What do you think, does Obamacare increase or decrease health insurance premiums?

[vwconvert]

I don't think jumping to socialized medicine is the solution. Fix the the incentive problems in our system first and then see where we are at. And a_riot, I agree with you. The current compensation system is a major problem.

[tjl]

I've read contradictory articles. I don't care if you like Obamacare or not, I just want to know how it's supposed to affect insurance premiums.

Any effect is likely to be in the noise compared to the typical rapid increases that would occur anyway with or without PPACA / Obamacare / Romneycare / HeritageFoundationCare.

http://www.economist.com/node/21557793

[tjl]

Much of the rising cost problem is in the mirror. I.e. people tend to think that more care is always better care, even though some common tests and procedures have been shown to have very little or no effect on survival rates or healthier outcomes (even disregarding monetary costs).

When the USPSTF says something about the dubious value of mammograms for <50 normal-risk women, or PSA screening for normal-risk men, there is a big outcry from people complaining about someone trying to ration their medical care (even though private and government insurance companies already ration medical care for all but the very rich self-pay people).

[6cylVWguy]

Much of the rising cost problem is in the mirror. I.e. people tend to think that more care is always better care, even though some common tests and procedures have been shown to have very little or no effect on survival rates or healthier outcomes (even disregarding monetary costs).

Most people don't really understand the sheer magnitude of the medical system and how many moving parts make up medical care in the civilized world. If any single problem (malpractice, pay, etc) were responsible for the majority of cost AND care issues with medicine, it would be much easier to fix the medical care system in the US. There are some interesting experimental healthcare models that being tried in various regions in the US, so it will be interesting to see how things pan out with healthcare in the next 10 years.

In addition to the above, which is certainly an issue, you have the administrative costs associated with medicine in the US. These are huge expenses that aren't "sexy" or hot topics, but along with the issues mentioned thus far, contribute to a large proportion of what people pay for medical care. Frontline ran a great story about healthcare several years ago and it was quite clear how much of a burden administrative costs are vs pretty much every other system of care out there. Not to say that universal healthcare-type systems don't have drawbacks because they do, but administrative costs are quite a bit lower in many places with this type of healthcare system. Of course there's also the contribution of costs for various drug and device therapies, which can be outrageously expensive. The fact is, that as people get older, they have more and more health problems and are receiving more and more drug or device therapy to manage their problems. As the US population gets older, this will be an increasingly significant problem.

The problem is, fixing things like malpractice or pay without touching anything else will only scratch the surface of addressing the healthcare problem in the US. The capitalist, "for profit", nature of many elements of the healthcare system, and the related consequences of such a system, represents a significant challenge for ourselves moving forwards. There is no healthcare magic bullet out there, unfortunately.

[blue70beetle]

The fact is, that as people get older and fatter, they have more and more health problems and are receiving more and more drug or device therapy to manage their problems.

FTFY

[vwconvert]

The problem is, fixing things like malpractice or pay without touching anything else will only scratch the surface of addressing the healthcare problem in the US.

This.

There is no healthcare magic bullet out there, unfortunately.

True again for the "system." However, I will say that there is a magic bullet for the average person. Just eat fresh unprocessed foods. Keep the sugar and animal proteins down. Cut out the processed foods. And exercise. Many of our chronic issues would disappear.

Easier said than done when the first option presented to the average medical system consumer is some new fancy drug. So being an informed consumer is part of the process. Not doing so means you will win the Darwin award.

[Vision33r]

It sucks that healthy people have to pay for unhealthy and stubborn people who refuse to get healthy.

Some docs are only interested in billing and writing prescriptions. Instead of telling the patient what they should do they write meds to keep people alive barely. Oh yea, you can't tell fat people to slim down, it's their right and it's also an insult and that's not socially acceptable.

These are the folks that are taxing our health care costs.

[spockcat]

It sucks that healthy people have to pay for unhealthy and stubborn people who refuse to get healthy.

Also sucks that money from my car insurance premiums go to pay for poor driver's accidents. They should learn how to drive properly or not be allowed to drive at all.

I'll let you determine the tone and level of sarcasm in this post.

[blue70beetle]

Instead of telling the patient what they should do they write meds to keep people alive barely. Oh yea, you can't tell fat people to slim down, it's their right and it's also an insult and that's not socially acceptable.

But how many of these people need a doctor to tell them that they're unhealthy? And how many of these same people need a doctor to tell them how to adopt a healthy lifestyle? Sure, a lot of prescriptions that are written are akin to giving a drunk a drink, but I don't think the doctors, in general, are responsible for the well-being of the people who don't really care about their own well-being...

