Health Insurance That Doesn’t Cover the Bills Has Flooded the Market Under Trump

[Individual]

Not quite.

It's actually acknowledging that the United States of America is not the only country in the known universe rather than pretending that "If Americans don't do it, then no one else is even remotely capable of doing it."

I confine myself to politics in the U.S., how other governments do things is the business of their citizens to try and control.

 

[Greenbeard]

True. Erase the board and start over is not an original idea, but sometimes necessary.

"Erasing the board and starting over" is not an idea. Everybody gets that the GOP wants the ACA gone, their problem (as should be clear from the last ten years) is that they have no alternative to put in its place. They're stuck between the reality that (1) repeal with nothing to replace is untenable and politically suicidal, and (2) anything they might want is already in the ACA. Which is why they've been stuck in neutral for a decade and no one trusts them when it comes to health care.

Facts I love it. Where are you going with this?

Responding to another poster's points. You?

 

[Jay59]

"Erasing the board and starting over" is not an idea. Everybody gets that the GOP wants the ACA gone, their problem (as should be clear from the last ten years) is that they have no alternative to put in its place. They're stuck between the reality that (1) repeal with nothing to replace is untenable and politically suicidal, and (2) anything they might want is already in the ACA. Which is why they've been stuck in neutral for a decade and no one trusts them when it comes to health care.

Of course it's an idea. How not?

You say everyone in the GOP wants ACA gone, which is not true or it would already be gone. The part that was taken from Massachusetts healthcare system, AKA Romneycare, is the system of exchanges. Those could be made to work. The parts affecting Medicare could be separated and put into the Medicare law after some conflict resolution. The overly broad mandated coverage can be scaled back and the unreasonable premium requirements brought to industry standards. This could all be done through about eight different laws, each focusing on one portion of the problem. ACA never addressed multi-state coverage or portability. That is one or two additional discussions.

One of the big sticking points is pre-existing conditions. Democrats want everything to be considered pre-existing--eg AIDS, cancer, addiction, etc. The term pre-existing has always meant things like diabetes and high blood pressure, which make serious conditions more likely. It never meant the serious conditions themselves. The usual analogy is buying car insurance after the accident and expecting the accident to be covered. Until terms are properly defined, progress in this area is going to be by main force.

 

[Individual]

The inclusion of pre-existing conditions, IMO, eliminates use of the word "insurance" being used in describing what is being discussed here.
Perhaps private insurance should be made available in 4 tiers of pricing.
Tier 1 would be the most expensive, covering the full costs of any care received.
Tier 2 would pay 75% of the costs of any care received.
Tier 3 would pay 50% of the costs of any care received.
Tier 4 would pay 25% of the costs of any care received.

Government assistance in providing care, seeing how many generous people support ACA, could be funded by the addition of an X% surtax on those with an AGI placing them in the top 10% of income earners, allowing the remaining 90% of earners to by choice, make a contribution to the pool which any excess would be accounted for in the same way as Social Security, allowing government to borrow any excess with interest repayment to be included in the surtax.

 

[Aberration]

True.



True.



Which, of course, is a complete explanation of the fact that the US spends (all 2016 US dollar figures) $9,892 per capita for health care while

1. Switzerland spends $7,919
2. Luxembourg spends $7,463
3. Norway spends $6,647
4. Germany spends $5,551
5. Ireland spends $5,528
6. Sweden spends $5,488
7. Netherlands spends $5,385
8. Austria spends $5,227
9. Denmark spends $5,205
10. Belgium spends $4,840
11. Canada spends $4,753
12. Australia spends $4,708
13. France spends $4,600
14. Japan spends $4,519
15. Iceland spends $4,376
16. United Kingdom spends $4,192 and
17. Finland spends $4,033

with all 17 of those countries offering more comprehensive coverage of equivalent quality to that of the United States of America.

Well?

Doesn't it?



Really?



Really? See above - obviously someone has been able to "make it work".

Are you REALLY trying to tell me that YOU think that Americans are too stupid and non-inventive to be able to do what at least 17 other countries have been able to do successfully?

I don't think that Americans are that stupid. (Pigheaded - possibly, but stupid - never.)

It’s you who thinks people are stupid. Arguing for socialism is arguing people are too stupid to make their own choices. I am saying that no governing body is smarter at making choices in the services and products people want than the individual. And every attempt they have ever made has only distorted the market.

 

[Aberration]

How does paying roughly 1/2 what you're paying now bankrupt you?

It's worked far better than your system in virtually every other Western nation.

