Obamacare cost...

[Mormon Red Death]

I don't see why that's true at all. Just because they negotiate locally today doesn't mean they still would if insurance could be bought across state lines. And while Obamacare isn't mandating that everyone pay the same prices, you are already starting to see master charge sheets being disclosed by Medicare which is leading to greater transparency and correspondingly less variation in pricing amongst hospitals in the same areas.

contracts between providers and health insurance companies are almost always complicated. National Health care companies like cigna, human etc... dont negotiate in specific states where they arent headquartered. They buy in to the contracts set up by local health plans.

BTW there is vast difference between Charges and prices being paid. Medicare reimbursement rates are already out there for everyone to see them. Health plans don't have to follow their reimbursement prices.

[calicoug]

contracts between providers and health insurance companies are almost always complicated. National Health care companies like cigna, human etc... dont negotiate in specific states where they arent headquartered. They buy in to the contracts set up by local health plans.

BTW there is vast difference between Charges and prices being paid. Medicare reimbursement rates are already out there for everyone to see them. Health plans don't have to follow their reimbursement prices.

My point is that you are extrapolating from how things are today and assuming it would be the same if the prohibition on purchasing across state lines was lifted. I think that's an error. There is a lot that would change. Some for the better, but those benefits would be outweighed by significant costs in my opinion.

[Mormon Red Death]

My point is that you are extrapolating from how things are today and assuming it would be the same if the prohibition on purchasing across state lines was lifted. I think that's an error. There is a lot that would change. Some for the better, but those benefits would be outweighed by significant costs in my opinion.

You are doing the same thing except with credit cards. My extrapolation is more realistic than yours

[calicoug]

You are doing the same thing except with credit cards. My extrapolation is more realistic than yours

No- I'm not. I'm predicting how things would evolve based off of how other industries have evolved in the exact circumstance we are discussing (deregulation across state lines). You are looking at how things exist today and then extrapolating they will be the same after deregulation even though we have many examples that say the opposite. We are actually saying two opposite things.

[Mormon Red Death]

No- I'm not. I'm predicting how things would evolve based off of how other industries have evolved in the exact circumstance we are discussing (deregulation across state lines). You are looking at how things exist today and then extrapolating they will be the same after deregulation even though we have many examples that say the opposite. We are actually saying two opposite things.

Except you don't understand how health insurance works. Extrapolating how you think health insurance might work based off of the credit card industry is completely off base.

[YOhio]

This article cracks me up.

http://www.politico.com/story/2013/0...691.html?hp=f1

Dozens of lawmakers and aides are so afraid that their health insurance premiums will skyrocket next year thanks to Obamacare that they are thinking about retiring early or just quitting.
The fear: Government-subsidized premiums will disappear at the end of the year under a provision in the health care law that nudges aides and lawmakers onto the government health care exchanges, which could make their benefits exorbitantly expensive.

Best part:

If the issue isn’t resolved, and massive numbers of lawmakers and aides bolt, many on Capitol Hill fear it could lead to a brain drain just as Congress tackles a slew of weighty issues — like fights over the Tax Code and immigration reform.

I'd hate to lose all that brain power on the hill.

[Moliere]

This article cracks me up.

http://www.politico.com/story/2013/0...691.html?hp=f1



Best part:



I'd hate to lose all that brain power on the hill.

Seems authored by The Onion

[calicoug]

Except you don't understand how health insurance works. Extrapolating how you think health insurance might work based off of the credit card industry is completely off base.

This isn't about "health insurance." It is about a regulatory race to the bottom. Why do you think it wouldn't occur in health care? You think if a state lowers capital requirements or permits very high deductibles or allows low caps on lifetime coverage or allows any other number if changes that insurance companies won't flock to that state to set up shop? If so, you don't understand capitalism.

[Uncle Ted]

This isn't about "health insurance." It is about a regulatory race to the bottom. Why do you think it wouldn't occur in health care? You think if a state lowers capital requirements or permits very high deductibles or allows low caps on lifetime coverage or allows any other number if changes that insurance companies won't flock to that state to set up shop? If so, you don't understand capitalism.

It is would more like a race to equilibrium.

Selling Health Insurance Across State Lines: A Race to the Bottom?

