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Politics : View from the Center and Left -- Ignore unavailable to you. Want to Upgrade?

To: Cogito who wrote (134026)	3/21/2010 6:48:46 PM
From: Lane3	Read Replies (1) \| Respond to of 542598

The risk pool isn't going to contract after that. No, it won't contract. But it won't get new blood, either. So the new blood is a one-off event, not repeatable.

To: Cogito who wrote (134026)	3/22/2010 8:46:22 AM
From: Lane3	Read Replies (2) \| Respond to of 542598

This morning I recalled a discussion from another thread where I had made the same point. Just in case my first response wasn't clear... The other question, IIRC, was about going to single-payer saving the overhead costs that providers now face dealing with so many different insurance companies. Like adding fresh, healthy bodies to the pool in 2014, that is a one-time savings. You cut out the overhead, fire the staff, and that's that. In doing so you cut X percent of cost out of the system. That creates a one-time dip in the trend line. After that, the trend line continues on its merry way X percent below where it would otherwise have been. You can't get rid of that same overhead again next year. Its benefit has already been garnered. One dip and one dip only. Likewise, the pool gets replenished with healthy bodies only once when folks who don't currently feel a need for coverage are required to buy it. Out of it we get an X percent dip in the trend line. Since there are no more members of that cohort remaining, there is one round of savings, one dip. The influx has a one-off impact on the cost of coverage per pool member. In this case, as you suggest, that influx is designed as a one-off offset for the influx of those with pre-existing conditions. What the one-off net of the two combined would be is beyond my back-of-the-envelope analytical capability. Where the two examples differ is that the overhead savings is simple with no lingering effects (unless the single payer manages to create as much new overhead as the current system has). The pool influx, not so much. Those healthy bodies will age out of that category and become sick like the rest of the middle aged and aged so their role changes over time. At some point their positive impact on the trend line should disappear.