It’s never good when actuaries collectively fall down on their job and fail to make good predictions, and it appears that this has happened with their efforts to estimate the total cost of claims under Obamacare health care plans. But let’s take a look at what caused the problem:
…Marinan R. Williams, chief executive of the Scott & White Health Plan in Texas, which is seeking a 32 percent rate increase, said the requests showed that “there was a real need for the Affordable Care Act.”
“People are getting services they needed for a very long time,” Ms. Williams said. “There was a pent-up demand. Over the next three years, I hope, rates will start to stabilize.”
…In its proposal to increase rates by an average of 25 percent for more than 397,000 consumers, Blue Cross and Blue Shield of North Carolina cited “inpatient costs, particularly in treatment of cancer and heart conditions, emergency room utilization, and cost for specialty drug medications” to treat hepatitis C, breast cancer and cystic fibrosis.
We had a bunch of people who had cancer, hepatitis, cystic fibrosis and other fairly urgent medical needs who were going untreated because they could not afford or access adequate care. You know what happens when you let millions of people go without preventative care or treatment for their progressive diseases?
Either they die, or it costs more money than it should have to keep them alive. You can consider this a bill that the past delivered to the present.
You want to know what is exactly like this?
The cost of maintaining critical infrastructure like tunnels, bridges, roads, railway tracks, and airports. When we finally get around to addressing our infrastructure needs, don’t be surprised if it costs more than the experts predict.
If you act stupid and greedy for any period of time, there’s a very big price tag for that.
Since it IS the fourth of July, please let me commercialize my response!
The ACA- OBAMCARE for Haters,is like oil changes on your car. You either pay me( society) now, or pay me( what happens when there is NO preventive maintenance) later!
With the ACA, people will be able to properly maintain their bodies, sooo the big LATER is not so expensive and
has a good chance for repair and go on to putter more miles!
Some of the young invulnerables paid their $95 and stayed out of the pool. As that penalty goes up, they’ll start to be driven into the pool.
When they get a chronic disease or need an operation they will get in the pool.
Oh, dear. The young invulnerables aren’t into paying for high profit health insurance and high profit medical care for others. Others that just happened not to have paid for others when they were themselves young and invulnerable.
The real problem here is that the politicians that have made the decisions in the past, did so knowing for them there would be no real personal cost. What needs to be done is ALL of Congress needs to be held responsible for their voting choices financially. Want the Government programs to operate smoother and more efficient? Then financially penalize those that vote against what is best for the USA. When it starts hitting their personal wallets they will take notice.
How do we determine ‘what is best for the USA’, exactly?
Why whatever Obama tells us, of course!
Don’t nit pick the TPP. Don’t criticize Indonesia. It all about jobs. Just trust me.
Well I would hope that some things would be very simple to understand what is good for the country. Infrastructure repair is one.
Clean air is another.
Clean drinking water.
I am sure there are numerous other examples. If you are really interested in it go for a drive and look around. While you are at it go to a VA hospital and see the carnage that my fellow Veterans have suffered and the then check out the numerous benefits that has been cut by Congress for us or getting medical benefits, vision and DENTAL is not due those that have served the country?
Your question is better directed at those that vote for the Congressional austerians, aka, Republicans and Democratic neoliberalcons.
Well since we don’t have a sect of infrastructure haters outside of Washington, there’s not even the excuse of bowing to the ‘govt run health care is socialism’ crew.
Instead, the infrastructure crumble is pure robbing Paul to pay Peter laziness. The Halliburtons won that round where Defense industry came first, now the 2nd round is almost over and they’re sitting mightly fine.
Note, it’s been over 100 here for a week, all the roads are literally caving in, the West is just smoldering so we’re coming face to face with the reality that climate change is going to bring our infrastructure to its knees.
(To head off any criticism, let me state that I’m an advocate for UHC. However, on a per capita basis the US “system” costs twice as much as that in other countries, and in those countries the per capita costs include everyone whereas in the US little to nothing is consumed by a large proportion of the population.)
