Senate health care plan

Other discussions not related to the Permanent Portfolio

Moderator: Global Moderator

Post Reply
WiseOne
Executive Member
Executive Member
Posts: 2692
Joined: Wed Feb 16, 2022 11:08 am

Senate health care plan

Post by WiseOne » Fri Jun 23, 2017 1:51 pm

It's hard to find news articles on mainstream sites that actually give you details of what's in a particular bill, but this one does:

http://money.cnn.com/2017/06/23/news/ec ... index.html

I like many aspects of this bill, but only if it's tied to measures to increase transparency of health care service pricing. As in, if you need a blood test or an MRI, you should be able to shop around to make quality vs cost decisions in exactly the same way that you do for anything else you buy. One element I particularly liked is that the USG will hand money to insurers to cover high cost enrollees. Obviously how that's done will make a big difference in how it works, but it's along the lines of our favorite "MediumTex care" plan, where the Federal government handles the astronomically costly (e.g. > $100,000/year) cases and lets insurance companies deal with the small potatoes stuff.

For those planning to retire over age 50 but before Medicare age: you'll need to manage your finances carefully to ensure that your taxable income is low enough to qualify for subsidies.

No mention of how the bill will handle pre-existing conditions though. I sincerely hope that issue does not come back.
Libertarian666
Executive Member
Executive Member
Posts: 5994
Joined: Wed Dec 31, 1969 6:00 pm

Re: Senate health care plan

Post by Libertarian666 » Fri Jun 23, 2017 6:12 pm

WiseOne wrote:It's hard to find news articles on mainstream sites that actually give you details of what's in a particular bill, but this one does:

http://money.cnn.com/2017/06/23/news/ec ... index.html

I like many aspects of this bill, but only if it's tied to measures to increase transparency of health care service pricing. As in, if you need a blood test or an MRI, you should be able to shop around to make quality vs cost decisions in exactly the same way that you do for anything else you buy. One element I particularly liked is that the USG will hand money to insurers to cover high cost enrollees. Obviously how that's done will make a big difference in how it works, but it's along the lines of our favorite "MediumTex care" plan, where the Federal government handles the astronomically costly (e.g. > $100,000/year) cases and lets insurance companies deal with the small potatoes stuff.

For those planning to retire over age 50 but before Medicare age: you'll need to manage your finances carefully to ensure that your taxable income is low enough to qualify for subsidies.

No mention of how the bill will handle pre-existing conditions though. I sincerely hope that issue does not come back.
Meaning what exactly? Do you want insurance companies to remain solvent, or should people be able to sign up after they develop expensive conditions?
User avatar
Tyler
Executive Member
Executive Member
Posts: 2066
Joined: Sat Nov 12, 2011 3:23 pm
Contact:

Re: Senate health care plan

Post by Tyler » Fri Jun 23, 2017 6:56 pm

Libertarian666 wrote:
WiseOne wrote: No mention of how the bill will handle pre-existing conditions though. I sincerely hope that issue does not come back.
Meaning what exactly? Do you want insurance companies to remain solvent, or should people be able to sign up after they develop expensive conditions?
Allowing people whose payments are in good standing to live free of the fear of policy rescission or do things like move to a new state without being forced into extremely expensive plans because of a preexisting condition does not make the insurance market insolvent. It's how the corporate insurance market has worked for years, and individuals deserve similar protections.

I agree that allowing people to freeload and then sign up for cheap insurance only after they are already sick is dumb. But there's a lot more to the preexisting conditions issue than that, and it requires legitimate attention.
WiseOne
Executive Member
Executive Member
Posts: 2692
Joined: Wed Feb 16, 2022 11:08 am

Re: Senate health care plan

Post by WiseOne » Sat Jun 24, 2017 9:33 am

What Tyler said, and more: the issue is far larger than the balance sheet of insurance companies. Having a pre-existing condition makes people uninsurable, and this limits their productivity. If you're uninsurable, you can't open your own business or work for a small company. It also limits even the larger companies you can work for, because not all of them will insure the pre-existing condition even if they offer insurance.