Our Federal Budget and Debt says otherwise.

 

[TU Curmudgeon]

I confine myself to politics in the U.S., how other governments do things is the business of their citizens to try and control.

Indeed. And that is why it is REALLY important to maintain as much lack of knowledge of what has been done elsewhere as possible. After all, the United States of America has absolutely nothing in common with any other country and the American people have absolutely nothing in common with the people of any other country.

If something isn't done in the US, then that absolutely proves that it is totally impossible to do it at all.

Right?

 

[TU Curmudgeon]

One of the big sticking points is pre-existing conditions. Democrats want everything to be considered pre-existing--eg AIDS, cancer, addiction, etc. The term pre-existing has always meant things like diabetes and high blood pressure, which make serious conditions more likely. It never meant the serious conditions themselves.

Really?

You mean that there were actually insurance companies that would sell people healthcare insurance that covered things like

• cancer treatments (if they had already been diagnosed with cancer);
• renal dialysis (if they had already been diagnosed with kidney failure);
• prepartum and postpartum care (if they were already pregnant);
• cardiac insult management (if they had a history of heart attacks); and
• diabetic sequalae management (if they had already been diagnosed as having diabetes);

at a price that the person could afford (and for LESS than the person would have to pay if they didn't have any "insurance" at all)?

You HAVE to be kidding.

 

[Individual]

Indeed. And that is why it is REALLY important to maintain as much lack of knowledge of what has been done elsewhere as possible. After all, the United States of America has absolutely nothing in common with any other country and the American people have absolutely nothing in common with the people of any other country.

If something isn't done in the US, then that absolutely proves that it is totally impossible to do it at all.

Right?

Your words, not mine.

 

[Jay59]

Really?

You mean that there were actually insurance companies that would sell people healthcare insurance that covered things like

• cancer treatments (if they had already been diagnosed with cancer);
• renal dialysis (if they had already been diagnosed with kidney failure);
• prepartum and postpartum care (if they were already pregnant);
• cardiac insult management (if they had a history of heart attacks); and
• diabetic sequalae management (if they had already been diagnosed as having diabetes);

at a price that the person could afford (and for LESS than the person would have to pay if they didn't have any "insurance" at all)?

You HAVE to be kidding.

You should read more closely. You would find that Democrats have demanded that the following are treated as pre-existing conditions:

• cancer treatments (if they had already been diagnosed with cancer);
• renal dialysis (if they had already been diagnosed with kidney failure);
• cardiac insult management (if they had a history of heart attacks); and
• diabetic sequalae management (if they had already been diagnosed as having diabetes)

You could have added antiviral treatment to those already HIV positive. The pre and post partum you might actually be able to get a rider to cover now. That one is at least imaginable.

 

[TomFitz]

It’s you who thinks people are stupid. Arguing for socialism is arguing people are too stupid to make their own choices. I am saying that no governing body is smarter at making choices in the services and products people want than the individual. And every attempt they have ever made has only distorted the market.

So? This entire right wing argument about “choice” in the American health care system is ridiculous!

Most Americans do not choose who their health insurance provider is. For the most part, they no choice at all, or, at best, a limited selection from a menu chosen by the employer.

If your company changes health insurance providers, and your doctor isn’t on the list, too bad. You don’t keep your doctor.

People take this for granted. Including the very people who rant about Obama “lying” about keeping your doctor.

Nor do people exercise much discretion in choosing providers. They go with whoever the insurance company will pay, and who their doctor refers them too.

 

[TomFitz]

You should read more closely. You would find that Democrats have demanded that the following are treated as pre-existing conditions:

• cancer treatments (if they had already been diagnosed with cancer);
• renal dialysis (if they had already been diagnosed with kidney failure);
• cardiac insult management (if they had a history of heart attacks); and
• diabetic sequalae management (if they had already been diagnosed as having diabetes)

You could have added antiviral treatment to those already HIV positive. The pre and post partum you might actually be able to get a rider to cover now. That one is at least imaginable.

And?

I don’t know what point you’re trying to make, when the national health insurance programs of most advanced nations treat all of these things.......

And most of them cover hearing aides, dental care, and eyeglasses, things that most American health insurance does not cover.

 

[TU Curmudgeon]

The inclusion of pre-existing conditions, IMO, eliminates use of the word "insurance" being used in describing what is being discussed here.
Perhaps private insurance should be made available in 4 tiers of pricing.
Tier 1 would be the most expensive, covering the full costs of any care received.
Tier 2 would pay 75% of the costs of any care received.
Tier 3 would pay 50% of the costs of any care received.
Tier 4 would pay 25% of the costs of any care received.

