Obamacare...(new title): GOP DEATH PLAN: Don-Ryan's Express

[chipwhich]

The link at the NYT that I posted before includes a graph based on the CMS data.

 

The link includes a link to the zip file that includes an excel and a cvs file that includes all costs from 1960-2012, and then is broken down into categories, including out of pocket costs, insurance costs, and government costs.

 

Then it breaks it down further into other categories (e.g. hospital spending).

I've posted links that include analysis on total health care costs, and out of pocket costs in this thread.

 

In each cases, the rate at which costs are growing is decreasing.

 

If you have a significant question that is worth any discussion at this point in time, I don't see it.

 

Again, you aren't answering the question, and I have asked it over and over.  Where is a chart showing premiums, deductibles, and copays and the total costs?

 

Some posts from your links:

 

The last few years have seen a significant slowdown in the growth of health spending. Across nearly every measure — medical price growth, employer insurance premiums, per capita Medicare spending — the amounts the country spends on health care have increased by much smaller margins than the nation is used to.

 

Where is the accounting for deductibles and copays????

 

And this:

 

The typical answer includes the recession (individuals and hospitals, facing financial stresses, reduced their health care spending); the rise of high-deductible health insurance plans;

 

[PeterMP]

Again, you aren't answering the question, and I have asked it over and over.  Where is a chart showing premiums, deductibles, and copays and the total costs?

 

Some posts from your links:

 

The last few years have seen a significant slowdown in the growth of health spending. Across nearly every measure — medical price growth, employer insurance premiums, per capita Medicare spending — the amounts the country spends on health care have increased by much smaller margins than the nation is used to.

 

Where is the accounting for deductibles and copays????

 

And this:

 

The typical answer includes the recession (individuals and hospitals, facing financial stresses, reduced their health care spending); the rise of high-deductible health insurance plans;

 

That's the point you made the first time I posted it, which is why I went out and found a link that talked directly about out of pocket costs.

 

Out of pocket costs growth rates are lower in 2013 then any year analyzed in the link I've already given you.

 

What significant point do you have other than nobody in the internet has actually collated the data the way you want in a single source and graph.

 

The rate at which out of pocket costs are increasing is going down.

[JMS]

http://www.nytimes.com/interactive/2014/10/27/us/is-the-affordable-care-act-working.html?_r=0#/

So read it and weep.. I think the criticism of Obamacare isn't that it was some radical game changing bill which dramatically changed our system. I think the reality is it was modest change, (If adding 20 million people to the insured list can be called modest) with modestly positive outcomes so far for the average consumer. The criticism is frankly it wasn't radical enough.

Obamacare was all about trying to get more people insured.. trying to make sure being insured meant something and in a revenue neutral way. Our healthcare costs are still the most expensive in the world and still dramatically more expensive per-capita than every other comparable industrialized country which all enjoy universal coverage systems.

Is the Affordable Care Act Working?

#1 Has the percentage of uninsured people been reduced?

Yes, the number of uninsured has fallen significantly.

#2 Has insurance under the law been affordable?

For many, yes, but not for all.

.....

For now, dire warnings that the law would cause premiums for most people to rise sharply have proved unfounded. The law has spurred competition, with new companies entering the market.

#3 Did the Affordable Care Act improve health outcomes?

Data remains sparse except for one group, the young.

......

Overall too soon to tell.. but in young people the data seems to suggest yes.

#4 Will the online exchanges work better this year than last?

Most experts expect they will, but they will be tested by new challenges.

#5 Has the health care industry been helped or hurt by the law?

The law mostly helped, by providing new paying patients and insurance customers.

#6 How has the expansion of Medicaid fared?

Twenty-three states have opposed expansion, though several of them are reconsidering.

#7 Has the law contributed to a slowdown in health care spending?

Perhaps, but mainly around the edges.

...

For decades, health care costs have been rising much faster than the rest of the American economy, outrunning inflation and wages and driving a growing imbalance in the federal budget. With the Affordable Care Act, President Obama promised to slow it all down. The law, he said often, would “bend the cost curve,” flattening health spending’s precipitous rise and making health care more affordable for the country.

The last few years have seen a significant slowdown in the growth of health spending. Across nearly every measure — medical price growth, employer insurance premiums, per capita Medicare spending — the amounts the country spends on health care have increased by much smaller margins than the nation is used to.

