I should say I don't purport to know anything about this subject, just bits and pieces.
But my understanding is that the cadillac plans are not generally plans that involve wasteful medical spending. They tend to be plans where the cohort is one that tends to have medical problems. For example, if you are a retired NFL player you probably are going to need expensive medical services vs. an office worker. The same would apply to dock workers, perhaps welders, steam fitters, and other construction/maintenance tradespersons. Even auto workers, although some would argue they're mostly pansies these days.
These are people who are going to have greater demand for health care than some others.
Here is something I found on Wiki that sort of talks about it:
A study published in Health Affairs in December 2009 found that high-cost health plans do not provide unusually rich benefits to enrollees. The researchers found that only 3.7% of the variation in the cost of family coverage in employer-sponsored health plans is attributable to differences in the actuarial value of benefits. Only 6.1% of the variation is attributable to the combination of benefit design and plan type (e.g., PPO, HMO, etc.). The employer's industry and regional variations in health care costs explain part of the variation, but most is unexplained. The researchers conclude "…that analysts should not equate high-cost plans with Cadillac plans, but that in fact other factors—industry and cost of medical inputs—are as important in predicting whether a plan is a high-cost plan. Without appropriate adjustments, a simple cap may exacerbate rather than ameliorate current inequities." [6]
So, my reading, which may be altogether wrong, is that these are medical costs driving up premiums and one presumes that it is does that mean those costs are just not going to be incurred, or that they may be unreimbursed?
If they are merely costs that are uninsured, I don't even see how that is a public policy benefit.
I honestly don't know though.. |