Government assistance in providing care, seeing how many generous people support ACA, could be funded by the addition of an X% surtax on those with an AGI placing them in the top 10% of income earners, allowing the remaining 90% of earners to by choice, make a contribution to the pool which any excess would be accounted for in the same way as Social Security, allowing government to borrow any excess with interest repayment to be included in the surtax.

I quite agree that you proposal makes as much sense as selling fire insurance where

1. Tier 1 would be the most expensive, covering the full costs of any fire damage suffered;
2. Tier 2 would pay 75% of the costs of any fire damage suffered;
3. Tier 3 would pay 50% of the costs of any fire damage suffered; and
4. Tier 4 would pay 25% of the costs of any fire damage suffered.

I mean, after all, EVERY house has a "preexisting condition" that means that it MIGHT catch fire and burn down.

Of course, the rate structure would have to be rather complex since it wouldn't be fair to expect someone whose house is only worth $100,000 to pay premiums based on the fact that the "average potential risk" to the insurance company is $200,000 - would it?

No, each policy would have to be based on an annual assessment of the actual replacement value of each individual house so that those people whose houses are worth less than the "average potential risk" would not be subsidizing the insurance of those people whose houses were worth more than the "average potential risk". And, of course, any benefits paid would not take into account any changes in the actual replacement value of the houses since the last annual assessment (unless, of course, the actual replacement value of the houses had declined).

And, of course, your proposal makes as much sense as adjusting the municipal taxes for (let's say) "policing" to reflect the crime rate in individual areas.

 

[Jay59]

And? I don’t know what point you’re trying to make, when the national health insurance programs of most advanced nations treat all of these things.......And most of them cover hearing aides, dental care, and eyeglasses, things that most American health insurance does not cover.

You don't understand because you are comparing an apple to an applet, specifically insurance vs national healthcare.

 

[Individual]

I quite agree that you proposal makes as much sense as selling fire insurance where

1. Tier 1 would be the most expensive, covering the full costs of any fire damage suffered;
2. Tier 2 would pay 75% of the costs of any fire damage suffered;
3. Tier 3 would pay 50% of the costs of any fire damage suffered; and
4. Tier 4 would pay 25% of the costs of any fire damage suffered.

I mean, after all, EVERY house has a "preexisting condition" that means that it MIGHT catch fire and burn down.

Of course, the rate structure would have to be rather complex since it wouldn't be fair to expect someone whose house is only worth $100,000 to pay premiums based on the fact that the "average potential risk" to the insurance company is $200,000 - would it?

No, each policy would have to be based on an annual assessment of the actual replacement value of each individual house so that those people whose houses are worth less than the "average potential risk" would not be subsidizing the insurance of those people whose houses were worth more than the "average potential risk". And, of course, any benefits paid would not take into account any changes in the actual replacement value of the houses since the last annual assessment (unless, of course, the actual replacement value of the houses had declined).

And, of course, your proposal makes as much sense as adjusting the municipal taxes for (let's say) "policing" to reflect the crime rate in individual areas.

You insure a house to limit your risk SHOULD it catch fire. A burning house, has a pre-existing condition.
Life is a terminal disease, live it as best you can, while you can.

 

[TU Curmudgeon]

It’s you who thinks people are stupid. Arguing for socialism is arguing people are too stupid to make their own choices. I am saying that no governing body is smarter at making choices in the services and products people want than the individual. And every attempt they have ever made has only distorted the market.

Yep, that is a 100% complete and irrefutable answer to

Which, of course, is a complete explanation of the fact that the US spends (all 2016 US dollar figures) $9,892 per capita for health care while

1. Switzerland spends $7,919
2. Luxembourg spends $7,463
3. Norway spends $6,647
4. Germany spends $5,551
5. Ireland spends $5,528
6. Sweden spends $5,488
7. Netherlands spends $5,385
8. Austria spends $5,227
9. Denmark spends $5,205
10. Belgium spends $4,840
11. Canada spends $4,753
12. Australia spends $4,708
13. France spends $4,600
14. Japan spends $4,519
15. Iceland spends $4,376
16. United Kingdom spends $4,192 and
17. Finland spends $4,033

with all 17 of those countries offering more comprehensive coverage of equivalent quality to that of the United States of America.

Well?

Doesn't it?
​

isn't it?