But it is hard to make a case that the Affordable Care Act deserves substantial credit for the recent trend

Edited October 30, 2014 by JMS

[chipwhich]

That's the point you made the first time I posted it, which is why I went out and found a link that talked directly about out of pocket costs.

 

Out of pocket costs growth rates are lower in 2013 then any year analyzed in the link I've already given you.

 

What significant point do you have other than nobody in the internet has actually collated the data the way you want in a single source and graph.

 

The rate at which out of pocket costs are increasing is going down.

 

Again, all of the numbers being posted don't account for the fact that health care costs are going down because of high deductible health care plans.  What I have said over and over is the amount, we the people pay isn't being calculated in these costs.  Your link basically says as much yet you keep telling me you posted a link which explains it.

WHY would they refer to the increase in high deductible plans reducing costs if that wasn't true?  It's simple logic.

[chipwhich]

Peter,

 

Just to follow up.  If high deductible plans are bringing costs down, doesn't it ring true to you that the money spent on the deductible isn't calculated in that number?  It's not rocket science. 

[JMS]

Again, all of the numbers being posted don't account for the fact that health care costs are going down because of high deductible health care plans.  What I have said over and over is the amount, we the people pay isn't being calculated in these costs.  Your link basically says as much yet you keep telling me you posted a link which explains it.

WHY would they refer to the increase in high deductible plans reducing costs if that wasn't true?  It's simple logic.

The NYTimes article I posted says deductibles are only 1 of four reasons being cited for the slowdown. And that the trend is global, and began before Obamacare passed.

See slowdown in healthcare spending..

http://www.nytimes.com/interactive/2014/10/27/us/is-the-affordable-care-act-working.html?_r=0#spending

Edited October 30, 2014 by JMS

[chipwhich]

The NYTimes article I posted says deductibles are only 1 of four reasons being cited for the slowdown. And that the trend is global, and began before Obamacare passed.

See slowdown in healthcare spending..

http://www.nytimes.com/interactive/2014/10/27/us/is-the-affordable-care-act-working.html?_r=0#spending

 

Again, I posted the facts, but ya'll keep ignoring them.  High Deductible plans decrease the slowdown in health care spending because they don't count those costs in healthcare spending.

 

I could get into what people USED to pay in healthcare when it only includes PREMIUMS but it seems lost on everyone.

 

Why aren't deductibles considered.

[PeterMP]

Peter,

 

Just to follow up.  If high deductible plans are bringing costs down, doesn't it ring true to you that the money spent on the deductible isn't calculated in that number?  It's not rocket science. 

 

From my post previously:

 

"Out-of-pocket expenditures are payments made by insureds directly to medical professionals, facilities, pharmacies, and other providers and suppliers, and are among the most visible health care costs to consumers"

 

And from the link I gave earlier:

 

"Out-of-pocket expenditures per capita: Out-of-pocket payments include the patients’ share of payment for the provision of health care services and prescriptions covered by insurance; this includes any copayments, coinsurance payments, or deductible payments. If an insurance claim was not filed (for example, for the purchase of over-the-counter medicines), the expenditures are not included in this metric. HCCI calculated out-of-pocket expenditures per capita by dividing total

out-of-pocket expenditures by the total insured population."

 

Would that include payments required because a deducatable hasn't been reached healthcare costs?

 

YES!

 

Here's an idea.  In the future, if you don't understand something instead of insisting things that are clearly wrong (that health care costs and out of pocket health care costs must not include costs that people are paying because they have a high deductable), try asking a question.

 

Instead of insisting that number X must not include number Y even though based on the definition of the number (e.g. total healthcare costs wouldn't really be total health care costs if they didn't include the money that people were paying because their costs wasn't covered by their deductible) and pretending like you have any clue what you are talking about, try saying that doesn't make sense to me can you explain it.

 

And MAYBE somebody will explain it to you.

 

The reason that high deductible plans are believed to lower health care costs is that they make the payer more responsible for the costs and therefore the payer more likely to make decisions based on costs and end up in many cases using less health care and/or cheaper health care (e.g. generics vs. brand prescriptions).

 

For example, I am slightly sick.  Maybe I have a small fever.  I have a no deductible insurance and a sick visit to my doctor is completely covered in my plan.

