President Trump says the bill will lower premiums, but with many healthy Americans opting not to obtain health insurance, those premiums could actually go up
As a 90-year old geezer, health insurance is very important to me. Fortunately, I am in a very good Medicare Advantage Plus plan that was negotiated by the Texas Employee Retirement System (ERS) with a major health insurance provider.
When Obamacare was passed, the law consisted of 828 pages with more than 20,000 pages of regulations added. Who in Congress actually read all that? And if they had, how much of the bill would they have understood? The truth is that many members of congress who voted for the Affordable Care Act really didn’t know what was in the bill.
President Obama promised that Americans would be able to keep their health plans under Obamacare. He also promised they would be able to keep their doctors. Both promises turned out to be untrue.
Affordable Care Act was a misnomer. While the poor obtained health insurance with the government subsidizing their premiums, other Americans saw their health insurance costs rise.
While Obamacare turned out to be a bad law, some parts were good. Coverage for pre-existing conditions comes to mind.
Which brings me to the health care bill just passed by the House. It scares me! Even though the bill consists of relatively few pages, it was rushed through the House. That is not good.
President Trump says competition by health insurance carriers will lower premiums. That’s questionable. Making a promise like that is akin to Obama’s promises on keeping one’s health plan and doctor.
Many healthy Americans will opt not to obtain health insurance under the House bill because Obama’s mandate will no longer be in force. That will leave the insurance carriers covering those who are not in the best of health and the elderly with their old age ailments. And that is going to raise insurance costs.
I’m pretty sure Obamacare did not affect my ERS health and drug coverage plan. I’m not so sure about the House bill should it ever become law. Hopefully the Senate will make some changes that all Republicans can live with, changes that will not raise premiums for the middle class and for the elderly, and that will leave the Medicare Advantage Plus plans intact.
Howie,
This post is an example of why the country is in such a financial mess. Conservatives want conservatism until it might possibly affect them.
I remember being in one of Rep. Gene Green’s townhalls during the Obamacare passage days. The rooms were packed with angry citizens. Green shut the room down to silence when he asked for a show of hands of those who were on Medicare. Dang near the whole room raised their hands. He said, then all of you are for socialized medicine, right?
That’s exactly what you are saying here. Don’t touch MY socialized medicine/subsidies/welfare. Forcing insurance companies to cover pre-existing conditions is socialized medicine/subsidies/welfare. Forcing young people to pay for us older folks is socialized medicine/subsidies/welfare. Call it what you want , take your pick but it is NOT free market insurance.
Gimme, gimme, gimme – the new American way.
Medicare is not free, one has to pay monthly and there are no family plans, plus one paid medicare when one was not using the insurance nor entitled to it, so not quite the same thing.
The mandates hurt people who may make too much to get subsidies but not enough to be able to afford the insurance especially with such high deductibles,
Nothing is free in this world, when insurance has to cover children till age 26, someone has to pay for that. Obamacare was an attempt to fix a problem, health care, that has no easy solutions in this country.
Disclaimer, I am on medicare, but like all the insurance that I have paid for in my life, I have never personally really had to use it as I very seldom get sick.
David
You’re absolutely right about conservatives want conservatism until it might possibly affect them. But surely you are not recommending that Medicare be abolished, are you?
I’m all for the free market but when it comes to health care the free market with its high insurance premiums will drive those who can’t afford them to the emergency rooms rather than to a physician. And who is going to end up paying for that? Why it’s going to be those who are more fortunate. If you think hospital bills are high, you ain’t seen nothing yet.
Of course I’m scared, but not so much for myself, but for other older Americans who do not have a powerful organization like ERS negotiating a health plan for them. And I’m scared for those with pre-existing conditions too. My son is in his mid-fifties and has Type 1 Diabetes. If I read you correctly, he and others with pre-existing conditions don’t deserve any protection from medical bankruptcy because in your mind that is “socialized medicine/subsidies/welfare.”
And here is how the free market will work. Because healthy Americans are likely to forego obtaining health insurance until their health begins to fail, Insurance premiums will be high, much higher than they are now.
Just look at automobile insurance to see how it works. GEICO, Progressive, Liberty and other companies promise they will save you $500 or more than what you are paying now. Yeah, but there’s a catch. They are not giving you the exact same coverage. If they did, their premiums would be the same as you are paying now, perhaps even higher. And so it will be with health insurance.
I didn’t realize that my Medicare Advantage Plus plan constitutes socialized medicine/subsidies/welfare. Obviously you and I have different interpretations of socialized medicine.
