milee
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Post by milee on Jan 13, 2017 10:00:07 GMT -5
No you can't unless maternity coverage goes away for everyone. That is how insurance works. A large group of people get banded together and as a group use a smaller amount of coverage. If you peel out groups of people to remove coverage like with maternity coverage then it simply goes away for everyone. This is like flood insurance. Once companies were allowed to remove it from their home owners policies it simply went away and the only one left to "insure" against it was the gov. Maternity coverage is the same thing. In the states that allowed it to be added separately only the people who thought they were going to use it ever bought it and not often even then because of how insanely expensive it was. As a result in those states the gov paid for the vast majority of all births that weren't covered by a group health insurance. Which for the record doesn't allow people to I cut out that maternity coverage and get a discount. Quoting my own post since you choose to edit it when you quoted it. I edited it because it had nothing to do with the claim that "this is how insurance works" and that maternity coverage would not be available if it weren't forced on 100% of everybody. The bolded quote has nothing to do with that erroneous assertion. And it would be interesting to see how and if the ACA has even greatly changed that situation since in many states the majority of births were already paid for by Medicaid and the ACA was mainly a Medicaid expansion tool. Part of the reason the ACA premiums are increasing is that young people (the ones having the babies) aren't signing up to get insurance because the ACA means their premiums are so expensive. So, before the ACA the government/Medicaid paid for most of the births... that's probably still the case today. And still has nothing to do with how insurance works and if maternity coverage would be available if it weren't mandated by law.
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milee
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Post by milee on Jan 13, 2017 10:12:18 GMT -5
No you can't unless maternity coverage goes away for everyone. That is how insurance works. A large group of people get banded together and as a group use a smaller amount of coverage. If you peel out groups of people to remove coverage like with maternity coverage then it simply goes away for everyone. This is like flood insurance. Once companies were allowed to remove it from their home owners policies it simply went away and the only one left to "insure" against it was the gov. Maternity coverage is the same thing. In the states that allowed it to be added separately only the people who thought they were going to use it ever bought it and not often even then because of how insanely expensive it was. As a result in those states the gov paid for the vast majority of all births that weren't covered by a group health insurance. Which for the record doesn't allow people to I cut out that maternity coverage and get a discount. Quoting my own post since you choose to edit it when you quoted it. We may be talking about different things here. My points are about how insurance works. Insurance worked in a way that made maternity coverage available but optional pre-ACA. Maternity coverage did not go away because 80 year olds opted out. You are talking about what the government pays for. That's a completely separate issue to what is available and how insurance works. Government may have paid for things, but that is not because insurance wasn't available and it wasn't because that's how insurance works.
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zibazinski
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Post by zibazinski on Jan 13, 2017 11:30:05 GMT -5
You used to be able to buy insurance that didn't cover maternity. We did.
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justme
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Post by justme on Jan 13, 2017 11:49:44 GMT -5
No you can't unless maternity coverage goes away for everyone. That is how insurance works. A large group of people get banded together and as a group use a smaller amount of coverage. If you peel out groups of people to remove coverage like with maternity coverage then it simply goes away for everyone. This is like flood insurance. Once companies were allowed to remove it from their home owners policies it simply went away and the only one left to "insure" against it was the gov. Maternity coverage is the same thing. In the states that allowed it to be added separately only the people who thought they were going to use it ever bought it and not often even then because of how insanely expensive it was. Not even remotely true. Pre-ACA, you could purchase plans with or without maternity coverage. I know - I still have (a grandfathered) one. Pre-ACA you could price out insurance based on what types of coverage you wanted. My guess is that an 85 year old man wouldn't get much of a price break on excluding maternity coverage from his plan since the actuarial assumptions would pretty much already provide for the fact that he wouldn't be giving birth. But for me as a woman in her 30's and now 40s, the premium difference between plans that had maternity coverage and those that didn't was substantial. As for the assumption that if I had gotten pregnant that the state would have paid for my care - again, not true. I could have covered the costs of my first two births out of my assets, and would have had to do the same if I'd had a third baby with no maternity coverage. Not everybody is a deadbeat with no savings. Not everybody, but all the studies point to a huge swath of people that don't have savings or have very little. I think well over half couldn't scrounge up more than 1000. Higher for those that are younger...and baby making age. So, I would think a lot of people couldn't afford a birth paying cash.