These medical pariahs can find safety by working for a large corporation or the government, but in many cases they end up avoiding paid work in order to qualify for Medicaid, or worse yet getting SSI whether they actually want it or not.

The idea of instituting privately enforced penalties for gaps in coverage is better than Obamacare's individual mandate which was simultaneously heavy-handed and unenforceable. But if you have other ideas tech, please share.
Libertarian666
Executive Member
Executive Member
Posts: 5994
Joined: Wed Dec 31, 1969 6:00 pm

Re: Senate health care plan

Post by Libertarian666 » Mon Jun 26, 2017 1:49 pm

WiseOne wrote:What Tyler said, and more: the issue is far larger than the balance sheet of insurance companies. Having a pre-existing condition makes people uninsurable, and this limits their productivity. If you're uninsurable, you can't open your own business or work for a small company. It also limits even the larger companies you can work for, because not all of them will insure the pre-existing condition even if they offer insurance.

These medical pariahs can find safety by working for a large corporation or the government, but in many cases they end up avoiding paid work in order to qualify for Medicaid, or worse yet getting SSI whether they actually want it or not.

The idea of instituting privately enforced penalties for gaps in coverage is better than Obamacare's individual mandate which was simultaneously heavy-handed and unenforceable. But if you have other ideas tech, please share.
Yes, here's my answer:

Get rid of rules restricting catastrophic-only policies.
Get rid of rules restricting cross-state-line health insurance sales.

For those who can prove that they can't get insurance due to pre-existing conditions, let them join Medicare.

As for those who develop conditions during a time when they are insured, the COBRA rules prohibited insurers from rating people if they had continuous coverage. Leave those rules in place.

Everyone else gets to pay what the market decides. For almost everyone, catastrophic-only coverage is the right decision, but if people want to pay for Lexus coverage, they should be free to do so.
User avatar
Tyler
Executive Member
Executive Member
Posts: 2066
Joined: Sat Nov 12, 2011 3:23 pm
Contact:

Re: Senate health care plan

Post by Tyler » Mon Jun 26, 2017 2:40 pm

IIRC, COBRA applied only to corporate plans and HIPAA portability guarantees only got individuals into an expensive high risk pool in most states. So even people who diligently paid their premiums every month could quickly see their premiums skyrocket the moment they lost their job. And people in the individual market were effectively locked out of switching providers (or moving out of state) if they had only a minor condition pop up along the way, which most people do at some point.

I personally applaud any effort to change the system that made full-time employment under a corporate umbrella a precondition for purchasing and maintaining affordable health insurance. The way the workplace is changing from lifetime employees waiting for their pensions to a more nimble and mobile workforce, we really can't afford to not also change the antiquated health insurance setup. That said, I agree that this issue could be addressed with some simple laws to sell policies across state lines and extend the same portability protections to the individual markets that corporate employees already enjoy and would never dream of giving up. It doesn't require a full takeover of the insurance marketplace.
Libertarian666
Executive Member
Executive Member
Posts: 5994
Joined: Wed Dec 31, 1969 6:00 pm

Re: Senate health care plan

Post by Libertarian666 » Mon Jun 26, 2017 8:36 pm

Tyler wrote:IIRC, COBRA applied only to corporate plans and HIPAA portability guarantees only got individuals into an expensive high risk pool in most states. So even people who diligently paid their premiums every month could quickly see their premiums skyrocket the moment they lost their job. And people in the individual market were effectively locked out of switching providers (or moving out of state) if they had only a minor condition pop up along the way, which most people do at some point.

I personally applaud any effort to change the system that made full-time employment under a corporate umbrella a precondition for purchasing and maintaining affordable health insurance. The way the workplace is changing from lifetime employees waiting for their pensions to a more nimble and mobile workforce, we really can't afford to not also change the antiquated health insurance setup. That said, I agree that this issue could be addressed with some simple laws to sell policies across state lines and extend the same portability protections to the individual markets that corporate employees already enjoy and would never dream of giving up. It doesn't require a full takeover of the insurance marketplace.
Agreed.
Post Reply