[Vision33r]

But how many of these people need a doctor to tell them that they're unhealthy? And how many of these same people need a doctor to tell them how to adopt a healthy lifestyle? Sure, a lot of prescriptions that are written are akin to giving a drunk a drink, but I don't think the doctors, in general, are responsible for the well-being of the people who don't really care about their own well-being...

Agree, however there was a well documented case involving a police officer who died of a heart attack when he was having a 3 some and the widow won a big suit against his doctor because he failed to warn him that he had a chronic condition. Lawsuits adds up because it gets folded into the cost of malpractice insurance which doctors pass directly to us.

[Vision33r]

I guess I cannot give a straight answer for this but, I know one thing's for sure. Obama wants everyone to get medical benefits especially in the lower class.

I think this is the best idea so far in the health care industry.

By adding an additional 150mil Americans to Health Care without adding enough doctors to support. It's a decision that will surely backfire.

[ValveCoverGasket]

Oh yea, you can't tell fat people to slim down, it's their right and it's also an insult and that's not socially acceptable.
.

youll pry this gravy from my cold, dead, heart diseased hands...

[Brett92]

The fact is, that as people get older, they have more and more health problems and are receiving more and more drug or device therapy to manage their problems. As the US population gets older, this will be an increasingly significant problem.

True, and the specialization of medical care care only adds to the amount of treatments available for certain ailments. I think about when you got sick 50 years ago...there was only so much that could be done.

Additionally, and no one talks about it for fear of losing votes, but old people have "Cadillac" health care as far as I'm concerned. My grandparents seem like they live at the doctor. Mostly they're there for bloodwork and follow up appointments (thankfully) and they always gloat about how medicare "picks this up and that up". That has to cost the taxpayers a lot of money. Not saying that they shouldn't have care, they definitely should IMO (Is there even private insurance available to people over the age of 85?) But, there has to be a way to cost cut it but still maintain quality care. Not to mention, that all the tests that seniors have performed on them can't be good for their psyche. Not to sound like a hippie, but if my doctor was constantly recommending tests because he noticed an abnormality, then I would be overly stressed and probably induce sickness.

I guess the real solution is the simplest one - everyone gets healthier...or starts tasking risks (driving fast, mountain climbing, bridge jumping, etc.) j/k

[blue70beetle]

By adding an additional 150mil Americans to Health Care without adding enough doctors to support. It's a decision that will surely backfire.

We can address that pretty easily by lowering the educational requirements that make it so difficult to become a doctor. Maybe that can be D'ohBama's key accomplishment for his second term...fix a mess from his first term by unleashing a swarm of incompetent "doctors" to fill the void.

[SAPJetta]

We can address that pretty easily by lowering the educational requirements that make it so difficult to become a doctor. Maybe that can be D'ohBama's key accomplishment for his second term...fix a mess from his first term by unleashing a swarm of incompetent "doctors" to fill the void.

Oy.... We dumb everything else down in this country, so why not.

[joness0154]

We can address that pretty easily by lowering the educational requirements that make it so difficult to become a doctor. Maybe that can be D'ohBama's key accomplishment for his second term...fix a mess from his first term by unleashing a swarm of incompetent "doctors" to fill the void.

For many, its not the educational requirements, its the cost and competitive barriers to entry. My GF just graduated medical school with ~ 250k in debt. Not many people want to practice primary care medicine with that kind of debt looming over their heads.

Not to mention the lack of new medical schools and the lack of residency positions. For some strange reason, residency positions are funded by Medicare. Whoever thought of that bright idea should be drawn and quartered.

[SpiffyGTI]

I love that there are high costs and competitive barriers to med school. I want my doc to be someone who beat the rest of the competition and busted his or her ass to get through school and worked hard to pay off their med school bills.

[Brett92]

We can address that pretty easily by lowering the educational requirements that make it so difficult to become a doctor. Maybe that can be D'ohBama's key accomplishment for his second term...fix a mess from his first term by unleashing a swarm of incompetent "doctors" to fill the void.

Not to belittle my past Primary Care Doctors, but all 3 have essentially been drug dealers. Hell, last time I went there I asked for the drugs I wanted, just like in the drug commercials.

I really like my current doctor, but I see him like every 2 years. Last time I saw him was to ask for Xanax for airplane flight, and ~2 years before that I got a physical (He didn't request it -I did it for myself out of curiosity).