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tskeeter
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Post by tskeeter on Jan 13, 2017 12:30:30 GMT -5
I can't see all of the ACA going away. I think the consequences to the public and the disruption to the medical services industry would be too great. But, I could see a roll back of some provisions, such as the requirement that my 85 year old father pay for maternity coverage. No you can't unless maternity coverage goes away for everyone. That is how insurance works. A large group of people get banded together and as a group use a smaller amount of coverage. If you peel out groups of people to remove coverage like with maternity coverage then it simply goes away for everyone. This is like flood insurance. Once companies were allowed to remove it from their home owners policies it simply went away and the only one left to "insure" against it was the gov. Maternity coverage is the same thing. In the states that allowed it to be added separately only the people who thought they were going to use it ever bought it and not often even then because of how insanely expensive it was. As a result in those states the gov paid for the vast majority of all births that weren't covered by a group health insurance. Which for the record doesn't allow people to I cut out that maternity coverage and get a discount. The difference between pre-ACA and post ACA is that insurance companies used to tailor insurance policies and the related premiums to the risks associated with the pool that you were a member of, based on your age, gender, etc. Post ACA, the government mandated what amounted to a single risk pool, so that millions of people ended up insuring against risks that they weren't exposed to. This created massive cost shifting and significantly increased the cost of medical insurance for many (Dad's HMO plan nearly doubled over a three year period).
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Deleted
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Post by Deleted on Jan 14, 2017 0:31:46 GMT -5
Fine. Maybe when they're doing my mammogram tomorrow I'll ask if they can squeeze my leg in there as a freebie. we only do this because we love you... and we want to hear more chicken stories. Ok. They looked at it at my appointment today and said she pretty much didn't think it was anything to worry about. She really thinks cyst, because it moves around and there is no discoloration to the skin. She said if it was closer to the surface she could just do a needle biopsy, and if I was really worried about it, dermatology would do a small incision and excise, but she thinks I should just monitor it because it's not in a location that would typically be anything bad (it's on the top of my thigh). I'm going with this for awhile.
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finnime
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Post by finnime on Jan 14, 2017 5:56:52 GMT -5
No you can't unless maternity coverage goes away for everyone. That is how insurance works. A large group of people get banded together and as a group use a smaller amount of coverage. If you peel out groups of people to remove coverage like with maternity coverage then it simply goes away for everyone. This is like flood insurance. Once companies were allowed to remove it from their home owners policies it simply went away and the only one left to "insure" against it was the gov. Maternity coverage is the same thing. In the states that allowed it to be added separately only the people who thought they were going to use it ever bought it and not often even then because of how insanely expensive it was. As a result in those states the gov paid for the vast majority of all births that weren't covered by a group health insurance. Which for the record doesn't allow people to I cut out that maternity coverage and get a discount. The difference between pre-ACA and post ACA is that insurance companies used to tailor insurance policies and the related premiums to the risks associated with the pool that you were a member of, based on your age, gender, etc. Post ACA, the government mandated what amounted to a single risk pool, so that millions of people ended up insuring against risks that they weren't exposed to. This created massive cost shifting and significantly increased the cost of medical insurance for many (Dad's HMO plan nearly doubled over a three year period). That's partially true and also untrue. Yes, insurance companies did assessments based on risk factors for populations and charged or excluded customers accordingly. Hence the common situation of precluding pre-existing conditions. In some cases certain insurance companies retroactively denied coverage for conditions that they would claim were "pre-existing" such as breast cancer years after the patient first was insured. Health care such as pre- and post-natal care often varied in individual plans depending on the patient. Someone healthy enough to have a healthy full-term baby was a good risk, but high intervention pregnancies and fragile newborns are crazily expensive. So some individual plans had a lot of exclusions for particular services. Yes to the prenatal ultrasound x 2, but no to the genetic testing. The biggest single flaw in comparing individual anecdotes, such as your father's experiences, is that we have had pre-ACA economic rationing of healthcare. Risk pools that exclude maternity care leave a lot of people subject to essential and unaffordable care for pregnancy. Your father's HMO plan is now required to cover services that it could exclude in the past, and to cover all customers equally, including diabetics and older people in kidney failure, for example. When these people can be excluded the healthcare available to them becomes limited to ER and hospital care until stable, or self-pay if they are sufficiently well off. It's worse than tough; people become permanently disabled and die far too soon, even in infancy, for want of care. Do we believe this is all right? I don't. I really do not. ETA: And yes, medical care in the U.S. is expensive as hell. Not because it is the best. Arguably, it is second rate. Our infant mortality rates, infection rates, life spans, non-disabled days per life, all do not compare well with other countries that have much less costly care, including Canada, Europe, Japan and Scandinavia. We pay through the nose because we support a for-profit model that demands insurance be paid, pharmaceutical companies prosper and medical supply distributors pay dividends. Non-profit hospitals, pediatricians and internal medicine specialists are not raking it in.
