Health Insurance Premiums
- Thread starter NYShoreGuy
- Start date
So much for Obamacare bending the cost curve down.
Insurance is what makes U.S. health-care prices so high
America needs a working marketplace where patients are the primary customers.
December 26, 2024
By David Goldhill
David Goldhill, the CEO of Sesame, a health-care marketplace, is the author of “Catastrophic Care: Why Everything We Think We Know About Health Care Is Wrong.”
Consider this: Health insurance is a product so terrible that few Americans voluntarily buy it without receiving a sizable subsidy.
No one would design a system like the one we have. And no one did,” UnitedHealth Group CEO Andrew Witty wrote this month. “It’s a patchwork built over decades.”
Today, insurers are accused of pushing up prices for medical care and then denying legitimate claims. Their leaders are said to be greedy or incompetent. In reality, we have a more fundamental problem: Health insurance can no longer pay for or manage modern health care, and the patchwork that Witty described is not fixable. It makes no sense to try.
Instead, Americans need to begin to create a working health-care marketplace that better aligns the incentives of health-care providers with the rapidly changing needs of patients.
Health insurance was meant to work like other kinds of insurance: When policyholders got sick, they would use the collective financial resources of the healthy to cover their costs. But this model was designed to pay for emergencies such as hospitalizations — not to “share the risk” of erectile dysfunction, weight loss, lifelong management of chronic conditions, or the mental health treatment needed by 1 in 5 Americans. The Centers for Disease Control and Prevention estimates that 90 percent of America’s health-care expenditure goes toward chronic and mental health conditions.
Insurance is what makes U.S. health-care prices so high
America needs a working marketplace where patients are the primary customers.
December 26, 2024
By David Goldhill
David Goldhill, the CEO of Sesame, a health-care marketplace, is the author of “Catastrophic Care: Why Everything We Think We Know About Health Care Is Wrong.”
Consider this: Health insurance is a product so terrible that few Americans voluntarily buy it without receiving a sizable subsidy.
No one would design a system like the one we have. And no one did,” UnitedHealth Group CEO Andrew Witty wrote this month. “It’s a patchwork built over decades.”
Today, insurers are accused of pushing up prices for medical care and then denying legitimate claims. Their leaders are said to be greedy or incompetent. In reality, we have a more fundamental problem: Health insurance can no longer pay for or manage modern health care, and the patchwork that Witty described is not fixable. It makes no sense to try.
Instead, Americans need to begin to create a working health-care marketplace that better aligns the incentives of health-care providers with the rapidly changing needs of patients.
Health insurance was meant to work like other kinds of insurance: When policyholders got sick, they would use the collective financial resources of the healthy to cover their costs. But this model was designed to pay for emergencies such as hospitalizations — not to “share the risk” of erectile dysfunction, weight loss, lifelong management of chronic conditions, or the mental health treatment needed by 1 in 5 Americans. The Centers for Disease Control and Prevention estimates that 90 percent of America’s health-care expenditure goes toward chronic and mental health conditions.
Mob mentality wants to point to a bogey-man when it comes to healthcare costs, but the reason we are approaching healthcare closing in on 20% of GDP isn't because of insurance.
- We are unhealthier than most industrialized nations.
- We want everything covered by insurance.
- We want to choose where we receive care and want it immediately.
- Our healthcare system is expensive...we pay doctors, nurses, radiologists, etc. at a higher rate than most other countries.
- Regulations are more rigid here as well (staffing numbers/percentage requirements, etc.)
Good points
-Diagnose more people now
-better/new treatments (costs more)
-boomers are “aging”
That’s just not true though. Premiums were increasing faster prior to the ACA than post ACA.
There was a lot of good in that bill. It didn’t solve all of the problems though so it still gets blamed for everything.
Obamacare was nothing more than a redistribution of wealth that did nothing to bend the curve and drove up administrative costs. The WSJ article that SPK linked was a good piece.
The system needed fixing well before, but the ACA made it worse.
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Quite the exaggeration as well.
2010s had the lowest healthcare per capita spending of any other decade and we had millions more covered while covering pre-existing conditions and preventative care. Administrative costs as a percentage of total healthcare spending increased the largest amount in the 2000s before the ACA.
Not a perfect bill and no one suggested it would be, but it’s a a boogeyman that gets blamed for everything bad that happens, accurate or not.
Do you think Obamacare was not a cause of higher premiums? What is/are the cause/causes?
Not really no. Given the rate of premium increases per year prior to and after the ACA, I don’t believe the ACA caused them to increase at a faster rate than they were previously increasing. In fact, it’s the opposite.
I don’t think people in general have an accurate grasp of how fast healthcare costs (including premiums) were rising prior to the ACA.
Here’s some data on the topic.
How has U.S. spending on healthcare changed over time? - Peterson-KFF Health System Tracker
This chart collection explores National Health Expenditure (NHE) data from the Centers for Medicare and Medicaid Services (CMS).
www.healthsystemtracker.org
Premiums are primarily driven by usage. The more we use that someone else pays for, the higher premiums go.
