I received an offer from my insurance company for another year of health insurance. This is the second consecutive year that my premium is up by more than 50%. The insurance companies are making out well with Obamacare. For a grandfathered plan, what rate should they charge? How about $10/month below the rate for an Obamacare plan? Sure, now I can choose to keep my existing grandfathered plan, but my insurance company knows exactly how much they can gouge me for because my only alternative is a more expensive Obamcare plan that is loaded with coverage that I have no use for.
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Those plans pay relatively little to providers, which is part of why the networks are so narrow. Conversely, plans with "traditional" networks (even HMOs) cost you more, because they pay more to the providers to be able to offer those wider networks.
Does your plan have a low retention rate? (You likely can't answer that.) This matters because the smaller the pool (even if the distribution of people in the pool doesn't change) the higher the risk to the insurer (and thus the higher the rate charged).
There are lots of reasons why rates go up. I had a plan which while not grandfathered, got a one year exemption. So it was still offered for 2014. That plan did not raise rates for two consecutive years (2012-2013, and 2013-2014). Proof that non-conforming plans do not all raise rates because of ACA.
before ObamaCare was a twinkle in anyone's eye I saw insurance premiums jump by 50% over a year's period.
from 2000 to 2007 - insurance rates for some probably tripled or quadrupled.
In the old days if you bruised your arm - you didn't have catscans, and millions of other procedures that doctors need to do, because they are scared of getting sued and the patients want the absolute most they can get since they paid the premium and they deserve it. You didn't have medical marketing on TV telling people to tell their doctor they want the more expensive pills.
It's only going to get worse and worse, whether ObamaCare is here to stay or not.
The whole medical practice - insurance - payment - health administrators and patient demands as well as malpractice insurance, and litigation - useless and unneeded procedures and meds either foisted upon patient or demanded by patient, there's only one way to go for the broken system - "to the moon" with premiums.
edit:
I've made up my mind. no matter what anyone says there is no one reason that causes health care premiums will continue to skyrocket. Totally broken system compared to many other countries in the world.
I submit that until this thing works for a couple of years we still won't have a great idea of all of the kinks and bends, good points or bad, and I have absolutely no doubt that further tinkering will be required to make this thing work as well as possible, if we keep it.
As to Maurice's statement that "no one in Congress... wants [the tax] broken out", I have to ask why those in Congress who oppose ACA wouldn't want that information broken out?
Maurice's broadside repeats the often-heard refrain that "you are subsidizing others, beyond the obvious of how much medical insurance you use in 2015."
Just who did he think was subsidizing all the the hospital ERs when the hospitals offset their uninsured ER expenses with $200 aspirins for those who did have health care plans, or (much) worse yet, had no health plan but attachable personal resources?
That's the fact, Jack!
http://www.truecostofhealthcare.org/summary
While there is no doubt that the legal weasels are a problem in their own right, part of the liability issue rests squarely on the demonstrable unevenness of care as it's typically dispensed. I really doubt that is an issue peculiar to the US- it's more than likely just the nature of the beast.
Two recent examples, both by coincidence within the Kaiser network here in the SF area-
• The girlfriend of a good friend of ours: known to have cancer which is affecting her hearing ability. Much recent medical history, including MRI. Her Kaiser doctor reports that MRI shows nothing, sends her to hearing specialist for hearing aid. Kaiser hearing specialist reviews exact same MRI, informs her that there is a buildup of fluid which is causing her immediate deafness problem, no hearing aid: refers her to surgery.
• Daughter of our neighbor: 40 years old, three young children including one toddler. Been visiting Kaiser primary health care doctor for several months with complaints of ill feeling. Nothing found. Last weekend, pain is excessive, visits Kaiser ER. They find, within a very short time, stage 4 cancer in both her neck and her kidney, prognosis not very good.
