Healthcare Premiums to Rise According to Obama Advisor - page 3

by SC_RNDude 2,774 Views | 28 Comments

"With the Presidential election one week away, itís worth reviewing how Obamacare will impact the residents of key swing states. In Wisconsin, as elsewhere, Obamacare will drive up the cost of private health coverage, especially... Read More


  1. 0
    Quote from mariebailey
    If you & Edward Zelinsky say it won't work, then it must be true.
    I'm willing to listen.

    The tax penalty costs people much less then it would be to buy insurance, and at the same time the only way they can collect on that tax penalty is to take it out of your refund, and the Obama administration itself admits millions will choose to still not buy insurance.

    I don't understand how the mandate will work as intended and as sold as to the American public. Please enlighten me.

    BTW, there are many others who also say it won't work. I chose the article I did for my post because it is from a liberal-leaning website which I know is one of your criteria for a "legitimate resource".
  2. 0
    Quote from SC_RNDude
    I'm willing to listen. Please enlighten me.
    BTW, there are many others who also say it won't work. I chose the article I did for my post because it is from a liberal-leaning website which I know is one of your criteria for a "legitimate resource".
    No, no, no...that's not my criteria. I am hopeful that it is a step in the right direction to cover the uninsured/underinsured. To say with certainty that it will work flawlessly would be foolish. It looks like our points will be moot b/c the individual mandate is headed our way. We'll see how it goes.
  3. 0
    Quote from mariebailey
    No, no, no...that's not my criteria. I am hopeful that it is a step in the right direction to cover the uninsured/underinsured. To say with certainty that it will work flawlessly would be foolish. It looks like our points will be moot b/c the individual mandate is headed our way. We'll see how it goes.
    Yep we will see. Hopefully I am wrong.
  4. 0
    Quote from SC_RNDude
    Increasing healthcare costs are a big problem. Having everyone purchase insurance does zilch to controll costs. It may bring in more money to help pay for things, but that does nothing to keep costs from increasing.

    The way health insurance works is NOTHING like car insurance, or home insurance, or life insurance, etc. Auto insurance works because they operate in a free market, they can charge more and even compete for higher risk customers, they don't pay out for (and aren't forced to by the gov't) routine care of the car that most people could and would pay for on their own, and they don't spend money managing every aspect of the care of the car.

    So, even if everyone is forced to purchase it, health insurance will not work the same way those other types of insurance do.
    I agree that ACA is mainly cost shifting and does little to control costs, although most attempts to control costs have been met with claims of "death panels" and "socialism".

    The car insurance/homeowners insurance example is actually a pretty good analogy. My car insurance company doesn't get involved in routine care of the car, but that's because they aren't covering the car in case it breaks down. My homeowner's insurance doesn't cover a remodel either, but they do require that I replace the roof when it's lifespan is up, they do require that I change my washing machine hoses every three years, maintain my smoke alarms, etc because those do affect what they are covering, because as an insurer it only makes sense to try and avoid whatever it is they are covering rather than just letting it happen.

    Medicare covers everyone at some point, they have a clear interest in encouraging basic maintenance to avoid major breakdowns. Imagine you are liable for fixing any mechanical problems in your friends car once it hits 65,000 miles. If your friend was avoiding putting oil in it even though it's near empty because he won't have to pay the bill after 65,000 miles (age 65), don't you think you'd have some interest in making sure oil gets put in the car so you don't have to pay for a new engine?
  5. 0
    Quote from MunoRN
    I agree that ACA is mainly cost shifting and does little to control costs, although most attempts to control costs have been met with claims of "death panels" and "socialism".

    The car insurance/homeowners insurance example is actually a pretty good analogy. My car insurance company doesn't get involved in routine care of the car, but that's because they aren't covering the car in case it breaks down. My homeowner's insurance doesn't cover a remodel either, but they do require that I replace the roof when it's lifespan is up, they do require that I change my washing machine hoses every three years, maintain my smoke alarms, etc because those do affect what they are covering, because as an insurer it only makes sense to try and avoid whatever it is they are covering rather than just letting it happen.

    Medicare covers everyone at some point, they have a clear interest in encouraging basic maintenance to avoid major breakdowns. Imagine you are liable for fixing any mechanical problems in your friends car once it hits 65,000 miles. If your friend was avoiding putting oil in it even though it's near empty because he won't have to pay the bill after 65,000 miles (age 65), don't you think you'd have some interest in making sure oil gets put in the car so you don't have to pay for a new engine?
    To make this analogy work, I wouldn't be in charge of just his car problems once his mileage hit 65 thousand, but I would be in charge of the vehicles of a whole population.

