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#31 PantherBrew

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Posted 03 October 2013 - 01:34 PM

Raising rates on young people is one part of the funding. Much of it comes from taxes.

 

However adding a new young insured only helps a little. Young people have medical claims too and create more expenses. So a large part of a young person's premium goes toward their own loss pool plus the added expense of having more insureds. It's only the excess over what they would pay today that subsidizes others.

 

Again the funding and cost are only explained in very vague terms.

 

Show me a chart of the increase in costs of healthcare in say 2018 over today and how much of that will be subsidized by an increase in younger insureds. It doesn't exist because nobody has a clue or they don't want to try to explain it.

I dont know if this specifically answered the question you have but, I feel it gives a decent explanation of all the funding measures.  

 

http://www.washingto...-in-two-charts/



#32 bleys

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Posted 03 October 2013 - 01:39 PM

I can tell Teeray knows what he's talking about. 

 

Just to add, young people do not cost near as much money in claims than those older people who have lived an unhealthy life and are paying the consequences.  Most every young person is healthy and only a percentage of older people suffer from careless living or hereditary health problems.  They are not even close to being balanced.  If young people are required to get insurance and there is no loop hole from one party undermining the other then the very nature of insurance law means the law of large numbers will outweigh pre-existing conditions.  Hospitals are responsible for lowering costs as a result.  It may take time to balance out but the idea itself is good.  Expecting both parties to work together to find the best solution may be the problem.

 

Oh, and also, 2018 might not look much better.  Every NC citizen can thank their General Assembly and Governor for opting to allow the Feds to run the exchange for it's people.  Good job voting them into office.

 

 

“The truth of the matter is, this is not ready for rollout,” said Chris Marie Farr, acting North Carolina director for Americans for Prosperity. “Only having two insurance carriers on the exchange – that’s a problem in itself. There are not enough choices and too many mandates.”

Adam Linker, a policy analyst with the N.C. Justice Center, said the limited competition is largely caused by North Carolina’s decision not to participate in the insurance marketplace and not to extend Medicaid.

States that have embraced the health law typically have a half-dozen or more insurers involved in their insurance marketplaces.

“When we get some competition, it’s going to be better,” said Pam Brennan, a Cary resident who has individual insurance through Blue Cross. “2015 will be a better year than 2014.”

 

http://www.newsobser...ew-federal.html

 

 

 

 

Dont care about the politics just want a straight answer. I have looked all over the web and ask people at my workplace. no one could answer me. I could probably find the answer but a rough estimate will suffice.

 

If I have BCBS through my company. I pay 70 a month for a pretty good plan (Id guess based on past plans it would cost me 200 a month for a similar individual plan..28/M/never had any conditions or issues). The rest is covered by my company.

 

How much increase can I expect on my premium(rough percentage)?. Is my company forced to cover the increase or can they pass it on to employees if they choose?

 

you're employer is offering a benefit, which has become an entitlement to many people.  However that employer is not required by law to offer you anything, hence the benefit.  The problem you're employer is going to have will be all of the people with pre-existing conditions looking for healthcare that will drastically increase the premiums for that entire demographic.  That employer will then realize they have to give the employees more risk (higher premiums, deductibles, etc) to off-set those premiums. 

 

many employers would be smart to start an HRA and allow people to get their own coverage with money stipend to them.  Employees would benefit from this because they don't risk losing their insurance when a serious health risk develops and can no longer work for the company (NC is a right to work state), or pay 101% of that costly premium on cobra (the whole reason you have insurance are for these moments, not entirely for the sniffles that will not cripple you financially)..  That coverage is then portable from job to job and you never have to worry about rate increases due to those health problems after they occur (unless you have BCBS).  That's at least how it used to work.  Pre-existing conditions may not be denied, but I'm not sure if they are still rated up.

 

This is why BCBS "Blue Advantage" was/is (depending if the rules changed from before) so scary for those who actually have to use their coverage.

 

 



#33 cookinwithgas

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Posted 03 October 2013 - 02:14 PM

If only there were other countries that had anything like this already in place we could look to to see what works and what doesn't and make sone basic assumptions from that data

#34 Happy Panther

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Posted 03 October 2013 - 02:29 PM

Just to add, young people do not cost near as much money in claims than those older people who have lived an unhealthy life and are paying the consequences.  Most every young person is healthy and only a percentage of older people suffer from careless living or hereditary health problems.  They are not even close to being balanced.  If young people are required to get insurance and there is no loop hole from one party undermining the other then the very nature of insurance law means the law of large numbers will outweigh pre-existing conditions.  

 

You may be going down the same misconception line that many are. Or maybe not.

