• Text Only
Voting History
rated:
Just a heads up in the event you currently have Aetna Health Insurance through ACA.

The Wall Street Journal reported yesterday:    "Aetna to Drop Some Affordable Care Act Markets - Insurer will withdraw from 11 of 15 states where it currently offers plans through the exchanges"

An excerpt:  " ...Aetna Inc. will withdraw from 11 of the 15 states where it currently offers plans through the Affordable Care Act exchanges, becoming the latest of the major national health insurers to pull back sharply from the law’s signature marketplaces after steep financial losses... it puts at least one county, Pinal in Arizona, at risk of having no insurers offering exchange plans in 2017, a circumstance that would present a major challenge to the basic mechanics of the ACA ... Stephen Briggs, a spokesman for Arizona’s state insurance regulator, said the state currently has no insurers that have filed to offer exchange plans in Pinal, a county in the Phoenix area.  “It’s a concern for us,” he said, but the regulator doesn’t “have any legal leverage to compel anyone to offer a plan... Aetna will reduce the number of counties where it sells exchange plans next year to 242 from 778, a dramatic turn that came a few weeks after the insurer said it expected steep losses for the year and would reconsider its participation in the market, which it had previously called an important opportunity..”  

Link to the WSJ article here:  http://www.wsj.com/articles/aetna-to-drop-some-affordable-care-act-markets-1471311737 

Member Summary
Most Recent Posts
The source article says that 17% of the us may only have one option next year in the exchanges.   Thats up from 2% this y... (more)

jerosen (Aug. 29, 2016 @ 9:06a) |

Thanks!

cestmoi123 (Aug. 29, 2016 @ 10:50a) |

B-b-b-but I thought the answer was always more rules to fix the problem!

That worked with the banks! Right?

justignoredem (Aug. 29, 2016 @ 12:39p) |

Obawa is a co- founder of ACA !
 
Staff Summary
Thanks for visiting FatWallet.com. Join for free to remove this ad.

Really bad for the consumer with so few ACA networks available.

Read an editorial noting how the insurance companies are still making record profits with the ACA off of Medicaid plans, suggesting the administration apply pressure to ensure they keep supporting individual ACA plans. Basically stipulate that if the insurer wants to keep raking in billions off of federal funds from Medicaid, there'd have to be some quid pro quo for other ACA plans.

Not sure if that would require additional legislation -- if so, wouldn't anticipate our do-nothing Congress to pass anything like that in the near future, unless the Democrats retake the House and Senate

monto888 said:   Really bad for the consumer with so few ACA networks available.

Read an editorial noting how the insurance companies are still making record profits with the ACA off of Medicaid plans, suggesting the administration apply pressure to ensure they keep supporting individual ACA plans. Basically stipulate that if the insurer wants to keep raking in billions off of federal funds from Medicaid, there'd have to be some quid pro quo for other ACA plans.

Not sure if that would require additional legislation -- if so, wouldn't anticipate our do-nothing Congress to pass anything like that in the near future, unless the Democrats retake the House and Senate

Neither political party will be able to easily fix this.

While I haven't read any articles that provide evidence that insurance companies are making record profits off Medicaid as you assert,  I wouldn't be surprised to hear that there is a lot of inflated billing going on undetected in Medicaid.

Supply/demand exacerbates the problem as described in this Denver Post article:  "Loss of VA health-care providers worsens as demand for care goes up"   "Annual VA outpatient medical appointments rose by 20 percent, or 17.1 million visits from fiscal 2011 through 2015, according to a new Government Accountability Office report."  Link to Denver article here: http://www.denverpost.com/2016/08/03/loss-of-va-health-care-providers-worsens-as-demand-for-care-goes-up/ 

I've not heard anything like that Monto - can you cite a source? I'd have to contest your assertion with the fact that the specfically established co-op insurers have also been failing recently (Land of Lincoln in IL most recently, I believe).

