As predicted by “The Simpsons” :
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“…finance the coverage for those eight percent of Americans under 65”
who have pre-existing conditions like cancer and other serious ailments,…
Cancer? Prior to the passage of the ACA, insurers were free to define pre-existing conditions in any way they saw fit. They’d call LASIK, a root canal, or a tonsillectomy a pre-existing condition if it got them out of paying a bill.
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It’s high time that the Democrats take a page from the GOP playbook and name these high risk pools for what they are “Death Pools”. If they limit the total amount spent between $1 million-$2 million, what happens when you hit that cap? One would assume, the insurance companies stop paying and the patient is no longer given treatment unless they can pay for it themselves. Without treatment, many of these patient’s will be literally left to do die.
So for all of their false crowing about Death Panels back in 2009, this is the real deal. We really will have insurance companies making the choice about who lives and who dies.
If that notion was so upsetting to them in 2009, surely it would be upsetting now, right? Of course, maybe Death Panels this go around are OK since it would be the private sector who decides who lives and who dies.
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Funny that other nations that the Repubs like to laugh at and claim are inferior solved this issue many, many deaths ago.
Conservatism has proven to be a mental sickness, it’s also funny that they quit recognizing that as a problem and it was their Golden God that did it.
True … he wasn’t. But the point was to see how far people would go. Now we’re finding out, except that we’re all part of the experiment.
Just meant to use Milgram as the reference for the concept. Not as someone who would perpetrate this in real life.
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You nailed it here. There’s no free lunch for healthcare and it’s an expensive, labor-intensive set of actions that requires high levels of skill or it’s less than worthless. Snake-oil salesmen sold cheap cures that didn’t work (except some placebo effect), and charlatans extracted blood with leeches fully convinced that it made people better.
Healthcare that actually heals people or improves health is a valuable but costly endeavor which most people cannot afford in large quantities, And for the basics like checkups and immunizations you can’t “insure” at all. From an accounting or actuarial basis at most it’s a prepaid expense, not insurance. But if people don’t do the basics to save money (a normal human conceit) it can end up costing far more later. And if people don’t have money to pay for the basics, they won’t have the money to pay for big healthcare needs.
The real question is how to distribute a) the costs for routine medical care and occasional emergencies like broken bones for those who can’t afford even those items, and b) the massive costs associated with chronic diseases like cancer or generic disorders. And you can tack on the softer less obvious afflictions like addictions or mental illnesses which fall somewhere in between.
In most developed countries, the people made the decision and the government executed a universal care model where they rely on the public’s recognition that they tax dollars pay for it so they won’t get elective items the minute they want them, and maybe there’s a slightly lower level of care than unlimited money can buy, but nobody is left behind. The interesting thing is that employers would just at a tax versus paying insurance companies, and most employees also pay into it. Those people whose employers pay a higher share just end up making less money than they would in earnings.
If not for the tax-phobic tendencies in the US, and the GOP always playing that political card, we’d have universal healthcare in this country now. Until then, expect some form of Darwinian healthcare.
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So, after bitching that the ACA is “a handout to insurance companies”, their solution is to enact an actual handout to insurance companies?
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Let me start out by saying that I am 100% in favor of a single-payer system. It clearly is the best option. However, since that is not politically feasible and Republicans are dead set on repealing ACA, what about a system where the insurance carriers have to pay the first $X in claims and the federal government pays the rest? I’m not an expert but believe this is similar to how reinsurance works.
More specifically:
- We keep the ban on preexisting condition exclusions, the low-income subsidies, expanded Medicaid (ideally with some mechanism to force states to adopt)
- We would also keep in place the essential health benefit requirements, the medical-loss ratio minimums, kids being able to stay on the parents plan until age 26, and limits on gender and age rating
- Deductible maximums would be lowered to $1,000 a year for individuals, $2,500 for families.
