Gallup Poll just in

[Dr. Chuckles]

You don't understand how it works at all, if you sign up AFTER you get sick or have an accident you go into the high risk pool and pay double at least for the rest of your life. Still sound like a good idea?

Unless those premiums can compete with the cost of covering a cancer diagnosis, there really is no incentive to buy into a plan. Sorry

I love how first you scream about the unfair mandate and then try to find ways to game the system. It shows that in reality, insufferable cheapness is the only "value" Conservatives have. It's ALL about YOU all the time.

I did? Can you please provide some quote substantiating this accusation, because otherwise it seems you're just throwing out cheap shots that have no relevancy to what I wrote

 

[Dr. Chuckles]

Do you honestly think that ACA is going to cause people who have insurance to drop it and pay a penalty? Is that what happened in Massachusettes?

Some, then, will find it cheaper to take the penalty—and the Journal talked to Peter and Kirsten MacDonald of Brockton, who did just that. The MacDonalds had insurance when Massachusetts enacted its reform law, but last year, when the monthly premiums reached $900, they dropped the policy and decided to self-insure. They set aside $750 a month and paid the required penalty, $2,136 (each adult pays a maximum of $1,068 this year). Before canceling the policies, the MacDonalds asked themselves: “What are we getting for it?”

The experience of Massachusetts can be instructive for the nation. If a bill requiring the mandate passes through Congress, it’s a good bet that millions of the uninsured would still be uninsured. Even paying $3,800, the highest penalty called for under the Baucus bill, a family whose income is $66,150—three times the federal poverty level—might find it cheaper than paying the premium. The average family premium is now over $13,000.

Examining the Individual Mandate : CJR

 

[AdamT]

Examining the Individual Mandate : CJR

That suggests to me that they canceled their insurance *in spite* of the mandate -- not because of it.

 

[Dr. Chuckles]

That suggests to me that they canceled their insurance *in spite* of the mandate -- not because of it.

well, your original remark was about the ACA. And while it's debatable on what level reform has influenced premiums in Mass, all seem to agree that it has had some negative effect on the matter. And at the very least, failed in controlling them.

 

[AdamT]

well, your original remark was about the ACA. And while it's debatable on what level reform has influenced premiums in Mass, all seem to agree that it has had some negative effect on the matter. And at the very least, failed in controlling them.

I'm not seeing any evidence that health care inflation has been worse in MA than other parts of the country.

 

[Dr. Chuckles]

I'm not seeing any evidence that health care inflation has been worse in MA than other parts of the country.

MICHAEL CANNON: ... health insurance premiums in Massachusetts are growing 20 percent to 40 percent faster than in the rest of the country. They are not falling. There are projections that came out recently that premiums will grow by 10 percent in Massachusetts in 2010, next year, whereas they're going to grow by about 5 percent to 7 percent, it's projected, for the rest of the country, so health insurance premiums are not falling in Massachusetts. The opposite is happening.

Tax Feud Emerges Over Health Insurance Mandates | Online NewsHour | September 21, 2009 | PBS

 

[AdamT]

Tax Feud Emerges Over Health Insurance Mandates | Online NewsHour | September 21, 2009 | PBS

2009? I could post an article from the same year claiming exactly the opposite. Ezra Klein - Massachusetts provides evidence that health-care reform lowers insurance premiums

Since its inception, however, it appears that health care inflation is about average in MA. Not that that's anything to brag about.

 

[Dr. Chuckles]

2009? I could post an article from the same year claiming exactly the opposite. Ezra Klein - Massachusetts provides evidence that health-care reform lowers insurance premiums

Since its inception, however, it appears that health care inflation is about average in MA. Not that that's anything to brag about.

from the article

And the results have been an enormous reduction in the cost of nongroup insurance in the state: The average individual premium in the state fell from $8,537 at the end of 2006 to $5,143 in mid-2009, a 40 percent reduction, while the rest of the nation was seeing a 14 percent increase.