Instead we've seen many of the large commercial insurers pull out of the majority of markets entirely because they're LOSING record amounts of money. Basically - as I and a lot of other people on this board said - the ACA made huge promises and committed the companies to covering a population that was relatively sick to begin with. The penalty for not having insurance was relatively minuscule. The plans offered were pretty poor, and had HUGE deductibles. And people could now buy insurance at basically any time with no regard to pre-existing conditions. What about that setup makes for a stable insurance market?? You have to have the healthy people buy in to subsidize the sick people - instead the sick people bought in and very few others! Add to that the ridiculous "risk corridors" idea where the government subsidized plans with "sicker patients" to a greater degree (note: this is REALLY hard to quantify in any meaningful way), and these programs now ending so some of these companies could see even higher losses going forward...

Anyone who DIDN'T see this coming wasn't listening when this legislation was passed. MANY MANY people predicted this outcome - Including just about anybody who works in the field.

Of course, if your end game is single-payer, then this is a great development, right? Some of the more cynical among us felt that failure of the ACA was the plan all along ....

rmf1981 said:   I've not heard anything like that Monto - can you cite a source? I'd have to contest your assertion with the fact that the specfically established co-op insurers have also been failing recently (Land of Lincoln in IL most recently, I believe).

Instead we've seen many of the large commercial insurers pull out of the majority of markets entirely because they're LOSING record amounts of money. Basically - as I and a lot of other people on this board said - the ACA made huge promises and committed the companies to covering a population that was relatively sick to begin with. The penalty for not having insurance was relatively minuscule. The plans offered were pretty poor, and had HUGE deductibles. And people could now buy insurance at basically any time with no regard to pre-existing conditions. What about that setup makes for a stable insurance market?? You have to have the healthy people buy in to subsidize the sick people - instead the sick people bought in and very few others! Add to that the ridiculous "risk corridors" idea where the government subsidized plans with "sicker patients" to a greater degree (note: this is REALLY hard to quantify in any meaningful way), and these programs now ending so some of these companies could see even higher losses going forward...

Anyone who DIDN'T see this coming wasn't listening when this legislation was passed. MANY MANY people predicted this outcome - Including just about anybody who works in the field.

Of course, if your end game is single-payer, then this is a great development, right? Some of the more cynical among us felt that failure of the ACA was the plan all along ....

  So, their record profits should come from healthy people while they avoid having to pay for sick people?  Sounds like a pretty good business model for them.  The government also pays for old and the most sick in the country.  Good deal for "health insurance"(only for the healthy) companies!

I've read a few articles saying that this is the result of the increased scrutiny on their potential merger with Humana. The opinion is that this is somewhat of a payback scenario. Interesting if that is true or not.

and if you live in the wrong part of Phoenix, AZ, no one is slated to offer any ACA plans.  So if you like your insurance, you can... move or pay a penalty?
WSJ  said: Aetna's move will sharpen concerns about competitive options in the exchanges—and it puts at least one county, Pinal in Arizona, at risk of having no insurers offering exchange plans in 2017, a circumstance that would present a major challenge to the basic mechanics of the ACA.

Stephen Briggs, a spokesman for Arizona’s state insurance regulator, said the state currently has no insurers that have filed to offer exchange plans in Pinal, a county in the Phoenix area.

“It’s a concern for us,” he said, but the regulator doesn’t “have any legal leverage to compel anyone to offer a plan.” However, the regulator is speaking to other insurers about offering exchange plans in Pinal, he said, and “circumstances could change.”

On the bright side, if you're at all healthy, paying a penalty is increasingly the best economic option.  Plus having a lack of any ACA options might qualify for one of the penalty exemptions (or at least it will as soon as this becomes a more widely known problem).  One failure after another for this ill-conceived legislation...

xerty said:   and if you live in the wrong part of Phoenix, AZ, no one is slated to offer any ACA plans.  So if you like your insurance, you can... move or pay a penalty?
[L=WSJ said: /Wall-Street-Journal-coupons/#shopnow=[L=http://www.wsj.com ]Aetna's]http://www.wsj.com ]Aetna's[/L] move will sharpen concerns about competitive options in the exchanges—and it puts at least one county, Pinal in Arizona, at risk of having no insurers offering exchange plans in 2017, a circumstance that would present a major challenge to the basic mechanics of the ACA.

Stephen Briggs, a spokesman for Arizona’s state insurance regulator, said the state currently has no insurers that have filed to offer exchange plans in Pinal, a county in the Phoenix area.

