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"The President's Proposal": Doing the math for families (and it's not pretty)

When I was going through "The President's [cough] Proposal," I was struck by how much it read like a health insurance company's brochure: There were so many %s and $s and decimal points and complicated explanations of who qualified when for what how, that one might conclude the point was to obfuscate, rather than clarify. Fortunately for the rest of us, while the access bloggers keep trying to pump blood into the so-called public option zombie, PNHP's Don McCann does the arithmetic for the family of four:

Let’s look at what the President expects a family of four with an income of $66,000 to pay for health care. The premium contribution would be 9.5% of income, or $6270 for the basic plan with an actuarial value of 70%. If they wanted or needed a better plan, they would have to pay the full difference in the premium. At an actuarial value of 70%, they would also have to pay an average of 30% of all health care costs. This can vary considerably because of plan design in the form of deductibles, copayments, coinsurance, non-covered benefits, stop loss, out-of-network care exempt from stop loss, and other factors. If they either elected not to or were unable to pay the premium, they would have to pay a penalty of $1650, but then, of course, they would have no protection at all against potential health care costs.

Clearly, President Obama has not done any better than Congress in protecting families from financial hardship should they have the misfortune of developing significant medical problems. Unaffordable underinsurance is not the change that we needed.

No, but a bailout is what the insurance companies need. And Obama gave it to them. Yay!

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Submitted by jawbone on

example?

There have been questions all over the left web sites as to what the 9.5% of income actually means--Is that what the premiums can come up to? Does it include other costs? ((I asked how could it, since they're unknown. Do I get some kind of stomach flu needing a doctor or not, for a very low level of seriousness example.)

Does 70% value mean there's always a 30% co-pay for the patient? I recall reading on, I think, FatWallet.com that people were getting changes to their employer paid plans which went from a set amount per co-pay to percentages of the overall cost as their co-pay. Instead of paying $30 for each co-pay, they might get hit with $300 if the cost as the insurer stated it were $1000.

I have to take two shots for a test to monitor my cancer; each shot costs $2000 retail; the insurance company only pays a bit over $600 per shot. Some insurers make the patient pay based on the retail amount; so I could be hit with $600 per shot or $191 per shot....instead of one co-pay.
Yikes!

Now, Obama likes the idea of people paying more for their health care in that he sees that as a way of cutting costs (if you can't afford it, you very well may go without...and die. Cost saving!), and he probably thinks I have a Cadillac plan, as I only pay 50% of prescription costs and have these set co-pays. Why, I just might demand nasty tests left and right.

But, since I'm in am HMO, and must have referrals, certifications, recertifications, etc,. there are already controls. What's his problem?

Yes, this makes clear Obama sure doesn't have the people's interests at heart. But his does love him those BHIPs! Hence:

BHIP-PPP : Big Health Insurance Parasite Proift Protection Plan

What a Dem!

MoveThatBus's picture
Submitted by MoveThatBus on

9.5% of the money I have at my disposal to spend, save or invest. But, I'm guessing 9.5% of income to those who are giving us the details are actually talking about our GROSS income, and not our NET. Today we are able to contribute to our medical savings accounts using PRE-TAX dollars. I'm guessing that will go away since I've yet to see any reference at all to pre-tax in anything.