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Author Topic: Health care game changer?  (Read 1697 times)
Landslide Lyndon
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« on: May 11, 2012, 11:06:59 am »
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http://politicalwire.com/archives/2012/05/11/health_care_game_changer.html

The Obama administration will soon announce $1.3 billion in rebate checks to nearly 16 million Americans from health insurance companies.

Mark Halperin: "From almost the moment the Affordable Care Act (a/k/a "ObamaCare") was signed into law, the administration has been playing defense... But the rebate provision of the law -- the fruits of the so-called '80/20 rule' -- is about to kick in big time, as millions of Americans receive rebate checks or premium reductions from insurance companies who have failed to spend enough on patient care. This cash could be a true game changer in public attitudes about whether the law actually is beneficial and good public policy."

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« Reply #1 on: May 11, 2012, 11:09:30 am »
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So, everyone gets 60.

Not even enough to fill up my car (maybe Americans can fill theirs twice) ... Tongue
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« Reply #2 on: May 11, 2012, 11:11:29 am »
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Now President McCain is sure to win reelection after the Bush administration's "let's send everyone a check!" policy totally worked.
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Torie
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« Reply #3 on: May 11, 2012, 11:32:45 am »
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Yes, I must give credit to the Dems for structuring the law so the ripe hanging fruit in the Garden of Eden can be so easily plucked before the election (not only this but that you can hang with your parents' policy that sbane is want to coo about), with the thorns saved for after. But apparently voters see the thorns behind the fruit anyway, even if they might not be the thorns that they should really be worrying about.
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Sbane
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« Reply #4 on: May 11, 2012, 03:50:45 pm »
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Yes Torie, keeping those who are in internships or graduate school on health plans where their costs are lower due to employer contributions is a good thing. Employer contributions into health care for everybody is necessary for the system to stay solvent. Whether you do that with payroll taxes followed up by subsidization of care or through schemes like keeping people on their parents plans till 26 is your choice. I prefer the former since it helps out everyone and not just those whose parents have insurance, bu the Republicans haven't proposed that have they? And speaking of which, have the Republicans proposed a plan that will ensure most of the uninsured get insured?
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Citizen Alfred
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« Reply #5 on: May 11, 2012, 04:44:16 pm »
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And speaking of which, have the Republicans proposed a plan that will ensure most of the uninsured get insured?
Well, it's not like they're going to start supporting ordinary Americans any time soon.
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« Reply #6 on: May 11, 2012, 07:37:41 pm »
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Yes Torie, keeping those who are in internships or graduate school on health plans where their costs are lower due to employer contributions is a good thing. Employer contributions into health care for everybody is necessary for the system to stay solvent. Whether you do that with payroll taxes followed up by subsidization of care or through schemes like keeping people on their parents plans till 26 is your choice. I prefer the former since it helps out everyone and not just those whose parents have insurance, bu the Republicans haven't proposed that have they? And speaking of which, have the Republicans proposed a plan that will ensure most of the uninsured get insured?

Mittens is chatting about insurance premium subsidies. He will need to flesh something out. But yes, the Pubs have not been particularly helpful on this. Granted I am not that familiar with the Ryan plan, or what it encompasses, but I think it just caps stuff, probably because the details of how to achieve some cap in real life through triage is just to politically toxic at the moment.

In any event, sbane, you are an adult and should have your own plan, with subsidies if impecunious (obviously temporary in your case). Tying adult kids to their parents' hip does not fit into my sense of aesthetics.
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Sbane
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« Reply #7 on: May 11, 2012, 09:02:30 pm »
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It's not just about me. Anybody who is not getting support from their work is paying more for insurance. Employers pay a lot into the system and anybody without that support is at a disadvantage.  The question is how do we pay for the subsidies. Will it be all from the people as opposed to businesses? Do we soak the rich, or do we institute a payroll tax that hits everyone and employers? Need I mention this will actually help small businesses provide insurance who otherwise cannot afford insurance due to their inability to negotiate rates as opposed to large corporations. Also Obamacare did institute exchanges where employers can come together to provide insurance at cheaper rates. Another good part of Obamacare that should not be thrown out with the bath water.
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« Reply #8 on: May 12, 2012, 01:14:26 am »
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I'm sure this will sway the Supreme Court with their gold-plated health insurance coverage.
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« Reply #9 on: May 13, 2012, 10:06:05 pm »

In any event, sbane, you are an adult and should have your own plan, with subsidies if impecunious (obviously temporary in your case). Tying adult kids to their parents' hip does not fit into my sense of aesthetics.