Quite frankly, I would be fine with a less qualified person (like a nurse) writing me prescriptions or giving me health advice/guidance. It's not like Doctors don't make mistakes. I used to work in a pharmacy as a teenager. According to the Pharmacists there were several cases where a Doctor would write prescriptions for multiple medications that potentially could have had FATAL results if taken together. Maybe it was just Pharmacists talking crap, but i have no reason not to have believed them.

[joness0154]

I love that there are high costs and competitive barriers to med school. I want my doc to be someone who beat the rest of the competition and busted his or her ass to get through school and worked hard to pay off their med school bills.

You wouldn't love it if you realized that many very qualified individuals are discouraged and dissuaded from entering the profession.

Additionally, the high cost of entry discourages many physicians from entering primary care because they can pay back their loans faster in a specialty. There's a huge demand that cannot possibly be filled at the current rate we're graduating primary care doctors and it's only going to get worse.

Even the AMA is realizing the seriousness of the issue. It's not something you should love at all.

[a_riot]

It's not something you should love at all.

Indeed. Medicine is an old boys club, and has been for a long time, and it needs to change. Due to the monopoly they have they've managed to keep it that way for longer than many other industries, but its all starting to crumble at this point. The alarming costs, poor patient outcomes, inaccessibility, fraudulent science, pharma corruption, etc, are all starting to catch up with the medical complex and people are realizing there really is no one behind the curtain, largely due to the information exchange allowed through the internet. This is why most doctors try to shame their patients for looking up their medical problems on the internet.

Not sure how it will end, but I think the outrageous costs will eventually force patients to seek alternatives, and when they find out alternatives work better, are safer, and much cheaper, and don't permanently chain them to expensive treatments, they won't return.

[GeoffD]

Even the AMA is realizing the seriousness of the issue.

No, the AMA is the root cause of the problem. It is a trade guild that exists to limit entry into the trade in order to keep compensation as high as possible. They spend enormous amounts of money to protect their market position.

The way to lower prices is to increase the number of doctors so there is competition.

[Vision33r]

Indeed. Medicine is an old boys club, and has been for a long time, and it needs to change. Due to the monopoly they have they've managed to keep it that way for longer than many other industries, but its all starting to crumble at this point. The alarming costs, poor patient outcomes, inaccessibility, fraudulent science, pharma corruption, etc, are all starting to catch up with the medical complex and people are realizing there really is no one behind the curtain, largely due to the information exchange allowed through the internet. This is why most doctors try to shame their patients for looking up their medical problems on the internet.

Not sure how it will end, but I think the outrageous costs will eventually force patients to seek alternatives, and when they find out alternatives work better, are safer, and much cheaper, and don't permanently chain them to expensive treatments, they won't return.

My mom went back to Korea to have an operation done. It wasn't that expensive at all and the heathcare services there was pretty good. Korea is the #1 destination in Asia for getting plastic surgery and other physical augmentation done afford-ably.

[FlashRedGLS1.8T]

http://www.npr.org/blogs/health/2012...ut-more-slowly

Insurance Costs Rise, But More Slowly
by Julie Rovner

If you get health insurance on the job, chances are it cost more again this year.

Annual family health insurance premiums rose about 4 percent to $15,745 in 2012, according to the latest survey by the Kaiser Family Foundation and Health Research and Educational Trust.

Now that's a fairly modest increase by historical standards, and well down from last year's 9 percent. Still, it's more than double the 1.7 percent increase in average wages and way above the 2.3 percent rate of general inflation this year.

"In terms of employee insurance costs, this year's 4 percent increase qualifies as a good year, but it still takes a growing bit out of middle-class workers' wages, which have been flat or falling in real terms," said Kaiser President and CEO Drew Altman.


Why the slowdown? One big reason may lie in a general decline in health care use. As the economy sputtered, people tended to be more reluctant to use health care services. At the same time, employers passed more of the costs to workers — in the form of higher premium and cost sharing, making them more reluctant still.

One new finding in this year's survey is that firms that employ mostly lower-wage workers (those earning $24,000 annually or less) are more likely to offer coverage with high deductibles and other out-of-pocket costs than firms that have mostly higher-paid (more than $55,000 annually) workers. At the firms with many lower-paid workers, 44 percent of those with coverage face an annual deductible of $1,000 or more, compared to only 29 percent of those at higher-paying firms.

Given that the survey comes in the midst of a presidential election campaign, the natural question will be what impact President Obama's Affordable Care Act has had on the better-than-expected results.

The answer: Not much.

