union should get a break and no company should get a break either.

I think it is fine for you to have that opinion, I appreciate the simplicity of such a "rule". I don't think it is practical though, and in a couple years the point will be moot anyhow.

"... are only available if the plan certifies that a waiver is necessary to prevent either a large increase in premiums..."

Define "significant". Because my preimums went up 25% last year and 35% more this year. And I am paying for 4 people out of my paycheck each month.

Well, man, those kinds of increases are definitely significant in my book, no question. Why your plan didn't get a waiver (presuming it did not) may well be because it doesn't have a lifetime limit of under $750,000. Of course, that's just a guess.