Posted on 03/05/2015 8:17:11 AM PST by knarf
I'm out'a the loop because I'm retired and on Medicare, but ...
Theoretically possible, but the complexity of the actuarial calculations is stunning.
Remember that insurers make money by creating risk pools, estimating the actuarial risks across those pools, setting premiums at *slightly* above the projected costs to insure and administer those risks, and then investing the revenues until they have to pay out. (I know of one insurer, for instance, that actually for several years in the 1990s priced its disability policies below the market price for the insured risks because it was able to make a profit on investing the premiums).
The pools are important, and this is what Obamacare is trying to get at. The larger the number of people in the pool, and the more standardized the policy, the easier it is to sell those policies at profit. That’s why Obamacare policies for men include coverage against ovarian cancer and for mammographies, and women have to pay for policies that include screening for prostate cancer. With the larger pools, there are more healthy people (who would often otherwise not buy insurance or would buy only catastrophic insurance) in the pool and fewer actuarial variations that have to be priced out.
It also involves a moral hazard issue. Under the a la carte plan, the only people who will buy insurance for diabetes, for instance, are people with a history of diabetes in their families or those who are risk averse. The cost to insure that pool will increase until it equals (1) the actual medical cost, discounted to present value, of treating diabetics plus (2) a profit margin and overhead for the insurer. At the theoretical top end of this, it would be cheaper to simply pay out of pocket for treatment because you don’t have to pay for the insurer to get in the mix.
That’s why insurance for known, necessary expenses is just stupid. Think about hair cuts. Unless you do it yourself or are bald, you need haircuts. We could set up an insurance system to cover those expenses. Assuming the bald and DIYers are permitted to opt out, the only people who will purchase the insurance are those who are likely to need it. So you go to your barber with your hair cut insurance card. The barber used to charge $10 on a cash basis, but now has increased administrative costs to deal with the insurance policies and increased risk of non-collection because insurers suck. The barber will have to increase charges to cover these costs, so your haircut will now cost $15. Additionally, the insurer will have to charge you premiums to cover the expected costs of the haircut ($15) plus its overhead and profit, meaning that your premiums will increase to $20 per haircut that used to cost $10 without insurance.
Additionally, because of the smaller and more specialized risk pools, with fewer healthy people in the mix to balance out the risk and pay premiums that cost more than their actual risk, the cost of insurance will rise across all risk pools.
So the long and short of it is that the insurance market simply cannot make it on an a la carte basis because of the moral hazard and actuarial problems it raises.
The possible responses to this are two-fold. The statist, communitarian response is Obamacare: force everyone into the risk pool. The market solution is self-insurance and catastrophic risk policies. There are actually lots of ways to mix those that may produce a workable market while making sure the stupidest people will still have access to health care. Rezident Zero, of course, chose the absolute worst of all options.
I've had teeth pulled, medication given to me and of course a free over all sitting in front of a doctor (I never abused the privilege) and it didn't cast me a dime
I never knew how they were funded, but Boston is LOADED (or WAS, anyway) with idealogues of all walks in life
The 60's were more terrific than drugged up crazy
When both your health care plans are totally FED controlled you get no choice. Medicare and Tricare Life,Nor can you upgrade a procedure with them. And they don’t cover a lot of stuff like hearing aids, glasses or dental. Just like with the cable company. Nor can you upgrade a procedure with them.
We have to by packages from the cable company in order to get the sports stuff and RFDTV. We have over 300 channels and watch at the most 35. Most prerecorded to fast forward through the to many commercials. A 1 hr show is actually 45 mins, rest is commercials we don’t want to see.
Simply because they want you to pay for coverage that someone else needs/wants.
That’s a big part of Obamacare - that everyone is required to have “full” insurance so that those who need both prostate and pregnancy coverage can be in the same pool as you.
I built a system like that in the late 80’s for a family member in the insurance business. It looked at all the underwriting guidelines for 2 dozen or so companies then compared the deductibles, co pay and coverages. It took those common elements and then allowed the end user to pick what they wanted or drop what they wanted to drop when possible. Then it looked at the basic rating tables and compiled rates and then compared those.
The problem with individual health insurance is that like automobile or home insurance the companies are regulated by the state and the policies are only sold within the state. Which is a good thing for those property and casualty lines of insurance because the physical risks vary by geography, among other things. Health insurance, like life insurance is based on the person. When you can cluster large groups of similar risks you can calculate losses forward with a great deal of accuracy. The simple fix to individual health insurance is to allow companies to sell across state borders. For example, if you have 1,000 registered nurses in a state your pool is much different if you have 100,000 registered nurses across the country in a risk pool. The loss experience is different, etc.