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formerroomate99
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Post by formerroomate99 on Jan 16, 2017 19:18:49 GMT -5
A friend of the family has privately insured himself and his family for the last 20 years. His stay at home wife had 3 kids while they were privately insured. His premiums skyrocketed once the ACA went in.
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justme
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Post by justme on Jan 16, 2017 19:42:27 GMT -5
I've always wondered if someone has ever studied to see US healthcare costs excluding the profits. Not every company is public, but I think most insurance companies are so it could probably be done.
Always wondered if costs - profits = single payer costs or not. My hunch is not, but I've been curious for a while.
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Deleted
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Post by Deleted on Jan 16, 2017 19:43:52 GMT -5
I'd like to see those costs minus the last year of life costs. Not that we can eliminate all last year of life costs, but it is an area we need to seriously address.
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naughtybear
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Post by naughtybear on Jan 16, 2017 19:56:29 GMT -5
The US is concerned with the looks of healthcare and not so much the expertise of the medical proffesionals.
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Post by Deleted on Jan 16, 2017 20:06:17 GMT -5
I've always wondered if someone has ever studied to see US healthcare costs excluding the profits. Not every company is public, but I think most insurance companies are so it could probably be done. Always wondered if costs - profits = single payer costs or not. My hunch is not, but I've been curious for a while. Health insurers have minimum loss ratios of 80-85% (I've seen both figures, not sure why/where they vary). That means they MUST pay out 80 to 85% of their premiums for covered claims. If they pay less, they have to give a dividend to the policyholders. So, if insurers didn't pay their employees, didn't advertise, didn't give them benefits and the CEO worked for free, your premium wouldn't drop by more than 20%. Profits, of course, are a much smaller subset of that 15 to 20%.
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Deleted
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Post by Deleted on Jan 16, 2017 20:07:52 GMT -5
Isn't that part of ACA though?
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justme
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Post by justme on Jan 16, 2017 20:12:16 GMT -5
I've always wondered if someone has ever studied to see US healthcare costs excluding the profits. Not every company is public, but I think most insurance companies are so it could probably be done. Always wondered if costs - profits = single payer costs or not. My hunch is not, but I've been curious for a while. Health insurers have minimum loss ratios of 80-85% (I've seen both figures, not sure why/where they vary). That means they MUST pay out 80 to 85% of their premiums for covered claims. If they pay less, they have to give a dividend to the policyholders. So, if insurers didn't pay their employees, didn't advertise, didn't give them benefits and the CEO worked for free, your premium wouldn't drop by more than 20%. Profits, of course, are a much smaller subset of that 15 to 20%. Those have different guidelines. That's a delineating on expenses - payments vs administrating. Which you could never get rid of all administration even in single payer. Profits for health insurance average around 3% I believe.
