Will Obamacare affect risk perception?

[Birchwood]

My opinion: For those of us who have prepared, saved and have coverage till medicare, it will be fine!
The real mess lies in the fact, that no matter what, if we want to cover everybody, all of us have to pay higher taxes! There is no Democrat or Republican magic bullet in solving this.
There are going to be rules, regulations and limits-there is too much greed in the medical and health establishment and they will always find ways to pad or insert new proceedures and treatments to increase their bottomline.
We have to define what is standard care and what's not covered.
Trickel down economics does not work here.
Although Obamacare is not perferct, no other plan will be perfect-there will always be complaints.
My suggestion is simple- I know I am going to get flacked for this:
My don't we extend medicare to everybody for standard care(if we can agree on what's covered) which will pay for 70%, and the rest is
supplementary insurance(30%) for options or cadillac additions for those who can afford. It work for medicare recipients, why not to all.

 

[easysurfer]

My opinion: For those of us who have prepared, saved and have coverage till medicare, it will be fine!
The real mess lies in the fact, that no matter what, if we want to cover everybody, all of us have to pay higher taxes! There is no Democrat or Republican magic bullet in solving this.
There are going to be rules, regulations and limits-there is too much greed in the medical and health establishment and they will always find ways to pad or insert new proceedures and treatments to increase their bottomline.
We have to define what is standard care and what's not covered.
Trickel down economics does not work here.
Although Obamacare is not perferct, no other plan will be perfect-there will always be complaints.
My suggestion is simple- I know I am going to get flacked for this:
My don't we extend medicare to everybody for standard care(if we can agree on what's covered) which will pay for 70%, and the rest is
supplementary insurance(30%) for options or cadillac additions for those who can afford. It work for medicare recipients, why not to all.

Maybe I'm in the same minority as you, but I would love Medicare for all as an option. Sure, there are plenty of reasons to say it won't work. But for those who can't get insurance (not me, as I love my HSA), having the option to openly enroll in Medicare sounds like a better option than going without, or doing the have to go to the emergency room for non emergency treatment route.

 

[samclem]

My don't we extend medicare to everybody for standard care(if we can agree on what's covered) which will pay for 70%, and the rest is
supplementary insurance(30%) for options or cadillac additions for those who can afford. It work for medicare recipients, why not to all.

Per earlier "warning shots" (see Post 8) this thread will need to stay focused (to avoid the fate of similar threads). Extension of Medicare was considered during the drafting of this legislation, and was rejected for a myriad of reasons. So, I guess that's why we're not doing it.

 

[teejayevans]

Assuming no OC, I have two options:
1. Convert my COBRA (anybody ever done this?), technically it's suppose to be possible.
2. HIPAA

For either option 1 or 2 I have no idea of cost (I'm assuming 2X the regular cost), it's this cost (next year and 10 years from now) are the big unknowns.
TJ

 

[Corporate ORphan]

Maybe I'm in the same minority as you, but I would love Medicare for all as an option. Sure, there are plenty of reasons to say it won't work. But for those who can't get insurance (not me, as I love my HSA), having the option to openly enroll in Medicare sounds like a better option than going without, or doing the have to go to the emergency room for non emergency treatment route.

I second Medicare for all!!! I have read that it would actually cost less thean what we spend now on health care. Soon health care will be 20% of GDP. That's insane! If we got rid of health insurance companies think of all the people who could have access to health care with the money currently spent on insurance.

 

[2B]

Yes, clearly. But we have very big penalties for disclosure of national security information, and look how often that gets out (always). And this is a topic of greater interest to far more people. Anyway, whatever they are doing seems to be working.

The big difference is that for a clerk to blab isn't a "crime." It would almost certainly result in that clerk being ostracized from the whole legal profession. This is after they had spent so much time and effort rising to the level necessary to be a clerk for SCOTUS. Who would ever trust them again? No trial or conviction would be necessary. I suspect there would be no redemption.

 

[2B]

That, plus the fact that we now mostly get to live to an age where we have chronic conditions that cost $$$ multiplied by years, rather than good old acute infectious diseases whose medical costs (regardless of the outcome) are measured in tens of dollars.

I don't believe that it's unsustainable, but it will require people to dig into their pockets. That may mean choosing between health care and the fifth family iPad for some, or it could be an altogether less comfortable choice for others.

The countries that have "universal" heath care also have some form of rationing. You can call it a shortage of facilities or simply a ranking of societal worth (death panels). At a certain point people are not given the latest and greatest no matter how much their family demands it. End of life and geriatric care are very high cost areas in the US that are key areas for financial savings under universal heath care.