Would you suspect that perhaps there was some problem in the provision of decent care in both of these instances? The hearing specialist can read the MRI better than her regular doctor? Why?? The ER finds advanced cancers, the primary care doctor can't? Same health system, same resources. Lack of competence? Lack of care? Malpractice?
What if these folks were your family, Maurice? Would you possibly consider legal issues?
Tough questions, for sure.
Regards- OJ
Esther J. Cepeda is a Washington Post columnist.
http://www.yakimaherald.com/news/latestnews/2634307-14/esther-cepeda-no-cure-for-health-care-malaise
My wife recently was diagnosed with early-stage breast cancer. This friend personally called a number of the best practitioners within the Sutter system, and arranged for immediate care. We were tremendously impressed by what the system can provide, when it wants to. Don't think for a minute that there aren't many different levels of competence and caring within any medical community, and you'd better believe that the practitioners within those communities know exactly who is who.
All is looking well at this time. The care couldn't have been better, for sure. What a shame that this level of competence and care is so hard to come by.
Maurice, absolutely no argument there. The legal scum certainly are no help.
Regards, OJ
It is just so freaking odd that someone supposedly as sharp as this guy did not instantly, instantly, instantly add:
OF COURSE THIS IS WHAT INSURANCE IS, and DOES, and ALWAYS HAS BEEN.
Are people really so totally unclear on the very concept? I got mine, let the sickies go to the EW? Seriously? It is all quite unbelievable. God forbid we have homeowner insurance for storms. Oh, wait, we do.
Even the best doctors have bad experiences. When mistakes like mentioned above happen that have gone through several people then that is a big problem.
i know this has nothing to do with the OP but I couldn't help myself. Nutty rant over.
As far as "It is all quite unbelievable", I'm afraid that actually it is quite believable, because "those" people who presumably may benefit are somehow not "our" people who are supposedly paying for the whole thing. "Us" and "them". Always has been, always will be: the definition of human beings, and many functions in nature also, I'm afraid.
I sometimes wonder if what we believe to be the outer limits of "the ever-expanding universe" isn't actually just an experimental lab flask- one of many- sitting on the shelf of some cosmic designer. Our flask, undoubtedly along with many others, is in the "failed model" group. Maybe eventually the designer will get things right.
Now I await the knives and stones.
I will agree with the presumption of a few conservatives here; but only to the point of those who have chosen to write; that may reflect this "tilt" here. Perhaps the "more conservative types" choose not to write.
I am sure someone has presented a thesis for a Master degree regarding what the political leanings are for active investors.
Political leanings and how or what one does in other parts of life seldom indicate clear paths; based upon my experience with regular folks. I exclude zealots or other radical political leanings of individuals.
In the lower half of the lower peninsula of Michigan, especially in the past few decades; a large portion of the workforce was involved with jobs in the auto industry. This work required membership in the United Auto Workers union.
I saw, too many times; the hyprocracy of the thought and actions; regarding their work benefits that they enjoyed, mixed with their religious convictions and the "I got my mine, you get your own" philosophy.
These union members had access to benefits that the non-union person did not; including attorneys for simple matters (wills, etc.) to having reduced costs for "online" connections in the early days of the internet. The healthcare/dental/vision benefits were unmatched; with perhaps the exception of government based program benefits. When the Japanese autos started to really take a bite out of the share of auto sales; a "trade readjustment act/bill" was put in place. This allowed those union auto workers who were displaced of work (due to production reductions); to receive 90% of pay for not working. A jobs pool. These workers were supposed to be at the job site and awaiting work. I know of many who showed up at the factory site for a short period of time and then went home to do their own work at remodeling, mowing the lawn or whatever was of interest to them.
Many of these same folks were also conservative relative to their religious convictions and practices. The conflict I saw too many times was that; these people really liked their benefits via the union (liberal/socialist ideals), but were conservative voters (Republican) in local, state and national elections. 'Course, this conflict reached farther into the programs of some churches with their "helping the locally needy"; as well as sponsoring monies for "outreach" programs that placed persons and monies into other countries. One event that I recall in particular was a fund raiser program to provide money to be sent to families in Africa to purchase cattle/cows. Sadly, not more than 1 mile away from this church location, were familes who were barely able to survive.
