Posted on 06/27/2012 11:01:27 PM PDT by iowamark
I'm scared.
I fear that even if the Supreme Court overrules most of Obamacare (or did already, by the time you read this), Republicans will join Democrats in restoring "good" parts of the law, like the requirement that insurance companies cover kids up to age 26 and every American with a pre-existing condition.
Those parts of Obamacare are popular . People like getting what they think is free stuff. But requiring coverage to age 26 makes policies cost more.
Even Bill O'Reilly lectures me that government should ban discrimination against those with pre-existing conditions. Most Americans agree with him. Who likes discrimination? Racial discrimination was one of the ugliest parts of American history. None of us wants to be discriminated against. But discrimination is part of freedom. We discriminate when we choose our friends or our spouse, or when we choose what we do with our time.
Above all, discrimination is what makes insurance work. An insurance regime where everyone pays the same amount is called "community rating." That sounds fair. No more cruel discrimination against the obese or people with cancer. But community rating is as destructive as ordering flood insurance companies to charge me nothing extra to insure my very vulnerable beach house, or ordering car insurance companies to charge Lindsay Lohan no more than they charge you. Such one-size-fits-all rules take away insurance companies' best tool: risk-based pricing. Risk-based pricing encourages us to take better care of ourselves.
Car insurance works because companies reward good drivers and charge the Lindsay Lohans more. If the state forces insurance companies to stop discriminating, that kills the business model.
No-discrimination insurance isn't insurance. It's welfare. If the politicians' plan was to create another government welfare program, they ought to own up to that instead of hiding the cost.
Obama -- and the Clintons before him -- expressed outrage that insurance companies charged people different rates based on their risk profiles. They want everyone covered for the same "fair" price.
The health insurance industry was happy to play along. They even offered to give up on gender differences. Women go to the doctor more often than men and spend more on medicines. Their lifetime medical costs are much higher, and so it makes all the sense in the world to charge women higher premiums. But Sen. John Kerry pandered, saying, "The disparity between women and men in the individual insurance market is just plain wrong, and it has to change!" The industry caved. The president of its trade group, Karen M. Ignagni, said that disparities "should be eliminated."
Caving was safer than fighting the president and Congress, and caving seemed to provide the industry with benefits. Insurance companies wouldn't have to work as hard. They wouldn't have to carefully analyze risk. They'd be partners with government -- fat and lazy, another sleepy bureaucracy feeding off the welfare state. Alcoholics, drug addicts and the obese won't have to pay any more than the rest of us.
But this just kills off a useful part of insurance: encouraging healthy behavior. Charging heavy drinkers more for insurance gives them one more incentive to quit. "No-discrimination" pricing makes health care costs rise even faster. Is it too much to expect our rulers to understand this?
Of course, the average citizen doesn't understand either. When I argue that medical insurance makes people indifferent to costs, I get online comments like: "I guess the 47 million people who don't have health care should just die, right, John?"
The truth is, almost all people do get health care, even if they don't have health insurance. Hospitals rarely turn people away; Medicaid and charities pay for care; some individuals pay cash; some doctors forgive bills. I wish people would stop conflating the terms "health care," "health insurance" and "Obamacare." Reporters ask guests things like: "Should Congress repeal health care?" I sure don't want anyone's health (SET ITAL) care (END ITAL) repealed.
Reporters also routinely called Obamacare health "reform." But the definition of reform is: making something better. More government control won't do that. We should call politicians' insurance demands "big intrusive complex government micromanagement."
Let the private sector work. Let it discriminate.
Another shining example of how sometimes the majority opinion is the wrong opinion once Aristotle Logic is applied.
Who wouldn’t want “Medicare for All”?
But who would pay for it?
If the SCOTUS overturns Obamacare (I personally would not bet on that), the Republicans will do what they ALWAYS do; Snatch defeat from the jaws of victory!
bump for later
Dependant coverage up to age 26 does not necessarily increase the cost to insurance companies, and even if it did, premiums are adjusted accordingly. For example, is a 23 year old significantly different health wise from a 20 year old? People 26 and under are generally pretty healthy. Does it cost an insurance company far more to cover a 26 year old dependent on a family plan compared to a 21 year old on the same plan? I don’t know.
Additionally, I don’t think the insurance mandates prevent premium increases. Using Tricare for example, you can keep a dependent covered until age 26, but you have to pay a substantial premium increase to do so (something like $150 extra per month). Yet, as I pointed out in the first paragraph, I don’t think a 26 year old is substantially different, health wise, than someone younger (you could possibly argue a 26 year old has even fewer health needs than a child).