Does tying health care into employment fit your sense of aesthetics?  It doesn't fit mine.  The system worked somewhat when we had a semi-feudal employment situation where people tended to stay at one principal job for most of their life, but the lords want to clear the highlands and not have to bother with the well-being of their serfs any more.
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« Reply #10 on: May 13, 2012, 11:02:13 pm »
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In any event, sbane, you are an adult and should have your own plan, with subsidies if impecunious (obviously temporary in your case). Tying adult kids to their parents' hip does not fit into my sense of aesthetics.

Does tying health care into employment fit your sense of aesthetics?  It doesn't fit mine.  The system worked somewhat when we had a semi-feudal employment situation where people tended to stay at one principal job for most of their life, but the lords want to clear the highlands and not have to bother with the well-being of their serfs any more.

I also think in theory getting away from the employer provided healthcare system is a good idea, but we must realize employers pay a lot for healthcare. How do we make that up if we move away from this system?
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« Reply #11 on: May 13, 2012, 11:15:09 pm »
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In any event, sbane, you are an adult and should have your own plan, with subsidies if impecunious (obviously temporary in your case). Tying adult kids to their parents' hip does not fit into my sense of aesthetics.

didn't you say your parents paid for 8 years of college?
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« Reply #12 on: May 13, 2012, 11:26:38 pm »

I also think in theory getting away from the employer provided healthcare system is a good idea, but we must realize employers pay a lot for healthcare. How do we make that up if we move away from this system?

Some form of individual subsidy for low-income and/or high-risk people.  For people who are well enough off that all they need is catastrophic health insurance for non-routine care, why should anyone else be paying for their health care?
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« Reply #13 on: May 15, 2012, 10:52:44 am »
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In any event, sbane, you are an adult and should have your own plan, with subsidies if impecunious (obviously temporary in your case). Tying adult kids to their parents' hip does not fit into my sense of aesthetics.

didn't you say your parents paid for 8 years of college?

Yes, they did, college, business school and law school (and I know I am very fortunate, yes I do), with their own money, not someone else's through statutorily imposed non means tested cross subsidies.
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« Reply #14 on: May 15, 2012, 04:21:38 pm »
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In any event, sbane, you are an adult and should have your own plan, with subsidies if impecunious (obviously temporary in your case). Tying adult kids to their parents' hip does not fit into my sense of aesthetics.

didn't you say your parents paid for 8 years of college?

Yes, they did, college, business school and law school (and I know I am very fortunate, yes I do), with their own money, not someone else's through statutorily imposed non means tested cross subsidies.

Money is fungible. If the government mandates that people will be paid more in the form of mandatory health insurance, this will translate into lower cash compensation over time. But since the numbers involved are fairly minimal no one's going to notice.
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« Reply #15 on: May 15, 2012, 05:04:53 pm »
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In any event, sbane, you are an adult and should have your own plan, with subsidies if impecunious (obviously temporary in your case). Tying adult kids to their parents' hip does not fit into my sense of aesthetics.

didn't you say your parents paid for 8 years of college?

Yes, they did, college, business school and law school (and I know I am very fortunate, yes I do), with their own money, not someone else's through statutorily imposed non means tested cross subsidies.

Money is fungible. If the government mandates that people will be paid more in the form of mandatory health insurance, this will translate into lower cash compensation over time. But since the numbers involved are fairly minimal no one's going to notice.

In the case of being on a parents' plan until 26, without having to pay a market based premium, that means somebody is subsidizing that discounted premium, in this case other insureds, to wit a cross subsidy. I agree with your post of course as to the effect of requiring folks to have a certain level of coverage through the vehicle of an employer plan, as opposed to an individual plan, where the money goes into the employee's pocket, and then out the other to pay the premium.

Anyway, there are two issues here - one is requiring folks to have insurance with some minimum coverage to avoid/mitigate the moral hazard problem, and the second is the cross subsidy issue. Conflating the two leads to confusion.
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Sbane
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« Reply #16 on: May 15, 2012, 05:58:42 pm »
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In any event, sbane, you are an adult and should have your own plan, with subsidies if impecunious (obviously temporary in your case). Tying adult kids to their parents' hip does not fit into my sense of aesthetics.

didn't you say your parents paid for 8 years of college?

Yes, they did, college, business school and law school (and I know I am very fortunate, yes I do), with their own money, not someone else's through statutorily imposed non means tested cross subsidies.

Money is fungible. If the government mandates that people will be paid more in the form of mandatory health insurance, this will translate into lower cash compensation over time. But since the numbers involved are fairly minimal no one's going to notice.

In the case of being on a parents' plan until 26, without having to pay a market based premium, that means somebody is subsidizing that discounted premium, in this case other insureds, to wit a cross subsidy. I agree with your post of course as to the effect of requiring folks to have a certain level of coverage through the vehicle of an employer plan, as opposed to an individual plan, where the money goes into the employee's pocket, and then out the other to pay the premium.