- The individual and employer mandates go away (Republicans won’t accept anything else)
- In exchange for preexisting conditions without a mandate, we would cap the annual amount insurance carriers have to pay out per policy. Not sure what this number should be but maybe something like $250,000, $500,000 or $1 million.
- Once the insurance carrier pays out that amount, the insurance carrier would submit any additional claims to the federal government for reimbursement for the remainder of the calendar year.
- For the uninsured who could have afforded coverage but chose to not buy it, they would be responsible for the first $X (maybe $50,000?) of any hospital bill and the federal government would reimburse the hospital for any amount above that.
There is a lot to hate about this plan. It privates profits and socializes losses. Again, I want single-payer. However, I believe capping the insurance carrier’s “loss” would lower premium prices while still enabling people with preexisting conditions to get coverage. The subsidies would ensure that everybody still has access to affordable health insurance.
Thoughts?
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Paul Ryan misnamed his ACA replacement plan. It is NOT “A Better Way”. It is “A Bitter Way”.
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As a tax accountant I can affirm that the opposition to the ACA in D.C. is 100% due to the taxes embedded in it. Repeal of the ACA is viewed as a tax cut. End of story.
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Could someone please explain why a subsidized high-risk pool is somehow better than just subsidizing coverage for everyone? The amount of subsidy needed would theoretically work out to the same, wouldn’t it?
That’s the whole point. You’re not supposed to do the math and verify their claims!
Disability advocacy groups are screaming their heads off right now, because this plan means actual death for many people. That’s not hyperbole or an exaggeration.
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We successfully got Republicans and Trump to proclaim that everyone should be insured. Next message is to make them proclaim that noone should be overcharged.
Of course these are all their ideas, we just need to help them articulate the reasoning.
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The cost of funding the high-risk pools would be a function of the cost of care for those with preexisting conditions. The cost of subsidizing everybody’s premiums would be a function of people’s incomes.
In other words, “Die Already.” Insurance is meant to be about spreading risk over as large a pool as possible (for the consumer) but for the companies the goal is to exclude as many people as possible to increase profit. The thing the dimwits in Congress don’t get either is that you can be perfectly insurable one day and uninsurable (in the normal pool) the next day. I saw this in my own family when one person got cancer at a relatively young age. The thought that her choices would be go broke paying for her care, pay unaffordable premiums for the rest of her life, or beg for help from her parents is obscene. She works hard and earns a reasonable salary and currently has good insurance through her work but if she can be excluded from the normal insurance pool, her decent salary will effectively be drastically cut. Nothing says “We think your life is worth tossing away” than the Republican creeps with the world’s best health care treating the lives of the citizens who pay their salaries as expendable.
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It’s “better” because the pools are deliberately underfunded, obstacles and delays are put in place to get into them (don’t die or go bankrupt while you’re waiting), and those not in the pools can get thoroughly screwed by insurance companies.
ETA: And that’s how you save money with high risk pools.
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I’ll pay a $5-$10,000 deductible in exchange for no caps. I do that now. $500,000 is nothing if you are really sick.
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Thought? It is a lousy idea.
Have you looked at a hospital bill recently? It is quite easy to rack up a bill of $250,000 or $1 million.
You would set up a whole layer of bureaucracy to examine and pay all those bills.
What is the incentive for insurers or hospitals to watch costs if they only need to pass a low threshold to pass the cost on to someone else?
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True, but it’s still unaffordable for most. Adding in the deductible plus the monthly premium and you’re looking at a cost of $2,000 per month averaged out. So if one is fortunate enough to be making $100,000 annually that’s 25% of your income spent on HC coverage. It’s actually higher of course as I’m basing income on gross, not what one takes home. And COBRA is usually the most expensive alternative.
Just imagine not having to worry constantly about HC coverage. To realize that you and family will be guaranteed excellent HC and coverage from first breath to last. it’s the best option by far as it also takes away all the anxiety of providing HC for yourself and family. It is invaluable and the only real answer. Just ask the rest of the industrialized world.
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The Ryan Plan
Repeal Obamacare, Replace with Dontcare.
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