Obamacare - It's gonna cost a lot more if you smoke

[haha]

Within any insured group the lucky ones, those that don't collect, subsidize the unlucky ones, those that do. That isn't really a subsidy, though, it's more of a reason to buy insurance.

Individuals that are unable to pay the full premium receive assistance from the taxpayer via the Federal Gov't, not other group members.

If "unable to pay" is restated to ''"payment is made by those who are unable to look poor enough by manipulating reported income, or those who while able bodied choose not to work, and by those who are not working or are marginally producing income, then I see you point. How successful would the campaign to get this bill have been if it had been presented as "a really big help to early retirees"?

Although narrowly defined the resource flow from healthy plan participants to unhealthy ones may not ordinarily be called a subsidy, economically it is. With adequate underwriting (making underwriting illegal is one goal of this legislation) this flow would not exist, and all that would be left would be luck, which is as you say the purpose of insurance. Distributing random costs. It may be a social goal to do no ordinary underwriting, but cost control must be paired with this, which it is not, and a predictable smashup will occur, though it will be spun away as best the powers can spin it.

A roofing company or a crab boat owner pays higher disability rates on its workers than an actuarial partnership, so insurance comes down to distributing the cost of random events. The rest is redistribution, no matter what its supporters choose to call it.

Ha

 

[MichaelB]

Although narrowly defined the resource flow from healthy plan participants to unhealthy ones may not ordinarily be called a subsidy, economically it is. With adequate underwriting (making underwriting illegal is one goal of this legislation) this flow would not exist, and all that would be left would be luck, which is as you say the purpose of insurance. Distributing random costs. It may be a social goal to do no ordinary underwriting, but cost control must be paired with this, which it is not, and a predictable smashup will occur, though it will be spun away as best the powers can spin it.

A roofing company or a crab boat owner pays higher disability rates on its workers than an actuarial partnership, so insurance comes down to distributing the cost of random events. The rest is redistribution, no matter what its supporters choose to call it.

Ha

The exchange prices we have seen so far are close to those of large group policies (where there is limited underwriting), so there is not any meaningful evidence of redistribution among the insured population eligible to use the exchange. There is significant redistribution, but from the taxpayer to the "qualified subsidy recipient", needy or clever. It is just one of many transfers that result from a lack of cohesive healthcare policy,and is not the largest by far.

Allowing different underwriting standards to apply across different groups of the population, with the insurers in charge of the application and having a financial interest in the outcome is a clear conflict. It's probably not a root cause of the out of control cost of healthcare in the US but it assures a very discriminatory access to coverage.

 

[sheehs1]

Have you noticed that this issue has not been addressed in the new and wondrous legislation?

Ha

Yes, Ha, I have noticed it is not addressed. What I wrote actually was my personal experience. Ended up in the ER. ER doc told me I had to be admitted. Didn't want to as I felt it could be treated at home. After all, I had been at home with it, walking around, shopping with my daughter, etc.

He then told me if I did not do what he said, my insurance would not cover the ER visit. Then he wouldn't release me until he did a CT scan of my brain. No darn reason for that CT scan. I don't know if the ER doc was correct or not but I did not appreciate the implied threat.

Hospitals putting pressure on the doctors to help the hospitals make a profit has been a huge part of the problem. 60minutes did a segment on that in the last year or two that I believe has been discussed here.
That speaks to controlling costs.

I'm sure a lot of us here have had similar experiences.

 

[sheehs1]

And a great incentive it is for one to seek employment.

+1
My thoughts exactly. With food stamps, subsidized housing, welfare, SSN and now health care, why SHOULD anyone be bothered to work. What are we doing to the younger generations!! For that matter, what have we already done to the?

It's the disincentive to take responsibility for oneself to the extent one can that bothers me tremendously.

 

[FinanceDude]

The PPACA allows the premium to be increased by up to 50% for a smoker but each state is free to implement as they wish, or not implement at all. The insurers are still subject to the same MLRs so the additional premium could end up being returned to all policyholders.

I think smoking should be a pre-existing condition..........

 

[FinanceDude]

The exchange prices we have seen so far are close to those of large group policies (where there is limited underwriting), so there is not any meaningful evidence of redistribution among the insured population eligible to use the exchange. There is significant redistribution, but from the taxpayer to the "qualified subsidy recipient", needy or clever. It is just one of many transfers that result from a lack of cohesive healthcare policy,and is not the largest by far.

Uh...no............

 

[haha]

+1
My thoughts exactly. With food stamps, subsidized housing, welfare, SSN and now health care, why SHOULD anyone be bothered to work. What are we doing to the younger generations!! For that matter, what have we already done to the?