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NastyWoman
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Post by NastyWoman on Jan 16, 2017 20:39:43 GMT -5
No you can't unless maternity coverage goes away for everyone. That is how insurance works. A large group of people get banded together and as a group use a smaller amount of coverage. If you peel out groups of people to remove coverage like with maternity coverage then it simply goes away for everyone. This is like flood insurance. Once companies were allowed to remove it from their home owners policies it simply went away and the only one left to "insure" against it was the gov. Maternity coverage is the same thing. In the states that allowed it to be added separately only the people who thought they were going to use it ever bought it and not often even then because of how insanely expensive it was. As a result in those states the gov paid for the vast majority of all births that weren't covered by a group health insurance. Which for the record doesn't allow people to I cut out that maternity coverage and get a discount. The difference between pre-ACA and post ACA is that insurance companies used to tailor insurance policies and the related premiums to the risks associated with the pool that you were a member of, based on your age, gender, etc. Post ACA, the government mandated what amounted to a single risk pool, so that millions of people ended up insuring against risks that they weren't exposed to. This created massive cost shifting and significantly increased the cost of medical insurance for many (Dad's HMO plan nearly doubled over a three year period). Well, but look at it this way (since males paying for birth control is a frequent lament): it makes sense that at the very least everyone who could be part of a risk group would have to pay for those risks → that would mean that every male with active little swimmers (= 50% of the material needed to make a baby) would have to pay for pregnancy related costs. It makes no sense and it defiitely goes against the principles of equality, to exclude all males from maternity coverage. And to carry this a step further: most females are no longer able to have children by age 50 (give or take a few years). males on the other hand can keep it going much longer in the baby making department. So unless/until they are infertile they should keep on paying too, and post meno-pausal females would be able to drop coverage
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naughtybear
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Post by naughtybear on Jan 16, 2017 20:49:44 GMT -5
What Athena said is true, well at least it was when I worked at BCBS, I think it was 87%. BCBS is a not for profit company so bonuses were given to all employees . There will always be paper pushers that need to be paid even in a single payer.
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tskeeter
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Post by tskeeter on Jan 17, 2017 0:10:26 GMT -5
The difference between pre-ACA and post ACA is that insurance companies used to tailor insurance policies and the related premiums to the risks associated with the pool that you were a member of, based on your age, gender, etc. Post ACA, the government mandated what amounted to a single risk pool, so that millions of people ended up insuring against risks that they weren't exposed to. This created massive cost shifting and significantly increased the cost of medical insurance for many (Dad's HMO plan nearly doubled over a three year period). Well, but look at it this way (since males paying for birth control is a frequent lament): it makes sense that at the very least everyone who could be part of a risk group would have to pay for those risks → that would mean that every male with active little swimmers (= 50% of the material needed to make a baby) would have to pay for pregnancy related costs. It makes no sense and it defiitely goes against the principles of equality, to exclude all males from maternity coverage. And to carry this a step further: most females are no longer able to have children by age 50 (give or take a few years). males on the other hand can keep it going much longer in the baby making department. So unless/until they are infertile they should keep on paying too, and post meno-pausal females would be able to drop coverage
Dad is 86. I don't think there is a significant probability that he'll be fathering many more children. So forcing him to pay for the same maternity coverage as a 25 year old doesn't seem like the risk pool he is assigned to truely reflects the risk he presents.