My rambling and review is that humans are very complex and conflicted in their thoughts; versus their actions.
I was very involved in attempting to disgest the ACA legislation before passage. Sadly, this major legislation is another common example of the dysfunction and political struggles that cause havoc within our society. Yes, the legislation; among other things, is a subsidy, from those who can afford, to those who did not have or could not afford healthcare. 'Course, who can and can not afford comes from charts and graphs generated by income tables; with a magic cutoff line drawn. My rub with this legislation is with the manner of presenting this as "law"; and the failing of the 100's of other related programs already in place.
Sadly, and disgustingly; Nancy Pelosi uttered the full view of this legislation just prior to passage that was more or less, "Let's pass this sucker and find out whats inside." One must consider that this example provides the true view of too many in congress. Is this as good as it gets???. Truly very sad. I saw her make this statement; and she seemed to be fully comfortable with the words. I would be totally embarrassed to utter similar words about a similar decision; be it in congress or my workplace. If I said such a thing about an important topic at my workplace; I would expect to have my ass thrown out of the door of employment.
ACA for those who can afford the "new" insurance do have their net spending monies affected by the costs. This is money that will not be spent for "other"; which includes anything one chooses to place on a list.
A sample that I am aware of locally; with this note: Yes, their new insurance is no questions asked and pre-existing conditions do not matter (although this is not a factor in the below).
One parent and one school age child. Parent's employer insurance plan now gone, as of the end of 2013. Prior plan required $150/month pay-in by employee, with a $250/year deductible for both the parent and child.
The ACA best choices in Michigan (affordability for them) for 2014 is:
---new combined monthly insurance cost = $691.51 vs old $150
---dental was combined before, monthly now = $140.67 vs old $0
Prior plan, annual cost = $1,800.00
New plan, annual cost = $7,434.12
***Another real kicker for the new health plan is that what was a $250 annual deductible, is now $12,700 annually.
New dental plan, annual cost = $1,688.04
***Sadly, the same company for dental coverage is being used; as this is a very good plan and as affordable as others from the list. The strange part, and something that pisses people regarding some of the ACA; is that although the original dental plan had been in place for many years, the company treats the parent and child as new policy holders. For the first year, the only dental items paid for are two check-ups for each. Everything else is at cost to the customers.....no deductible applies.
Update: the above health insurance has a 8.6% rate increase for 2015
Everyone will have their own stories and reality about where ACA takes them.....,but it will displace monies from those who can afford some form of the insurance; and I expect the burden to be on the back of the so-called middle class families; which will help this group move backwards to become the subsidized. Then, the government may start again, to re-work the program.
Signing off:
Catch
John Roberts didn't say Congress has the right to tax. The Constitution of the United States of America does.
Similarly, the Supreme Court didn't rule insurance premiums a tax. The question was whether the mandate was constitutional. The ruling only said the fine was a sort of tax, and therefore constitutional. The devil is in the details.
If the op is upset about what they are paying or receiving, they have the ability to shop for a new plan. They can even do so on the nifty ACA website, where they'll find a choice in coverage at differing rates, to a maximum of a certain percentage of their income.
Those aren't "Obamacare" packages, because there is no such thing. Those are insurance products sold by private companies. Private companies, who, as Accipiter pointed out, used the passage of the ACA to increase premiums. Law of unintended consequences is rule number one in legislative drafting was the first thing i learned on the Hill.
Until we're all talking about what the ACA is and does, the conversation about the legitimacy of the ACA is difficult at best. But we can start from basics. There are three possible current ways to approach Healthcare:
1) the old system where most people have privately held insurance, possibly supplemented/provided through their employer, but where a large number of Americans don't have any insurance. This creates the largest expense because there is a disproportionate level of care sought by the uninsured and provided by emergency services. Individuals don't see this, however, because it is paid indirectly through your tax bill and increased medical costs and insurance premiums.