It's the disincentive to take responsibility for oneself to the extent one can that bothers me tremendously.

Agree completely. Many sociologists and political scientists have pointed out that there are two leisure classes in modern welfare societies. The very top, and the very bottom. It amuses me that the "poor" are usually referred to as "those less fortunate than us". But this is a matter of judgment. ERs, who above all appreciate the value of leisure and strive to leave the working world as early as they can, will never rival the "poor", who play during school while we losers are hitting the books, then go straight to hanging out on the corner, going to cock fights and drinking and smoking if men, or if women having the babies that middle class people often feel that they cannot afford to have. All this with good incomes in guaranteed services and cash from the Great Father the State.

Sounds like we strivers are the less fortunate. Someone should be directing charitable giving to us.

Ha

 

[sheehs1]

I think smoking should be a pre-existing condition..........

+1

 

[Mulligan]

Agree completely. Many sociologists and political scientists have pointed out that there are two leisure classes in modern welfare societies. The very top, and the very bottom. It amuses me that the "poor" are usually referred to as "those less fortunate than us". But this is a matter of judgment. ERs, who above all appreciate the value of leisure and strive to leave the working world as early as they can, will never rival the "poor", who play during school while we losers are hitting the books, then go straight to hanging out on the corner, going to cock fights and drinking and smoking if men, or if women having the babies that middle class people often feel that they cannot afford to have. All this with good incomes in guaranteed services and cash from the Great Father the State.

Sounds like we strivers are the less fortunate. Someone should be directing charitable giving to us.

Ha

+1... But you forgot to mention free cell phones, too! The current system would work just fine in the "theoretical world". Unfortunately, human nature can be modified with incentives and disincentives that create the problems you describe above.

 

[sheehs1]

Agree completely. Many sociologists and political scientists have pointed out that there are two leisure classes in modern welfare societies. The very top, and the very bottom. It amuses me that the "poor" are usually referred to as "those less fortunate than us". But this is a matter of judgment. ERs, who above all appreciate the value of leisure and strive to leave the working world as early as they can, will never rival the "poor", who play during school while we losers are hitting the books, then go straight to hanging out on the corner, going to cock fights and drinking and smoking if men, or if women having the babies that middle class people often feel that they cannot afford to have. All this with good incomes in guaranteed services and cash from the Great Father the State.

Sounds like we strivers are the less fortunate. Someone should be directing charitable giving to us.

Ha

That may be where we are headed although may take a bit longer to get there.

 

[Chuckanut]

Healthy versus unhealthy people. The way I see it, a healthy person can be forced to join the unhealthy group at any time, through no fault of her own. And an unhealthy person may be moved back to the healthy group through good medical care. So....

 

[F4mandolin]

And an unhealthy person may be moved back to the healthy group through good medical care. So....

Orrrrrr.....eating better and getting exercise. I eat like a pig.....but I exercise to keep from getting fat. For most people....it's a choice. Easier for some than others....and certainly a LOT harder for me than it used to.....I have a 400lb brother. Knees shot, can't move......they won't do knee work on him because he won't lose weight. He could still swim...but doesn't want to.

 

[audreyh1]

Orrrrrr.....eating better and getting exercise. I eat like a pig.....but I exercise to keep from getting fat. For most people....it's a choice. Easier for some than others....and certainly a LOT harder for me than it used to.....I have a 400lb brother. Knees shot, can't move......they won't do knee work on him because he won't lose weight. He could still swim...but doesn't want to.

You can try to live as healthy as possible, but that doesn't mean you won't get sick or need massive medical intervention! There's genes, there's accidents, there's just terrible luck.

 

[audreyh1]

Healthy versus unhealthy people. The way I see it, a healthy person can be forced to join the unhealthy group at any time, through no fault of her own. And an unhealthy person may be moved back to the healthy group through good medical care. So....

+1.

 

[Chuckanut]

Orrrrrr.....eating better and getting exercise. I eat like a pig.....but I exercise to keep from getting fat. For most people....it's a choice. Easier for some than others....and certainly a LOT harder for me than it used to.....I have a 400lb brother. Knees shot, can't move......they won't do knee work on him because he won't lose weight. He could still swim...but doesn't want to.

You are correct. People do things all the time to harm their health. For example, athletes tear up knees, ruin shoulders, and and fall off bicycles. But, I think for most people, getting sick is not a choice, it just happens. And accidents can happen to to the most health conscious of us. My good friend died of lung cancer. He never smoked, nor worked with asbestos, or did any of the things that are supposed to cause the disease. It just got him. Very sad.

 

[W2R]

Thanks to all for your contributions!

Porky Pig Cartoon Ending "That's All Folks!" - YouTube