Obamacare’s Skyrocketing Premiums? Why the Sky Isn’t Falling
nejm.org
nejm.org
Some deductibles are $5000 or more. There are copays on some of the plans.
The overall costs have increased for most of the people who already had insurance prior to the implementation of the ACA.
A lot of the increased costs are that people who have very high medical costs have now been included on plans to be subsidized by others.
Much of the higher costs are from choices patients have made such as smoking cigarettes or overeating.
The ACA allows for smokers to be charged premiums 50% higher than non-smokers. But most plans do not implement this option and relatively few smokers report that they are smokers and the information is not verified.
Instead of having people paying higher costs not only in premiums but in large deductibles and high co-pays the ACA should have done what most developed countries (eg, Canada, UK, France) have done which is to increase the tobacco tax to $5.00 or more per pack (the US Federal tax is about $1). That way, it doesn't matter if smokers lie about their smoking status or of the plan charges the allowed 50% increase in costs for smokers.
The author is an MD PhD with the PhD has a sub specialization in Economics. He should know (as should the editors of the New England Journal of Medicine) that the proper economic analysis of insurance costs should include not only the premiums but the costs of deductibles and the costs of co-pays. The fact that this was not done suggests a political axe to grind and not giving complete and transparent information to their readership.