    In that case, I would like for my friend to have a tax-free savings account that he, and as an employee benefit, his employer could contribute to (and then, if indingent then the govt, or me in this case, can chip in) for the purpose of car maintenance. When he is contributing to this account and is controlling the money, he will shop for the best value and quality. He will be able to consult with his car "doctor" to decide what is best for him and his car without approval from me. Businesses in the car maintenace sector will compete for his business. This will encourage innovation, value, and quality in providing those services.

    He would be able to care for his care more efficently and with better quality then I would if I was managing the care of everyone's car.

    If I was managing everyone's car maintenance and paying for it, my friend would have less control of how maintenance is done, would be far less inclined to shop around for a better value, and more inclined to use services he may not need or that may not be beneficial.
  6. 0
    HSA's and FSA's are great for predictable costs and as a stop-gap in high deductable plans, but they don't work as free-standing insurance coverage.

    What you're suggesting is instead of large insurance pools, with broadly shared risk, we instead make every insurance pool for one person only. The problem with this is that this account has to cover a wide range of possibilities; Someone may need open heart surgery and a rehab stay, which means they'll need $120,000 in their account. I've had patients who hit the $1 million mark. Are you really going to put $1 million in everybody's HSA? Since most people won't need that much, that would seem likely to waste huge amounts of money in accounts where it won't be needed. In which case it would make more sense to just pay those costs as they arise out of a larger account, which just brings us back where we're at currently; insurance.

    I agree with you for the most part on competition, although it's not quite the same as other business sectors. There are over 200 restaurants in my area that compete for my business when I go out, yet there's only one hospital (which also owns the only lab group, only imaging, and 90% of the Primary Physicians).

    What you seem to be suggesting is that insurers be taken out of the decision equation, which is actually done successfully in many countries that we refer to as having "socialized" medicine. Much of "socialized" medicine still has for profit care delivery and even for-profit insurers, they just can't improve their profit by denying services, they have to pay for whatever the Physician and Patient decide is best.
  7. 0
    Quote from MunoRN
    HSA's and FSA's are great for predictable costs and as a stop-gap in high deductable plans, but they don't work as free-standing insurance coverage.What you're suggesting is instead of large insurance pools, with broadly shared risk, we instead make every insurance pool for one person only. The problem with this is that this account has to cover a wide range of possibilities; Someone may need open heart surgery and a rehab stay, which means they'll need $120,000 in their account. I've had patients who hit the $1 million mark. Are you really going to put $1 million in everybody's HSA? Since most people won't need that much, that would seem likely to waste huge amounts of money in accounts where it won't be needed. In which case it would make more sense to just pay those costs as they arise out of a larger account, which just brings us back where we're at currently; insurance.I agree with you for the most part on competition, although it's not quite the same as other business sectors. There are over 200 restaurants in my area that compete for my business when I go out, yet there's only one hospital (which also owns the only lab group, only imaging, and 90% of the Primary Physicians).What you seem to be suggesting is that insurers be taken out of the decision equation, which is actually done successfully in many countries that we refer to as having "socialized" medicine. Much of "socialized" medicine still has for profit care delivery and even for-profit insurers, they just can't improve their profit by denying services, they have to pay for whatever the Physician and Patient decide is best.
    There will still be insurance, but it will be for emergency care and catastrophic situations, like the heart surgery. It won't be tied to your work, and you'll be able to choose from any insurance company. All things that make it more affordable, much like home our auto insurance.
  8. 0
    Then that's the same system we have now, HSA's have been around since 2003. The main problem is that it's not the things covered by HSA's that are hurting us financially, it's the big ticket items; it's the patient who doesn't get their DM treated and ends up on chronic dialysis with a stroke living in a Nursing Home, it's the 20% 30-day CHF admission rate, it's the 2 month hospital stay for 450lb MI patient, etc.
  9. 0
    Quote from MunoRN
    Then that's the same system we have now, HSA's have been around since 2003. The main problem is that it's not the things covered by HSA's that are hurting us financially, it's the big ticket items; it's the patient who doesn't get their DM treated and ends up on chronic dialysis with a stroke living in a Nursing Home, it's the 20% 30-day CHF admission rate, it's the 2 month hospital stay for 450lb MI patient, etc.
    No, it's not even close to being the same. Right now, most of your money goes to the insurance company, and most of your employers contribution goes to the insurance company. Then, some people put some more into a HSA, if they can afford it.

    What I am describing would be a system in which all that money goes into a HSA instead. From the HSA is where your most of your healthcare bills will be paid from. Also from the HSA you would buy the "catastrophic" type of insurance for emergencies and things like a cancer dx, etc.

    I discussed this in more detail in a couple of posts on this page in another thread.

    http://allnurses.com/nursing-activis...268-page3.html


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