“It’s a concern for us,” he said, but the regulator doesn’t “have any legal leverage to compel anyone to offer a plan.” However, the regulator is speaking to other insurers about offering exchange plans in Pinal, he said, and “circumstances could change.”

On the bright side, if you're at all healthy, paying a penalty is increasingly the best economic option.  Plus having a lack of any ACA options might qualify for one of the penalty exemptions (or at least it will as soon as this becomes a more widely known problem).  One failure after another for this ill-conceived legislation...

  ill-conceived or poorly executed?


why not
Disclaimer
shitrus said:   
 ill-conceived or poorly executed?

  

rmf1981 said:   
Of course, if your end game is single-payer, then this is a great development, right? Some of the more cynical among us felt that failure of the ACA was the plan all along ....




shitrus said:     ill-conceived or poorly executed?
 

  
...or performing as designed?
I had two friends who were vehement supporters of the ACA.
Both were actually strong supporters of single payer, but they considered the ACA an important step forward.

I can't say about medicaide insurance companies raking it in but we don't see a mass exudus either so it likely is profitable. I find few physicians in my field take it though.



Just an FYI Pinal county is Tucson AZ metro area . It's over 100 miles from Phoenix.... But yes it does bring up interesting questions.

xerty said:   and if you live in the wrong part of Phoenix, AZ, no one is slated to offer any ACA plans.  So if you like your insurance, you can... move or pay a penalty?
[L=WSJ said: /Wall-Street-Journal-coupons/#shopnow=[L=http://www.wsj.com ]Aetna's]http://www.wsj.com ]Aetna's[/L] move will sharpen concerns about competitive options in the exchanges—and it puts at least one county, Pinal in Arizona, at risk of having no insurers offering exchange plans in 2017, a circumstance that would present a major challenge to the basic mechanics of the ACA.

Stephen Briggs, a spokesman for Arizona’s state insurance regulator, said the state currently has no insurers that have filed to offer exchange plans in Pinal, a county in the Phoenix area.

“It’s a concern for us,” he said, but the regulator doesn’t “have any legal leverage to compel anyone to offer a plan.” However, the regulator is speaking to other insurers about offering exchange plans in Pinal, he said, and “circumstances could change.”

On the bright side, if you're at all healthy, paying a penalty is increasingly the best economic option.  Plus having a lack of any ACA options might qualify for one of the penalty exemptions (or at least it will as soon as this becomes a more widely known problem).  One failure after another for this ill-conceived legislation...

  That's a very bad idea. You CANNOT just go out and get an ACA plan anytime you want. If you choose not to sign up, you're stuck till next enrollment period without health insurance. That means almost a year with no coverage. There are not many illnesses and accidents where you can just wait up to a year for treatment. You WILL be paying the bill yourself, AND the penalty on top of that. Those bills are usually 3x-4x larger than the insurer-negotiated rates. You will go bankrupt with almost any significant health issue.

Of course, if you have a really good crystal ball, and know you won't need healthcare, the penalty option is more economical. However, if your crystal ball is that good, you're a billionaire anyway because you can win the lottery and pick winning stocks.
For the rest of us, and for anyone with any assets to protect, it doesn't make economic sense to roll the dice like that.

If you're stuck buying individual insurance, you better hope and pray that Congress finally sees the light and tries to do something constructive to keep that insurance available. 

canoeguy1 said:     That's a very bad idea. You CANNOT just go out and get an ACA plan anytime you want. If you choose not to sign up, you're stuck till next enrollment period without health insurance. That means almost a year with no coverage. There are not many illnesses and accidents where you can just wait up to a year for treatment. You WILL be paying the bill yourself, AND the penalty on top of that. Those bills are usually 3x-4x larger than the insurer-negotiated rates. You will go bankrupt with almost any significant health issue.

Of course, if you have a really good crystal ball, and know you won't need healthcare, the penalty option is more economical. However, if your crystal ball is that good, you're a billionaire anyway because you can win the lottery and pick winning stocks.
For the rest of us, and for anyone with any assets to protect, it doesn't make economic sense to roll the dice like that.

If you're stuck buying individual insurance, you better hope and pray that Congress finally sees the light and tries to do something constructive to keep that insurance available. 

