Larry

One of the great things about competition. Want to find out what's bad about an insurance plan? Just let his competitor tell you. one of the advantages you have, compared to a whole lot of people. Yeah, you no doubt get slanted information. But often, slanted information from multiple, competing, sources, beats the heck out of no information at all. (Which is what almost everyone else is stuck with.)

This is, perhaps, because it is the FICA tax. The "employer's contribution" of the FICA tax. (See, for every dollar if FICA that most people's employers take out of their paycheck, the employer is required to "contribute" another dollar. The self employment tax exists because, when someone is self employed, then he is both the employer and the employee. And, therefore, is on the hook for both halves of the tax.) Larry chose to let the topic drop, because Larry knew it was a distraction from the topic of the thread, and wasn't relevent to the question Larry asked. (Whether HSA contributions actually reduced said tax.)

I'm certain that lots of people's insurance costs have gone up. But how much of that is because the insurance companies doubled their rates, and how much is because their employer decided to cut back on the amount that he was chipping in? (And I absolutely guarantee you that nothing in Obamacare mandated that your rates double, two years before the mandates go into effect. Simply because, if there were such a clause in the law, people attacking it would be pointing at it, instead of finding people who's employer decided to eliminate their insurance (and pocket the money), and somebody claimed it was because of Obamacare.) ---------- It's one of the things that certainly makes discussing this topic tough. There's so much going on that the end user doesn't see. AND so many hidden things that it's pretty much impossible to compare apples to apples. (I've been saying for years that IF Obamacare can create an environment where it IS possible to compare apples to apples, then that might have more of a downward effect on health care costs than anything else in the law. But, I'm not certain that it can accomplish that goal.)

Pointing out that somebody in this thread (forget who) has made the claim that nationwide, health care costs have been increasing, but at half the rate they were increasing, before Obamacare passed. (I'm not at all sure I believe it, myself. But I haven't challenged it, and really haven't seen anybody else do so, either.) But yes, I assume that it's pretty much guaranteed that some increases are due to the law. (The law mandates coverage for some things. I understand that psychiatric treatment for alcohol or drug addiction, for example. You can argue about whether that mandate is good or not, but I think you'd have to be really divorced from reality to argue that said mandate didn't cost a dime.) (And other mandates, like mandating the same prices for men and women, I assume force rates higher for some people, and lower for others.) But I'll point out that there's a huge difference between "paying for benefits that have not been provided" (which, I will point out, is what insurance IS), and asserting that the money being paid in will NEVER be paid out. I assume it's certainly possible that all of the insurance companies are simply gouging people, and charging them vastly more than they intend to pay out in benefits. But it's not the first assumption I'd make. And it's certainly not proven.

Ah. I see we've fallen back on name calling. A tactic that seems inconsistent with trying to claim that the other guy is refusing to discuss the actual issue. But wait. Consistency is a word, therefore it's semantics. But let's leave aside the name calling, and see if there's actually a point, in there, to respond to. Really? You think that having a $0 deductible might cause people to spend more on health care? Let's examine that theory which might be true. Granted, I'm going from memory, but I seem to remember an assertion along the lines that 80% of your employees run through their deductible in three months or less, and that virtually all of them do so within the year. What percentage of the person in the "typical person buying the highest deductible plan on the exchange" profile, runs through $5000 in medical expenses, in the first three months of the year? Is it 80%? Or do their numbers differ from the numbers you're using your employees as examples of? Is it perhaps possible that your employees might have different health care spending, compared to the people signing up on the exchanges? Is it possible that these people aren't the average health care consumer? Therefore, is it possible that maybe we (let's be generous with the "we") could stop trying to use people with $0 deductible, fully paid, health insurance, to represent average people who are signing up for high deductible plans that they're paying for, themselves?

Ah. I see we've moved from "let's consider a hypothetical person under Obamacare, who has $12K in medical expenses, and pretend that Obamacare caused those expenses", to "let's assert that people are paying a thousand dollars a month for insurance which nobody will ever collect on". If the insurance companies never (or almost never) have to pay any money out, then why do the plans cost so much?