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tskeeter
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Post by tskeeter on Jan 17, 2017 0:24:11 GMT -5
The difference between pre-ACA and post ACA is that insurance companies used to tailor insurance policies and the related premiums to the risks associated with the pool that you were a member of, based on your age, gender, etc. Post ACA, the government mandated what amounted to a single risk pool, so that millions of people ended up insuring against risks that they weren't exposed to. This created massive cost shifting and significantly increased the cost of medical insurance for many (Dad's HMO plan nearly doubled over a three year period). That's partially true and also untrue. Yes, insurance companies did assessments based on risk factors for populations and charged or excluded customers accordingly. Hence the common situation of precluding pre-existing conditions. In some cases certain insurance companies retroactively denied coverage for conditions that they would claim were "pre-existing" such as breast cancer years after the patient first was insured. Health care such as pre- and post-natal care often varied in individual plans depending on the patient. Someone healthy enough to have a healthy full-term baby was a good risk, but high intervention pregnancies and fragile newborns are crazily expensive. So some individual plans had a lot of exclusions for particular services. Yes to the prenatal ultrasound x 2, but no to the genetic testing. The biggest single flaw in comparing individual anecdotes, such as your father's experiences, is that we have had pre-ACA economic rationing of healthcare. Risk pools that exclude maternity care leave a lot of people subject to essential and unaffordable care for pregnancy. Your father's HMO plan is now required to cover services that it could exclude in the past, and to cover all customers equally, including diabetics and older people in kidney failure, for example. When these people can be excluded the healthcare available to them becomes limited to ER and hospital care until stable, or self-pay if they are sufficiently well off. It's worse than tough; people become permanently disabled and die far too soon, even in infancy, for want of care. Do we believe this is all right? I don't. I really do not. ETA: And yes, medical care in the U.S. is expensive as hell. Not because it is the best. Arguably, it is second rate. Our infant mortality rates, infection rates, life spans, non-disabled days per life, all do not compare well with other countries that have much less costly care, including Canada, Europe, Japan and Scandinavia. We pay through the nose because we support a for-profit model that demands insurance be paid, pharmaceutical companies prosper and medical supply distributors pay dividends. Non-profit hospitals, pediatricians and internal medicine specialists are not raking it in. Finnime, what did I say that you believe is not true? You talk about pre-existing conditions. I didn't even mention pre-existing conditions. You talk about pre-ACA economic rationing of medical services. I didn't mention rationing of medical care. Nor did I discuss the cost to value of US medical care as compared to other countries. If you don't agree with my opinions, fine. But don't claim that I've lied or presented misleading information when I have not.
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Post by The Walk of the Penguin Mich on Jan 17, 2017 11:06:33 GMT -5
Well, but look at it this way (since males paying for birth control is a frequent lament): it makes sense that at the very least everyone who could be part of a risk group would have to pay for those risks → that would mean that every male with active little swimmers (= 50% of the material needed to make a baby) would have to pay for pregnancy related costs. It makes no sense and it defiitely goes against the principles of equality, to exclude all males from maternity coverage. And to carry this a step further: most females are no longer able to have children by age 50 (give or take a few years). males on the other hand can keep it going much longer in the baby making department. So unless/until they are infertile they should keep on paying too, and post meno-pausal females would be able to drop coverage
Dad is 86. I don't think there is a significant probability that he'll be fathering many more children. So forcing him to pay for the same maternity coverage as a 25 year old doesn't seem like the risk pool he is assigned to truely reflects the risk he presents. Forcing that 25 year old woman to pay for your father's heart attack or stroke isn't fair to her either. Do you really want your dad put into a pool of risks where the members are 70+ year old? As end of life issues are the most expensive that will occur, it won't be cheap for him. At all ages of our lives, risks increase and decrease to certain conditions. Your 86 year old father being in a large pool normalizes ALL risks, including those that are increased for an 86 year old male and not a 25 year old female.
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finnime
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Post by finnime on Jan 17, 2017 11:43:37 GMT -5
Finnime, what did I say that you believe is not true? You talk about pre-existing conditions. I didn't even mention pre-existing conditions. You talk about pre-ACA economic rationing of medical services. I didn't mention rationing of medical care. Nor did I discuss the cost to value of US medical care as compared to other countries. If you don't agree with my opinions, fine. But don't claim that I've lied or presented misleading information when I have not. I don't mean to imply you're lying, tskeeter. Your original reference to cost shifting from specified risk pools to all risks was what I was referring to. Pre-existing conditions and flat out excluding certain risk pools did help insurance companies control their exposure, and hence costs to their clients. That's true. It is not true that all people could be insured even if they paid pre-ACA. Many people could obtain individual policies, but it was common for even those policies to exclude certain medical care for services now covered under the ACA, such as preventive care, cancer screenings, birth control, dialysis. Costs weren't really "shifted" some much as insurers could no longer duck them altogether. So patients precluded from services then are now covered. And they can't drop patients such as your dad now no matter what issues he may present, even just from being older.