The choices you are referring to are:

• Do I want to have healthcare insurance that will protect me from financial chaos if I get sick?
  • ____ YES
  • ____ NO
• If my answer to Question A. is "YES", do I want to
  • ____ pay 100% of $X.xx for a policy which may or may not actually protect me (but which will allow someone to make a lot of money regardless of whether it protects me); or
  • ____ pay less than 100% of $X.xx for a policy which will protect me (even though no one is getting rich by selling it to me)?

The likely answer to Question A. is going to be Answer a. in a close approximately of 100% of the cases.

That leaves Question B. as the operative question.

The likely answer to Question B. is going to be Answer b. in a close approximation of 100% of the cases (where the respondent is rational).

 

[Individual]

Yep, that is a 100% complete and irrefutable answer to

Which, of course, is a complete explanation of the fact that the US spends (all 2016 US dollar figures) $9,892 per capita for health care while

1. Switzerland spends $7,919
2. Luxembourg spends $7,463
3. Norway spends $6,647
4. Germany spends $5,551
5. Ireland spends $5,528
6. Sweden spends $5,488
7. Netherlands spends $5,385
8. Austria spends $5,227
9. Denmark spends $5,205
10. Belgium spends $4,840
11. Canada spends $4,753
12. Australia spends $4,708
13. France spends $4,600
14. Japan spends $4,519
15. Iceland spends $4,376
16. United Kingdom spends $4,192 and
17. Finland spends $4,033

with all 17 of those countries offering more comprehensive coverage of equivalent quality to that of the United States of America.

Well?

Doesn't it?
​

isn't it?

The choices you are referring to are:

• Do I want to have healthcare insurance that will protect me from financial chaos if I get sick?
  • ____ YES
  • ____ NO
• If my answer to Question A. is "YES", do I want to
  • ____ pay 100% of $X.xx for a policy which may or may not actually protect me (but which will allow someone to make a lot of money regardless of whether it protects me); or
  • ____ pay less than 100% of $X.xx for a policy which will protect me (even though no one is getting rich by selling it to me)?

The likely answer to Question A. is going to be Answer a. in a close approximately of 100% of the cases.

That leaves Question B. as the operative question.

The likely answer to Question B. is going to be Answer b. in a close approximation of 100% of the cases (where the respondent is rational).

Any/all rational persons would most likely simply ignore your ridiculous questions.

 

[bluesmoke]

Yep, that is a 100% complete and irrefutable answer to

Which, of course, is a complete explanation of the fact that the US spends (all 2016 US dollar figures) $9,892 per capita for health care while

1. Switzerland spends $7,919
2. Luxembourg spends $7,463
3. Norway spends $6,647
4. Germany spends $5,551
5. Ireland spends $5,528
6. Sweden spends $5,488
7. Netherlands spends $5,385
8. Austria spends $5,227
9. Denmark spends $5,205
10. Belgium spends $4,840
11. Canada spends $4,753
12. Australia spends $4,708
13. France spends $4,600
14. Japan spends $4,519
15. Iceland spends $4,376
16. United Kingdom spends $4,192 and
17. Finland spends $4,033

with all 17 of those countries offering more comprehensive coverage of equivalent quality to that of the United States of America.

Well?

Doesn't it?
​

isn't it?

The choices you are referring to are:

• Do I want to have healthcare insurance that will protect me from financial chaos if I get sick?
  • ____ YES
  • ____ NO
• If my answer to Question A. is "YES", do I want to
  • ____ pay 100% of $X.xx for a policy which may or may not actually protect me (but which will allow someone to make a lot of money regardless of whether it protects me); or
  • ____ pay less than 100% of $X.xx for a policy which will protect me (even though no one is getting rich by selling it to me)?

The likely answer to Question A. is going to be Answer a. in a close approximately of 100% of the cases.

That leaves Question B. as the operative question.

The likely answer to Question B. is going to be Answer b. in a close approximation of 100% of the cases (where the respondent is rational).

"where the respondent is rational"

Aye, and there's the rub!

 

[TU Curmudgeon]

You should read more closely. You would find that Democrats have demanded that the following are treated as pre-existing conditions:

• cancer treatments (if they had already been diagnosed with cancer);
• renal dialysis (if they had already been diagnosed with kidney failure);
• cardiac insult management (if they had a history of heart attacks); and
• diabetic sequalae management (if they had already been diagnosed as having diabetes)

You could have added antiviral treatment to those already HIV positive. The pre and post partum you might actually be able to get a rider to cover now. That one is at least imaginable.

