edit: Hey downvoter, let me educate you - the worst thing about a coverage gap used to be the potential to have an illness classified as a preexisting condition, and then to never be able to get private insurance coverage again. The ACA prohibits that practice by insurers as of next year. Here, I even dug up a pre-ACA article on the practice for you, served up on a silver platter: http://articles.latimes.com/2006/sep/17/business/fi-revoke17
edit 2: You know what, prospective downvoters can kiss my butt. Sorry that you don't like the health care reform law. It may be a total mess, but it's no worse that it was before. The only people that are pissed off are healthy, young people (hello, HN) that are paying next to nothing for individual coverage that is garbage. Get sick or old and then tell me how bad the ACA is.
Beneficiaries of wealth transfer are fans of the wealth transfer! Film at 11.
... And actually, I completely reject your characterization of it as a wealth transfer. It's insurance. You have no idea if you're going to need it. You may be in a car accident and badly break your legs, and require corrective surgery and rehab. You may get pneumonia or a bad MERSA infection. If you haven't saved up a few hundred thousand dollars and you show up at an ER, then the wealth transfer is to you when the hospital eats the cost and passes it along to properly insured people. That's not even going chemo/surgery should you develop cancer, god forbid.
More importantly, Mr. RacerX cannot call the insurance company from the scene of an accident, say that he needs auto care, and expect to pay the same rate that you do. Yet this is the financial equivalent of knowing that you have cancer, and signing up for a new insurance policy.
Finally, there's catastrophic health care insurance (which the ACA has more or less outlawed) which is in fact similar to auto insurance... then there are fancier plans with more coverage, which are more like warranty / service plans for your car. If you have an old car with 300,000 miles on it, it is likely to need more service or develop a crazy expensive engine issue than a brand-new car. If a warranty service plan or similar contract is available to you, you would expect to pay more for it. Likewise a human being, but the ACA has both mandated these plans and limited the amount that older human beings may be charged.
Please note that the moral rectitude, overall desirability, or similar characteristics of the wealth transfers associated with the ACA, or of other hypothetical wealth transfers or health-care related scheme... are not addressed by this post, which examines only financial structures. (The grandparent post examined only incentive structures.)
AFAIK, at least in California and I think this is true more generally, you don't. In order to drive legally on public roads, you must demonstrate the ability to meet a certain minimum amount of financial liability in the event that you are responsible for a collision either by posting a bond or by demonstrating that you have adequate liability insurance.
Most people choose to meet that requirement through insurance, because it has a lower up-front cost (though likely higher lifetime cost), and because they also want other coverage besides the required liability coverage along with it.
> ... And actually, I completely reject your characterization of it as a wealth transfer. It's insurance.
It is insurance, but rules like the "no exclusions for pre-existing conditions" and controls on what factors can be used in rate setting also make it a wealth transfer. (At least part of the idea of making it a wealth transfer is to improve overall access to insurance and, through that, preventive care, to make the overall system more effective for everyone.)
I know less about the age rating bands. Off the top of my head, it's to smooth costs over a lifetime. So it's a wealth transfer from your young self to your old self, if you have typical health care costs over your lifetime: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361028/
edit: http://www.rwjf.org/content/dam/farm/reports/issue_briefs/20... for more on age banding.
Now, yes, you can argue that it's good to smooth costs over a lifetime ... but that also hits the young very hard when they can least afford it. As does their FICA taxes for Social Security and Medicare.
As we've seen in pretty much every other developed country, this whole welfare state approach is a self-correcting dead end, as enough of the young decide not to play the rigged game and decline to have children.
To be clear, I am not saying wealth transfers are bad, but we should be honest about what is happening.
Unless we want to decide as a country to not subsidized healthcare for those that can't afford it and to allow hospitals to refuse treatment without upfront payment... then let's be honest about what's happening there, too. The money comes from somewhere, it's every bit as much of a wealth transfer.
FYI, not having "prescription drug coverage" does not mean insurance does not cover any medication. It is a pharmacy benefit, in other words, over-the-counter medication. In my personal experience, I pay significantly less without the coverage than with it. I also don't have to worry about formularies, prior authorization, or generic swap-outs.
To give you a specific example, in 2013 I paid $107/mo for a private individual policy with a $2,700 deductible, $5,250 max out-of-pocket (inclusive of the deductible) and unlimited lifetime benefits. Next year under ACA I'll be paying $283/mo for a policy with a $4,500 deductible and $6,350 max out-of-pocket (inclusive of the deductible) and unlimited lifetime benefits.
The most important clause in the ACA is limiting the rating factor due to age to a maximum of 3x. That clause alone makes it the single largest tax increase ever passed on young middle class families with children. By my estimates, it will cost families like mine about $50,000 in increased insurance premiums over the next 10 years, because the least we can now pay is 1/3rd the rate of unhealthy 64 year-olds.
Am I parsing that incorrectly?
"Prescription drug coverage" has always covered prescription drugs, in my experience. I've never had a policy that would (to my knowledge) cover OTC meds.
If you're going to have to go outside the exchange for coverage, the open enrollment period is probably closing very soon. My work ones have traditionally needed a decision made by mid November. By now, I'd have had to tell my employer yes/no on his healthcare - regardless of whether I'd been able to log in to shop around.
I do not think this is system is well thought-out or particularly good, but this is the only explanation I can find.
>the idea is that restricting the enrollment period will cause uncertainty (or fear) that the citizen may 'miss out' on the opportunity to save money on treatment throughout the year.
I believe this logic shows that enrollment periods are reasonably related (, Supreme Court language for constitutionally permissible,) to the free rider issue. Whether it is a sufficient justification for government intrusion into independent decision making by citizens is a completely different, and entirely normative judgement.
But lots of people are angry about the new health care laws and are linking the laws with the excecutive branch's ineptness at website building, and trying to imply the two are related.
Others just like reading about conflict and struggling against a problem, and getting "insider" information.
The way this article is written helps both groups get that entertainment.
I can't see anything useful about the article though. It's not clear what the website is trying to do, how it interacts with the insurance companies, or to get anything else out of the set of metaphors the author is using to try to describe a website.
Has anyone found any good articles detailing the problems or, better yet, any description of how governments can create or have created successful websites, or how future administrations might approach creating a highly visible website?
Of course the article isn't useful, that's not what it's for. As a description of a problem that has affected people in terms that they may actually understand, I think it works pretty well.
Hopefully we'll get some good detailed post-mortems eventually, but they certainly won't be in the newspaper.