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tskeeter
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Post by tskeeter on Jan 17, 2017 11:57:07 GMT -5
Dad is 86. I don't think there is a significant probability that he'll be fathering many more children. So forcing him to pay for the same maternity coverage as a 25 year old doesn't seem like the risk pool he is assigned to truely reflects the risk he presents. Is he no longer human? He is part of the human risk pool for health issues. Chopping us into tiny little subsets and risk pools is one of the problems with the American HE system. The advantage of many risk pools is that it minimizes the extent to which one group subsidizes another. The disadvantage of many risk pools is that one group doesn't subsidize another. Guess whether you view this as a problem or not depends on the extent to which you believe that we lshould take from one group to benefit another group.
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formerroomate99
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Post by formerroomate99 on Jan 17, 2017 12:17:07 GMT -5
I've always wondered if someone has ever studied to see US healthcare costs excluding the profits. Not every company is public, but I think most insurance companies are so it could probably be done. Always wondered if costs - profits = single payer costs or not. My hunch is not, but I've been curious for a while. I used to work in the insurance industry. My job wouldn't exist if the paperwork for claims wasn't a confusing labyrinth. Even if insurance companies aren't making a lot of money, a shit ton of money is being wasted on disparate paperwork that could be standardized. Just look at your doctor's office. There's a small army of nonmusical support staff that do nothing but fill out paperwork And you can bet that your insurance company employs an equal number of people on their end. That's a lot of overhead that could be eliminated by standardized paperwork and software.
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naughtybear
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Post by naughtybear on Jan 17, 2017 12:17:18 GMT -5
I bet the pool for 86 year old men would be really expensive.
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tskeeter
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Post by tskeeter on Jan 17, 2017 12:19:25 GMT -5
Dad is 86. I don't think there is a significant probability that he'll be fathering many more children. So forcing him to pay for the same maternity coverage as a 25 year old doesn't seem like the risk pool he is assigned to truely reflects the risk he presents. Forcing that 25 year old woman to pay for your father's heart attack or stroke isn't fair to her either. Do you really want your dad put into a pool of risks where the members are 70+ year old? As end of life issues are the most expensive that will occur, it won't be cheap for him. At all ages of our lives, risks increase and decrease to certain conditions. Your 86 year old father being in a large pool normalizes ALL risks, including those that are increased for an 86 year old male and not a 25 year old female. You're right, Dad is among the most expensive to insure, if you consider the risks and potential costs. How, then, is it possible for his medical insurance rates to increase dramatically when he is included in a large risk pool that "normalizes" ALL risks, rather than being in a pool that reflects the risks he poses? Is that unusual circumstance a reflection that the ACA wasn't designed very well? It seems that, for most taxpayers and many insurance companies, the ACA is anything but affordable. And we are yet to learn to what extent to which the ACA can fund all the medical care that people desire. Or if, like some countries with national health care, the demand for services will outstrip the supply.
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Post by The Walk of the Penguin Mich on Jan 17, 2017 12:22:40 GMT -5
I can't see all of the ACA going away. I think the consequences to the public and the disruption to the medical services industry would be too great. But, I could see a roll back of some provisions, such as the requirement that my 85 year old father pay for maternity coverage. I'm pretty sure that your dad's Medicare policy was not paying for maternity coverage - even if he was paying for an Advantage plan via an HMO. I seriously doubt that the risk of pregnancy where better than 90% of the enrollees are 65+ is factored heavily into his Advantage plan price.
