I'm going to wait and see how all this pans out in the end before I pass personal judgement, however...
I have felt that the health care reform bill was a turd of a bill, at least in part. Getting needy people healthcare is good, of course. Expanding coverage and the subscriber base is good as well.
The personal mandate leaves a bad taste in my mouth, however. I fully recognize that there are myriad reasons why people choose to go uninsured (leaving aside for the moment those who simply cannot afford it at all). I suspect that a great many of them choose to do so because a) they are healthy, and b) the cost of premiums is too burdensome. Mandating that they purchase coverage doesn't alter the economics of b), and yet, it is on the backs of these same people that is to finance this reform.
I look at my own out-of-pocket premiums and can fully understand how many who cannot qualify for subsidized care cannot afford insurance. I wonder how many will opt to pay the tax instead? Note that premiums are only going to come down by having more relatively healthy people paying more in premiums than they take in benefits - those opting out aren't going to help (this of course assumes that overall costs remain about the same).
This bill may have been the best that could be accomplished at the time, but it's still a turd.
From my own personal perspective - I work for a fairly small company with a few hundred employees, a large percentage of whom work in our customer service call center, are young and healthy, and don't make much in wages. As a result, the majority do not participate in our health care plan. This I can understand, it's a high-deductible plan (HDP) backed by a employee Health Savings Account (HSA). When you consider the cost of the premiums and HSA contributions to cover the deductible, it's not something a low wage earner would be interested in. (Compared to the traditional PPO plan that used to be offered, it's a hell of a deal - the worst case scenario under the HDP/HSA plan is less expensive than just the premiums on the PPO plan.)
It will be interesting to see what happens to our premiums when those that opted out are on the plan. We've had huge premium increases for the last 4-5 years - that's one of the bad things about being in a small group plan, a couple of huge claims can blow the profitability of the plan to hell. In this case, it's not because the insurer is greedy - I have access to the numbers, and our plan has lost money most years. They probably would have declined to offer a renewal if the law did not require them to do so.
So on the one hand, I'm glad that something is being done - and on the other, I'm very disappointed that more hasn't been done. As I said at the beginning, time will tell whether or not we can polish this turd.
I have felt that the health care reform bill was a turd of a bill, at least in part. Getting needy people healthcare is good, of course. Expanding coverage and the subscriber base is good as well.
The personal mandate leaves a bad taste in my mouth, however. I fully recognize that there are myriad reasons why people choose to go uninsured (leaving aside for the moment those who simply cannot afford it at all). I suspect that a great many of them choose to do so because a) they are healthy, and b) the cost of premiums is too burdensome. Mandating that they purchase coverage doesn't alter the economics of b), and yet, it is on the backs of these same people that is to finance this reform.
I look at my own out-of-pocket premiums and can fully understand how many who cannot qualify for subsidized care cannot afford insurance. I wonder how many will opt to pay the tax instead? Note that premiums are only going to come down by having more relatively healthy people paying more in premiums than they take in benefits - those opting out aren't going to help (this of course assumes that overall costs remain about the same).
This bill may have been the best that could be accomplished at the time, but it's still a turd.
From my own personal perspective - I work for a fairly small company with a few hundred employees, a large percentage of whom work in our customer service call center, are young and healthy, and don't make much in wages. As a result, the majority do not participate in our health care plan. This I can understand, it's a high-deductible plan (HDP) backed by a employee Health Savings Account (HSA). When you consider the cost of the premiums and HSA contributions to cover the deductible, it's not something a low wage earner would be interested in. (Compared to the traditional PPO plan that used to be offered, it's a hell of a deal - the worst case scenario under the HDP/HSA plan is less expensive than just the premiums on the PPO plan.)
It will be interesting to see what happens to our premiums when those that opted out are on the plan. We've had huge premium increases for the last 4-5 years - that's one of the bad things about being in a small group plan, a couple of huge claims can blow the profitability of the plan to hell. In this case, it's not because the insurer is greedy - I have access to the numbers, and our plan has lost money most years. They probably would have declined to offer a renewal if the law did not require them to do so.
So on the one hand, I'm glad that something is being done - and on the other, I'm very disappointed that more hasn't been done. As I said at the beginning, time will tell whether or not we can polish this turd.