I focused only on the 26 year old mandate in Obamacare, but the point isn’t really whether something is cost effective or not. In a free market, policies are tailored to provide the best possible services to the greatest number of people. The problem isn’t about what coverage is best. The problem is the mandate itself! It’s about people who think they know best taking away the right of other people to make their own decisions!
In a free country, I’d be able to purchase whatever coverage I want, to include pregnancy coverage for a 100 year old dependent if I’m paying the premiums. Think that’s irrational, a waste of my money? What’s freedom if it doesn’t include the liberty to make bad choices?
You don’t think you’ll bear any burden if my six twenty somethings are covered under my insurance plan ?
Line up a hundred 18-to-25 year old folks, and ask them to list their visits to the doctor over the past two years. The vast majority will be women for birth control, or visits over serious flu-like symptoms. They rarely go to the doctor for anything much.
Go and find a hundred folks between fifty and sixty years old, and add up their visits to the doctor. It’ll be a fairly significant amount of visits.
Statistically, I don’t see how any insurance company could crank up insurance costs on some parent with two or three kids in the 20-25 year old range over this. I’d be more worried if they said your parents could move in with you, and you could cover them with your insurance....then you could watch your rates triple up overnight.
So,
by this logic, government mandates are ok as long as the stats support them.
I think Stossel would agree that, insuring kids past 23 is a wonderful benefit. If a company wants to offer it, they become it a more attractive place to work for people in my position. The increased cost for everyone else makes it less attractive for them.
What he and I both detest is the government dictating that all companies must offer it. It's a very rare thing when government intervention in business improves anything.
Age 26 is right in the middle of Child bearing age. I believe that a pregnancy would involve a heck of a lot more expense. If the inmsurance company wants to chage that extra premium then so be it.
onona: “You don’t think you’ll bear any burden if my six twenty somethings are covered under my insurance plan?”
I suppose that would depend on your insurance. If you pay a flat rate regardless of the number of dependents, then yes. Your extra dependent children, whether they are 10, 20, or 26, add to the overall cost which is shared by everyone. If, on the other hand, you’re paying a premium increase per child (or twenty something), then no.
It seems probable that the more healthy people on a given insurance plan, the lower cost per person. As I pointed out, a child might actually need more health care than a twenty something. I don’t really know. I do know a lot of twenty somethings that pretty much never go to doctors. If they’re paying in and not using care, wouldn’t they actually be helping to lower the cost for everyone else?
I did a quick price check on Humana Insurance (Autograph Total/5000 Plus RX/HSA). The premiums went up per child covered.
One Adult = $154.36
Two Adults = $294.27
Three covered = $383.07 (added child under 21)
Four covered = $503.98 (added child over 21, under 26).
So, it looks like this plan at least makes the insured pay more per child covered. I think some government plans have family or single rates and don’t take increase the price for additional children. I’m not sure about that, but if you’re paying more for child and adding more healthy people to the plan, the actual cost should be less for everyone, shouldn’t it?
pepsionice: “Statistically, I don’t see how any insurance company could crank up insurance costs on some parent with two or three kids in the 20-25 year old range over this.”
Oh, I definitely see why they would charge more per extra person covered, but like you wrote, I don’t see this as a money loser for the insurance companies. Isn’t that why Obamacare wants to force everyone on insurance in the first place? I think it’s another form of government mandated wealth redistribution. The healthy people are picking up the tab for those who need more care.
onona: “by this logic, government mandates are ok as long as the stats support them.”
Government mandates ARE the problem.
We’re discussing the relative merits of various insurance mandates when we should be discussing liberty. You see, the left has all sorts of plans that they think are going to save us. They’re just trying to help us.
It really doesn’t matter if one method is more cost effective than another. What matters is a bunch of bureaucrats seized our right to make our own health care decisions (in the interest of helping everyone of course).
Like I wrote, why should anyone care if I want to spend every dime I own on a premium health care plan? Shouldn’t I have that right in a free country? (Hint: This isn’t a free country anymore.)
The left, of course, has to take away my freedom in order to help me, when all I REALLY want is for them to leave me alone. Ah! But that makes me part of the problem, because I’m not contributing to their grand solution. I’m not paying my share.
I’m sure the Soviets only wanted to help people, too.
During the recent hurricane in NJ, my basement flooded. I called my insurance company, and they confirmed that I had no flood insurance.
I asked the agent, could have have coverage now for my “pre-existing condition”? He did not even think that my request was funny.
If you can wait until you have a condition before getting insurance, then it is not really insurance.
I forgot to mention: when my basement flooded, I was looking for coverage for my pre-existing condition.
What I wanted was a bale-out. Heh-heh!
Just because you're in the minority doesn't mean you're wrong,....
it just means you need to explain your stance so that even an idiot can see the logic....
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