 

So I go to the doctor.  The doctor decides to practice defensive medicine and prescribes me an antibiotic.

 

There's costs associated with that.  That usage increases the amount of health care spending.

 

I'm in a high deductible plan.  The sick visit isn't going to be covered.  If I go, I am going to be paying out of pocket.

 

I don't go (at least not right away).  I wait two days and after two days I'm starting to get better.  It was probably just a virus and the doctor visit and antibiotics would have in reality done me no good.

 

I've used less health care.  I've spent less money on health care.  Health care spending is down.

 

There's actually quite a bit of literature on high deductible plans and their expected affect on health care spending and health out comes.

 

And the use of less health care is at least a large part of what we see with respect to lowering spending recently in health care.

 

(I'll also point out that lowering usage is part of what parts of the ACA is attempting to do too.  The link I quoted before talks about re-hospitalization.  If you leave the hospital unsure about what you are supposed to do at home (in terms of things like taking medications), get sick because of it, and end up back in the hospital as a result, then you've used more health care then really needed, and health care spending will god up.)

 

The rate at which total healthcare spending is increasing is falling and that includes payments made because of high deductible plans.

 

The rate at which out of pocket spending for health care, which includes payments made because of high deductible plans, is increasing is falling.

Edited October 30, 2014 by PeterMP

[chipwhich]

And MAYBE somebody will explain it to you.

 

The reason that high deductible plans are believed to lower health care costs is that they make the payer more responsible for the costs and therefore the payer more likely to make decisions based on costs and end up in many cases using less health care and/or cheaper health care (e.g. generics vs. brand prescriptions).

 

For example, I am slightly sick.  Maybe I have a small fever.  I have a no deductible insurance and a sick visit to my doctor is completely covered in my plan.

 

So I go to the doctor.  The doctor decides to practice defensive medicine and prescribes me an antibiotic.

 

There's costs associated with that.  That usage increases the amount of health care spending.

 

I'm in a high deductible plan.  The sick visit isn't going to be covered.  If I go, I am going to be paying out of pocket.

 

I don't go (at least not right away).  I wait two days and after two days I'm starting to get better.  It was probably just a virus and the doctor visit and antibiotics would have in reality done me no good.

 

I've used less health care.  I've spent less money on health care.  Health care spending is down.

 

There's actually quite a bit of literature on high deductible plans and their expected affect on health care spending and health out comes.

 

Peter, please.  I understand what a high deductible plan is.  I run a business, I buy health insurance.  I am more versed in health care costs than the average person.  I purchase it and review it every year.  I know why high deductible plans lower prices, I switched to them in my business to drive down costs.

I will ask you in as simple terms as I possibly can.  Show me a chart that shows health care costs and how they compare historically which includes deductibles and copays.  I am not asking that difficult of a question.

 

I don't not understand anything.  I understand everything.  What I HAVEN'T seen is a chart that includes all costs including deductibles and copays.  You keep posting links that don't show that.  Then you try and explain insurance to me.  I understand what I buy.

 

[PeterMP]

Peter, please.  I understand what a high deductible plan is.  I run a business, I buy health insurance.  I am more versed in health care costs than the average person.  I purchase it and review it every year.  I know why high deductible plans lower prices, I switched to them in my business to drive down costs.

I will ask you in as simple terms as I possibly can.  Show me a chart that shows health care costs and how they compare historically which includes deductibles and copays.  I am not asking that difficult of a question.

 

I don't not understand anything.  I understand everything.  What I HAVEN'T seen is a chart that includes all costs including deductibles and copays.  You keep posting links that don't show that.  Then you try and explain insurance to me.  I understand what I buy.

 

Charts of total healthcare costs include co-pays and deductibles.

 

There is one at the NYT link I posted earlier in this thread.

 

But your largest issue seems to be how high deductible plans can actually lower out of pocket costs.

 

The other link I linked to directly addresses out of pocket costs.

 

And the rate at which they are increasing is going down.

 

In addition, the CMS link that I provided has a link for an Excel sheet that includes health care costs (which includes co-pays and money paid because it was not covered by high deductible plants), and then they break down into sections (e.g. out of pocket expenses).

