Health insurance rate hikes. Why so surprised? | Hacker News Reader

Health insurance rate hikes. Why so surprised?

katgleason.tumblr.com

16 pointskategleason11 comments

Perhaps I'm the stupid one here but I was never expecting higher levels and availability of health care to be less expensive (or even as expensive), at least in the short-term. I supported it anyways because it's the right thing to do.

A cheaper health-care option would be to take the sick out behind a barn and put them out of their misery, which is why we don't turn health care into a linear optimization problem.

It is my understanding that one of the most cited justifications for passing healthcare reform was to lower costs. Specifically, the monthly cost for individuals who need to purchase their own health insurance plans.

Indeed:

To Save Money, Save the Health Care Act (Peter Orzag) http://www.nytimes.com/2010/11/04/opinion/04orszag.html?_r=3...;

As the bill was being debated it was my understanding that the lowering costs would come from improvements in health as a direct result of increased preventative care and earlier detection of disease (in the stage where it is cheaper to treat).

It is impossible to have the increased preventative care come before patients' access to that care, just as it's impossible to detect illness when a patient cannot even be seen due to lack of insurance.

That was the reason I said I didn't expect a reduction in price in the short-term, because it simply doesn't make sense. That doesn't mean costs won't eventually go down compared to what they would have been if PPACA didn't go into effect, but that's getting beyond my ability to predict based just on simple principles.

Note that the original MA reform was never designed to lower system-wide costs; the goal was universality, not cost. The ACA was targeted at universality along with a bunch of experimental cost control reforms. You can't really point at the original MA reforms and say 'see! this proves the ACA cannot lower system-wide costs'.

Health insurance covering male maternity care is a complete no-op. It adds no benefit, but it never costs health care companies either. So it shouldn't cause a premium rate rise so is a bit irrelevant.

I get the feeling it was cited as an example to make the reforms look stupid, even though it doesn't actually have any negatives.

It was cited because health care plans are not sold by gender. Therefore the plan's actuarial risk assessment needs to account for maternity whether or not the person signing up for the plan is a male or female.

The ignorance on display here is a bit astonishing.

Health insurance in MA is not equivalent to health insurance in Idaho; in MA insurance is much more tightly regulated so that you can rely on it. What good is a largely unregulated insurance policy that refuses to pay out when you're really sick?

Now, if Idaho had strong regulators that were enforcing the same sort of standards as MA, you might be able to compare but then you'd run smack into the fact that...the cost structures are completely different. Everything is more expensive in MA, including housing and doctors.

That is a good point in comparing Idaho to MA housing and pricing costs. But then how can you justify California's low insurance monthly rates (before the new hikes that just happened this month) California: $157

I don't know much about the state of CA insurance regulation. I live in MA.

Off the top of my head, it seems like mean premium prices is going to depend on a lot of different factors, ranging from demographics (younger folks make up a larger fraction of the population in TX than in MA) to cost of living.

I think your whole analysis fails because you're missing half of the Cost Benefit Analysis. You're looking only at costs, without assessing benefits. One might as well look at Somalia and proclaim how awesome it is to not have to pay taxes.

I don't know where you're getting your figures from, but our monthly per employee rate is closer to $500/month in CA (with a family it's like $1200/month).

It's going up like $20/month for 2013. Which is immaterial, since it was ridiculous to begin with, because the entire system is broken.

Reply on news.ycombinator.com