[lbo-talk] Obama's Not-So-Affordable Care Act

Jordan Hayes jmhayes at j-o-r-d-a-n.com
Thu Nov 29 09:08:19 PST 2012


It's nice that they waited until paragraph 8 to say this:


>> To be sure, the costs will be far less than what many with
>> preexisting conditions would pay in the absence of the overhaul.

Takeaway: the name of legislation usually doesn't correspond to what's being done. The important part of "The Affordable Care Act" (sic) is to, as a first step, get everyone into the system. Is it expensive? You bet. But this kind of thing, I believe, will make it more transparent just how expensive it is. Which should push for fixing the main problem: cost.

And that's really the problem: health care in the US is far more expensive than anywhere else. And a lot of it has to do with how we do it. It's hugely inefficient and has incentives in all the wrong places.

Note that, up higher in the article, when they say this:


>> A family of four earning $75,000 will pay $7,125 in annual premiums
>> and as much as $8,333 in co-pays and deductibles, according to
>> apreliminary estimate by the Kaiser Family Foundation.

... they are just pulling numbers out of tables. This makes it sound like it's going to be a *new* cost. There's very few people in the US who are a family of four earning $75k/yr who don't have some kind of coverage already. Most people who have employer-sponsored coverage will see no change to their premiums and coverage; but most of them have no idea how much it is costing their employers. Over time, some of these plans have started "leaking" some of the costs to their employers. In the above case, that's about $593/mo and maybe the employee has to start paying $100/mo of it. But really, whoever pays which part of it, from a total-cost perspective, it has to come down.

Which means, ultimately, getting rid of the biggest non-health-care-related cost in the system: overhead and profit.

I don't know if the Subject: line is from Bloomberg or Marv, but it's pretty misleading.

/jordan

[*] I know that the plural of anecdote isn't evidence, but one thing I've seen so far with my personal insurance is that I got a rebate because my insurance company wasn't efficient enough: apparently there's some new requirement that some amount (80%? Should be higher!) of premiums need to go to care and if not, they have to rebate it. I got a rebate that amounted to something like half a month of premium, along with an apology letter from them. I'd be curious to know if anyone who has an employer-sponsored plan heard about this ... my guess is not :-)



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