Speak of exagerations...no one blames Obamacare for everything wrong with healthcare. It is a system that needs fixing. It didn't accomplish what was advertised (i.e. Bending the curve, "If you have your doctor, you can keep your doctor"...).
What about co-pays and out-of-pocket? Has that stayed relatively flat as well? Premium is only one aspect of what the consumer pays.
It did though. Costs per capita curve slowed. Out of pocket costs per capita slowed. Millions more have coverage and no one can be denied care for a preexisting condition. The FAR majority of Americans were able to keep their doctor… there is still a thread on here about projections or 30% of employers dropping coverage… I said that was nonsense then, of course it turned out to be nonsense.
I wish politicians who campaigned for killing it had spent 1% of that energy to think of fixes… but a decade and a half later and nothing. They don’t have a better opinion, and we were worse off before the ACA. People just lost the context of what was happening with costs in the 2000s
Out of pocket costs increased at a slower rate in the 2010s compared to the 1990s and 2000s.
What the hell is wrong with you people? It's New Year's Eve. If you are working, finish and go home. If you are off, make more egg nog. None of you have anything better to do today than relitigate ACA?
for preventive care in the NJ offerings with get covered an individual is probably looking at approx 10k a year in expense
Their options were help the wife set up for tonight, get ready to watch the seton hall game or relitigate the ACA. They are making the wise choice.
By any long term metric healthcare expenses have continued to rise in a pretty linear fashion. My original point was that the ACA has had little impact on that (and I listed the main drivers), and it was really just a cost shift.
Sure, more people are “insured”, but could that have been done more efficiently by expanding existing programs like Medicare or Medicaid?
I don’t blame the ACA for what’s wrong with our system. I think it really hasn’t done much if anything to reduce costs or improve outcomes.
https://www.healthsystemtracker.org...penditures, by source of funds, 1970 and 2023
Well… yes? A public option for a buy into Medicare would have been great, as I have said here for well over a decade. But that was not on the table as a possibility.
It did slow costs, both premiums and out of pocket… it also had measures to improve outcomes that helped (slightly) like penalizing readmissions. Outcomes from covering preventative care is a little harder to gauge, so I can’t really make that argument with data, but theoretically, outcomes should be improved compared to not having preventive care covered.
The biggest impact though is ensuring that people can get coverage and not denied care when a lapse in coverage occurs, though it is a shame the mandate was removed.
Good, not perfect bill. Should have been built upon instead of demonized.
Read the board from a decade ago. Everyone here was in favor of a cost shift to drive utilization down. When someone else is paying, utilization goes up. We need the right balance so people can access healthcare as needed but don’t abuse it.
There were benefits to insurance companies as well, but at the cost of ensuring that millions more had access to care and couldn’t be denied was worth it in my opinion.
Slowest growth of any decade was in the 2010s.
You might think it’s insignificant, but it’s not an unimportant part of the story especially considering the aging population. Covid did throw things off though.
And we discussed this at the time of the ACA, that you would have to measure the results over the long term. The line like I said is essential
I guess you missed the link I posted. I guess you didn’t see that since your nose was so far up merge’s ass…lol
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Indeed, something like readmission rates being down is a success for an improvement in outcomes.
What is the metric you’re using to indicate impact on outcomes?
It was the same as the one I posted earlier, which showed slower growth post ACA… if it was going the other way, everyone here would be blaming the ACA, but that’s not what happened and people are still here blaming the ACA.
How The ACA Dented The Cost Curve - PubMed
Numerous provisions of the Affordable Care Act (ACA) were designed to make health care more affordable, yet the act's cumulative effects on health care costs are still debated. A key question is whether or not the ACA reduced the annual rate at which total national health care spending increased...
pubmed.ncbi.nlm.nih.gov
As I said, it was a start. It wasn’t the ideal bill, it was the bill that would get through congress. Republicans are going to unveil the alternative any day now.
A public option would have been better than the exchanges, but it’s not the bills fault that didn’t happen. That was because of the members of congress who wouldn’t let that happen because “socialism”
Yes, and the point I made with that source is that per capita spending has been essentially a straight line.
And for the fifth time, I am not blaming the ACA for our healthcare system problems.
So let’s just pass a bill that really does very little. Both parties have done a lousy job addressing the healthcare problems, but go back to the WSJ article that SPK linked and my follow up comments. Congress has been focused on the wrong things to lower costs and improve the health of the nation.How The ACA Dented The Cost Curve - PubMed
Numerous provisions of the Affordable Care Act (ACA) were designed to make health care more affordable, yet the act's cumulative effects on health care costs are still debated. A key question is whether or not the ACA reduced the annual rate at which total national health care spending increased...
As I said, it was a start. It wasn’t the ideal bill, it was the bill that would get through congress. Republicans are going to unveil the alternative any day now.
A bill that expanded access of insurance to millions of people, ensured that preventive care was paid for, and ensured that pre-existing conditions would not be denied coverage, all while not increasing premiums or out of pocket costs any more than they were already increasing (and in fact less) was not “very little”
Those were very significant steps even if they haven’t impacted you personally.
We should be making improvements, but improvements don’t win elections. Demonizing it does, hence why we have never seen an alternative or fixes proposed.
