revolution in the us of a?

[vinnie97]

Re: revolution in the us of a?

Forget Dungar's cherrypicked op-ed. Just read the report he referenced (keeping in mind how incomplete it is with only 39 states providing data). It's not all roses (and the $2500 savings are nowhere in sight, but you're okay with that lie since it came from the great messiah who you defend no matter what): Exchanges year 2: New findings and ongoing trends | McKinsey on Healthcare

We elicited five key observations from our analyses:

• Competition and choice are increasing nationwide. In most counties, consumers shopping for coverage on the 2015 public exchanges have more carriers and more products from which to choose. Nationwide, the number of carriers participating on the exchanges has increased 19 percent since the 2014 OEP, and the number of products has increased 27 percent.
• Gross premium prices are rising, especially for PPO and broad-network products. Between the 2014 and 2015 OEPs, gross premiums of the lowest-price exchange products rose by a median of 6 percent across metal tiers.3 Among the lowest-price 2014 exchange products re-filed for 2015, the median gross premium increase is 10 percent. Premiums for re-filed products built on health maintenance organizations (HMOs), narrowed networks, or both increased much less than did the premiums for products based on preferred provider organizations (PPOs) or broad networks.
• Switching products would minimize or eliminate premium increases in many cases, but would not always lower overall costs. We estimate close to three-quarters of 2014 exchange enrollees have access this year to a product that is within the same metal tier as the product they bought last year but priced below the 2015 premium of last year’s plan. Often, however, the lower-premium products have higher deductibles.4
• Net premiums for subsidy-eligible consumers have often risen. Net premiums for the lowest-price silver products have increased for nearly three-quarters of those eligible for subsidies, but in most cases the increases are less than 10 percent.
• Recent and new entrants are often price leaders. Just over half of new price leaders are either recent or new entrants (i.e., carriers that entered the individual exchange market in one or more states last year or this year). In many counties, there is a significant change in competitive price positions.

What's missing is the kind of rate increases experienced after many were forced onto the exchange in 2014. This is wonderful news only to those who subscribe to the one-size-fits-all theory. For some it makes sense to pay out of pocket and to negotiate with their providers. The mandate removes that option. I hate it 1000000 times as much as I did in 2010.

[vinnie97]

Re: revolution in the us of a?

The comments on the article are much more telling than the propaganda Dungar is dishing:

As usual, McKinsey’s work is outstanding. It is Mr. Ungar’s conclusions from the study that are awry. First, the author claims that a 5% increase represents some sort of reduction in premium increases to be praised. He seems to forget that the same Kaiser family report showed an identical 5% increase in the average family healthplan premiums between 2008 and 2009, 2 years before inception of Obamacare. In fact individual policies increased by just 2.5% that year. At at that time, Sen. Reid, in response to Kaiser’s report of the 5% increase said, “The trends are crushing millions of businesses and American families.” So upset were politicians with the crushing 5% increase that even Mitch McConnell agreed it was a hardship and Pres. Obama used it as more evidence why we needed his new health care plan. In fact, if you check Kaiser’s annual reports, individual and family premiums routinely increased from 2% – 5.5% annually and were actually decreasing when the ACA was being written. So, what happened that turned a 5% premium increase from a sign of the catastrophic failure of the entire American healthcare system to a signal of success? The answer is simple. Political marketing. It was ACA proponent politicians who endlessly promoted the handful (compared to 10′s of millions of policies) of extravagent policy increases like the 2010 Anthem increase of 39%. Then there were the 11% and 20% increases many business policies faced. The news media and the politicians regurgitated these numbers ad nauseum creating the false and ubiquitous impression that the “rapacious” healthcare industry was forcing families into bankruptcy under the weight of the outlandish rising costs. Even the Pres. offered a personal story of his mother’s passing embellished with a story of how insurers were battling over her claim on her death bed. (It later turned out that his mom had a well-paying job, and her insurance covered the hospital bill with few questions. It was a disability claim that was questioned and that had nothing to do with the hospital bill. But, such was the nature of the marketing campaign.) Suddenly the exceptions became the rule. Few outlets noted that as many policyholders had premium reductions as had those epic increases. The issue became so polarized and emotionalized that soon the facts didn’t matter. Premiums were rising 2 – 5.5% before the ACA and they continue to do so after its passage. But, as the author points out, basic premiums only represent one part of your total healthcare plan costs under the new Act. There are hidden taxes, medical device taxes, losses of formerly deductible health expenses, reductions in the tax deductibility for Medical Savings Accounts, and most pernicious, taxes on corporations that are passed on to consumers of all income brackets in the form of higher cost goods. All of these hit the poor and the middle class the hardest. McKinsey is correct in calculating the cost of higher dedcutibles, but they only do so for the past year drawing the baseline at 2013. This is an interesting calculation, but it does not represent the true consumer affect since the deductibles are assumed to be the same as the year before. To decipher the true cost to Americans you would have to go back to the year before these deductible increases existed and that figure of increase must be carried forward to each current year as a constant. Not a pretty picture. Still, with or without the deductibles, at best, we are no better off than before the ACA and at worst, as health plan designer, state and presidential advisor Jonathan Gruber said in his 2009 Policy Brief for Syracuse University, “there are no cost controls in the ACA, and it will not be affordable.” Those savings, according to Gruber, will come later as benefits are cut so that people only get what they pay for. Regardless of whether or not you like the ACA, there are some interesting times ahead!

Don't piss on me and tell me it's raining, Florida.