 

The rate at which health care costs are going up is declining.  The rate at which out of pocket health care costs are going up is declining.

Edited October 31, 2014 by PeterMP

[chipwhich]

Peter,

 

My largest issue isn't how high deductible plans lower out of pocket costs.  My issue is you and others seem to claim they do and costs are going down.  Maybe I can explain myself a little more clearly.

 

I renew my insurance every year.  My insurance bill was skyrocketing.  The only way I could control my bill was to move to a high deductible system which pushed deductibles to my employees (in my case I paid their deductibles for them but that isn't the norm).  Year 1 I had to go to a $1200/$2400 high deductible system.  $1200 for single, $2400 for family.  EVERY other aspect of the plan remained the same, doctors, insurance companies, copays.  A few years into high deductible prominence and my employees deductibles are now $2000 and $4000 single/family.  In addition I had to change the insurance company from BCBS to Cigna.

I was able to "control" costs but my employees and I are not receiving the same benefits that I had prior to the high deductible plan.

 

I am basically buying a different product.  When these high deductible products get pushed to an insured, the ONLY way that out of pocket costs can decline is if a) the insured don't go to the doctor because they don't want to pay for it and stay home sick or the numbers in your chart don't include the deductible.  I did try and look at the spreadsheet, it's pretty complicated and I couldn't figure it out.  I also asked you to post the specific spot in the NYT article where it says it includes all deductibles but I haven't seen where in the article it says that.

 

Regardless, the insurance in these high deductible plans will do 1 of two things.  Stop you from getting care because it will cost you money, OR cost you more out of pocket.  There has been a short term savings in the cost of premiums, but with the proliferation of high deductible plans and an increasingly high percentage of the population moving to them, the premium blip in the costs will be short lived.

 

Prices have been held in check by playing this deductible game.  But it's a temporary savings.  As a buyer for my company, I am running out of moves to keep my premiums in check because I am now all in on the high deductible play and I got no more cards being dealt to allow my to bypass the premium skyrocketing game....well other than pushing my deductible up even higher.

Edited October 31, 2014 by chipwhich

[ABQCOWBOY]

Personally, my healthcare costs have increase 4 fold since we have gone to the Affordable Care Act.  That's all inclusive and I actually cover two less people, with no major medical incident.  This is just for business as usual health coverage.  That's the reality for me. 

 

And this does not include prescription drug increases.  This is only for the cost of the plan. 

Edited October 31, 2014 by ABQCOWBOY

[PeterMP]

When these high deductible products get pushed to an insured, the ONLY way that out of pocket costs can decline is if a) the insured don't go to the doctor because they don't want to pay for it and stay home sick or the numbers in your chart don't include the deductible.

 

I've already explained this in the concept of a sick visit.  If for minor issues, I don't go to the doctor, then I don't pay the co-pay for the visit (I'm guessing your insurance didn't completely cover sick visits before going to a high deductible plan).  I don't pay whatever the co-pay are to me because the doctor is practicing defensive medicine.

 

And other costs are going down.  The most highly used prescription drugs are all getting cheaper.  My mom has gone to something that she was paying $150 for (I don't know what her insurance was paying) to $3 because it is now a generic.

 

That sort of savings can off set spending shifting to high deductible plans.

 

Here's quote from the link again that talks about what is in out of pocket expenses:

 

""Out-of-pocket expenditures per capita: Out-of-pocket payments include the patients’ share of payment for the provision of health care services and prescriptions covered by insurance; this includes any copayments, coinsurance payments, or deductible payments. If an insurance claim was not filed (for example, for the purchase of over-the-counter medicines), the expenditures are not included in this metric. HCCI calculated out-of-pocket expenditures per capita by dividing total out-of-pocket expenditures by the total insured population.""

 

Just because you don't understand something doesn't make it wrong.

 

And the results of that study show that the rate of growth of out of pocket costs is decreasing for people with insurance.

 

Guess what the numbers they are talking about includes?

 

Can you tell me?

Edited October 31, 2014 by PeterMP

[chipwhich]

Peter,

 

I am buying insurance for my employees.  I fully understand what is "covered".  Sick visits aren't covered.  You don't get free sick visits.  I can roll out a bunch of links to show you are wrong if you want me to.  Again I am well aware of what high deductible plans are.  I have one for my family and my employees.  I have been using one the last 3-4 years.  I know all of the issues and benefits of the plan.