  The philosophical acceptance of one's impending death can be a mitigating factor for some.

taxmantoo said:   
rmf1981 said:   
Of course, if your end game is single-payer, then this is a great development, right? Some of the more cynical among us felt that failure of the ACA was the plan all along ....



shitrus said:     ill-conceived or poorly executed?
  
...or performing as designed?
I had two friends who were vehement supporters of the ACA.
Both were actually strong supporters of single payer, but they considered the ACA an important step forward.

  It IS an important step forward, but only a step. It does not address cost and pricing very well. It makes insurance affordable to the poor, but of course the newest game that the insurers play is raising deductibles through the roof and making the networks so narrow that they're unuseable. 
Much work needs to be done. I just wish that the House would help out and start to figure out how to improve the system, instead of just wanting to destroy it,

If nothing is done, the entire health insurance market will likely collapse within 10 years or so. People cannot take another doubling of premiums, and at the current rate of premium increases, it won't be long before that happens. Some hard choices about rationing will have to be made.

DTASFAB said:   
canoeguy1 said:     That's a very bad idea. You CANNOT just go out and get an ACA plan anytime you want. If you choose not to sign up, you're stuck till next enrollment period without health insurance. That means almost a year with no coverage. There are not many illnesses and accidents where you can just wait up to a year for treatment. You WILL be paying the bill yourself, AND the penalty on top of that. Those bills are usually 3x-4x larger than the insurer-negotiated rates. You will go bankrupt with almost any significant health issue.

Of course, if you have a really good crystal ball, and know you won't need healthcare, the penalty option is more economical. However, if your crystal ball is that good, you're a billionaire anyway because you can win the lottery and pick winning stocks.
For the rest of us, and for anyone with any assets to protect, it doesn't make economic sense to roll the dice like that.

If you're stuck buying individual insurance, you better hope and pray that Congress finally sees the light and tries to do something constructive to keep that insurance available. 

  The philosophical acceptance of one's impending death can be a mitigating factor for some.

  Yes, of course. Suicide will certainly solve the problem too. Maybe that's why people keep guns in their glovebox. If they have a car accident, they can quickly dispatch themselves because they can't pay for medical care.

However, if it's your kid or your spouse that's had an accident, will you still just accept it and let them bleed to death in the ditch cause you were too cheap to get insurance?

canoeguy1 said:   
DTASFAB said:   
canoeguy1 said:     That's a very bad idea. You CANNOT just go out and get an ACA plan anytime you want. If you choose not to sign up, you're stuck till next enrollment period without health insurance. That means almost a year with no coverage. There are not many illnesses and accidents where you can just wait up to a year for treatment. You WILL be paying the bill yourself, AND the penalty on top of that. Those bills are usually 3x-4x larger than the insurer-negotiated rates. You will go bankrupt with almost any significant health issue.

Of course, if you have a really good crystal ball, and know you won't need healthcare, the penalty option is more economical. However, if your crystal ball is that good, you're a billionaire anyway because you can win the lottery and pick winning stocks.
For the rest of us, and for anyone with any assets to protect, it doesn't make economic sense to roll the dice like that.

If you're stuck buying individual insurance, you better hope and pray that Congress finally sees the light and tries to do something constructive to keep that insurance available. 

  The philosophical acceptance of one's impending death can be a mitigating factor for some.

  Yes, of course. Suicide will certainly solve the problem too. Maybe that's why people keep guns in their glovebox. If they have a car accident, they can quickly dispatch themselves because they can't pay for medical care.

However, if it's your kid or your spouse that's had an accident, will you still just accept it and let them bleed to death in the ditch cause you were too cheap to get insurance?

  All pertinent questions... no right or wrong answers!

xerty said:   
On the bright side, if you're at all healthy, paying a penalty is increasingly the best economic option.  Plus having a lack of any ACA options might qualify for one of the penalty exemptions (or at least it will as soon as this becomes a more widely known problem).  One failure after another for this ill-conceived legislation...

