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0 pointslotsofpulp5y ago0 comments

I would add a 4th service for health insurance in the US to be a way for healthy, young people to pay for the care of sicker, old people due. AKA, a tax, due to the following stipulations of the ACA.

1) Age Rating Factors

https://www.cms.gov/CCIIO/Programs-and-Initiatives/Health-In...

2) Out of pocket maximums for in network care

3) Elimination of pre-existing conditions, i.e. accepting all lives no matter how costly

4) The recently eliminated mandate to purchase health insurance.

The above conditions mean that premiums from healthy people that don't use healthcare is used to pay for the healthcare for sick people. It gets a little complicated with the ability for employers to silo their employees' lives from the rest of the population, but in general, US health insurance premiums are basically a tax on the healthy to pay for the healthcare for the sick.

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bhupy5y ago

That’s captured by (1) risk sharing. Pooled risk sharing is great for things like fire departments where out of 1000 homes, one might catch fire every few months. It’s also great for societies where out of 1000 people, a small handful suffer from chronic illnesses or tragic accidents and the remaining are healthy. The problem is that it’s just a hammer, and not everything in healthcare is a nail.

lotsofpulpOP5y ago

Taxes are basically risk sharing across the whole population. But I wanted to specify that it's not risk sharing like your auto insurance is, or home insurance, or term life insurance. Those are infrequent, random events for the most part.

Whereas, healthcare is a guaranteed expense, so the premiums are just prepaying for the coming expenses. But today, you're not paying for your healthcare expenses, but for the older, sicker person's healthcare, just like FICA taxes are paying for healthcare for those 65 years and older.

bhupy5y ago

It's incorrect to say that premiums are only prepaying for coming expenses, but not risk sharing. They cover both. That's the whole point, health insurance today is a bundle of all of those things.

While FICA taxes (partially) pay for senior citizens' healthcare, your health insurance premiums both pay for your annual physical (especially on Platinum PPO plans) as well as care for sicker people that are not eligible for Medicare/Medicaid. I assure you that there are plenty of sick people that are under the age of 65, and actuaries price them in when computing premiums for private health insurance.

And as a minor point of order, even Medicare isn't "free" for seniors — the FICA taxes only cover Part A benefits, and seniors still need to pay monthly premiums to Medicare to cover Part B benefits. And even those benefits aren't 100% covered — Medicare only covers 80% of outpatient care.

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peter3035y ago

You will get old

lotsofpulpOP5y ago

I know. I wasn’t complaining about it being a tax. I wish it was implemented properly by dumping everyone on healthcare.gov and removing employers from the equation. And reinstating penalty for not buying health insurance.

Or implementing taxpayer funded healthcare.

ytwySXpMbS5y ago

Well, Obama has publicly said he believed in single-payer healthcare, if in a sly way, in an interview. However, he recognised the practical approach is small steps towards that goal.

smabie5y ago

I mean, not necessarily

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0 pointslotsofpulp5y ago0 comments

I would add a 4th service for health insurance in the US to be a way for healthy, young people to pay for the care of sicker, old people due. AKA, a tax, due to the following stipulations of the ACA.

1) Age Rating Factors

https://www.cms.gov/CCIIO/Programs-and-Initiatives/Health-In...

2) Out of pocket maximums for in network care

3) Elimination of pre-existing conditions, i.e. accepting all lives no matter how costly

4) The recently eliminated mandate to purchase health insurance.

0 comments

bhupy5y ago

lotsofpulpOP5y ago

bhupy5y ago

It's incorrect to say that premiums are only prepaying for coming expenses, but not risk sharing. They cover both. That's the whole point, health insurance today is a bundle of all of those things.

1 more reply

peter3035y ago

You will get old

lotsofpulpOP5y ago

Or implementing taxpayer funded healthcare.

ytwySXpMbS5y ago

Well, Obama has publicly said he believed in single-payer healthcare, if in a sly way, in an interview. However, he recognised the practical approach is small steps towards that goal.

smabie5y ago

I mean, not necessarily

j / k navigate · click thread line to collapse