 

Young people have way fewer losses than older people is why young people pay less premium. The way insurance works is the company wants each risk pool to fund itself. So the losses in the male 18-25 group non-smoker should drive the premium. Insurance companies don't try to have young people subsidize other groups because it ruins competition (young people would simply flock to another company that isn't subsidizing while the old costly people would stay and enjoy lower rates.

 

So if a male in that group has an actuarial determined rate of say $100, you can't just pile on a bunch more males in that group and think you are making money. In fact the first thing you may have to do is raise the rate to $110 to cover the added expense of having more insureds.

 

Then if you want to subsidize an older group you have to raise the rate further to say $150. But that extra $40 of subsidy doesn't mean a whole lot to to a 55 year old smoker paying $1400 for health insurance. And it doesn't help subsidize the poor guy who can't afford it. So in reality you have to force you people to sign up at a rate of $400.

 

Add to that the fact that the ACA is going to limit insurance profits and you now have 2 groups who are incentivized to work the system. Young people don't want to pay $400 and insurance companies want their profits back. The insurance companies start pumping as much money into the republican party and the young kids cheat or just ignore it.

 

As someone who works in this industry, all I can say is that you can look at how this system is going to be set up and can tell it's set up for failure.



#35 MadHatter

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Posted 03 October 2013 - 02:47 PM

If only there were other countries that had anything like this already in place we could look to to see what works and what doesn't and make sone basic assumptions from that data

 

Only valid if you could find one as large as the US and with a population with similar demographics......one where nearly 50% of the people don't even pay Fed Income Taxes and such a high % already are on the gov't juice.

 

The countries where the programs are effective have low unemployment and an educated workforce.  Not even close to the US>



#36 Kitten Diver

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Posted 03 October 2013 - 02:49 PM

BCBS could raise their premiums or the company could raise your contribution.

But they shouldn't except for a normal annual increase. You are likely already in a group plan so your age shouldn't have any bearing on what you pay.

For people who get insurance through larger companies or work for the government, the exchanges are just trying to duplicate what insurance companies have been doing for years with those entities. They are just going it on a much larger scale with the general public.

In large companies like that, in most cases, of you are 65 years old or 25 years old it doesn't matter. Everyone pays the same rate for whatever plan they choose.

But 65 year old employees will statistically have more claims than 25 year olds so the rate has to be enough to cover the insurance companies payouts to providers (and be profitable) for both age groups so the premium for everyone is calculated thusly.

Also people buying in bulk will often get discounts in order to obtain the mass customers.

The exchanges are trying to allow individuals to do the same. Large number of people buying into the same plan at a pretty much fixed rate. They are also lumping multiple providers into the exchange to create competition for business, which theoretically should help keep rates down.

But that is a long winded response that I am not sure even answered your question :lol:

 

No worries :) I have yet to find someone to answer it....so I guess  we'll all find out once that first check come for October!
 



#37 Kitten Diver

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Posted 03 October 2013 - 03:04 PM

Only valid if you could find one as large as the US and with a population with similar demographics......one where nearly 50% of the people don't even pay Fed Income Taxes and such a high % already are on the gov't juice.

 

The countries where the programs are effective have low unemployment and an educated workforce.  Not even close to the US>

 

And this right here is what scares me the most about our idea of European Socialism. There are fundamental elements we are adjusting for the "welfare" voter base.

 

Sure France has socialized medicine, but thats only for their citizens. If an uninsured illegal gets sick do they get treatment or turned away? Its a tough pill to swallow, but maybe our lax stance on immagration and "open door to eveyone" healthcare policy are not feasible in a socialist environment.

 

Does Sweden have 30-50% of the population that is solely on the *** for everything..food, housing, medical, cell phones, shopping money?Maybe they do and are going down the path of Greece, but my guess is they don't.



#38 cookinwithgas

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Posted 03 October 2013 - 07:31 PM

Only valid if you could find one as large as the US and with a population with similar demographics......one where nearly 50% of the people don't even pay Fed Income Taxes and such a high % already are on the gov't juice.

 

The countries where the programs are effective have low unemployment and an educated workforce.  Not even close to the US>

 

 

I'm sure you could find something wrong with every single thing out there that you can use to sidestep the point.

 

http://en.wikipedia....e_United_States

 

The U.S. is one of two OECD countries not to have some form of universal health coverage, the other being Turkey. Mexico established a universal healthcare program by November 2008.

Hey other than Turkey we are exceptional!



#39 cookinwithgas

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Posted 03 October 2013 - 07:31 PM

Lets face it the only real difference there is between us and the rest of the world is the bat poo crazy Tea Partiers.