But who can afford $6000, without premiums. Yes, I understand that $6000, plus premiums, is more than $6000, without premiums. But Obamacare didn't make that person pay $6000. No, I will not allow you to play "let's compare a person who pays $6000, and premiums, against a person who pays no premiums, and doesn't get sick". Exactly. They aren't paying out "that kind of money". Not the kinds of numbers you keep trying to pretend are Obamacare's costs. They're paying out the premiums. Period. Every single dime of money, beyond that, is money that they would have paid, anyway. (And you have to engage in extraordinary levels of cherry picking, to make it even that bad.) When somebody signs up for Obamacare, they don't suddenly have to pay the premiums, and another $12K on top of that, that they didn't have to pay, before.

Thought I'd come back to this one. Yes, those are the family deductibles. The deductibles per person are lower. But then, you're all about "let's try to make the numbers as scary as I possibly can". But you are quite correct. If we assume a head of household. If we assume that he had no insurance whatsoever, before Obamacare. If we assume that he signs up for the highest deductible he's allowed to sign up for. If we assume that, next year, multiple people in his family need medical care. If we assume that his total family medical expenses are $12,000. (Not more, because if it's more, then the insurance starts paying) But, we assume that no individual in his family has more than $6,000.(If one individual has more, then the insurance starts paying.) If we assume that no one in his family used any of the services which Obamacare mandates not counting towards the deductible . . . THEN Obamacare will have cost this person . . . . the amount of the premium. And that's all. All of the other expenses will be expenses that he would have had, anyway. That's a whole lot of cherry picking, just to come up with a worst case hypothetical, where the worst case is "the amount of the premiums"

Might want to check the question again. (I know that moving goalposts is a full time job, around here. So I'll quote it.) Note: The question was "before their insurance will pay". Not "Well, it we assume that a person knows in advance that the only medical expense they will have, this year, is a kid's ear infection, then is it to their advantage to have any insurance at all?" Yes, we all understand that the premiums for "insurance" are higher than the premiums for "no insurance". It's just that the "no insurance" option has some rather scary risks, too. (And the "insurance" option has some benefits, before you get to that deductible, too.) But yeah, we all get that it is possible to construct a person for whom he will "lose money" on Obamacare insurance. (That's true of all insurance, actually.)

Haven't you heard? Obama is gonna throw people in jail if they don;t sign up. At least, that was the basis for the claims that the law was unconstitutional. ---------- Having got that out of the way, though, . . . . As I understand it, they very well might not (sign up) this year. As I understand it, the insurance plans are kinda expensive (because of various mandates designed to make plans cheaper for some people, at the expense of making them more expensive, on others). And the penalty for not signing up isn't very big. (And I could also see some people deciding to gamble, and to hope that the penalty gets repealed, before it becomes effective. Or similar excuses being used to justify not spending money, right now.) I'm not gonna be surprised at all, if complience isn't rather low. At least for 2014. And I would expect young people to be the main component in that demographic.

---------- Funny. I was under the impression that the Medicaid expansion was part of Obamacare. Really? HSA contributions don't count as income for purposes of FICA calculations? I'm not 100% certain that's not true, but it sure would be surprising, to me. Funny, I was under the impression that pretty much all plans had to comply with Obamacare's mandates. Kinda thought that was the excuse being given for why so many people's insurance are being cancelled. Coulda sworn that, one sentence ago, you were asserting that such plans don't even have to be compliant. Even used pretty colors to try to make that claim.

Really? How much does this hypothetical person, (concerning whom we have been given no information whatsoever), have to pay, right now? Would it be silly for me to ask where you're getting this "deductible upwards of $12,000" from?

