Monday, February 07, 2011

Headline of the Day

From the February 4th New York Times:
For Tucson Survivors, Health Care Cost Is Concern
It's bad enough to try to exploit a tragedy to shore-up support for Obamacare. Especially when the article itself concedes that "most, if not all, of the 13 people wounded that morning had health insurance, and health care providers say they expect insurance companies to cover the bulk of the medical cost."

(via Best of the Web)


MaxedOutMama said...

And with the exchange version of health care reform, the cost split is 70-30 (at best, higher for higher incomes), so I guess the victims would STILL be worrying about medical bills.

This is almost as good as the NY Times and Ezra Klein writing articles about kids dying or other people being denied surgery, when those people are already receiving Medicaid.

This type of unthinking idiocy is hard to truly comprehend.

MaxedOutMama said...

I mean, look at the Kaiser health care reform calculator.

For a single adult with an income of 30K, the person's share of the premium would be $2,509. Cost-sharing would be 30% (only for covered benefits) until the person reached the maximum out-of-pocket cost of $3,125.

That's $5,634 in payments, plus any for non-covered benefits which is likely.

One night in a hospital will cost you about 15K in a lot of areas, so that would cost you $4,500 in cost sharing right there what with wound care and maybe surgery.

For a single adult making 36K (median US) the premium would be $3,420 plus $4,167 in cost sharing - a total of $7,587.

These people are so dumb and so uninformed.

Carl said...

BTW, M_O_M, the New York Times also confuses "free" with "cross-subsidized by other taxpayers":

The Obama administration is examining whether the new health care law can be used to require insurance plans to offer contraceptives and other family planning services to women free of charge.

Such a requirement could remove cost as a barrier to birth control, a longtime goal of advocates for women’s rights and experts on women’s health. But it is likely to reignite debate over the federal role in health care, especially reproductive health, at a time when Republicans in Congress have vowed to repeal the law or dismantle it piece by piece. It is also raising objections from the Roman Catholic Church and is expected to generate a robust debate about privacy.

The law says insurers must cover "preventive health services" and cannot charge for them. The administration has asked a panel of outside experts to help identify the specific preventive services that must be covered for women.

Administration officials said they expected the list to include contraception and family planning because a large body of scientific evidence showed the effectiveness of those services.

MaxedOutMama said...

Yes, but Carl, this sort of thing is part of the problem.

Preventive services and other required coverage for these plans is going to be set by a panel.

There is no cost-sharing for preventive services. How nice. But in the main, those services are the type that people can pay, and that is replaced by very large cost-sharing percentages.

Very few plans now require the patient to cover more than 20%. This is going to leave the worst injured patients or the most gravely injured subject to the most financial uncertainty.

This is not my idea of insurance.

Also, depending on the decisions made, the premiums are going to go up considerably from those estimated by the Kaiser calculator.

I mean, try the same calculator with an income of 50K, which you'll agree is not uncommon. For a 55 year old, the premium of $8,495 is entirely his or her responsibility. The actuarial value is 60%, meaning that the insured's coverage only pays 60% of covered benefits (aside from the "preventive" stuff). The sole benefit to this person is that out-of-pocket costs are limited to $6,250.

Thus, if such a person were a victim with serious injuries, it is almost certain that his or her annual medical cost for that year would be $14,745 plus any costs for non-covered services. '

The legislation allows for a 4:1 age differential. I would think in most states the premium would be more like $13,000, which would leave the annual costs for serious illness or injury at $19,250.

It has to be obvious that rates of medical bankruptcy won't drop, and that many people will lose their homes, etc.

The more you make insurance pay for predictable services, the less it can pay for unpredictable services. But the plan's effect is to create a large, less well-off constituency that wants as much as possible shunted into required and preventive coverage, which means that payments for injuries and severe illness will be cut.

Carl said...

M_O_M: Your last paragraph makes me still more frightened of Obamacare . . .