Speaking of socialized medicine, President Trump says it’s better than what we have. In his recent meeting with Australian Prime Minister Malcolm Turnbull, he told the PM that “I shouldn’t say this to our great gentleman and my friend from Australia because you have better health care than we do.” Later he defended his praise of Australia’s system by tweeting, “Of course the Australians have better healthcare than we do –everybody does.”
So what does everybody else have? Most of the Western nations – Canada, England, Germany, France, Sweden and other European countries have a one-payer universal health care system.
Now that’s my interpretation of socialized medicine. I certainly do not advocate that!
Under the House-passed bill, people with pre-existing conditions would be placed into a ‘High Risk Pool” with high premiums, high deductibles and minimal coverage. As for people over 65, it has been estimated their premiums could be five times higher than they are now.
David, maybe you can afford a free market health care plan, but many, many Americans will have to choose between putting a roof over their heads and food on the table or paying those high premiums. What they’re going to do is fill those emergency rooms up when they get sick and you’ll end up paying for that.
Yes, I’m scared, and I pray that the Senate will come up with a better plan than that passed by the House.
Howie,
So just say that you are for a single payer, government run healthcare system and be done with it. Say that you think that health care is a right.
But don’t pretend that is a conservative philosophy.
David, what part of “I certainly do not advocate that!” don’t you understand?
Howie,
You cannot come here and advocate for generalized welfare for a certain class of people at a severe cost to others and not expect to be challenged. If you think that your advantage plan is private, you need to think again. Try this for starters: http://www.ncpssm.org/Document/ArticleID/754
And yes, we certainly do have different definitions/interpretations of socialized medicine. You are currently receiving socialized medicine, that’s a simple fact.
What we are doing to our children should be considered a crime.
Just got back from the dentist. Shelled out $90 to have my teeth cleaned. Got to return next Wednesday to have a tooth rebuilt and a crown placed on it. That will cost me another $1,100. Fortunately I have the funds to pay for my dental work.
David, what’s great about our country is that we are free to say what’s on our minds and that we can agree to disagree without retribution.
I just hope you won’t squeal like a stuck pig when you get hit with those high premiums if a bill similar to the one passed by the House becomes law.
Howie,
Someone might be crying like a stuck pig in this conversation. But it ain’t me. Take a look at what you’ve written.
DJ
“I’m pretty sure Obamacare did not affect my ERS health and drug coverage plan.” It damn sure did by requiring you to pay for maternity insurance among many other things. Costs went up. Our policy, we pay for ourselves, went up from about $400 per month to about $700 per month due to the extra mandates. THEN, our provider and others we had used in the past withdrew from selling insurance all together. The Obamacare Exchange plans were all double to 4-times the cost and had much higher deductibles and out-of-pocket expenses – terrible policies that cost more than our mortgage payment!
A couple of thoughts on medical care in general and insurance in particular.
First, in the US, we pay a much higher percentage of GPD for health care than most other developed countries and we get a worse return, lower life expectancies, higher maternal deaths, etc. In almost every measurable way, we do worse than countries like Switzerland and, yes, even France. We need to see what they’re doing right and wrong and maybe steal some ideas.
Second, as to insurance, health insurance is no different than any other kind of insurance. When you buy your car insurance policy, the premiums you pay likely won’t cover the cost of repairing your car after a wreck or personal injury. The way it works is that you take a large number of people, many of whom will not have wrecks and some of whom will. Based on history, it is possible to calculate risk in the form of likely payout. I haven’t had a car insurance claim in years but I pay my premiums like clockwork. I am paying to repair other people’s cars and for damages other people cause. If I have a wreck, people who haven’t had wrecks pay for my car repair.
The same goes for health insurance. You have to have a pool of healthy people to pay the medical care costs for sick people. It’s just like you have to have a pool of drivers who don’t get into wrecks and people whose houses don’t burn down to cover losses in car insurance and homeowner’s insurance.
What I want to know and no one has ever explained it to me, is how the Department of Defense can charge retired reservists $402.81 and for families, $1,013.36 for really good health insurance with no government subsidy while private insurers can’t or won’t. If I learned anything in my 23 years in the Army, the Department of Defense isn’t the most efficient operation in the world.
And, that Tricare Retired Reserve insurance covers 80 percent of things like doctors visits, has a cheap mail order pharmacy and a $3,000 per family per year cap on costs. It even includes mental health care, maternity and emergency care. You can go to any doctor who takes Tricare. No need for a referral from a primary care physician.
The bottom line is society as a whole is going to pay for medical care. We can do it through universal insurance, a single payer lime Medicare or through those of us who can pay subsidizing those who can’t with higher hospital and other medical bills.