Worst advice, ever. Even "healthy people" can have life-altering accidents.
  

montee4 said:   I've read a few articles saying that this is the result of the increased scrutiny on their potential merger with Humana. The opinion is that this is somewhat of a payback scenario. Interesting if that is true or not.
  Yeah I had that thought as well, and then saw it written in a few places.  Would make sense, right?  Very interesting if "retaliation."  Hello, wikileaks .... ?  Or Russian Hackers?

rmf1981 said:   
montee4 said:   I've read a few articles saying that this is the result of the increased scrutiny on their potential merger with Humana. The opinion is that this is somewhat of a payback scenario. Interesting if that is true or not.
  Yeah I had that thought as well, and then saw it written in a few places.  Would make sense, right?  Very interesting if "retaliation."  Hello, wikileaks .... ?  Or Russian Hackers?

  We live in a capitalistic society in which medicine is sold for profits.  If I owned Aetna stock, I'd be lighting cigars and drinking champagne to celebrate.  It is, after all, a business.

rmf1981 said:   
montee4 said:   I've read a few articles saying that this is the result of the increased scrutiny on their potential merger with Humana. The opinion is that this is somewhat of a payback scenario. Interesting if that is true or not.
  Yeah I had that thought as well, and then saw it written in a few places.  Would make sense, right?  Very interesting if "retaliation."  Hello, wikileaks .... ?  Or Russian Hackers?

  There's no denying that Aetna linked the two.  From today's W5J --

In a July 5 letter to the Justice Department, reviewed by The Wall Street Journal, Aetna said that if the Humana deal drew a legal challenge, “instead of expanding to 20 states next year, we would reduce our presence to no more than 10 states.” In addition, the letter, signed by Aetna Chief Executive Mark T. Bertolini, said the insurer believed “it is very likely that we would need to leave the public exchange business entirely and plan for additional business efficiencies should our deal ultimately be blocked.”

DTASFAB said:   
rmf1981 said:   
montee4 said:   I've read a few articles saying that this is the result of the increased scrutiny on their potential merger with Humana. The opinion is that this is somewhat of a payback scenario. Interesting if that is true or not.
  Yeah I had that thought as well, and then saw it written in a few places.  Would make sense, right?  Very interesting if "retaliation."  Hello, wikileaks .... ?  Or Russian Hackers?

  We live in a capitalistic society in which medicine is sold for profits.  If I owned Aetna stock, I'd be lighting cigars and drinking champagne to celebrate.  It is, after all, a business.

  
LOL.  Medicine not capitalistic in the US.  For all intents and purposes it's an oligopoly.

I read the letter from Aetna that someone posted above.  Far from a "smoking gun."  They note very plainly that they are losing money on their exchange plans (like ALL THE REST).  So they think they can mitigate some of that loss by buying Humana.  So DOJ says no, they decide to cut their losses and cut the ACA plans.  

Agree with DTASFAB as above on that - why stay in the business if you're not making money?  That seems awfully silly ....

Universal healthcare, that's what we need. No one cannot make a meaningful solution to the nation's healthcare problem while gelling up with insurance providers, who need to worry about share holders. The nation needs to come to a realization that healthcare is a money losing proposition and the citizens have to take up the burden, somehow.

delhel said:   Universal healthcare, that's what we need. No one cannot make a meaningful solution to the nation's healthcare problem while gelling up with insurance providers, who need to worry about share holders. The nation needs to come to a realization that healthcare is a money losing proposition and the citizens have to take up the burden, somehow.
The problem with that idea is some citizens want to tax the shit out of each other to pay for their excessive waste of unnecessary medical services, while others would rather save money by suffering while they don't go to the doctor at all.  This isn't France and every individual should decide whether to pay into the system.  You want services, pay for them.  You don't want services, don't pay for them.  This lends itself to a privatization model, not a single payer public system.

tuphat said:   
xerty said:   
On the bright side, if you're at all healthy, paying a penalty is increasingly the best economic option.  Plus having a lack of any ACA options might qualify for one of the penalty exemptions (or at least it will as soon as this becomes a more widely known problem).  One failure after another for this ill-conceived legislation...

Worst advice, ever. Even "healthy people" can have life-altering accidents.
  

  "Worst" is pretty harsh - just look at premiums for healthy people before and after ACA and you know you got screwed.  Instead, just get some non-ACA coverage where you can still pick your doctor, get good care, and pay almost nothing (current health and preexisting conditions are checked).  Then if you get very sick or something, switch to the ACA plan when they won't renew you after 6-12 months.

https://www.healthinsurance.org/short-term-health-insurance/

DTASFAB said:   
 
The problem with that idea is some citizens want to tax the shit out of each other to pay for their excessive waste of unnecessary medical services

  FWIW, that is because I paid a buttload in deductibles. If I didn't have a HDHP and my insurance paid for everything, I'd feel ethically obligated not to try to get as much out of it as possible.