I will point out that if that were his point, that the lower class would likely benefit a whole lot more from a plan that covers ear infections (and broken bones, and colds and flu, and cholesterol screening, and vaccinations, and things like that), than from a plan that covers major medical events, but only after said lower class pays a third of his annual salary, first, then I'd be agreeing with him. (And have stated that position, previously, in this thread.) But then, I have trouble with the dual assertions that Obamacare doesn't pay a dime for anything until after the poor is bankrupt, AND that it's outrageously expensive. To me, the fact that these plans cost so much is an indication that they DO cover things, before the insured goes bankrupt. If they didn't, then they'd be cheaper. But I've been saying since this debate started that I think that, to the poor, the un- or under-insured, that no-deductible coverage for the basic (and cheap) things would be vastly more helpful than coverage for cardiac bypass surgery. Simply because people get colds a lot more often than they have cardiac bypass. I certainly haven't seen anything that says they can't. (Admitting that I'm on my way out the door, and haven't got time to read your links.) Now, as to how many of the (people who will be going to the exchanges demographic) have the money to put into such accounts, I suspect that's not that big a number. Unfortunately, you're looking at a "person who used to have no deductible, and now that have a high deductible (and somebody else is pocketing the savings from the switch), and they hate it" . . . . . . and applying those feelings to "people who didn't have insurance at all, and now they have a high deductible plan, and they are pocketing the savings from choosing that plan".

Can you? Answer's complicated, isn't it? Here's a simpler one: Can you actually state your point?

Admiring the number of conservatives claiming, well, all kinds of. things. The government is going to mandate blood, urine, and hair testing as part of tax audits. They're complaining that Obamacare mandates things. (In fact, it's unconstitutional). AND mad that it doesn't mandate enough. Private insurance companies are going to charge people double what they're paying now, for insurance that won't pay for anything. (And it's Obama's fault, because he's making them do it).

And many people have claimed, in this thread, that that's all the lower priced plans on the exchanges ARE.

You mean, congress actually might do something? And, something desirable? And that might make things better? AND which actually brings reality into future budgeting, instead of creating a fictional future world? I'm having a LOT of trouble believing this.

Uh, at least as I understand it, people don;t have a choice as to whether to go with the exchanges, or with Medicaid. Well, actually, I think the choice is "You can go to the exchange, and pay full price, because the rule is, if you're poor enough for the Medicaid expansion, then you aren't eligible for any subsidies on the exchanges. (If you make more than the cutoff for Medicaid expansion, THEN you can get subsidies on the exchanges.)" (And, as I understand it, that was before Obama waved a magic wand, and announced that in some jurisdictions, where the state has chosen not to allow the Medicaid expansion, then Obama has allowed at least one of those states to take the money that was budgeted for Medicaid expansion, and spend the money, instead, on giving subsidies to people who weren't supposed to be eligible.)

I do see that a lot. My suspicion is that the margins have been cut so thin, that the only way for providers to make money is for them to be busy 100% of the time. Everything at the doctor's office is geared around one thing: Making sure that the Doctor has no idle time whatsoever. And I'm sure it's not just doctors, either. Recall hearing somebody (on here?) commenting that, where they are, the law says that there has to be one RN for every X patients. And every hospital and nursing home in the state has exactly that number. And that, if you do the math, it works out that that RN, in an 8 hour shift, has 18 minutes per patient. And that's only if said patients are considerate enough to need the nurse one at a time, in turn, spaced evenly throughout the shift. The impression I get is that there really isn't a whole lot of fat, to trim, medically. Now, when I was repairing computers, I saw a lot of billing offices. And I feel like there's got to be some way we could cut health care costs, by reducing the legion of people whose job is to deal with 137 different insurance companies and so forth. I think that the amount of administrative overhead in health care is probably staggering. I keep thinking that the insurance companies will come up with a way of simplifying all this. Since, after all, they're the ones paying for it. But it doesn't seem to be happening.

OT, anecdotal. Heard some woman doing a health call-in radio show, about natural cures and all. One of the things that struck me, was that it seemed like every single caller, no matter what their problem, Garlic was at least part of her answer. At one point she was lamenting the way the medical profession downplays the effects of diet and supplements. She said she was attending a medical conference, and overheard two doctors discussing the merits of two different brands of prescription anti-cholesterol pills. She walked up to them, stuck her nose in, and asked "What about garlic?" They looked puzzled at her. Eventually one of them said "But garlic only lowers cholesterol by 10%." Her response was "And . . . . ?" ---------- That said, though. I wonder, IF there is some kind of prejudice in the medical profession, towards pills, how much of it is because "When I tell the patient to exercise, or to cut down on fats, or whatever, they don't do it. But, when I tell them to take this pill, they do."