The truly wealthy can always come to the US. Here we ration our heath care by the ability to pay. Yes, we do have a charity system but treatments are frequently limited. The types of treatments not covered will quickly outstrip the cost of the iPad.

This is not intended to be political but only a reflection on what I see.

 

[clifp]

Regardless of thread subject, I found this statement "interesting", especially in a "high value" (I assume) monthy expense.

Heck, I/DW are a bit more than FI, but we still track spending, closely ...

You don't know where you are going unless you know were you've been...

At times I've wished that tracked my expenditures more closely. Although there is an opportunity cost to do so and I'm not entirely sure what benefit I'd gain by knowing that my Kaiser premiums were $120/month or $140/month back in 2001.

I'd started using Mint.com this year and the fairly automated nature of it seems worth the time expenditure.

I do keep track of my net worth and projected income from dividends and interest, and that in turns establishes my annual budget.

 

[MichaelB]

Supreme Court Justice Ginsburg last week in a speech joking about the health care case

“If the individual mandate, requiring the purchase of insurance or the payment of a penalty, if that is unconstitutional, must the entire act fall?” she said, then offering up the alternative to throwing out the whole law because of the mandate. “Or, may the mandate be chopped, like a head of broccoli, from the rest of the act?”

Commenting on leaks, she said

At the Supreme Court, those who know don't talk,” she said. “And those who talk don't know.”

 

[easysurfer]

I read that article (think it was on Politico), but didn't post it for fear of making this thread come to a screeching halt (porky pig?).

More broccoli talk with the health care decision. From that article (or perhaps it was another, I forget) there's a good chance the decision won't happen until near the end of the month. Well, I suppose we've waited this long, what will a couple more weeks do anyhow?

 

[MichaelB]

I read it elsewhere but it is widely available and didn't see anything political or provocative in her words. One was Supreme Court humor, the other a comment on leaks, both relevant to this thread.

As my father used to say "we will know when we know, and not any sooner".

 

[Mulligan]

I just read today that RAND Corp researchers estimated premiums to rise an average of 2.4% if mandate is eliminated and rest of law remains in effect. I wonder how that number came about. Lets see, you bring on a bunch of people presently uninsurable and allow healthy people to not purchase insurance, allowing them to wait until they are sick. Seems like a pretty low estimate to me, but I am no expert. On the other side, republicans keep talking about increased HSA deductions. Personally, as someone with a good pension, and no deductions, I would shovel extra money into an HSA by the wheel barrel loads if that ever came to pass. Doesn't seem like an optimal solution for poor people though.

 

[Animorph]

I just read today that RAND Corp researchers estimated premiums to rise an average of 2.4% if mandate is eliminated and rest of law remains in effect. I wonder how that number came about. Lets see, you bring on a bunch of people presently uninsurable and allow healthy people to not purchase insurance, allowing them to wait until they are sick. Seems like a pretty low estimate to me, but I am no expert. On the other side, republicans keep talking about increased HSA deductions. Personally, as someone with a good pension, and no deductions, I would shovel extra money into an HSA by the wheel barrel loads if that ever came to pass. Doesn't seem like an optimal solution for poor people though.

Very interesting article about that:

Washington state provides case study on effects of heath-care reform - The Washington Post


"In 1993, Washington state passed a law guaranteeing all residents access to private health-care insurance, regardless of their health, and requiring them to purchase coverage.

The state legislature, however, repealed that last provision two years later. With the guaranteed-access provisions still standing, the state saw premiums rise and enrollment drop, as residents purchased coverage only when they needed it. Health insurers fled the state and, by 1999, it was impossible to buy an individual plan in Washington — no company was selling."

"Jonathan Hensley, who then served as president of local health plan Premera Blue Cross, recalls one letter he got from a healthy woman canceling her insurance policy.
“She wrote in her letter that she very much appreciated our excellent service [and] that she would certainly pick our plan again when she became pregnant,” says Hensley, who now works for Cambia, another health insurer in Washington.

Big premium spikes indicated that many Washingtonians were making similar decisions: Premera Blue Cross increased premiums on its most popular product by 78 percent over three years."

Pretty obvious behavior if you can buy HI only when you are sick.

