Health care game changer?

[Sbane]

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?

[Sbane]

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.

[Sbane]

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?

[Sbane]

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.

[Sbane]

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.

[Sbane]

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

[Sbane]

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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.

So kids of all ages are being subsidized right now? Because the plan is not being changed, just the eligibility.

Also in Switzerland, where insurance companies are private (not sure if non-profit), administrative costs are about 5% of total costs. For individual plans here, it runs above 20%. You are deluded if you somehow think we have the best health care system, even after excluding those dirty uninsureds.

[Sbane]

The scope changed, but not the price. That suggests a subsidy. This administrative cost issue does deserve study of course. I do know that the billing system through insurance companies is expensive and time consuming, and needs to be revamped. In fact the way medical services are delivered needs to be revamped, using HMO's and having telephone consults, and everything getting computerized, and so forth.

If you can find where I ever wrote that the US has the best health care system in the world, putting aside the uninsureds or otherwise, I will give you one of  my properties. I am confident that I didn't, because I think our current system sucks. Cheers.

Ugh, you must pay for healthcare yearly when getting it through your employer. If your kid stays on your plan longer, you pay more for longer and so does the employer. Again you refuse to answer my question, but do you think the employer paying for a kid who is under the age of 18 a subsidy or part of compensation?

And you think the current private insurance system sucks leaving aside Medicare and Medicaid? That's news to me. I always though you had a love affair with insurance companies. And I don't think they are evil or anything but the way our system is set up imposes these extra costs on them. In our system the healthy might just not purchase insurance if not provided by their employer, which is why insurance companies are paranoid about making sure they know exactly what every applicants health history is. In a group, the paranoia subsides a bit. And if we ensured that the entire population had to join the market, the paranoia would subside further. Hmm, I wonder which bill did that.

As for reducing costs we need to go to a system where payments are made based on outcomes and not services provided. Easier said than done though. And I'm glad to see Romney talking about it. Though if a Democrat came out and proposed it (let's not forget the individual mandate was a republican idea) suddenly all republicans would be against it.

[Sbane]

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Part of it is a government subsidy because the "compensation" is not taxed (while the poor individual has to use after tax dollars), but otherwise presumably yes, it is a part of compensation. And then suddenly for the same price insurance companies have to keep covering the rug rats until age 26 rather than 18 or 21 or whatever. That suggest a subsidy, because if that rule did not screw them, why wouldn't they just do that on their own? So since all insurance companies have to do this, they recover their additional costs through raising premiums on others.

Anyway, those are my factual assumptions and reasoning. I hope I answered your f'ing question! 

Fair point on the tax incentives, something that needs to be changed of course.

The people getting screwed here are the employers providing insurance, not the insurance companies. They have to pay for a part of their premiums for about 5-6 years longer than they would otherwise. They will likely take this out of compensation for the employees or raise premiums for the family plan. I couldn't find much complaining about this on the Internet so I don't know exactly who is so pissed off about this. Seems like you are alone here.

As for the insurance companies, I am sure they love this arrangement. More customers for them who otherwise would likely not purchase health insurance unless they needed access to health care.

And my overall point here is that parts of Obamacare are good. Not just the letting adult children stay on plans but the creation of exchanges and letting people form groups to lower costs as well as the individual mandate which is also a good idea. Changes should be made to it but the whole thing should not be discarded. Republicans only want to do that for political reasons so they can get credit for health care reform when in fact they were too timid to start when they were in power.

[Sbane]

You are certainly wrong about insurance companies being forced to cover more people for the same money. Completely wrong.

What did Clement say btw? I am interested in reading or hearing that. Which day of the oral arguments was that?

[Sbane]

Oh I remember that, but that was not dealing with keeping adult children on their parent's insurance, but rather cross subsidies from the young who purchased their plans to the old.

Also it looks like if you have an individually purchased family plan, insurers would be required to keep on your kids until the age of 26. Of course you would still be paying the premium for the family plan so I don't see what the problem is. If covered by your employers, you and the employer would be paying the premiums on a shared basis.

This is what is confusing you I think....this is what the department of labor says.