a drop in one section of the market =/= evidence of a lack in " health care inflation"

but on the above point

One of the Massachusetts law’s objectives was insurance market reform, which would merge two formerly separate types of policy markets—the individual market, where people bought policies on their own, and the small group market, where small businesses bought policies for their workers. The idea was to expand the so-called risk pool, bringing insurers a better mix of sick and healthy people who would in turn make premiums more affordable and coverage more attractive—at least for individuals. More attractive individual coverage, a.k.a. lower-priced policies, would help insurers enlarge their market share. “Blue Cross wanted the merged market so they could increase their market,” one business executive told me. “They were the major driver behind combining the small group and individual markets, which was a huge cost shift onto small employers.”

http://www.cjr.org/campaign_desk/health_reform_lessons_from_mas_6.php?page=all

 

[cpwill]

That suggests to me that they canceled their insurance *in spite* of the mandate -- not because of it.

Sort of. They canceled in spite of the mandate because insurance companies not being allowed to charge you more or refuse to take you for preexisting conditions means that they are effectively insured even if they don't buy insurance.

You know how your types were convinced that the real problem in American healthcare was all those folks using emergency rooms? Well, your "solution" makes that problem worse.

 

[cpwill]

I'm not seeing any evidence that health care inflation has been worse in MA than other parts of the country.

CNN: The Massachusetts plan does not control costs.

...When Massachusetts launched its reform program in 2006, it already had the highest medical costs in the nation. Today, the burden is still rising far faster than wages or inflation, from those already lofty levels. A report from that state attorney general in March -- remember, this is a Democratic administration -- asked rhetorically "Can we expect the existing health-care market in Massachusetts to successfully contain health-care costs?" The report concluded, "To date, the answer is an unequivocal 'no.'"

Costs are rising relentlessly for both families and for the state government. The median annual premium for family plans jumped 10% from 2007 to 2009 to $14,300 -- again, that's a substantial rise on top of an already enormous number. For small businesses, the increase was 12%. In 2006, the state spent around $1 billion on Medicaid, subsidies for medium-to-lower earners, and other health-care programs. Today, the figure is $1.75 billion. The federal government absorbed half of the increase.

Hence reform's proponents boast that expenses have risen only $354 million or around 6% a year. But the real increase is double that, including the federal share. And it's highly possible that given the current budget pressures, the U.S. will reduce the contribution that has encouraged the state to spend so lavishly....

How did costs in Massachusetts get so big to begin with? A major reason is the adoption of guaranteed issue and community rating in the mid-1990s. The new federal bill would expand those rules to the entire nation. Under guaranteed issue, insurers must accept all enrollees regardless of their medical condition; under community rating, they must charge all customers similar premiums, even if their costs are far different. The result is that prices rise steeply for young, healthy customers, who must pay far more than their actual costs. It also give them a strong incentive to drop insurance; then they can "game the system" by signing up any time they need surgery or get diabetes.

Hence the pool of insured people gets older and sicker as the healthy drop out. That's what happened in Massachusetts, and it contributed to soaring premiums. The 2006 reform plan was supposed to solve the problem by requiring that everyone buy coverage or pay a fine of around $1,000. It worked, but only in part: Of the 600,000 uninsured in 2005, around 450,000 are now covered. But a large share of 150,000 who still lack coverage are young residents who choose to pay the fine instead of high premiums. Insurers are also getting socked by people who sign up for insurance to get expensive care mandated under state law, including hospitalization for childbirth or hip replacements, and then depart once the procedure is completed....

 

[AdamT]

CNN: The Massachusetts plan does not control costs.

So the mandate worked. :shrug:

And not only that -- your article establishes that you can't effectively cover those with preexisting conditions if you don't have some kind of mandate.

And as someone posted in another thread, a recent study shows that only around 1,000 out of MA's 6.5 million citizens have gamed the mandate system. That's a fraud rate of 0.015%, which is astonishingly low.

Next.

 

[cpwill]

So the mandate worked. :shrug:

And not only that -- your article establishes that you can't effectively cover those with preexisting conditions if you don't have some kind of mandate.

reading comprehension much? the article points out that the mandate has failed to control costs and the negative results of community rating and not forcing insurers to cover preexisting conditions.

 

[Dr. Chuckles]

So the mandate worked. :shrug:

And not only that -- your article establishes that you can't effectively cover those with preexisting conditions if you don't have some kind of mandate.