 

[Mulligan]

Animorph says- "Jonathan Hensley, who then served as president of local health plan Premera Blue Cross, recalls one letter he got from a healthy woman canceling her insurance policy.
“She wrote in her letter that she very much appreciated our excellent service [and] that she would certainly pick our plan again when she became pregnant,” says Hensley, who now works for Cambia, another health insurer in Washington.


Animorph, that letter should be submitted to the "Letter Writing Hall of Fame". You have to love a letter that is very sincere and appreciative of services rendered.

 

[haha]

As common sense dictates, and the experience in my state demostrates, a health care system is not broccoli, from which one section can be chopped and the rest still be expected to work.

All this spin reminds me of Harry and Louise- totally nuts and out of touch of any kind of reality.

As written the law is poor; without puchase mandates it is even worse.

Ha

 

[Mulligan]

As common sense dictates, and the experience in my state demostrates, a health care system is not broccoli, from which one section can be chopped and the rest still be expected to work.

All this spin reminds me of Harry and Louise- totally nuts and out of touch of any kind of reality.

As written the law is poor; without puchase mandates it is even worse.

Ha

I have to agree with you. I just hope my pre Obamacare purchased individual HI plan insulates me from the initial chaos that could come about if the broccoli head is chopped off.

 

[donheff]

As written the law is poor; without puchase mandates it is even worse.

Ha

I have to agree with you. I just hope my pre Obamacare purchased individual HI plan insulates me from the initial chaos that could come about if the broccoli head is chopped off.

I agree with both comments but hope that if the mandate fails to pass muster, the SC chops the head off the broccoli. That will result in pressure to arrive at a compromise of some sort. I believe complete repeal will lead to a decade or more of the existing system.

 

[M Paquette]

Financially, I have to prudently plan for any outcome that has a reasonable chance of occurring. Unfortunately in this case, there is a reasonable chance of:

1) ACA being struck down or repealed in the near future, with no reasonable equivalent being put into place.

2) Since I have had relatively high medical expenses this year, I expect that my policy will be reviewed against MIB data for potential recission under pre-ACA terms, where recission is allowed for any inaccurate or missing information, rather than the ACA requirement for fraudulent information. The applications don't have enough space to list all the ear infections, runny noses, and acne outbreaks I probably had when growing up. I certainly don't remember everything. ( http://articles.latimes.com/2009/jun/17/business/fi-rescind17 )

3) Since there is a reasonable chance that I will lose and be unable to obtain individual insurance, I may be looking for work solely to gain access to medical coverage. As an alternative I am looking into forming a small business, a private investment management firm dedicated to 'family office' operations, which will be able to buy a small group policy. I've already spent a few hours with a legal specialist on structuring such a setup to be fully legitimate.

I consider all this nonsense as just another manifestation of our current national insanity, ideologues of various types counting coup with the lives of millions.

 

[clifp]

3) Since there is a reasonable chance that I will lose and be unable to obtain individual insurance, I may be looking for work solely to gain access to medical coverage. As an alternative I am looking into forming a small business, a private investment management firm dedicated to 'family office' operations, which will be able to buy a small group policy. I've already spent a few hours with a legal specialist on structuring such a setup to be fully legitimate.

I consider all this nonsense as just another manifestation of our current national insanity, ideologues of various types counting coup with the lives of millions.

Perhaps all of us independent family money manager could get together and form a company so we could get better group rates...

 

[MichaelB]

Financially, I have to prudently plan for any outcome that has a reasonable chance of occurring. Unfortunately in this case, there is a reasonable chance of:

1) ACA being struck down or repealed in the near future, with no reasonable equivalent being put into place.

2) Since I have had relatively high medical expenses this year, I expect that my policy will be reviewed against MIB data for potential recission under pre-ACA terms, where recission is allowed for any inaccurate or missing information, rather than the ACA requirement for fraudulent information. The applications don't have enough space to list all the ear infections, runny noses, and acne outbreaks I probably had when growing up. I certainly don't remember everything. ( Rescission Health Insurance | Blue Cross praised employees who dropped sick policyholders, lawmaker says - Los Angeles Times )

3) Since there is a reasonable chance that I will lose and be unable to obtain individual insurance, I may be looking for work solely to gain access to medical coverage. As an alternative I am looking into forming a small business, a private investment management firm dedicated to 'family office' operations, which will be able to buy a small group policy. I've already spent a few hours with a legal specialist on structuring such a setup to be fully legitimate.

I consider all this nonsense as just another manifestation of our current national insanity, ideologues of various types counting coup with the lives of millions.