Tom, the difference is that the government under Obamacare tried to force those of us in the low risk pool into paying a great deal more to cover those who were in the high risk pool. Using your analogy, if I maintain my car and house the way they should be, and do likewise to my body by eating right, exercising, and avoiding high risk behaviors, I feel I should be rewarded with lower premiums. Instead, those of us in similar situation get to pay for those who smoke, eat fatty foods, only get exercise when walking to the refrigerator, and sunbath as though melanoma is a word only found on games shows.
The studies largely point to high risk behaviors as the triggers for cancer and other major diseases, even the least believable suggesting behavior accounts for about 40{997ab4c1e65fa660c64e6dfea23d436a73c89d6254ad3ae72f887cf583448986} of most problems with cancers for example, and the bulk of studies going as high as over 90{997ab4c1e65fa660c64e6dfea23d436a73c89d6254ad3ae72f887cf583448986}. If I’m going to have to subsidize others, I think requiring them to engage in healthier choices and/or pay a higher premium, is fair game. Those with private insurance routinely pay a lot more for coverage if they smoke but those under Obamacare do not pay more because their subsidy is tied to their economic situation. And unlike other countries that ration out medical care, demand certain babies be killed (Google “Down’s Syndrome abortions” to see how enlightened our European counterparts are) or make people wait longer,to see a doctor, at least our system has incentives to keep people from abusing usage.
As a lawyer who has practiced in war crimes courts, I guarantee that forced abortions would be either genocide or crimes against humanity. The European Court of Human Rights would go nuts. They have experience with that type of thing and don’t want to repeat it. Women may get “suggestions” to abort Downs Syndrome fetuses but they aren’t forced to do so.
But two things about Downs Syndrome babies since you mentioned them.. First, a lot of people including me have problems with Sarah Palin but I give her great credit for knowingly carrying a Downs Syndrome fetus to term rather than aborting it. It shows she has the courage of her convictions. I admire her for that.
Along the lines of preventing disease you talk about, remember, once a woman reaches about 40, the chances of her having a Downs Syndrome baby go through the roof. To prevent that should women over 40 be required to have their tubes tied or pay much higher premiums for health insurance? I don’t think my brand of conservatism would allow either.
As for rationing health care, you must have a traditional insurance policy. If you were in a PPO or HMO, you would know the insurer rations health care when you need to see a specialist. Health insurance companies ration health care every day.
That’s why many are cancelling their contracts and refusing to pay for care at M.D. Anderson. The high quality of cancer care you get there costs a lot of money. So does the research they are doing to prevent and cure cancer. But if you need that high level of care, you might find yourself SOL when you find out your insurance carrier doesn’t pay for M.D. Anderson.
Tom, “suggestions” comes across as more likely when the number is less than 100{997ab4c1e65fa660c64e6dfea23d436a73c89d6254ad3ae72f887cf583448986}, much less in fact, but those who promote abortion as a default expectation deserve what they get on Judgement Day. Whatever brand of conservatism you embrace, the kind found in these parts is pretty clear about abortion. It’s also pretty clear that demanding others pay for choices made by liberal democrats is to be fought against, no RINO’s need apply.
Tom: “health insurance is no different than any other kind of insurance.” No sir. Respectfully it is absolutely not. Your car insurance is there to cover situations where there is a major problem – usually an accident of some kind. We don’t expect our auto insurance to cover routine old changes, or a new generator, or new tires, or a blown A/C compressor. And you people routinely want their health care insurance to cover every single doctor’s visit, every single prescription, a wide range of medical hardware, etc. You can call it what you like, but today most people are like Howie, they call it insurance, but what they are actually looking for is someone to come in and pay for everything.
And, the healthcare and insurance industries are certainly willing to help! Why does that prescription cost $250? Because the local pharmacy (and the pharmaceutical manufacturer) know that the insurance companies will refuse to pay for 90{997ab4c1e65fa660c64e6dfea23d436a73c89d6254ad3ae72f887cf583448986} of the “cost”. So, they simply jack up the price of the drug by a factor of 10. This happens all of the time.
I believe that the problems in our healthcare system could be alleviated with a few simple changes. 1. Make the cost of health insurance deductible for individuals as well as employers. 2. Allow insurance companies to compete across state lines. 3. Require all medical providers to provide clear, simple invoices to the patient, even if the bill is being paid by the insurance company. 4. Allow insurance companies to structure insurance plans that actually suited the needs of their customers.
Actually, you can get insurance to pay for routine maintenance and repairs on your car. It’s called a warranty and extended warranty. I have a friend who has to take an expensive pill daily for a chronic earth problem/. She filled a prescription in Europe once. The bottom line is if she could get a 90 day rather than a 60 day supply, she would save enough to have a week in Paris every three months to fill the prescription. That’s nuts.
Why do Americans pay way more than Canadians or Germans for the same drug?