And as someone posted in another thread, a recent study shows that only around 1,000 out of MA's 6.5 million citizens have gamed the mandate system. That's a fraud rate of 0.015%, which is astonishingly low.

Next.

1) just so we are clear, are you finally admitting that mass is having above average issue with healthcare inflation?

2) if the mandate failed to control rising insurance costs, then how did it work? We have been discussing the costs issues with an ineffective mandate for the past 3-4 pages. So it seems rather disingenuous to now shift your argument to one of preexisting conditions

3) can you post that study here

PS on the issue of people gaming the individual mandate, wouldn't a better measure of it's effect be the cost of the treatment they received, while insured?

 

[Dr. Chuckles]

Adam, after doing some research, I'm assuming your claim is based on the 2010 article in the Boston globe?

Short-term customers boosting health costs - The Boston Globe

If so, the most glaring mistake would be assuming that number represented the entire state, as opposed to the numbers presented by one insurer

from the article:

***In 2009 alone, 936 people signed up for coverage with Blue Cross and Blue Shield*** of Massachusetts for three months or less and ran up claims of more than $1,000 per month while in the plan. Their medical spending while insured was more than four times the average for consumers who buy coverage on their own and retain it in a normal fashion, according to data the state’s largest private insurer provided the Globe.

The typical monthly premium for these short-term members was $400, but their average claims exceeded $2,200 per month. The previous year, the company’s data show it had even more high-spending, short-term members. Over those two years, the figures suggest the price tag ran into the millions.

***Other insurers could not produce such detailed information for short-term customers*** but said they have witnessed a similar pattern. And, they said, the phenomenon is likely to be repeated on a grander scale when the new national health care law begins requiring most people to have insurance in 2014, unless federal regulators craft regulations to avoid the pitfall.

 

[AdamT]

reading comprehension much? the article points out that the mandate has failed to control costs and the negative results of community rating and not forcing insurers to cover preexisting conditions.

I agree that O'Romneycare does not do enough to control costs, as it's primary focus is expanding coverage. What the article does NOT say is that MA's rates are increasing faster than other states. Their rates were already high because the state previously restricted who insurers could reject and what they could charge without implementing a mandate.

The article states that the biggest threat is that employers will drop coverage ... but notes that employer coverage actually expanded under Romneycare....

 

[Dr. Chuckles]

I agree that O'Romneycare does not do enough to control costs, as it's primary focus is expanding coverage. What the article does NOT say is that MA's rates are increasing faster than other states.

I was waiting for Ifill to ask the obvious next question—why were insurance premiums for small businesses climbing higher than Mt. Everest? But she didn’t, and switched subjects. Cannon, however, noted that premiums ***as a whole in Massachusetts were growing 20 to 40 percent faster than premiums in the rest of the country***. “Health insurance premiums are not falling in Massachusetts,” he said. “The opposite is happening.” But Cannon didn’t mention the small business issue either, and that night a major deficiency created by reform went unexplored.

Health Reform Lessons from Massachusetts, Part VII : CJR

this will be the second, or third time, I have posted something directly contradicting this claim of yours

 

[AdamT]

Adam, after doing some research, I'm assuming your claim is based on the 2010 article in the Boston globe?

Short-term customers boosting health costs - The Boston Globe

If so, the most glaring mistake would be assuming that number represented the entire state, as opposed to the numbers presented by one insurer

from the article:

The claim was actually based on something that was quoted by an opponent of the mandate, and I assumed that the quoted section was a fair representation of the article, but you are right -- it wasn't. Still, the insurer in question is one of the biggest in the state, indicating that the problem isn't very big. And it does seem that it can be controlled by limiting open enrollment, which is something that could be added to ACA if it proves to be a problem.

 

[Dr. Chuckles]

The article states that the biggest threat is that employers will drop coverage ... but notes that employer coverage actually expanded under Romneycare....

the issue here is that for at least small businesses, this coverage has also come with drastically higher premiums and deductibles, as small employers struggle with rising costs (and believe this trend is true, though to a lower degree, of all polled workers). So it seems rather reasonable to question if that trend will continue, is nothing is done to address rising costs.