"We're still waiting for a lot of the important provisions to take effect for small firms," said Kaiser's Gary Claxton. That won't happen until 2014.

That didn't stop opponents of the law, however, from blaming it for the increases — or rather, blaming it for not stopping the increases altogether.

"Candidate Obama said repeatedly his bill would CUT premiums by an average of $2,500 per family — meaning premiums would go DOWN, not merely just 'go up by less than projected.' The campaign also promised that that those reductions would occur within Obama's first term," said a release from the Republican staff of the Joint Economic Committee.

But the survey did point out at least one clear — and popular — result of one of the health law's early benefits. It found 2.9 million young adults (up to age 26) are currently covered on their parents' plans who otherwise wouldn't have employer coverage. That's up from 2.3 million a year earlier.

[blue70beetle]

That last bit is the part that confuses me...we're going to insure more people under existing policies, but we're going to promise rates will go down? Politicians' logic at its finest! Those policies are going to pay out more in claims because there are more people covered...how difficult is it to recognize the lie?

Sure, we spread the risk across a larger pool, but that pool will include a whole bunch of people who were previously uninsured due to pre existing conditions, who will initially run to the doctor for a bunch of what I'll call "deferred maintenance."

[maskedSONY]

http://www.ritholtz.com/blog/2012/12...ames/#comments

The comments section has some quality comments/discussion.

[484]

We're seeing massive spikes this year, and the brass at this 80-person company has said they will probably find it cheaper to pay the $2000/person penalty than continue to offer insurance under obamacare.

[AZGolf]

We're seeing massive spikes this year, and the brass at this 80-person company has said they will probably find it cheaper to pay the $2000/person penalty than continue to offer insurance under obamacare.

My company's massive spike (150% increase) was last year; this year is a meager 7% increase, so still probably more than double what anyone will get in raises. Meanwhile, it turns out that because many veterinary supplies are classified by the government as "dual use" it will cost more to take your animals to the vet too under the new taxes going into effect in 2013 for Obamacare.

[XClayX]

My cost of insulin was cut in half mid year. I have no idea why that happened. Not complaining.

[FlashRedGLS1.8T]

My insurance premiums went up exactly $0.00 per month starting in January 2013. Same coverage, same carrier, same employer.

[Vision33r]

We're seeing massive spikes this year, and the brass at this 80-person company has said they will probably find it cheaper to pay the $2000/person penalty than continue to offer insurance under obamacare.

That's why Obamacare has been deemed a failure by both parties. It amounts to nothing more than a taxation since there is no mandate and they didn't want to quickly destroy small businesses and instead made it either a smaller tax or a bigger one.

[maskedSONY]

That's why Obamacare has been deemed a failure by both parties. It amounts to nothing more than a taxation since there is no mandate and they didn't want to quickly destroy small businesses and instead made it either a smaller tax or a bigger one.

For those who have health insurance it's no change or a plus. If you don't have any insurance, it's still the same BS game as before. And it won't be cheap either. http://cnsnews.com/news/article/irs-...e-20000-family

The last straw to see if this all works are the health care exchanges, which I hope the feds setup and effectively enforce.

[tbvvw]

My insurance premiums went up exactly $0.00 per month starting in January 2013. Same coverage, same carrier, same employer.

Mine went up 5%, same coverage except deductibles and co-pay increased, same carrier, same employer. If you make >$250K/yr it went up 9%, if you make <$50K it was 0%.

[ValveCoverGasket]

My insurance premiums went up exactly $0.00 per month starting in January 2013. Same coverage, same carrier, same employer.

i think mine went up <$5/month.

i simply wont stand for it!

[jnm2.0t]

Mine went up 5%, same coverage except deductibles and co-pay increased, same carrier, same employer. If you make >$250K/yr it went up 9%, if you make <$50K it was 0%.

god damn socialist employers *

*sarcasm

Anyhow, it really should be based at least somewhat on overall health of the person imo. Closest we come to that is smoker premiums, but there needs to be a tub of lard premium too.

[tbvvw]

god damn socialist employers *

*sarcasm

Anyhow, it really should be based at least somewhat on overall health of the person imo. Closest we come to that is smoker premiums, but there needs to be a tub of lard premium too.

Agreed on overall health. I did a health assessment for a credit - non-smoker, height/weight, waist size, blood pressure, blood work...all good.
As for the increase, I was surprised because leadership and HR did not think it was going to be significant back in Aug...however thanks to a nice company profit last in '12...my 2013 salary increase offsets this HC increase and the 2% payroll tax increase.

Yea for the evil, capitalist banking industry!