Like when I goto the vegas buffets, I tip over 20%. When I paid $150 an hour for three guys , plus $150 service fee, for a move, i didn't tip at all.

 

Bend3r said:   http://www.politico.com/tipsheets/politico-pulse/2016/08/aetna-warned-doj-sue-us-and-we-scale-back-on-obamacare-215923 
http://www.wsj.com/articles/aetna-warned-it-would-withdraw-from-exchanges-if-humana-deal-was-blocked-1471436663 
http://www.businessinsider.com/aetna-humana-merger-reason-for-leaving-obamacare-2016-8 

Basically they tried to coerce unchallenged acceptance of the merger by threatening to withdraw from exchanges, and they followed through with their threats.

  They were also bleeding money.
Aetna said: We have been operating on the public exchanges since the beginning of 2014 at a substantial loss. And although we have been working to improve our operations over the last 2 1/2 years, we are challenged to get to break even this year and it will be some time before we recoup our investment (including a return on invested capital in the exchange business).

xerty said:   
tuphat said:   
xerty said:   
On the bright side, if you're at all healthy, paying a penalty is increasingly the best economic option.  Plus having a lack of any ACA options might qualify for one of the penalty exemptions (or at least it will as soon as this becomes a more widely known problem).  One failure after another for this ill-conceived legislation...

Worst advice, ever. Even "healthy people" can have life-altering accidents.
  

  "Worst" is pretty harsh - just look at premiums for healthy people before and after ACA and you know you got screwed.  Instead, just get some non-ACA coverage where you can still pick your doctor, get good care, and pay almost nothing (current health and preexisting conditions are checked).  Then if you get very sick or something, switch to the ACA plan when they won't renew you after 6-12 months.

 

  Well thats very FWFy , but you're basically gaming the system by not getting real health coverage until you get sick then you ACA it.

rufflesinc said:   
DTASFAB said:   
 
The problem with that idea is some citizens want to tax the shit out of each other to pay for their excessive waste of unnecessary medical services

  FWIW, that is because I paid a buttload in deductibles. If I didn't have a HDHP and my insurance paid for everything, I'd feel ethically obligated not to try to get as much out of it as possible.

Like when I goto the vegas buffets, I tip over 20%. When I paid $150 an hour for three guys , plus $150 service fee, for a move, i didn't tip at all.

 

  In many cases HDHP deductibles + premiums are less than premiums on non-HDHPs. HDHP deductibles are just a form of premiums.

stanolshefski said:   
rufflesinc said:   
DTASFAB said:   
 
The problem with that idea is some citizens want to tax the shit out of each other to pay for their excessive waste of unnecessary medical services

  FWIW, that is because I paid a buttload in deductibles. If I didn't have a HDHP and my insurance paid for everything, I'd feel ethically obligated not to try to get as much out of it as possible.

Like when I goto the vegas buffets, I tip over 20%. When I paid $150 an hour for three guys , plus $150 service fee, for a move, i didn't tip at all.

 

  In many cases HDHP deductibles + premiums are less than premiums on non-HDHPs.

  you can't prove that. moreover, my employer's yearly contribution to my HSA is less than half the deductible.

Why doesn't anybody say anything about the high cost of services that the hospitals and doctors charge to the insurance companies? There is no basis for the charges and anybody can charge what they want. If this is regulated, the insurance companies are still evil but they may relent and our premiums may go down and we won't have to pay for the 'non-insured' people who abuse the ERs

stanolshefski said:   
rufflesinc said:   
DTASFAB said:   
 
The problem with that idea is some citizens want to tax the shit out of each other to pay for their excessive waste of unnecessary medical services

  FWIW, that is because I paid a buttload in deductibles. If I didn't have a HDHP and my insurance paid for everything, I'd feel ethically obligated not to try to get as much out of it as possible.

Like when I goto the vegas buffets, I tip over 20%. When I paid $150 an hour for three guys , plus $150 service fee, for a move, i didn't tip at all.