Or perhaps the actuaries were directed not to do their work correctly? (Not at all uncommon for upper management to direct actuaries to come up with a “better” number.)
The rates that were posted on-line that I scanned, sure looked like teaser rates to me after factoring the population purchasing the coverage. Attempted to point that out but was told that I was either an idiot or an Obama hater.
Have to wonder how far off the expanded Medicaid will end up costing.
US doctors charge about twice as much as European doctors. That’s not all profit because European doctors don’t have massive student loans, or any student loans unless they went to school in the USA. Us Pharma costs MUCH more because there is no negotiation.
Germany in particular still uses wards instead of semi-private rooms. Don’t know if this really makes a lot of cost saving. I wouldn’t think so unless they are cutting the nurse/patient ratio.
Very good point about per capita costs vs per patient costs.
If the physicians’ education/training debt were truly a significant driver in the high cost of US healthcare, collectively we could fix that quickly and simply. But we actually know that it’s a medical-industrial-complex and bogus claim because primary care doctors in the US don’t earn more than their UK-European counterparts and most earn less. Primary care physicians, in general, have less total educational debt than specialists, but their debt to income ratio is higher than that for specialists.
PHarma and all the other components of the US healthcare system could make the same claim: “We have to pay our employees more because they too are carrying large amounts of student loan debt.”
Higher education in the US has become a seller’s market. And to some extent that has largely always been true in medicine because the profession restricts the number of med schools and number of students to limit the competition which in turn keeps their incomes high. The situation was problematical back when Truman proposed UHC, but at least then med schools were pumping doctors in the various disciplines that was reasonably balanced (although overall there were too few). What’s happened since then is that they have been pumping out far too few primary care docs and far too many specialists. They’ve found the “holy grail” in capitalism — increase the supply of high-end products beyond the demand/need and prices go up.
At the federal level, we actually know how to correct some of the imbalance – National Health Service Corps. Although the program has been underfunded (slightly increased in the PPACA which was one of the few good components of it). However, this program is still dependent on med schools that aren’t turning out enough primary care docs. (Similar problem with nursing programs.) A more robust public education system for health care professionals would alleviate some of the disfunction, but as this is a significant public investment, federal/state coordination would be helpful so that say California taxpayers aren’t funding new doctors that will practice in say Texas and there’s no vice versa.
It’s my understanding that semi-private hospital rooms are disappearing in the US. Everybody wants a private room. Probably some measurable improved health outcomes with private rooms. That is a metric that hospitals (and the public) like. But it does increase costs. Wards are much less costly and if combined with highly restrictive visitor policies may produce health outcomes equal to that of private rooms. An issue for a no-visitor policy is a patient’s psych health. Being not physically well AND isolated from family and friends isn’t healthful. However, with a smart phone, would younger patients today even perceive that they were isolated? With headphones, the other major problem for patients in wards — noise — is reduced. (Apparently a desirable prison commissary product. If we were more humane, it would be a standard issue for all prisoners.)
My rate doubled this year, and even though I make less money, my subsidy dropped. I haven’t paid my premium in months, bease I can’t afford it. Blue cross sent me a bill for $770 in back payments, which I’m not paying because I cant. I’m registering for Medicaid in PA when I get home, but I got rejected a few months ago, and expect the same.
I knew this was going to wind up like this.
Also, I am currently uninsured. Blue cross dropped me for nonpayment in May. Can’t get blood from a stone.
I knew this was going to wind up like this.
Why did your subsidy drop if you’re making less money? Do you mean that you did not shop for insurance at HealthCare.gov during open enrollment and thus recalculate your subsidy for this year?
Nope, I shopped. That’s what the navigator told me. I could have had a cheaper rate, but that would have meant changing my doctor, a higher deductible, and switching insurance providers. Philly is a Blue Cross town, and far fewer doctors accept the other available plan. Aetna was too expensive.