Allowing individuals to purchase health insurance from out of state would certainly make for a more robust, competitive health insurance market. Individuals would no longer be stuck with dwindling in-state options for health plans, which means that many residents in states with abnormally high insurance premiums would be able to buy insurance from states where prices are less expensive.


Now, in many cases, those premium prices are less expensive because they’re saddled with fewer state-level insurance mandates. According to insurance industry data, state mandates can add anywhere from 30-50 percent to the price of an insurance premium, so states with more mandates tend to have more expensive premiums. Allowing the purchase of health insurance across state lines would allow individuals to circumvent those mandates and purchase insurance from states that have fewer requirements. That’s why many Democrats say deregulating health insurance would lead to a “race to the bottom.”

[...]

The Cato Institute’s Michael Cannon dismissed this complaint rather effectively in Cato’s Handbook for Policymakers:

Opponents will claim that regulatory federalism will lead to a ‘‘race to the bottom,’’ with some states so eager to attract premium tax revenue that they will eliminate all regulatory protections or skimp on enforcement. In reality, both market and political forces would prevent a race to the bottom. As producers of regulatory protections, states are unlikely to attract or retain customers—insurers, employers, or individual purchasers—by offering an inferior product. Purchasers will avoid states whose regulations prove inadequate, and ultimately, so will insurers. Moreover, the first people to be harmed by inadequate regulatory protections will likely be residents of that state, who will demand that their legislators remedy the problem. The resulting level of regulation would not be zero regulation. Rather than a race to the bottom, regulatory federalism would spur a race to equilibrium—or multiple equilibria—between too much and too little regulation. That balance would be struck by consumers’ revealing their preferences.

The point I would add to this is that we already know that many of the state-level mandates are unnecessary. In 2010, state mandate levels varied from as few as 13 in Idaho to as many as 69 in Rhode Island. But it’s not as if there’s a major national outcry about the dangers faced by residents of Idaho buying comparatively less regulated insurance. There’s no good reason to force residents of other states to purchase insurance that is more comprehensive, and therefore more expensive, than they want or need.


So sure: Maybe deregulation would lead to a sort of "race to the bottom," with high-mandate states dropping legal requirements in order to better compete with low-mandate states like Idaho. But with essentially no one worried about health insurance offerings in existing low-mandate states, and with those states generally offering far cheaper prices, you have to ask: Is the bottom actually so bad?

http://reason.com/blog/2011/05/26/se...nsurance-acros

[cowboy]

No- I'm not. I'm predicting how things would evolve based off of how other industries have evolved in the exact circumstance we are discussing (deregulation across state lines). You are looking at how things exist today and then extrapolating they will be the same after deregulation even though we have many examples that say the opposite. We are actually saying two opposite things.

Since both you and MRD are using theoreticals to support your position, I think the insurance industry would provide the best indicator as to who is more likely to be accurate. While it is widely believed that the insurance lobby was behind McCain's proposal to eliminate the state line rule, individual companies have been conspicuously silent on the issue. The two exceptions are the AARP, which sells insurance and opposes cross-state insurance pooling, and Blue Cross, which takes this position on its BCBS Minnesota website:

Selling Across State Lines
Under current state law, out-of-state insurers already sell health care coverage in Minnesota. They must abide by all state laws and regulation, which are in place for the benefit of all Minnesotans. The state should not cede its authority to fully regulate the health insurance market by granting out-of-state insurers an exemption from Minnesota laws, regulations, taxes and assessments.

Maintaining consumer protections
It is critical that all Minnesota consumers be assured the same high-level protections when purchasing health care coverage. Allowing an out-of-state insurer to disregard state requirements, places consumers at risk. State agencies regulate health plan companies for the protection of their own state’s residents, and lack the time or resources to protect residents of another state. If the state cedes its authority to fully regulate the Minnesota marketplace, Minnesotans will have little recourse for their grievances. Accordingly, out-of-state insurers must be required to abide by all state laws and regulations.

I would suppose that insurers would be all over a proposal that allowed them to reside in one state and profit by pooling across state lines, but at least in two instances, insurers are taking the opposite position. This at least suggests that the current arrangement allows companies to benefit more by having their own monopoly than they would by taking up residence in a less regulated state.