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https://www.dol.gov/ebsa/faqs/faq-dependentcoverage.html

[Sbane]

Oh I remember that, but that was not dealing with keeping adult children on their parent's insurance, but rather cross subsidies from the young who purchased their plans to the old.

Also it looks like if you have an individually purchased family plan, insurers would be required to keep on your kids until the age of 26. Of course you would still be paying the premium for the family plan so I don't see what the problem is. If covered by your employers, you and the employer would be paying the premiums on a shared basis.

This is what is confusing you I think....this is what the department of labor says.

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https://www.dol.gov/ebsa/faqs/faq-dependentcoverage.html

I am not sure what the bolded part means exactly, or its intent. This will just have to be researched as to whether insurance companies are losing money on these 18 to 26 year olds.

I think it means others who are dependent on health insurance from another persons employment such as spouses and children under the age of 18.

[Sbane]

Oh I remember that, but that was not dealing with keeping adult children on their parent's insurance, but rather cross subsidies from the young who purchased their plans to the old.

Also it looks like if you have an individually purchased family plan, insurers would be required to keep on your kids until the age of 26. Of course you would still be paying the premium for the family plan so I don't see what the problem is. If covered by your employers, you and the employer would be paying the premiums on a shared basis.

This is what is confusing you I think....this is what the department of labor says.

You must be logged in to read this quote.

https://www.dol.gov/ebsa/faqs/faq-dependentcoverage.html

I am not sure what the bolded part means exactly, or its intent. This will just have to be researched as to whether insurance companies are losing money on these 18 to 26 year olds.

I think it means others who are dependent on health insurance from another persons employment such as spouses and children under the age of 18.

What it means is that the people who were kicked off their parent's plan because they were too old but are now eligible to be covered cannot be charged the higher rate that some plans charge if the parent chooses to drop coverage of their dependents, but then seeks to resume coverage.

Ah, thanks for that. So does the requirement to cover kids up to 26 years of age a burden on insurance companies as opposed to those paying the premiums, whether it's just the parent in an individual plan or the employer and the parent in an employer provided plan?

[Sbane]

I mean feel free to explain to me where I'm wrong. I'm not saying Obamacare is a bad thing in fact I do agree with how it adresed the healthcare issue in our country.

By socialization I mean mandating everyone to buy healthcare so because everyone is puting money in so then you can distribute the HC to the whole country.

And let me explain I don't belive socialism is a dirty word I just associate it with the extremeist on the far left because I've seen a lot of similarities between the socialist party specificlly in france and far left democrats.

Democrats I don't associate with socialism, however extreme democrats who wants to repubuild this country by applying a hundread taxes, rasing corprate taxes and taxing the rich so they can spend more do seem to cross that border in my opinion.

Just like I have a tendency to associae people on the far right as extreme neo-con capitalist who don't truly understand why certain things that support the middle class and the poor sholdn't be cut before the military budget.

Again I'd be happy to be corrected as I'm only 18 and gained and intrest in politics within the last 7 months.

Saying Obama's plan is as far left as you can go just sounds ridiculous if you look at it from an international perspective. And you say forcing everyone to buy health insurance is "socialization" and far left but that is actually a Republican idea. Do a little search on the individual mandate and you will see this is what the Republicans proposed in contrast to Hillarycare and most supported it until 2009 when it suddenly became unpopular with them when Obama endorsed it. A real Democratic plan would be to provide a public option with high subsidies for the poor and no mandate. Countries like France have no mandate, if you don't want health insurance you don't need to get it. But of course they pay their premiums through payroll taxes basically. And they also pay about 30-40% copays with a cap on total expenditures per year. Yet, there is no mandate to purchase private insurance, and I can see why it pisses off people. Really the solution is to tax, and provide subsidies for the poor so they will willingly get insurance, not to mandate buying insurance and then providing them with little subsidies. This is what Obamacare does, and while you may not agree with it, by no definition of the word would it be left wing. Indeed, it is a right wing solution.

[Sbane]

By the way since you brought up Hillary Care didn't Obama actually campaign against an individual mandate?

I don't think it was an issue really talked about in 2008. Universal healthcare was talked about in broad terms, with perhaps the public option being mentioned. Of course when I say hillarycare, I am talking about her healthcare plan she proposed under President Clinton in 1993-4.