 

Your singular example of your moms prescription is a meaningless example.  I have one example where a 2 month prescription drug was in the 10's of thousands of dollar.

 

And you missed the entire point in my previous post.

 

I will go back to the NYT article and reread the part you posted and reply shortly.

[PeterMP]

Peter,

 

I am buying insurance for my employees.  I fully understand what is "covered".  Sick visits aren't covered.  You don't get free sick visits.  I can roll out a bunch of links to show you are wrong if you want me to.  Again I am well aware of what high deductible plans are.  I have one for my family and my employees.  I have been using one the last 3-4 years.  I know all of the issues and benefits of the plan.

 

Your singular example of your moms prescription is a meaningless example.  I have one example where a 2 month prescription drug was in the 10's of thousands of dollar.

 

And you missed the entire point in my previous post.

 

I will go back to the NYT article and reread the part you posted and reply shortly.

 

1. I never said that anybody gets free sick visits.

 

2.  That's not from the NYT link.  It is from the other link I gave you, and I've quoted from (including that quote) several times now.

 

Here's the other quote I pulled from it:

 

"Between 2012 and 2013, out-of-pocket ex-penditures per capita rose from $660 to $800 (Table 1). This 4.0% increase was the lowest growth in the out-of-pocket spending during the study period."

 

Can you tell me what is included in out of pocket costs?

 

3.  And if it was just my mom, you'd have a point, but it isn't so:

 

http://online.wsj.com/articles/SB10001424127887323494504578340393335386084

 

"Spending on basic prescription drugs like cholesterol-lowering pills recorded a rare decline in the U.S. last year, but spending on more complicated drugs continued to soar, according to the nation's biggest pharmacy-benefit manager."

 

It is something that is happening on a population wide (at least with in the US) level.

Edited October 31, 2014 by PeterMP

[chipwhich]

I've already explained this in the concept of a sick visit.  If for minor issues, I don't go to the doctor, then I don't pay the co-pay for the visit (I'm guessing your insurance didn't completely cover sick visits before going to a high deductible plan).  I don't pay whatever the co-pay are to me because the doctor is practicing defensive medicine.

 

Then what does this mean????

[PeterMP]

Then what does this mean????

 

The doctor prescribes antibiotics because I have a fever when I go there sick.  It is almost certainly just viral, but just in case the doctor prescribes them any way.

 

I have a co-pay for the antibiotics.

 

or blood tests or whatever the doctor decides to do based on what drove me to the visit them.

 

The end result is that not visiting the doctor for a case where it is really probably unnecessary saves me money.

 

On a side note, the other thing that is happening with the move to high deductible plans is plans that limit annual out of pocket costs.

 

I pay more up to a spending point, but then I actually pay less (or none).

 

On an average year, I pay more, but if I have a year with a lot of expenses, I pay less.

 

This helps control out of pocket costs at a population wide level.

 

http://www.washingtonpost.com/blogs/wonkblog/wp/2014/09/10/yes-you-are-paying-a-lot-more-for-your-employer-health-plan-than-you-used-to/

Edited October 31, 2014 by PeterMP

[chipwhich]

3.  And if it was just my mom, you'd have a point, but it isn't so:

 

http://online.wsj.com/articles/SB10001424127887323494504578340393335386084

 

"Spending on basic prescription drugs like cholesterol-lowering pills recorded a rare decline in the U.S. last year, but spending on more complicated drugs continued to soar, according to the nation's biggest pharmacy-benefit manager."

 

It is something that is happening on a population wide (at least with in the US) level.

 

We are really veering of the issue I that I am speaking to.

 

http://www.businessweek.com/articles/2014-05-08/why-prescription-drug-prices-keep-rising-higher

 

Increases in prices for existing branded prescription drugs accounted for $20 billion of the industry’s 2013 sales growth before discounts and rebates. That largely offset $19.3 billion in revenue declines because of patent expirations, according to the IMS Institute for Healthcare Informatics.

The doctor prescribes antibiotics because I have a fever when I go there sick.  It is almost certainly just viral, but just in case the doctor prescribes them any way.

 

I have a co-pay for the antibiotics.