#40 MadHatter

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Posted 04 October 2013 - 08:36 AM

Lets face it the only real difference there is between us and the rest of the world is the bat poo crazy Tea Partiers.

 

Go look at the % of GDP that countries pay on social services.  We already pay as much if not more in entitlements and benefits as other countries that do provide universal healthcare. 

 

Clean up the waste and fraud that goes on in existing programs and you would go a long way in funding healthcare.



#41 bleys

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Posted 04 October 2013 - 09:07 AM

You may be going down the same misconception line that many are. Or maybe not.

 

Young people have way fewer losses than older people is why young people pay less premium. The way insurance works is the company wants each risk pool to fund itself. So the losses in the male 18-25 group non-smoker should drive the premium. Insurance companies don't try to have young people subsidize other groups because it ruins competition (young people would simply flock to another company that isn't subsidizing while the old costly people would stay and enjoy lower rates.

 

So if a male in that group has an actuarial determined rate of say $100, you can't just pile on a bunch more males in that group and think you are making money. In fact the first thing you may have to do is raise the rate to $110 to cover the added expense of having more insureds.

 

Then if you want to subsidize an older group you have to raise the rate further to say $150. But that extra $40 of subsidy doesn't mean a whole lot to to a 55 year old smoker paying $1400 for health insurance. And it doesn't help subsidize the poor guy who can't afford it. So in reality you have to force you people to sign up at a rate of $400.

 

Add to that the fact that the ACA is going to limit insurance profits and you now have 2 groups who are incentivized to work the system. Young people don't want to pay $400 and insurance companies want their profits back. The insurance companies start pumping as much money into the republican party and the young kids cheat or just ignore it.

 

As someone who works in this industry, all I can say is that you can look at how this system is going to be set up and can tell it's set up for failure.

 

 

 

I get what you're saying.  I think the very basic idea itself can work, however, I'm not even sure if all young people will be accounted for.  And I don't see how the Feds should be involved on the state level, but our leaders have elected to do just that.  

 

 

To circumvent the system is something I do understand and I think in large part because we will have politicians too busy fighting their own agenda than to ensure the final product is the most efficient.



#42 TANTRIC-NINJA

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Posted 04 October 2013 - 09:56 AM

The ACA is highly flawed... Has ripple effects(positive and negative) we will find only after its implementation.

Then once identifiying them they can make adjustments, admendments to streamline the program. No program this size is going to come out perfect this is basically the "Rough Draft" stage of the ACA.

Some edits will make it better and this is what we have, a law written BY Health Insurance companies bc the GOP was against the single payer option to begin with.

The ACA is a compromise created and re imagined to appease the GOP who now opposes the whole thing.

Regardless of your political leanings the insurance system we had before was broken and was out of control which is why this was created.

People now get coverage that could not otherwise and healthcare costs are rising at a much lower rate than in previous years.


As for employer premiums going up we live in a time where most companies are trying to figure out any excuse to cut payroll or decrease benefit investments to employees.

We will find a few companies that simply want to pay less of the Healthcare premiums and blame the gov in the process...I have dealt with a few business owners or CFO's that have casually revealed a bit too much to me about cutting costs before. I am not shocked.

#43 cookinwithgas

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Posted 04 October 2013 - 11:12 AM

That's why I take all of these doomsday predictions with a shaker of salt.

#44 TANTRIC-NINJA

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Posted 04 October 2013 - 06:29 PM

That's why I take all of these doomsday predictions with a shaker of salt.



From utopia to doomsday the truth is usually in the middle. You are being rational.

#45 Firefox

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Posted 05 October 2013 - 07:10 AM

Across North Carolina, thousands of people have been shocked in recent weeks to find out their health insurance plans will be canceled at the end of the year – and premiums for comparable coverage could increase sharply.

 

One of them is George Schwab of Charlotte, who pays $228 a month for his family’s $10,000 deductible plan from Blue Cross and Blue Shield of North Carolina.

 

In a Sept. 23 letter, Blue Cross notified him that his current plan doesn’t meet benefit requirements outlined in the Affordable Care Act and suggested a comparable plan for $1,208 a month – $980 more than he now pays.

 

“I’m 62 and retired,” Schwab said. “This creates a tremendous financial burden for our family.

 

“The President told the American people numerous times that… ‘If you like your coverage, you can keep it,’” Schwab said. “How can we keep it if it has been eliminated? How can we keep it if the premium has been increased 430 percent in one year?”
 

Schwab and others who purchase insurance individually, and not through employer-sponsored group plans, are finding that the Affordable Care Act may be unaffordable for their families.

 

Read more here: http://www.charlotte...l#storylink=cpy




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