 

  In many cases HDHP deductibles + premiums are less than premiums on non-HDHPs. HDHP deductibles are just a form of premiums.

  HDHP deductibles alone are usually around $6K per person. And prescription drugs are SUBJECT to the deductible, which is rarely the case for non-HDHP plans.
The premiums may be a few hundred dollars cheaper, but if you have to use the HDHP plan, you will almost certainly be much worse off than with non-HDHP plans.

The only time the HDHP plans really come out ahead is for very healthy people who need no medications except over-the-counter or cheap generics. ie "young invincibles"

canoeguy1 said:   
stanolshefski said:   
rufflesinc said:   
DTASFAB said:   
 
The problem with that idea is some citizens want to tax the shit out of each other to pay for their excessive waste of unnecessary medical services

  FWIW, that is because I paid a buttload in deductibles. If I didn't have a HDHP and my insurance paid for everything, I'd feel ethically obligated not to try to get as much out of it as possible.

Like when I goto the vegas buffets, I tip over 20%. When I paid $150 an hour for three guys , plus $150 service fee, for a move, i didn't tip at all.

 

  In many cases HDHP deductibles + premiums are less than premiums on non-HDHPs. HDHP deductibles are just a form of premiums.

  HDHP deductibles alone are usually around $6K per person. And prescription drugs are SUBJECT to the deductible, which is rarely the case for non-HDHP plans.
The premiums may be a few hundred dollars cheaper, but if you have to use the HDHP plan, you will almost certainly be much worse off than with non-HDHP plans.

The only time the HDHP plans really come out ahead is for very healthy people who need no medications except over-the-counter or cheap generics. ie "young invincibles"

My 62 year old chiropractor has an irregular heartbeat that's genetic.  He's had it his entire life and it's completely benign.  When a nurse in an MD's office detected it, she asked him what medications he's on.  He said none.  She said, "That's unusual."

His curiosity was piqued.  "It's unusual that I'm healthy and I don't need drugs?" he asked.

Her jaw dropped to the floor and she had no answer.


cool story bro
Disclaimer
DTASFAB said:   
canoeguy1 said:   
stanolshefski said:   
rufflesinc said:   
DTASFAB said:   
 
The problem with that idea is some citizens want to tax the shit out of each other to pay for their excessive waste of unnecessary medical services

  FWIW, that is because I paid a buttload in deductibles. If I didn't have a HDHP and my insurance paid for everything, I'd feel ethically obligated not to try to get as much out of it as possible.

Like when I goto the vegas buffets, I tip over 20%. When I paid $150 an hour for three guys , plus $150 service fee, for a move, i didn't tip at all.

 

  In many cases HDHP deductibles + premiums are less than premiums on non-HDHPs. HDHP deductibles are just a form of premiums.

  HDHP deductibles alone are usually around $6K per person. And prescription drugs are SUBJECT to the deductible, which is rarely the case for non-HDHP plans.
The premiums may be a few hundred dollars cheaper, but if you have to use the HDHP plan, you will almost certainly be much worse off than with non-HDHP plans.

The only time the HDHP plans really come out ahead is for very healthy people who need no medications except over-the-counter or cheap generics. ie "young invincibles"

My 62 year old chiropractor has an irregular heartbeat that's genetic.  He's had it his entire life and it's completely benign.  When a nurse in an MD's office detected it, she asked him what medications he's on.  He said none.  She said, "That's unusual."

His curiosity was piqued.  "It's unusual that I'm healthy and I don't need drugs?" he asked.

Her jaw dropped to the floor and she had no answer.

  

xerty said:   
tuphat said:   
xerty said:   
On the bright side, if you're at all healthy, paying a penalty is increasingly the best economic option.  Plus having a lack of any ACA options might qualify for one of the penalty exemptions (or at least it will as soon as this becomes a more widely known problem).  One failure after another for this ill-conceived legislation...

Worst advice, ever. Even "healthy people" can have life-altering accidents.
  

