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UnitedHealth is considering dropping out of Obamacare
Yes. Read about this earlier today and was about to post a story link, too. Will have to review some healthcare holdings at this house.
"The plan" was that enough healthy folks would be in the gov't. plans to offset those less healthy and needing more care, would support this group monetary. This plan is not working for the "for profit". And co-ops can not stand on their own, as slightly noted below.
A piece from the article also notes:
That has included the planned shuttering of what will be more than half of the new co-ops created to sell insurance on the exchanges, the government's announcement that insurers will receive just a small fraction of the money they could have expected under a financial risk protection program, and stories detailing how rising premium prices and deductibles are causing consumers to question whether to buy exchange-sold plans.
I recall (correct me if I am wrong) that about 23 non-profit health co-ops were in place and about 12 or 13 will have filed for bankruptcy by the end of this year. Don't know where these folks venture to for their health plans.
I suspect a rework of ACA is in the card game coming after the next election. Which will bring forth more confusion for all.
Evidently a major problem, mentioned in both the United Health article and also a number of other recent articles involves many people gaming the system by signing up just long enough to collect for major medical procedures, and then dropping the coverage afterwards. This is resulting in an unpredictable patient pool, evolving towards sicker patients with long-lasting medical issues, and is also responsible in large part for the large premium increases by many carriers this year.
I agree with Catch regarding "a rework of ACA is in the card game coming after the next election."
If the people gaming the system are ruining it for everyone else, I'm afraid that I don't see it as some sort of "victory" to be celebrated. More like yet another indictment of the human race, as if we needed any more examples in that category.
@Old_Joe as someone who is playing by the rules, I am celebrating a potential rework of the system. Very frustrating situation for someone like me! My premiums went up by 25% this year....and I have perfect health...no smoking, exercise, thin, no medication, etc. When I hear examples like this, it raises my low blood pressure! I shopped for plans everywhere...my current plan is the best I can do...bronze/$6800 deductible/$551 per month. I can afford it, but it doesn't make me happy. I'm hoping that the "gamers" are simply desperate.
I was wondering about this. The marketplace is similar to the Federal Employees Health Benefit (FEHB) Plan (FEHBP) today.
You see FEHB is the "best healthcare blah, blah" in the world. And it is excellent but expensive. It is a grocery store with more shelves than ever intended.
Back in the 80's (my first encounter), the insurance was good and moderately priced with couple or three selections. You signed up, went for health care when ill or injured and never thought about things like in and out of network. [That may have existed but I never knew about it or encountered it with GEHA, which had one policy for all, not this high and low stuff (bronze, etc.)]
Along came the HMOs and, then, later the HSAs, CHDPs, etc. which effectively made the insurance pools smaller and smaller. So employees went from nationwide large participation plans to depooled plans. Retirees ended up in the original BCBS FFS type plans. Young people with the help of modern medicine planned everything and jumped into the PPO/FFS plans between open seasons to have babies, elective surgeries, etc.
If the need was temporary, they went back to a cheaper, younger plan the next open season. If they had jumped into the FFS plans because they developed a chronic illness, they stayed. But, unlike the days of yore, the young did not pay their dues for getting the services once they needed them - they paid some other insurer. So the FFS plans started having single year increases ranging from 5-20% and they broke into high and low, adding co-pays, co-insurance and ever higher deductibles.
I would suggest that the "marketplace" approach causes many of the problems and failure. This is especially true when the insurance is different plans and pools in different states. I am sure some would like to take my head off for the mere suggestion that national pools and less "choice" would solve many problems. The good of the people seems at odds with the modern model of healthcare insurance.
Obama didn't invent the model, true. Not even Romney did. This has been happening for years and what you see is what you get.
I feel that way, too, sometimes, but I keep reminding myself that I really don't want to reach my $6800/year deductible...I would probably be gravely ill.
Comments
Yes. Read about this earlier today and was about to post a story link, too.
Will have to review some healthcare holdings at this house.
"The plan" was that enough healthy folks would be in the gov't. plans to offset those less healthy and needing more care, would support this group monetary. This plan is not working for the "for profit". And co-ops can not stand on their own, as slightly noted below.
A piece from the article also notes:
That has included the planned shuttering of what will be more than half of the new co-ops created to sell insurance on the exchanges, the government's announcement that insurers will receive just a small fraction of the money they could have expected under a financial risk protection program, and stories detailing how rising premium prices and deductibles are causing consumers to question whether to buy exchange-sold plans.
I recall (correct me if I am wrong) that about 23 non-profit health co-ops were in place and about 12 or 13 will have filed for bankruptcy by the end of this year. Don't know where these folks venture to for their health plans.
I suspect a rework of ACA is in the card game coming after the next election. Which will bring forth more confusion for all.
Regards,
Catch
I agree with Catch regarding "a rework of ACA is in the card game coming after the next election."
You see FEHB is the "best healthcare blah, blah" in the world. And it is excellent but expensive. It is a grocery store with more shelves than ever intended.
Back in the 80's (my first encounter), the insurance was good and moderately priced with couple or three selections. You signed up, went for health care when ill or injured and never thought about things like in and out of network. [That may have existed but I never knew about it or encountered it with GEHA, which had one policy for all, not this high and low stuff (bronze, etc.)]
Along came the HMOs and, then, later the HSAs, CHDPs, etc. which effectively made the insurance pools smaller and smaller. So employees went from nationwide large participation plans to depooled plans. Retirees ended up in the original BCBS FFS type plans. Young people with the help of modern medicine planned everything and jumped into the PPO/FFS plans between open seasons to have babies, elective surgeries, etc.
If the need was temporary, they went back to a cheaper, younger plan the next open season. If they had jumped into the FFS plans because they developed a chronic illness, they stayed. But, unlike the days of yore, the young did not pay their dues for getting the services once they needed them - they paid some other insurer. So the FFS plans started having single year increases ranging from 5-20% and they broke into high and low, adding co-pays, co-insurance and ever higher deductibles.
I would suggest that the "marketplace" approach causes many of the problems and failure. This is especially true when the insurance is different plans and pools in different states. I am sure some would like to take my head off for the mere suggestion that national pools and less "choice" would solve many problems. The good of the people seems at odds with the modern model of healthcare insurance.
Obama didn't invent the model, true. Not even Romney did. This has been happening for years and what you see is what you get.
There is no incentive to maintain good health
@dicksonL I feel that way, too, sometimes, but I keep reminding myself that I really don't want to reach my $6800/year deductible...I would probably be gravely ill.