Did you know that there is no such thing as a "pre-existing condition" under the Canada Health Act? Did you know that the average annual per capita cost of providing healthcare in Canada is approximately 48% of what it is in the US? Did you know that in Canada (roughly) 25% more of the population has healthcare insurance than is the case in the United States of America? Did you know that the quality of healthcare available in Canada is equivalent to that available in the US? Did you know that (once you factor in the percentage of the population that simply doesn't get the needed healthcare) the average waiting times in Canada are actually shorter than the average waiting times in the US? Did you know that the average life expectancy at birth is longer in Canada than it is in the US? Did you know that the average expected healthy years of life is longer in Canada than it is in the US? Did you know that the international ratings of healthcare systems consistently rank the Canadian healthcare system as superior to the US one?

Obviously the only rational thing for the government and people of Canada to do is to abandon their existing healthcare system model and adopt the American one. Right?

Obviously it would be totally irrational for the government and people of the US to abandon their existing healthcare system model and adopt a different one since the existing American healthcare system model is so obviously superior to any other possible healthcare system model. Right?

 

[TU Curmudgeon]

Any/all rational persons would most likely simply ignore your ridiculous questions.

Absolutely. Depending on what you are using as a definition for "rational".

I DO NOT prefer to define "rational" as "totally disinterested in actually examining actual facts but completely wedded to mindlessly repeating slogans and cant that they have been told to believe actually make sense in the real world". Obviously, some people DO prefer to define "rational" as "totally disinterested in actually examining actual facts but completely wedded to mindlessly repeating slogans and cant that they have been told to believe actually make sense in the real world".

 

[Individual]

Absolutely. Depending on what you are using as a definition for "rational".

I DO NOT prefer to define "rational" as "totally disinterested in actually examining actual facts but completely wedded to mindlessly repeating slogans and cant that they have been told to believe actually make sense in the real world". Obviously, some people DO prefer to define "rational" as "totally disinterested in actually examining actual facts but completely wedded to mindlessly repeating slogans and cant that they have been told to believe actually make sense in the real world".

Until you have something constructive to offer I'll return you to my ignore list.

 

[TU Curmudgeon]

Until you have something constructive to offer I'll return you to my ignore list.

Je suis "crushed".

 

[Neomalthusian]

It should come as no surprise that the Trump administration has made enabling predatory actions by bad actors and promoting junk insurance the centerpiece of its health care agenda, such as it is. Junk plans--"short term" health plans, despite the fact that they're now available for the entire year--are on the verge of becoming a bonanza for hucksters no longer bound by consumer protection rules.

Think of these plans as the Trump University of health insurance. Beyond failing to offer the basic protections and coverage people have come to expect in the age of the ACA (pre-existing condition protections, no caps or limits, etc), short term plans on average spend an absurdly low 39 cents of every premium dollar they collect on actual medical care. By contrast, ACA-compliant plans are legally required to dedicate at least 80-85% of premiums on actual care.

Health Insurance That Doesn’t Cover the Bills Has Flooded the Market Under Trump

"Grifters gonna grift" remains the guiding philosophy of policy coming out of this administration.

Looking at the source (of the source), some of these loss ratios are all over the map (not just on ST plans). Even some plans with billions in revenue have loss ratios well under 80. Some of the ratios on accident, specific illness and “other” insurance are obscenely low as well.

https://www.naic.org/prod_serv/AHP-LR-19.pdf

Is the take home message that insurance in general is often ripping people off? It’s hard to see these numbers and conclude much else.

Why doesn’t market competition rein more of this in? And on ACA-compliant coverage, why aren’t these loss ratios used to deny premium increase requests?

 

[TU Curmudgeon]

Why doesn’t market competition rein more of this in? And on ACA-compliant coverage, why aren’t these loss ratios used to deny premium increase requests?

Because the people requesting the increases [a] make bigger campaign contribtions than the people opposing them, and because the people requesting the increases have total control over the data used to support their request and can use (or not use) whichever portions of it they think will best suit their requirements (for increased profits)?

 

[Neomalthusian]

Because the people requesting the increases [a] make bigger campaign contribtions than the people opposing them, and because the people requesting the increases have total control over the data used to support their request and can use (or not use) whichever portions of it they think will best suit their requirements (for increased profits)?

This is an unsupported conspiracy theory. Divisions of insurance and related regulators are not a bunch of elected politicians accepting campaign donations.

Further, if we should blindly assume government is so hopelessly corrupt, then it reflects very badly on any notions to look to government to address this problem or any other one.