So, you don't object to how much they cost. You object to the fact that they're prescribed in the first place? I assume that Doctors disagree. (If they do object to them, then they should not prescribe so many of them.) ---------- That said, though. I came up with an idea, probably a decade ago. I don't think it should be legal to advertise prescription medication. I came to this conclusion when I came to the impression that a lot of pharmaceutical advertising consists of trying to get patients to pressure their doctors to prescribe things. My reasoning is that supposedly, requiring a prescription to need a prescription is a determination that only a trained professional has sufficient knowledge to decide whether this drug is right for you. That advertising prescription medication to consumers is like advertising Cap'n Crunch to children. (And I suspect that the drug companies are a lot more manipulative than the cerial companies. Because there's a lot more money involved. I assume that they aren't just advertising, but bet that they do things like "visit our web page, and we'll steer you towards the doctor that prescribes more Damitol than any other doctor in your county." Part of my reasoning for this was that, 10 years ago, Mom watched a steady diet of Matlock, on TV. And, on that show, I'd say a third of the commercials were for drugs. And every commercial Mom saw, she wanted. Even the erectile dysfunction ones. (Another third of the commercials were for electric scooters or stair lifts "completely free to you. Medicare pays for it.". And the other third were "If you or anyone you know has ever had anything bad happen to them, anywhere within 100 yards of a nursing home, call 1-800-. . . ")

Well, they certainly are contributing. "Biggest", I think, she's wrong on.

I'm not 100% certain that it's impossible. I've been saying for years that I think what's needed, in a perfect world, would be a single payer, national, taxpayer-paid, basic health care coverage. Something that would cover things like doctor visits when you have a cold. X rays. Blood tests. Diagnostics. The kinds of things that I assume are done at urgent care centers. Basics. And let the private insurance industry compete to sell coverage that takes over, after the basic coverage stops covering. Medicare supplement coverage, so to speak. I would assume that something like that would be pretty cheap, because I assume that those aren't the big ticket items that drive up the cost averages. I could also see a single payer system offering several advantages to that kind of care. It would mean that everybody would accept that insurance (since that's the insurance that 100% of the people have.) Providers in that segment of the business would have only one set of (hopefully minimalist) billing procedures to deal with. (Hopefully cutting down on the administrative overhead, which I suspect is a major part of health care costs.) Hopefully, it would lead to such care being available on short notice. Unfortunately, I'm not sure something like that would work, in the real world. The threat that I see is that, if something like that goes into effect, everybody in the world is gonna be leaning on the government to add more and more things to the universal coverage. (Should electric scooters be covered? I can see some arguments in favor of it. And so forth.) Everybody. Providers, the insurance companies, the voters. Everybody will want this plan to cover everything. The result on Congress, of all of those special interests all pulling in the same direction, is predictable. But, I think it would be a great idea, in theory. ---------- Ah, got it. I'm Semantic Larry, and you "simply asked".

I would agree, If I saw somebody try8ng to argue that "well, if you're mad about Obamacare, you should be mad at the Republicans, cause they did it." (Although, the counter argument that the Republicans had absolutely zero effect on it whatsoever, in fact, the continuing attempt to complain that they never even saw or debated it, is, well, let's just say it's roughly equally true.) But I'm not seeing people try to make that claim. I see people trying to claim that the Republican refrain that this is a treasonous nationalization of the health care industry, and the worst thing done to the country since Social Security, and a socialist takeover, is simply political theater. (Which it pretty much is.) Reduce? Absolutely not. Nothing will reduce health care spending. (Well, maybe a program of killing everybody in the country when they turn 70, or something equally impossible.) Will it result in spending that's lower than it would have been, without it? I suppose there's a slim chance. But I'm sure not counting on it.

That would explain things. If different ages were charged differently, but there's cap, or some other artificial constraint. And I assume prices change based on location, because health care costs may change based on location. Starting to look like at least part of the problem is that whole thing about "good intentions". Attempts to artificially help certain demographics. (At the expense of others.) (Although, when I see them trying to artificially lower prices for women, I assume it's payback for women voting Democrat. But then, trying to artificially lower rates for people in their 50s, by raising prices on people in their 20s? The young folks are a D constituency.)