Americans are getting hammered on healthcare. You’re right that because of insurance, patients don’t ask about prices. On the other hand, when you’re sick or injured you can’t shop around like you can when you buy a car or TV.
I don’t have the answer but what we’re doing and talking about doing isn’t the way to go.
Tom,
Damn right.
Fat Albert,
I would add, educate people as to how insurance is designed to work.
Insurance is purchased to protect you from an event that although unlikely to occur, would have a large negative impact on you. When insurance is used to pay for all doctor visits, prescriptions etc.., It drives costs up, as additional employees are required to process all this paperwork.
Ask a doctor who has practiced for thirty years how his staffing compares to when he started the practice.
I will point that this a national issue for those who claim that is not discussed in this blog.
I will point that if one has private insurance through your job (like I did for at least 40 years), it is also subsidized by the government. Those insurance payments are not counted toward income, so one is getting help. When asked if I wanted a pay increase or an increase toward insurance I always went with more money for insurance.
We are a socialized country we just don’t know it, or at least most of us don’t. The public schools, the streets,etc.are all paid by government/and or maintained. We need to look what is good for our country and is it worth the investment by all. We all subsidized rural areas when it comes to many things they would not normally be able to have like electricity, mail service,phone service, etc.
I don’t think this is the answer, but to try and travel down the path Howie is suggesting why not declare medical care a utility and let the states sort it out with the various insurance/utility boards they have/will establish to address the situation? That would serve both the pseudo socialized healthcare system Howie is pointing towards as well as hit the conservative principle of state’s rights and states coming up with the solution.
Two things seem certain:
Obamacare is a failure for everyone who is not on the subsidies
The republican replacement will face backlash.
If there’s going to be a backlash, politically it seems smarter to punt and let the states sort it out. Hopefully less harm (to consumers) is inflicted by having 50 separate systems trying to find a workable solution.
The so called health care “free market” got excessively greedy, which opened the door for demagogues that forced Obamacare into law. Healthcare today is a cartel consisting of providers/insurers/big pharm. Prices are artificial and contrived, with little or no basis in reality. A friend recently had a broken foot and the final tab was $58,000. There’s no way on earth that it actually cost that much. Copays are actually what the cost of service should be. Insurance companies have created a shell game where “someone else is picking up the tab.” Insurance companies created this mess approximately 30 years ago and I hope that there is a special place in hell for all of those responsible.
This says it much better than I.
http://www.houstonchronicle.com/business/columnists/tomlinson/article/Other-countries-have-lower-health-costs-11134406.php?cmpid=twitter-premium
If you can explain Chris Tomlinson’s whacked out math we’d love to hear it. He says health care is 17.8{997ab4c1e65fa660c64e6dfea23d436a73c89d6254ad3ae72f887cf583448986} of our $18t GDP ($3.2 trillion). Divide by his 321 million population and that’s $9,981/year/person. Total population average.
Slice out the 148 million that receive direct g’ment funded healthcare at $1.32 trillion and you get $8,919/year/person for those folk.
Spread the rest among us that pay for our own – (321 m – 148 m) / ($3.2 t – $.32 t) = $10,867/year/person.
Pay for a bronze Obamacare plan with premiums for a family of four at $1,200/ month with a $7,500 deductible and you’ll spend at least $21,900 if one of you is chronic but only $5,475/year if all four get sick enough max out that deductible.
Make up a scenario where the entire population shares 7.3{997ab4c1e65fa660c64e6dfea23d436a73c89d6254ad3ae72f887cf583448986} of GDP for medical expenses and you get his $4,110. Chris relies on that mathmagical formula that liberals use to paint whatever scenario they are trying to sell to their constituents that want all that free stuff.
We can apply that formula to government pensions, national debt, universal health care, renewable energy, perpetual motion and all the other basics we depend on.
Dan: You’re mixing apples and oranges. The GDP numbers are the cost of medical care, not how they’re paid for. So, my Medicare/Tricare counts in the costs even though no traditional insurance company pays a dime.
The president is right about one thing: health care and more important, health care financing is much more complicated than one would expect. Big insurance, big pharma and lots of big hospital corporations (both for profit and nonprofit) are making a killing.
Tomlinson is a very, very strange dude. Just sayin’.
Tomlinson is saying that if you take what the government spends on Medicare, Medicaid, VA Health care, DoD health care, and CHIP and average that across the entire population, it comes to $4110 per person in the US. He then compares that cost to the $3620 other industrialized countries average per person, and makes the point that if we managed to cover everyone for what the rest of the top countries pay, we could cover all 321 million Americans for what the Federal programs spend now on 148 million Americans and eliminate premiums for everyone.