 

 

 

Peter, I can get into a drawn out discussion of how high deductible plans work.  Trust me I understand them.  You keep making statements that are wrong, then I respond, then you change the statement.

 

If you are sick and got to the doctor and your deductible is $1,000.  You pay out of pocket for the doctors visit.  If your doctor at that visit prescribes you a drug that costs $500.  If you haven't reached your deductible you pay that $500 for the entire cost of the prescription.  You don't get it for a copay.  The number 1 cause for my employees to burn through their deductibles is prescription drug costs.

 

On a side note, the other thing that is happening with the move to high deductible plans is plans that limit annual out of pocket costs.

 

I pay more up to a spending point, but then I actually pay less (or none).

 

On an average year, I pay more, but if I have a year with a lot of expenses, I pay less.

 

Perhaps you missed all of my posts where I said moving to high deductible plans is pushing us to better catastrophic coverage but more money out of pocket for basic coverage.

Edited October 31, 2014 by chipwhich

[PeterMP]

We are really veering of the issue I that I am speaking to.

 

http://www.businessweek.com/articles/2014-05-08/why-prescription-drug-prices-keep-rising-higher

 

Increases in prices for existing branded prescription drugs accounted for $20 billion of the industry’s 2013 sales growth before discounts and rebates. That largely offset $19.3 billion in revenue declines because of patent expirations, according to the IMS Institute for Healthcare Informatics.

 

 

Peter, I can get into a drawn out discussion of how high deductible plans work.  Trust me I understand them.  You keep making statements that are wrong, then I respond, then you change the statement.

 

If you are sick and got to the doctor and your deductible is $1,000.  You pay out of pocket for the doctors visit.  If your doctor at that visit prescribes you a drug that costs $500.  If you haven't reached your deductible you pay that $500 for the entire cost of the prescription.  You don't get it for a copay.  The number 1 cause for my employees to burn through their deductibles is prescription drug costs.

 

1.  That's right in 2013.  2013 saw a small increase as compared to what we were seeing in the last 2 decades.  The rate at which the increase is going up is down.  There was still an increase, but it was a smaller amount than in the past.  The rate at which costs are going up is decreasing.  There were years where the increase in prescription drug spending was double digits.  It was regularly over 5% in the last 2 decades.

 

That wasn't the case last year (or 2012) and that has been driven by the patent cliff largely.

 

2.  Yes in a high deductible plan, but most no deductible plans have a co-pay.  Going back to my example of an office visit for a congestion with a minor fever:

 

1.  High deductible plan.  I wait 2 days to see if I start to feel better.  After two days, I do.

 

My costs:  $0

 

2.  No deductible plan.  I go to the doctor.  I pay my co-pay for the sick visit and for the antibiotics he prescribes that aren't actually going to do me any good:

 

My costs $50

 

The high deductible plan helped control my out of pocket spending.

Edited October 31, 2014 by PeterMP

[chipwhich]

 

My costs $50

 

The high deductible plan helped control my out of pocket spending.

 

Again, I understand what a high deductible plan is.  Not sure why you state the obvious, and again you changed your post and ignored the obvious nonsense about the prescription drug copay.

 

1)   As I stated a high deductible plan is a DIFFERENT product.  You have a weird way of stating things.  Let me state your thing another way:

 

1.  High deductible plan.   I go to the doctor.  I pay for the entire doctor visit and any associated costs and for the antibiotics he prescribes that aren't actually going to do me any good:

 

My costs:  Anywhere from the costs of a doctor visit to my entire deductible cost depending on what is done.

 

2.  No deductible plan.  I go to the doctor.  I pay my co-pay for the sick visit and for the antibiotics he prescribes that aren't actually going to do me any good:

 

My costs $50

 

Or you could look at it in this light:

1.  High deductible plan.  I wait 2 days to see if I start to feel better.  I can't afford to go to the doctor because I can't afford to pay my deductible.  So I just stay home.  THIS IS EXACTLY WHAT INSURANCE COMPANIES WANT

 

My costs:  $0

 

2.  No deductible plan.  I go to the doctor.  I pay my co-pay for the sick visit and for the antibiotics he prescribes that aren't actually going to do me any good:

 

My costs $50

 

You are arguing for a plan that is designed to push us all to becoming SELF INSURED.  Meaning we have catastrophic coverage but up front costs for sick visits and stuff are all self insured until the ever increasing deductibles are met.