The thing called ObamaCare is not insurance by the way. It works in a fashion like federal flood “
insurance” which is not insurance either. Both take adverse risks (pre-existing conditions) and use monies from good risks to subsidize bad risks. In the case of federal flood “insurance” what Congress did is an even bigger joke because regular income tax payers subsidize the so-called flood insurance. After catastrophes the system which is not based on any real actuary foundation runs out of money and then Congress pushes money blocks from the US Treasury in to the NFIP. This is done through FEMA. The even bigger joke is that since they are using borrowed money (The US is broke) the math is simply retarded if you view it from a real insurance viewpoint. Simply put, a fellow who lives on top of a mountain in the desert pays via his income taxes that go to pay US debt service for flood “insurance” losses a fellow has had who built stupidly on the beach or outside of New Orleans:)
Politicians are unqualified to do most anything in comparison to the capitalistic system that allows companies to compete for providing goods and services. In this case insurance. Dump ObamaCare and allow health insurance companies to issue policies countrywide and the problem is mostly solved.
Unfortunately, most members of Congress and certainly the moron that is president cannot handle simple math and they cannot even come close to grasping the things they pass laws about.
The socialization of risk/responsibility (insurance) collective socialists have the responsible right where they want them. Paying.
Pay for another socialist scheme…and another…and another.
Stay healthy my friend…and pay…and pay…and pay…and
Die
That’s one of the most reasonable and factual things I’ve read in a long time .... thank you.
Jeez, I start some fascinating threads ....
I’ve got Tricare for life. It covers birth control along with other things which I don’t need. My hearing aides are covered under the VA since my hearing loss was during active duty.
I have separate vision and dental through where I work now.
As for TV, I very rarely ever watch anything. If I do I record it for later. If I didn’t have a wife I wouldn’t have TV at all. Here (Houston area) we have a lot of Spanish channels that are included (we don’t habla).
Does it say that it has to be “your” phone number?
What? You mean actually have an effective market in health insurance? We can’t have that. Too many companies base their entire business model on lack of transparency provided by the current system.
Duncan Hunter wanted to do this very thing
Insurance controlled by political hacks at the state level. It is used as a political weapon. When a goobernor wants more votes they have the state insurance commissioners add more goodies to required services. I am a male. I don’t need gynecological services but I still have to pay for them.
isthisnickcool’s response is also highly worth reading. The NFIP was a perfect example of why Obamacare couldn’t work.
Must be gettin' old .... er.
The ACA mandates insurance companies provide only 3 plans. All plans between insurance companies are the same. And calling it insurance is wrong, its 3rd party prepaid health care with a very high initial out of pocket to make sure most people with their shiny new health care card don’t try to use it. The only difference between plans are what drugs are covered. Unfortunately it would appear Roberts is going to screw US again. His only question was weather a new president could redefine State there by making the subsidies illegal.
That is the problem, I’m the spouse, so I don’t qualify for anything. Except what Medicare and Tricare Life limits you too.
Yes it will cover Viagra too. But not needed hearing aids or glasses that must be replaced yearly as vision continues to deteriorate due to health reasons. And I can’t use those cheap box store crap. I have to have high end Zeiss lenses.
Hubby is nearly 75 Ret SCPO, he is being fitted for hearing aids, and they will pull the 5 teeth he has and make him dentures. Under disability as he does not qualify for VA care Means Testing.
I am nearly to the point I can’t walk, much less work. Their answer to the back pain is have ‘your breast reduced’. BTW you pay for it. No more ineffective bone destructive steroid shots. To bad we ruined your Gastro track with our OA drugs and ruined your bones with our PPI’s. And the PT damaged your spine more. TOUGH LUCK we did all this to you in the name of medicine. Learn to sleep in the recliner for the rest of your life.
We are already set up for antenna for the local news channels as we lose the dish during weather. That is all I need and a radio. I’d be rid of the dish tomorrow if he didn’t want the sports junk. I’ve never been much of a TV watcher unless I could learn something.
I read up on the steroid shots as I have a herniated disc. I told them I wasn’t taking them. And I can relate to sleeping in the recliner although I prefer the floor. The PT messed up my knees but all they wanted to do was give me more Motrin.
I tell my wife she is lucky because I don’t watch any sports. There are more business than sports. She had some issues while I was in that never got fixed so we are paying for them now.
Motrin will kill your gut.
I like History channel best. And RFDTV as it has Whispering Bill Anderson’s Family Reunion, Larry’s Diner, and I hope they bring back the Joey and Rory show.
We rarely go see any concerts, but did go to Pottsville, TN and to their barn to see theirs. Good Christian couple, very down to earth. They even have a good sound man, who knows how to run a mixing board, so music does not over ride the vocals. Hammerin Nails was written by Rory. Enjoy. http://www.youtube.com/watch?v=fkTzE1g3Zfc
Are You Washed In The Blood https://www.youtube.com/watch?v=xQ1pfbmCKb0
Joey had her first child last year, mild downs, then a hysterectomy for cancer. You can’t shake their faith.
Joey & Rory are awesome! I haven’t seen nor heard anything regarding them in a while. That’s some good wholesome music. Not the garbage that is put out today. Even today’s country is mostly crap.
Sad to hear about her cancer. My wife lost a sister about six weeks ago from it.
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