[Coach McGuirk]

The Unaffordable HealthCare Act

http://www.ksl.com/?sid=25578335&nid...&s_cid=queue-2

t's called the Affordable Care Act, but President Barack Obama's health care law may turn out to be unaffordable for many low-wage workers, including employees at big chain restaurants, retail stores and hotels.

[Color Me Badd Fan]

I remember someone on here talking about how significant Obama's presidency was because of this landmark health legislation.

Those who can least afford it are getting their hours cut.

Health insurance costs are spiraling out of control.

Democratic Congressmen are scattering on the eve of the legislation taking effect.

I guess the Taney Court was significant for its Dred Scott decision -- just not significant for the right reasons.

[Uncle Ted]

The Unaffordable HealthCare Act

http://www.ksl.com/?sid=25578335&nid...&s_cid=queue-2

But do the math from the worker's side: For an employee making $21,000 a year, 9.5 percent of their income could mean premiums as high as $1,995 and the insurance would still be considered affordable.

Even a premium of $1,000 – close to the current average for employee-only coverage – could be unaffordable for someone stretching earnings in the low $20,000's.


With such a small income, "there is just not any left over for health insurance," said Shannon Demaree, head of actuarial services for the Lockton Benefit Group. "What the government is requiring employers to do isn't really something their low-paid employees want."
Based in Kansas City, Mo., Lockton is an insurance broker and benefits consultant that caters to many medium-sized businesses affected by the health care law. Actuaries like Demaree specialize in cost estimates.


Another thing to keep in mind: premiums wouldn't be the only expense for employees. For a basic plan, they could also face an annual deductible amounting to $3,000 or so, before insurance starts paying.


"If you make $20,000, are you really going to buy that?" asked Tracy Watts, health care reform leader at Mercer, a major benefits consulting firm.


And low-wage workers making more than about $15,900 won't be eligible for the law's Medicaid expansion, shutting down another possibility for getting covered.


It's not exactly the picture the administration has painted. The president portrays his health care law as economic relief for struggling workers.

Dude, where's my "free" Obama birth control?

dude-wheres-my-car.jpg

[calicoug]

It is would more like a race to equilibrium.



http://reason.com/blog/2011/05/26/se...nsurance-acros

I don't think the Cato Institute understands the race to the bottom concept. They think that market forces will push insurers to offer more expensive options than they have to? Why? It is virtually impossible to find a credit card issued in Arkansas today. Why is that? Because Arkansas has very strict usury laws. Market forces haven't combined to eliminate ultra-high rates on defaults for credit cards. Consumers believe those rates don't matter when they obtain the card- it's only later when they realize the regulations offered by Arkansas would have been of significant value. Similarly, people don't tend to think something like a lifetime cap on benefits will really matter either- until something catastrophic happens and they discover the low insurance product they purchased doesn't provide the coverage they want.

You can disagree with this, but it has played out over and over.

Luckily, there is a path forwards that doesn't carry this risk at all- and it happens to be the one Obamacare used. Why not set up national requirements for insurance products as a baseline. All insurers must meet those minimum baselines. You can even set up more than one baseline (let's say a gold, silver and bronze level, which is what Obamacare used). Then when purchasers buy insurance products no matter where they are located, they know they are getting the same goods making price comparisons very easy and denying insurance companies the ability to hurt consumers through regulatory arbitrage. It would have been preferable to set up a national exchange with these baselines in place, but a state based exchange with the option to expand to a regional exchange is still better than what Republicans proposed.

[calicoug]

I remember someone on here talking about how significant Obama's presidency was because of this landmark health legislation.

Those who can least afford it are getting their hours cut.

Health insurance costs are spiraling out of control.

Democratic Congressmen are scattering on the eve of the legislation taking effect.

I guess the Taney Court was significant for its Dred Scott decision -- just not significant for the right reasons.

Health care costs are not spiraling out of control. Growth in health care costs is actually slowing. Bad news for those who predicted Obamacare would cause costs to skyrocket.

Obamacare certainly has flaws, but it is nonsense like comparing the health care bill to the Dred Scott decision that makes it impossible to take seriously anything Republicans are saying.