This also touches on another huge issue that no one seems willing to discuss : what type of coverage are we talking here, expensive plans that have 4 grand deductibles and premiums that cripple the lower and middle class? I really fail to see how that is effective reform. not to mention, both plans seemingly ignore the fact that lack of primary care is a huge cost issue, effecting everything from an over reliance on ERs, to people getting ineffective, and ultimately, costlier care

 

[Dr. Chuckles]

The claim was actually based on something that was quoted by an opponent of the mandate, and I assumed that the quoted section was a fair representation of the article, but you are right -- it wasn't. Still, the insurer in question is one of the biggest in the state, indicating that the problem isn't very big. And it does seem that it can be controlled by limiting open enrollment, which is something that could be added to ACA if it proves to be a problem.

on what are you basing this claim that it isn't a major problem? Small employer premiums, which are saddled with individuals, have been skyrocketing in the state

 

[AdamT]

Health Reform Lessons from Massachusetts, Part VII : CJR

this will be the second, or third time, I have posted something directly contradicting this claim of yours

The contradiction comes from a guy with the Cato Institute? And the claim is hyperlinked to a story that doesn't support the claim? Hmm.

Here's an article that lists the 15 states with the worst health care inflation: The 15 States Getting Killed By Health Insurance Inflation - Business Insider

Massachusettes is not among them.

 

[AdamT]

on what are you basing this claim that it isn't a major problem? Small employer premiums, which are saddled with individuals, have been skyrocketing in the state

Look, if you are going to credit everything that insurance companies claim and deny everything consumer advocates and state representatives claim, you aren't going to have a balanced view of this problem. FYI -- insurance companies say all kinds of **** to make more money.

 

[cpwill]

I agree that O'Romneycare does not do enough to control costs, as it's primary focus is expanding coverage. What the article does NOT say is that MA's rates are increasing faster than other states. Their rates were already high because the state previously restricted who insurers could reject and what they could charge without implementing a mandate.

that is correct. As we have pointed out, the threat isn't the tax (though that is odiferous enough). The threat is community rating and guaranteed issue. The problem being that Obamacare does the exact same thing; meaning that the mandate will be useless.

 

[AdamT]

that is correct. As we have pointed out, the threat isn't the tax (though that is odiferous enough). The threat is community rating and guaranteed issue. The problem being that Obamacare does the exact same thing; meaning that the mandate will be useless.

Yes, you keep saying that and the results in MA keep saying something else. They have near-universal coverage -- highest in the nation, and the people of MA like the system. It has 62% approval.

And please stop quoting to me articles from 2009, which only cover half of Romneycare's tenure. If you take those same numbers and expand them to succeeding years they show that MA's health care costs are growing SLOWER than the rest of the country's:

Wonkbook: Romneycare is working -- and Obamacare might be, too - The Washington Post

 

[Dr. Chuckles]

The contradiction comes from a guy with the Cato Institute? And the claim is hyperlinked to a story that doesn't support the claim? Hmm.

Here's an article that lists the 15 states with the worst health care inflation: The 15 States Getting Killed By Health Insurance Inflation - Business Insider

Massachusettes is not among them.

1) if you feel his claim is false then directly address it. But simply dismissing it, because you don't like his politics is rather weak sauce

2) The writer who quoted him is a liberal policy expert that focuses on healthcare. So i'm unsure how attacking ideology actually helps here

3)

Massachusetts spends more per capita on health
care than any other state. From 2009 to 2020, health
spending is projected to double, outpacing both
inflation and growth in the overall economy. The
rapid rate of growth squeezes out other spending,
both for individual households and in the state
budget.

http://www.statecoverage.org/files/BCBSMAF-Health_Care_Spending_Cost_Deck_March_2012_report.pdf

 

[Dr. Chuckles]

Look, if you are going to credit everything that insurance companies claim and deny everything consumer advocates and state representatives claim, you aren't going to have a balanced view of this problem. FYI -- insurance companies say all kinds of **** to make more money.

most of the material I have quoted here comes from Trudy Lieberman. A rather well known, respected, and very liberal consumer advocate.

PS it's also worth nothing I never simply dismiss anything in this thread, either. Might have Challenged certain claims, with conflicting information. But that is drastically different than simply dismissing something