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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?

To: Alighieri who wrote (16096)	4/4/2010 11:36:48 AM
From: Lane3	2 Recommendations Respond to of 42652

the bronze summary doesn't say what deductible which is likely to be high. The 60%/40% covers everything--deductible, copayments, and co-insurance. They use what's called "actuarial value." That's how the industry rates coverages for comparison purposes. Takes everything into account and comes up with a bottom line number for how costs are shared. Frankly I think you are nitpicking. I am not nitpicking. The fundamental underlying difference between the two is at stake here. On one hand you have an insurance model, which means that insurance companies underwrite risk. That's the way your car insurance works. You pay more for insurance if you have more accidents or a more expensive car. And you only use your insurance if there's an accident. You don't use it to replace your tires and get your oil changed. You pay for that yourself. That's what an insurance model does. It is a hedge against big but unlikely. Real insurance, as I stated, was the basis for my notion of what we should do. On the other hand you have the collectivized model for health care. In it there is one big pot of money for health care everyone shares. That's your notion of what we should do. In Obamacare, "insurance" is a misnomer in part because the plans cover everything from earaches to brain surgery. It covers the equivalent of oil changes. That misnomer causes a lot of confusion when trying to differentiate it from "real" insurance but it is the popular terminology. In real insurance, coverage is only for the big, rather rare stuff. That's what major medical does, covers the big stuff. (Catastrophic policies do something similar in that the do cover both earaches and brain surgery but only after annual costs reach a certain threshold.) What is popularly called "insurance" I would call "prepaid health plans." Obamacare is about prepaid health plans, not real insurance. Obamacare may have large deductibles or co-insurance but it pays for both big and little things and, for the highest level plans, pays first dollar on many services. That difference is not nitpicking. They are fundamentally different concepts. Not only are they fundamentally different concepts, the difference matters in a variety of ways when comparing the potential for cost savings. One of the best ways of reducing costs is for participants to have skin in the game. Deductibles and co-insurance do that. Explicitly separating major medical from earaches is another option for getting skin in the game. Maybe for the wealthy, but the average person is limited by geographical choices regardless of where insurance is purchased. Even if only some people can take advantage of a cost saving feature, there are overall cost savings. We've reduced the country's health care expenditures and the federal budget. That's a main if not the main point of this exercise, isn't it? your "plan" is mostly what's already in place with some minor nuances. Let's stop being pretentious. It's a more dramatic change from the status quo ante than Obamacare is and runs in a different direction. Your missing or discounting the differences doesn't make them "minor nuances."