So you are saying that kids who are covered under their parent's plans are being subsidized by others who are insured under that group plan? You do realize family plans cost more than individual plans?

I don't know why you are having such a hard time understanding this since it's quite simple, but the subsidy for the premium is coming from the company and is a part of the compensation package. There is no cross-subsidization of the premium costs. Where there is cross-subsidization, which will occur in any health plan, is from the healthy to the sick. So a healthy 24 year old's premium (subsidized in part by the company as compensation for their parent) will be paying for the sick olds who work for the company and are part of the same group.
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wormyguy
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« Reply #17 on: May 15, 2012, 09:44:13 pm »
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It is not possible to have a regulation that simultaneously makes consumers, insurance agencies, and health care providers *all* better-off.  If having children on their parents' plans until age 26 made everyone better off beforehand, there would be no need to mandate it because everyone would have that sort of health insurance already.
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« Reply #18 on: May 15, 2012, 10:35:00 pm »

In any event, sbane, you are an adult and should have your own plan, with subsidies if impecunious (obviously temporary in your case). Tying adult kids to their parents' hip does not fit into my sense of aesthetics.

didn't you say your parents paid for 8 years of college?

Yes, they did, college, business school and law school (and I know I am very fortunate, yes I do), with their own money, not someone else's through statutorily imposed non means tested cross subsidies.

Money is fungible. If the government mandates that people will be paid more in the form of mandatory health insurance, this will translate into lower cash compensation over time. But since the numbers involved are fairly minimal no one's going to notice.

In the case of being on a parents' plan until 26, without having to pay a market based premium, that means somebody is subsidizing that discounted premium, in this case other insureds, to wit a cross subsidy. I agree with your post of course as to the effect of requiring folks to have a certain level of coverage through the vehicle of an employer plan, as opposed to an individual plan, where the money goes into the employee's pocket, and then out the other to pay the premium.

So you are saying that kids who are covered under their parent's plans are being subsidized by others who are insured under that group plan? You do realize family plans cost more than individual plans?

I don't know why you are having such a hard time understanding this since it's quite simple, but the subsidy for the premium is coming from the company and is a part of the compensation package. There is no cross-subsidization of the premium costs. Where there is cross-subsidization, which will occur in any health plan, is from the healthy to the sick. So a healthy 24 year old's premium (subsidized in part by the company as compensation for their parent) will be paying for the sick olds who work for the company and are part of the same group.

But what about the sick 24 year olds?  Granted, there aren't many of them, but since being covered under your parent's coverage is optional, the sick 24 year olds are far more likely to take advantage of that than the healthy 24 year olds.
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Hammond(R) Sec. of State
Diggs(D) Att. Gen.
Herbert(D) Comptroller Gen.
Spearman(R) Supt. of Education
DeFelice(American) Commissioner of Agriculture
Hutto(D) US Sen (full)
Scott(R) US Sen (special)
Geddings(Labor) US House SC-2
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« Reply #19 on: May 15, 2012, 11:45:26 pm »
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In any event, sbane, you are an adult and should have your own plan, with subsidies if impecunious (obviously temporary in your case). Tying adult kids to their parents' hip does not fit into my sense of aesthetics.

didn't you say your parents paid for 8 years of college?

Yes, they did, college, business school and law school (and I know I am very fortunate, yes I do), with their own money, not someone else's through statutorily imposed non means tested cross subsidies.

Money is fungible. If the government mandates that people will be paid more in the form of mandatory health insurance, this will translate into lower cash compensation over time. But since the numbers involved are fairly minimal no one's going to notice.

In the case of being on a parents' plan until 26, without having to pay a market based premium, that means somebody is subsidizing that discounted premium, in this case other insureds, to wit a cross subsidy. I agree with your post of course as to the effect of requiring folks to have a certain level of coverage through the vehicle of an employer plan, as opposed to an individual plan, where the money goes into the employee's pocket, and then out the other to pay the premium.

So you are saying that kids who are covered under their parent's plans are being subsidized by others who are insured under that group plan? You do realize family plans cost more than individual plans?

I don't know why you are having such a hard time understanding this since it's quite simple, but the subsidy for the premium is coming from the company and is a part of the compensation package. There is no cross-subsidization of the premium costs. Where there is cross-subsidization, which will occur in any health plan, is from the healthy to the sick. So a healthy 24 year old's premium (subsidized in part by the company as compensation for their parent) will be paying for the sick olds who work for the company and are part of the same group.

When you can keep you kids on a plan until 26, paying less than if the kid got his own insurance, because the company has to do it, and cannot charge a market rate for it (if it could, then of course why not?), that sbane my man is a subsidy which someone is paying, in this case other insureds. And then when you hit 26, the field reverses, and you get to subsidize others (e.g., moi!) as opposed to you/your parents being subsidized. Wonderbar!
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« Reply #20 on: May 16, 2012, 12:55:23 am »
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In any event, sbane, you are an adult and should have your own plan, with subsidies if impecunious (obviously temporary in your case). Tying adult kids to their parents' hip does not fit into my sense of aesthetics.

didn't you say your parents paid for 8 years of college?