2) a single payer system where Healthcare is run by one entity and funded out of tax dollars like Britain's NHS. If you don't want this, stop fighting the ACA. Seriously.
3) A middle ground like the ACA that uses mandates and taxes to ensure people get insurance, whether private or public, so they don't cost other taxpayers as much as choice one. This is cheapest (until private companies jack rates anyway), but creates the illusion of expense because of a new regulatory and tax structure where individuals can now see the money being taken where they didn't before. This also leads to unfortunate comments about the stupidity of the electorate being taken out of complete context.
We have a busted system, imo. But I'm all ears if someone has a solution outside of those three. Otherwise we're just spinning wheels over rehashed "facts" that aren't.
I'll just say from an investment standpoint the whole thing kind of circles back to the idea of does this mean that there will be less discretionary spending if healthcare costs continue to skyrocket. It doesn't seem like we've hit that point yet, but if costs continue to ramp higher, do people forget that Starbucks latte and things of that nature? Personally, I continue to move towards a focus more on investing in needs than wants (and obviously, the definition of "need" and "want" is flexible, but I continue to like health care, for example.)
Now, the following generally applies for the most part; for those who are in a position to take advantage of circumstances based upon their personal abilities and/or financial situation.
Our house, attempts to offset whatever areas are or may be problematic with spending needs going forward.
Currently, for most of the past 18 months; we have about 25% of our portfolio directly in healthcare.........being PRHSX and FSPHX (and whatever other healthcare is within other broadbased equity funds we hold), and a recent venture into DPLO (a recent "IPO" stock of a company with which I am familiar).
The point being, individual investors do have the possibility to offset future expenses with profitable investments. Not news to anyone here; but tis the reality.
I noted healthcare above, not solely because it is a viable investment sector; but may have a direct relationship to an area with rising costs that may be offset with rising profits to an investor.
The motive to this type of investing relates to comments I have placed to many I have known over the years; regarding some of their investment choices, and is based upon "bitching and price concerns". Two that come to mind right now are bitching about cable tv/internet pricing and shoes. These folks complained/conversed about pricing in these two areas; but really liked or needed the product. "Okay", I would note. Then go purchase Comcast and Nike stock. These investment returns may pay for all of your tv/internet time and all the shoes you will ever need into the future.
I joked during the ACA game, before the legislation was passed; that everyone who had to enroll in a new insurance plan would also receive a percentage related dollar amount in their choice of any of several healthcare etf's.
Take care of you and yours,
Catch
Since I am now retired and currently covered under BCBS of NC Advantage Blue Medicare HMO for 2014 I changed to BCBS of NC Advantage Blue Medicare PPO for 2015 to prevent getting hit with potential out of network medical expenses that would be covered under the PPO but not the HMO. Interestingly, the monthly premium is about $10.00 a month less under the PPO (with broader coverages) over the HMO. Go figure.
I'd say to anyone be ware in some cases the hospital might be an in network provider; however, some of its contracted doctors and others that provided services (xray, labs, etc.) might not be. And, with this comes an out of network bill to be digested. So I went with the PPO to cover these potential out of network billings.
The drug benefit seems to be the same under both plans.
And, yes my premiums have more than doubbled, from 2014 to 2015 for the BCBS Medicare Advantage wrapper.
Old_Skeet
http://mobile.nytimes.com/2014/11/20/us/politics/obamacare-unlikely-for-undocumented-immigrants.html?referrer=
Don't think for a minute that there aren't many different levels of competence and caring within any medical community, and you'd better believe that the practitioners within those communities know exactly who is who.
You don't think that doctor #2 will be talking within his medical community regarding doctor#1? They ALL KNOW. But they won't tell you.