Health Insurance

[Tyler]

So, my 2015 premiums are set to be nearly 2.5 times my 2013 premiums. I thought this wasn't supposed to happen? Or was it supposed to happen but I wasn't supposed to care?

[Didier]

My understanding is that health insurance costs have been skyrocketing for years, and Obamacare didn't really try to address this. Instead Obamacare focused on getting more people insured and left the whole cost thing TBD.

In the meantime, Canada.

[Tyler]

I guess that's possible, but my premiums were basically the same from 2009-2013. And now huge increases two years in a row.

[EOst]

A 250% premium increase is not normal; nationally premiums are either staying the same or seeing very small increases. Did anything change in your situation between 2012 and now?

[Tyler]

I got older. But no. I've never even filed a claim since i got insurance in 2009.
$129.50/mo from 2009-2013
$189.50/mo in 2014
$299.50/mo coming in 2015
I'm just going to raise my deductible a bunch rather than pay that...

This seems in line with what happened to me in 2014:
http://www.healthpocket.com/healthcare- ... FmW8luMEnU

[Nick]

Is your plan through an employer? Or do you have your own individual policy?

[Tyler]

Individual.

[Gman12]

I had a large increase after steady rates previously as well. Had been $130 for 2010-2014, for 2015 $210 with individual Blue Cross plan. Only claim has been one flu shot. Hopefully there's an explanation for the sharp increase. I'll probably raise my deductible since I never use it.

What I don't get about the whole affordable health care act is they didn't address the problem, the outrageous price gouging of the health care. No one ever looks at the bill from medical care because insurance is paying for it not them, which isn't true, we are all paying for it, and notices that they are charging $50 for a cup of mouthwash! What a racket.

[twincitizen]

Well yeah, the whole point was to get that public option... Things would be very different if that had stayed in the bill.

The act still did a lot of good things not directly tied to cost: letting people stay on their parents' plan til age 26 is HUGE. Pre-existing conditions too. Also, the insurance companies must give rebates if a certain percentage of revenue is not spent on care vs. administration. As far as keeping costs down for individual plan buyers who don't qualify for subsidies, not so much.

Honestly, I sometimes think/hope the whole thing collapses so we have no choice but to pass a new healthcare law with a public option, but that won't even be possible for at least several more election cycles.

[xandrex]

I'm kind of curious to see how all these numbers play out. Increases are apparently small, but there seems to be anecdata that suggests otherwise.

I know my dad, who runs a small business, had his group plan canceled and he had to pick a new one. The plan they have now apparently costs $1000 more a month (there are only a few employees even on the plan, so this is quite a jump and doesn't include any employee portion) and benefits have been slashed, with a huge deductible. And because of the limitations of the plan, I was more or less booted off the family coverage portion and had to purchase my own through work, despite being under 26. Lame.

Something is definitely going to have to be done to fix the costs. Despite my father definitely harping on the law because of his politics, he's kind of got a point: Is a much higher bill with dramatically slashed benefits really what this law was supposed to do? At least my work plan is reasonably priced and has decent benefits and I finally have dental...

[David Greene]

What I don't get about the whole affordable health care act is they didn't address the problem, the outrageous price gouging of the health care. No one ever looks at the bill from medical care because insurance is paying for it not them, which isn't true, we are all paying for it, and notices that they are charging $50 for a cup of mouthwash! What a racket.

Medical pricing is super-complicated. It's not just that, "people don't see it so they don't know so they use it too much." Honestly, how many people *want* to go to the doctor? If anything we have people who don't go enough and end up being more expensive because they didn't get preventative care earlier.

My wife works in health care and I've got some new insight into the system I didn't have before. Hospitals charge huge amounts for aspirins and other things because they're trying to make up huge loses for required free ER care. This is how you and I subsidize an important public good. Yes, it's ridiculous but it's ridiculous not due to price gouging but due to our lack of a rational public health care system.

The medical factory my wife works for has all of the provider incentives wrong. It actually incentivizes expensive doctors sitting around doing northing while relatively inexpensive physician assistants and nurse practitioners do most of the provider care. This is not at all the fault of the doctors. The incentives are such that it benefits the PAs and NPs to do all of the patient work and score more "points" that raises their salaries in the next cycle. There is absolutely no financial benefit for the doctors in these cases to do any work. Of course many do anyway because the clinic is swamped and/or they became a doctor because they like the job. My point is that financially, the incentives by the industry are set up to make care more expensive.

Many people have talked about outcome-based pay but that has the same problems performance pay has for teachers. The provider is relying on the patient to actually follow instructions, which is depressingly rare. Pay-per-patient doesn't work but I'm not convinced pay-per-insulin-shot is any better.

Then you have ridiculous duplication of expensive equipment like MRIs because every hospital needs one to compete with the other hospitals who have one.

I used to think that insurance company overhead was the major health care cost. It is still a huge cost but it's become clearer to me that one of the, if not the major health care cost driver is our complete lack of coordination. If we had a British-style public health care system we could allocate resources more sanely while still allowing private hospitals and clinics for those who want that. A public insurance option would cut a lot of administrative overhead and private insurers could still function as add-on plans.

The ACA did almost nothing to change the fundamental cost drivers as far as I can tell. Which is exactly what health care experts said was the problem with the Heritage Foundation private-insurer-based plan the ACA is modeled on.