Charles Blahous has an interesting post in which he analyzes a number of prospective reforms to the PPACA from the standpoint of three criteria:
- Does the reform correct a substantive problem with the law?
- Does it have or can it get bipartisan support?
- Does it improve or at least not worsen the law’s finances?
Unsurprisingly, although there are many prospective targets for reforming the law, none satisfy all of those criteria. It seems to me that the next step in this analysis should be an attempt at quantifying the effects of repeal.
Just as a reminder my view of the PPACA is that I think it’s a distraction. It needs to be fully implemented as soon as possible so we can return to the desperately needed chore of reforming our healthcare system with an eye towards cost reduction. To whatever extent the PPACA reduces healthcare costs that aspect of it operates in geological time and we don’t have geological time in which to make the changes we need.
Our family coverage premium is increasing 67% next year. It looks like we are being pushed into a “consumer driven” plan, which is a poor man’s HSA.
I’m afraid to find out about premium increase, because we just transitioned from an Aetna Gold to a Humana Platinum plan and have had 400% increases in two of our drug copays (from $60 to $237.) I had mistakenly thought these drugs were in third tier, but Humana has some additional tiers higher than that so I wasn’t comparing apples to apples when I was shopping out the insurance plan.
I’m already inclined to try stopping these prescriptions but was thinking we’d try to swing it and reevaluate whether the Platinum level still makes sense. If premiums go up as much as I’m hearing they might, there’s no way we can pay the Platinum premium and the high copays.
And to clarify- I’m not generally inclined to purchase Cadillac insurance. In fact in the past I have always considered the HSA/catastrophic insurance plan more sensible (but never was in charge of making the decision since we had insurance through an employer.)
My husband became self employed this year and when I looked at the available plans I saw that the lower tier plans are worthless and when I ran the numbers (based, unfortunately on a faulty assumption) the Platinum beat out the lower levels because of our heavy known ongoing medical expenses.
Coverage appears to be becoming more U-shaped, with physicals and certain introductory services free or close to free, but if your doctor prescribes medicine or a course of treatment after your physical, the health care coverage is hollowing out.
Our insurance has and continues to not charge for one wellness visit per year, but when our daughter had a biking accident a few months ago, which left her unable to move, the insurance covered about 15% of the cost of the urgent care visit for x-rays and a set of crutches. Turned out to be a contusion with some shock and she was fine in a few days. In retrospect the costs were excessive, the doctor ran extra tests in an “abundance of caution” for potential spinal cord issues, the child was largely incommunicative, and the parents are going to be cheap about spinal cord concerns either, particularly as the doctor is assuring us that it would be covered by our insurance.
In any event, seems backwards to me. Unplanned, unexpected event, which the insured has little control over is being expected to use “consumer power” to help drive down costs for things like that, but planned expenses like an annual visit are simply free. Of course, I avoid check-ups, even if they’re free — it’s how that get you.
Unfortunately, CStanley, I think the linked piece is only concerned with what is affordable to the federal budget, not our households.
Re: “Does the reform correct a substantive problem with the law?”
Obamacare fails this first test, since its mandates seriously infringes on the liberty and human rights including the right to work.
Indeed, the Third Reich law setting up concentration camps did solve the serious “Jewish Problem,” was passed unanimously by a democratically elected Reichstag, and served wonderfully to fill the coffers of the government and to ease the labor shortage.
That is the direction that I see it moving in as well, PD. My guess is that the idea is for all of the services beyond the PE to have more cost sharing with the consumer, which is not a bad concept but I don’t really think it is workable either. For one thing, the services that are expected and unexpected are all going to get swept up- maybe there is a way to separate them a bit but it would be cumbersome. And when it is an expected need, where the consumer theoretically can respond to the price pressure, there aren’t any good options. The blue pills really aren’t the same as the red pills, so the choice is to go into hock for the stuff that works or just forego the treatment altogether. Will the drug companies then respond by lowering prices as demand falls? Somehow I doubt it.
And yeah, I see that but was riffing off of your comment about personal expenses.
PD and CS are clearly wreckers, and Jimbino is a known enemy of the people. Everyone KNOWS that the PPACA has reduced costs for everyone. AFFORDABLE is right there in the title, folks, so don’t try pulling any of that crap on us!
More seriously, my wife’s company is weird, and their plans change on June 1. So we won’t know what’ll happen until then.
But this year we switched plans, again, and found some things better for a while. But the drug costs have gone up and will have burned through our FSA with six months to go. This is gonna suck. Especially as I need a procedure done that while not expensive in the absolute sense IS going to cost us more than we can reasonably pay. My options are wait another six months or bite the bullet an hope to work out a payment schedule.
The gamble is even worse because there is no guarantee that the procedure will either diagnose the problem, or lead to a reasonable treatment option that we can afford. Oy. And it just occurred to me that if they find anything DURING the procedure that could explode the cost. Holy Hell but this is hard.
But at least my refrigerator is working properly again! Fuck yeah, go Team DIY! Hey, I wonder if I can do a DIY colonoscopy….
So it sounds like health insurance is becoming less and less like insurance.
Less and less like insurance, and more and more like a screw job by the government, the health industry, and the insurance industry. And it’s mandatory or the IRS will give you a free and semi-permanent colonoscopy of their own!
Well, there you go icepick- your problem is solved!
Yeah, I’ve been thinking about this all wrong!