My assessment and approach is not unlike yours. In Florida the insurance company will issue a small business policy only after receiving a copy of 2 or 3 years of schedule C. They will also ask for payroll records. In addition, regulations for a business of 1 are different (more strict) than those for a business of 2-50, and policies are more limited. This is just their way of keeping out the marginal and part-time businesses. With a complete rejection of the law the way forward will be neither easy nor simple for many.

 

[M Paquette]

Perhaps all of us independent family money manager could get together and form a company so we could get better group rates...

Current law does have a specific provision for such umbrella groups to be formed specifically to obtain group health insurance, including trade, industry, and small business associations. The relevant law is part of the Affordable Care Act, Title 1, Part 2, Sec 1311, which declares these as groups eligible to participate in the group insurance exchanges.

Of course, if ACA is gone, it would only be a group if the insurer says it's a group...

 

[M Paquette]

My assessment and approach is not unlike yours. In Florida the insurance company will issue a small business policy only after receiving a copy of 2 or 3 years of schedule C. They will also ask for payroll records. In addition, regulations for a business of 1 are different (more strict) than those for a business of 2-50, and policies are more limited. This is just their way of keeping out the marginal and part-time businesses. With a complete rejection of the law the way forward will be neither easy nor simple for many.

Yup. This is why I want to get the plans laid this year. Statistically, the recission routine was done more often on claims for a new condition reported on an insured person than after treatment is done and paid for. I want to have the groundwork laid to become a small business employer this year, if needed.

Our state legislature has a bunch of bills now pending to implement some of the consumer protections currently in ACA, only at the state level. The insurance lobby is fighting these tooth and nail.

 

[FUEGO]

The amazing part, to me, is that we've heard no "leaks" regarding the deliberations and back-and-forth of the Justices. There are lots of clerks involved in the research needed to write the opinions that will accompany this decision, and I haven't read anything resembling a hint of the outcome. Surely some folks are getting rubbed the wrong way, and that normally (in politics, business, etc) results in disgruntled folks talking to their pals. Apparently this effective secret-keeping is the norm--the SCOTUS has a good record for keeping their work under wraps until the designated official unveiling.
A little advance notice of the ruling could make somebody a LOT of money via the options market.

Intrade Prediction Markets

Looks like financial markets are pricing a 72% chance that the individual mandate element of Obamacare will be ruled unconstitutional. That is a big rise since mid-May when the odds were under 60%. Maybe some info is trickling out?

Could be pure speculation and analysis informing the market price, but never rule out insider information leading to profit as a motive.

 

[MichaelB]

Intrade Prediction Markets

Looks like financial markets are pricing a 72% chance that the individual mandate element of Obamacare will be ruled unconstitutional. That is a big rise since mid-May when the odds were under 60%. Maybe some info is trickling out?

Could be pure speculation and analysis informing the market price, but never rule out insider information leading to profit as a motive.

Intrade is not part of financial markets, it's a betting market and far too small to make enough money to offset the risk of getting caught. Even if someone knew the decision and was tempted to invest, stock market reaction isn't that predictable in a situation like this.

 

[FUEGO]

Intrade is not part of financial markets, it's a betting market and far too small to make enough money to offset the risk of getting caught. Even if someone knew the decision and was tempted to invest, stock market reaction isn't that predictable in a situation like this.

I was using the term financial market loosely. Intrade is a market where buyers and sellers meet and exchange value for derivative products.

Here is a peer reviewed academic article whose abstract says prediction markets (like Intrade) can be effective predictive tools. ScienceDirect.com - International Journal of Forecasting - Prediction market accuracy in the long run

Here, we present evidence that prediction markets outperform polls for longer horizons. We gather national polls for the 1988 through 2004 U.S. Presidential elections and ask whether either the poll or a contemporaneous Iowa Electronic Markets vote-share market prediction is closer to the eventual outcome for the two-major-party vote split. We compare market predictions to 964 polls over the five Presidential elections since 1988. The market is closer to the eventual outcome 74% of the time. Further, the market significantly outperforms the polls in every election when forecasting more than 100 days in advance.

So take the Intrade prediction for what it is worth in your own evaluation of its usefulness.

Real people who have money at stake think there is a 72% chance of the SC striking down individual mandates. The neat thing about prediction markets is that they isolate (almost) all the variables and let you look into collective knowledge of all market participants about a particular event or issue. Whereas the stock market, or Dow Jones index combines everything known about everything into one price indicator (so it isn't any good for knowledge on particular issues). Just IMHO.