So you basically go from a insured that can feel comfortable that the can go to a doctor whenever they have a concern, to an insured person that has to take their financial situation into account before deciding to go to a doctor.

Would you want a child to not get taken to the doctor because instead of paying a small copay a family is concerned they will have to pay a large doctors bill?????

 

Where do you get your logic...

 

High deductible plans are great for insurance companies.  Period.

 

For the population that had full coverage, no deductibles, with only copays that are being forced into high deductible plans where they have to pay deductibles, they are unhappy.  We live in an over prescribed US and prescription drugs costs if you are medicated can cause you huge out of pocket expenses at the beginning of each plan year.

 

[PeterMP]

You are arguing for a plan that is designed to push us all to becoming SELF INSURED.

 

I'm not arguing for anything.

 

I'm not saying that long term that high deductible plans are good.

 

I'm explaining to you why the rate at which the increase in out of pocket costs goes up can go down even as there is a shift to high deductible plans.

 

The percentage of people with insurance that have high deductible plans is up.  Simultaneously to that, the rate at which out of pocket spending is increasing is going down.

 

Those two things are both true.  You seem to be having an issue with that and I'm trying to explain it to you.

 

(Though, I don't of anybody that studies health economics that doesn't believe that part of our problem is that we simply use too much health care, and everybody that I know that studies health care economics believes high deductible plans will help with that.  They aren't the only way.  They might not be the best way.  And they might not be an efficient way to do it.

 

And no matter what happens as long as we have for profit insurance companies, the result is going to be great for insurance companies.

 

**EDIT**

I'll also point out that there are real long term costs to over prescription of antibiotics at a economic and healthcare level.

 

http://www.ncbi.nlm.nih.gov/pubmed/25194120

Edited October 31, 2014 by PeterMP

[chipwhich]

 

(Though, I don't of anybody that studies health economics that doesn't believe that part of our problem is that we simply use too much health care, and everybody that I know that studies health care economics believes high deductible plans will help with that.  They aren't the only way.  They might not be the best way.  And they might not be an efficient way to do it.

 

And no matter what happens as long as we have for profit insurance companies, the result is going to be great for insurance companies.)

 

Well we agree on that.  100%.

 

What I probably don't make clear and my argument are probably more in terms of people who have had the plans of the good old days, the move to the high deductible plans causes all of us who lived through the health care free for all to pay more out of pocket.  Now in terms of everyone insured, that's not the case based on what you are saying in the articles posted.  Everyone in my industry who had great insurance hates the new plan.

I hate the fact that we are going to a self insured model.  This has really been my major argument all along.

[Larry]

The number 1 cause for my employees to burn through their deductibles is prescription drug costs.

Actually, I would assert that the number 1 reason why your employees burn through their deductible so quickly (I seem to remember you once claiming that 2/3 of your employees go through their deductible in the first three months of the year, and that every single one goes through their deductible before the year is out) is because they don't have one.

 

Take your employee who has a $5000 (or whatever) deductible, give him a $5000 raise, and tell him to pay his own deductible.  And watch how his behavior changes. 

 

[chipwhich]

Actually, I would assert that the number 1 reason why your employees burn through their deductible so quickly (I seem to remember you once claiming that 2/3 of your employees go through their deductible in the first three months of the year, and that every single one goes through their deductible before the year is out) is because they don't have one.

 

Take your employee who has a $5000 (or whatever) deductible, give him a $5000 raise, and tell him to pay his own deductible.  And watch how his behavior changes. 

 

I don't really disagree other than those employees that have recurring prescription drug costs.  People for whatever reason get enamored with their particular prescription and don't want to change.

As far as why I don't do that, it's necessary as a recruiting tool, so I can't change my policy, although this year I did put a minor dent in that armor.

[Tulane Skins Fan]

So, while anecdotal tails of those who saw an increase in rates, or had their (very bad) plan cancelled will be told for decades, it does seem that Obamacare is working:

 

http://www.forbes.com/sites/rickungar/2014/06/23/coverage-expansion-success-nearly-sixty-percent-of-obamacare-exchange-enrollees-were-not-previously-insured/

 

From the "liberal rag" forbes.