  "Worst" is pretty harsh - just look at premiums for healthy people before and after ACA and you know you got screwed.  Instead, just get some non-ACA coverage where you can still pick your doctor, get good care, and pay almost nothing (current health and preexisting conditions are checked).  Then if you get very sick or something, switch to the ACA plan when they won't renew you after 6-12 months.

https://www.healthinsurance.org/short-term-health-insurance/

  Remember that these plans are cheap because they skirt the ACA rules.
Pre-existing conditions aren't covered, so you have to be very healthy to make use of these plans.
You also have to make sure that the network is adequate. ACA plan networks are scrutinized and must be approved, short-term-plan networks may not be. If you get a bad plan with few doctors in-network (essentially an indemnity-only plan), prepare to be balance-billed out the wazoo if you actually need to go to a hospital.

DTASFAB said:   
delhel said:   Universal healthcare, that's what we need. No one cannot make a meaningful solution to the nation's healthcare problem while gelling up with insurance providers, who need to worry about share holders. The nation needs to come to a realization that healthcare is a money losing proposition and the citizens have to take up the burden, somehow.
The problem with that idea is some citizens want to tax the shit out of each other to pay for their excessive waste of unnecessary medical services, while others would rather save money by suffering while they don't go to the doctor at all.  This isn't France and every individual should decide whether to pay into the system.  You want services, pay for them.  You don't want services, don't pay for them. 
 

  
Emergency health care isn't like buying a new TV.
Don't want a new TV? Don't buy one!
Had a heart attack? Just leave me here, I don't want any health care <--- not going to happen.
Unless we have single payer OR we are willing to leave people to die, those of us who are responsible will continue to underwrite those who are not.

DTASFAB said:   
delhel said:   Universal healthcare, that's what we need. No one cannot make a meaningful solution to the nation's healthcare problem while gelling up with insurance providers, who need to worry about share holders. The nation needs to come to a realization that healthcare is a money losing proposition and the citizens have to take up the burden, somehow.
The problem with that idea is some citizens want to tax the shit out of each other to pay for their excessive waste of unnecessary medical services, while others would rather save money by suffering while they don't go to the doctor at all.  This isn't France and every individual should decide whether to pay into the system.  You want services, pay for them.  You don't want services, don't pay for them.  This lends itself to a privatization model, not a single payer public system.

  I somewhat agree, but you have to be willing to withhold services to those that don't/can't pay.  You can't have it both ways like we do now where you get care if you can't/don't pay.  Society would have to get used to seeing people dying of completely curable diseases because they can't afford it for that kind of system to work.  Of course, everyone wants that kind of system until it is their grandmother, dad, mom, girlfriend, aunt, neighbor, etc. is dying and then someone (government) needs to pay to save nana, cupcake, etc. 

Skipping 302 Messages...
IMBoring25 said:   As others have said, even if those numbers are right, it can be preferable to spend extra on overhead vs. what you would spend on other forms of waste if you didn't spend it.

Does the Medicare number capture Medicare-related overhead spending at all levels of government?

It is extremely likely that a far higher proportion of the cost that doesn't go to legitimate patient care gets chalked up as overhead in the private sector number than in the public sector number. I have seen entire government organizations lauded for saving money by making decisions that will ultimately cost multiple orders of magnitude more than they saved. I've said before nothing is as expensive as saving money poorly.

Finally, what the private sector and the public sector have in common is that the public sector writes the rules under which they operate. If Medicare had to jump through the hoops private companies do, they'd never get to patient care. Understand that every regulation that's put in place, even if it's not specifically written to abet entrenched players (which a lot of them are), carries with it a cost of compliance that not only increases the cost of providing the product or service but raises the barrier to entry for new entrants. If insurance and licensing laws were being properly enforced, we wouldn't have Uber and Lyft. There is no way for upstarts to get away with disruptive innovation in the medical sphere. It's just too complex and too expensive. So we get the same old megacorporations with the same old entrenched bureaucracy.

  
B-b-b-but I thought the answer was always more rules to fix the problem!

That worked with the banks! Right?



Disclaimer: By providing links to other sites, FatWallet.com does not guarantee, approve or endorse the information or products available at these sites, nor does a link indicate any association with or endorsement by the linked site to FatWallet.com.

Thanks for visiting FatWallet.com. Join for free to remove this ad.

While FatWallet makes every effort to post correct information, offers are subject to change without notice.
Some exclusions may apply based upon merchant policies.
© 1999-2017