Yes, they did, college, business school and law school (and I know I am very fortunate, yes I do), with their own money, not someone else's through statutorily imposed non means tested cross subsidies.

Money is fungible. If the government mandates that people will be paid more in the form of mandatory health insurance, this will translate into lower cash compensation over time. But since the numbers involved are fairly minimal no one's going to notice.

In the case of being on a parents' plan until 26, without having to pay a market based premium, that means somebody is subsidizing that discounted premium, in this case other insureds, to wit a cross subsidy. I agree with your post of course as to the effect of requiring folks to have a certain level of coverage through the vehicle of an employer plan, as opposed to an individual plan, where the money goes into the employee's pocket, and then out the other to pay the premium.

So you are saying that kids who are covered under their parent's plans are being subsidized by others who are insured under that group plan? You do realize family plans cost more than individual plans?

I don't know why you are having such a hard time understanding this since it's quite simple, but the subsidy for the premium is coming from the company and is a part of the compensation package. There is no cross-subsidization of the premium costs. Where there is cross-subsidization, which will occur in any health plan, is from the healthy to the sick. So a healthy 24 year old's premium (subsidized in part by the company as compensation for their parent) will be paying for the sick olds who work for the company and are part of the same group.

When you can keep you kids on a plan until 26, paying less than if the kid got his own insurance, because the company has to do it, and cannot charge a market rate for it (if it could, then of course why not?), that sbane my man is a subsidy which someone is paying, in this case other insureds. And then when you hit 26, the field reverses, and you get to subsidize others (e.g., moi!) as opposed to you/your parents being subsidized. Wonderbar!

So kids in employer plans are subsidized right now by others who are insured?
I don't think you know what you are talking about here. Nobody pays market rates when they are covered by their employer.....

Maybe this will come as a shock to you, but employers on average pay about 65-75% of premium costs.
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« Reply #21 on: May 16, 2012, 01:03:33 am »
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Presumably the employers pay market rates, and if the law does not allow insurance companies to charge market rates for employers due to kids up to age 26 being covered, then somebody else has to pay.

You do get the point, that if insurers could offer plans at market rates that cover kids up to age 26, and there was a demand for it, then obviously they would offer the product. But I think Obamacare forced insurers to cover kids up to age 26 without a premium increase, which means to stay in business they must get the revenue from elsewhere. There is no free lunch!
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« Reply #22 on: May 16, 2012, 01:20:35 am »
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Presumably the employers pay market rates, and if the law does not allow insurance companies to charge market rates for employers due to kids up to age 26 being covered, then somebody else has to pay.

You do get the point, that if insurers could offer plans at market rates that cover kids up to age 26, and there was a demand for it, then obviously they would offer the product. But I think Obamacare forced insurers to cover kids up to age 26 without a premium increase, which means to stay in business they must get the revenue from elsewhere. There is no free lunch!

Yeah, you don't get it.....it didn't force insurers to do anything. Companies on the other hand were mandated to cover adult children if they already provided healthcare to dependents. So the same plan that allowed kids to stay on the plan till they were 19 or until they got out of college (btw, why shouldn't grad students be covered then?) would have to be extended up to age 26. Meaning the parents would be paying a part of the premium, with the employer covering the rest. And of course it would still be purchased at market rates from the insurer. Employers wouldn't be allowed to charge more for an adult child than those under the age of 18, which is where you are getting confused I suspect.

Also I seem to have found the reason why individual health plans are more expensive. Just way more administrative costs. When insurers cover individuals, they want to make sure they aren't taking on a sickly and so they spend way more on ensuring that. Thus administrative costs are way higher than they are with group plans (where administrative costs are already much higher than the global standards). So even at market rates, a young adult in the individual marketplace would end up paying more than they would if they could buy insurance through a group. Something Obamacare makes possible just in case you didn't know.

http://www.americanprogressaction.org/issues/2009/03/administrative_costs.html
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« Reply #23 on: May 16, 2012, 08:31:04 am »
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Quote
Employers wouldn't be allowed to charge more for an adult child than those under the age of 18,

Isn't this a subsidy, to wit not being "allowed to" charge market rates?  I will take a look at your link. The assumption that with government involvement, "administrative costs" will just magically disappear or at least be slashed, is one that I question of course.
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« Reply #24 on: May 16, 2012, 09:09:56 am »
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There is nothing approaching a "free market" in health insurance, with or without some of the tinkering Obamacare does around the edges.
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