3 ms·
The 3x cap is not universal, and what it ultimately does is raise the price of insurance for younger and healthier groups. Smaller groups are exempt from that r
by brianwawok 5y ago
The 3x cap is not universal, and what it ultimately does is raise the price of insurance for younger and healthier groups. Smaller groups are exempt from that requirement.
Since my company skews younger/healthier than the average company (hey we are a startup after all, new to this) - we are able to join a state commerce association and get rates calculated on our actual risk, which saves us roughly half over the national pool. I think it also takes full medical history into account, to again give us lower rates.
But of course the global effect of this, is as younger and healthier groups leave the national pool - those left gets even HIGHER rates, as the super profitable healthy young people are gone. And the more the global pool rates go up, the more people pull out. Until the national pool is only sick and old groups, with insane rates.
- lotsofpulp 5y agoYes, that was one of the unfortunate compromises that had to be made to get ACA passed. We could not get taxpayer funded healthcare passed, so they tried to dump everyone on the insurance market. Then the people that work at healthy, younger white collar firms balked at subsidizing others, so they were left out. We Americans are quite good at making systems that benefit others just enough to create plausible deniability, but with enough loopholes to evade helping shoulder the burden, if you are playing with the right cards.
- deleted 5y ago[deleted]
- brianwawok 5y agoYah it's just a silly system. We need full universal healthcare. These other things are just a mess.
- lotsofpulp 5y agoConceptually, I think the MCO (managed care organization) system works as well. In a taxpayer funded system, the MCO activities are performed by government employees directly. In an MCO system, there is some extra overhead, but MCO profit margins are 5% or less, so it is not terrible. It is just that everyone needs to be forced to go through healthcare.gov, and I don’t see why Medicare or Medicaid should even be a thing. The hodge podge of systems is the worst of all worlds. Of course, I know why it is a hodge podge, and that is because increasing the amount of healthcare available to everyone would increase costs and hence taxes and/or premiums.
- brianwawok 5y agoMaybe. But the current system means a lot of people never get care until things get real bad, and it's the ER. I am not sure the total price goes up with a full universal healthcare... but, a lot of large companies (blue cross, etc) are obsolete.