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Post by The Walk of the Penguin Mich on Jan 17, 2017 12:27:36 GMT -5
Forcing that 25 year old woman to pay for your father's heart attack or stroke isn't fair to her either. Do you really want your dad put into a pool of risks where the members are 70+ year old? As end of life issues are the most expensive that will occur, it won't be cheap for him. At all ages of our lives, risks increase and decrease to certain conditions. Your 86 year old father being in a large pool normalizes ALL risks, including those that are increased for an 86 year old male and not a 25 year old female. You're right, Dad is among the most expensive to insure, if you consider the risks and potential costs. How, then, is it possible for his medical insurance rates to increase dramatically when he is included in a large risk pool that "normalizes" ALL risks, rather than being in a pool that reflects the risks he poses? Is that unusual circumstance a reflection that the ACA wasn't designed very well? It seems that, for most taxpayers and many insurance companies, the ACA is anything but affordable. And we are yet to learn to what extent to which the ACA can fund all the medical care that people desire. Or if, like some countries with national health care, the demand for services will outstrip the supply. Because he is NOT under the ACA if he is receiving Medicare. If he was, then it is very likely that his policy would be lower because your dad is in one of the most expensive classes to insure. In reality, your dad is now paying more accurately, what it costs to insure him at this stage of life.
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finnime
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Post by finnime on Jan 17, 2017 12:28:38 GMT -5
If people can opt out of healthcare until/unless they need it and insurers can opt out of covering people, then inevitably you have what we did have (and still do in some states): people who sustain something they cannot pay for, such as a chronic illness, catastrophic illness, or the birth of quadruplets, and risk pools of people who cannot get insurance no matter what. IS THAT OK?
I have a friend who's DH was diagnosed at 52 with progressive recurring MS. Treatment costs $30,000 per month and will for years to come, unless he dies soon. My DB, then 24, was using a chain saw to cut firewood for our mother. The chain broke and laid open his cheek. Except for insurance he would have had a truly life-changing scar. As a healthy adult I've had appendicitis / appendectomy, Lyme disease and mononucleosis that turned into a hospital stay for hepatitis. Plus 2 babies.
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finnime
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Post by finnime on Jan 17, 2017 12:30:22 GMT -5
You're right, Dad is among the most expensive to insure, if you consider the risks and potential costs. How, then, is it possible for his medical insurance rates to increase dramatically when he is included in a large risk pool that "normalizes" ALL risks, rather than being in a pool that reflects the risks he poses? Is that unusual circumstance a reflection that the ACA wasn't designed very well? It seems that, for most taxpayers and many insurance companies, the ACA is anything but affordable. And we are yet to learn to what extent to which the ACA can fund all the medical care that people desire. Or if, like some countries with national health care, the demand for services will outstrip the supply. Because he is NOT under the ACA if he is receiving Medicare. If he was, then it is very likely that his policy would be lower because your dad is in one of the most expensive classes to insure. In reality, your dad is now paying more accurately, what it costs to insure him at this stage of life.
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NastyWoman
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Post by NastyWoman on Jan 17, 2017 12:55:13 GMT -5
I bet the pool for 86 year old men would be really expensive. and I would also bet that the chances of a 86yo male to impregnate a female are bigger than that of a 65yo female getting pregnant. Besides I don't remember reading anything about a surcharge on insurance for (the chance) of prostate cancer...
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emma1420
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Post by emma1420 on Jan 17, 2017 14:50:28 GMT -5
You're right, Dad is among the most expensive to insure, if you consider the risks and potential costs. How, then, is it possible for his medical insurance rates to increase dramatically when he is included in a large risk pool that "normalizes" ALL risks, rather than being in a pool that reflects the risks he poses? Is that unusual circumstance a reflection that the ACA wasn't designed very well? It seems that, for most taxpayers and many insurance companies, the ACA is anything but affordable. And we are yet to learn to what extent to which the ACA can fund all the medical care that people desire. Or if, like some countries with national health care, the demand for services will outstrip the supply. Because he is NOT under the ACA if he is receiving Medicare. If he was, then it is very likely that his policy would be lower because your dad is in one of the most expensive classes to insure. In reality, your dad is now paying more accurately, what it costs to insure him at this stage of life. My mom went from an ACA program to Medicare. The first couple years that she was on disability she didn't qualify for Medicare and so went with an ACA plan. Keeping in mind that before the ACA she would have had to go without insurance company and she'd probably be dead. Her ACA policy was slightly cheaper than Medicare + Medicare Advantage Plan because she got more government aide to help her pay for her insurance costs when on the ACA. Single payer would be what would benefit the most people and would be the cheapest. But, it won't ever go anywhere here sadly.
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