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[Black Mamba]

Except you didn't have to shell out a few hundred dollars every month to be on Medicare.

You do pay a 1.45% payroll tax (and really it's double that since employers shift their portion onto workers). So you do pay about 2.9% of your income on it every year or close to 0.25% every month.

I'm young and healthy and I would love to have insurance.

I just can't afford it. Maybe can't afford Obamacare prices, we'll see.

Maybe you can. What is your age and how much do you earn, if you don't mind stating.

 

[Wiktor]

It honestly doesn't work if it's not mandated. d.

It can only work properly as mandated is if government is running the whole thing and setting up the prices for all procedures. Mandating it plus giving it all into private corporations is a terrible terrible idea.

 

[gohepcat]

Here's my paranoid view, this is the first step of the "beloved" single payor system. People are going to be angry at the insurance companies since they are paying them. The government will then say the current system is broken and the people need health insurance since everyone has the expectation of it now. The government will graciously go to a single payor and your wages will be even more redistributed in the form of taxes.

Paranoid?
"Beloved" ?

I don't understand.

Yes. This is obviously the first step to single payer. It is the most obvious and only solution. It's not "beloved", it's the only fucking logical option.

 

[Fnord]

It can only work properly as mandated is if government is running the whole thing and setting up the prices for all procedures. Mandating it plus giving it all into private corporations is a terrible terrible idea.

The fact that the insurance companies fell in love with the bill should have been a huge warning sign.

 

[Velcro Fly]

Unemployed right now and also uninsured. I'm pretty sure my base income of $0 will mean that I'll get something right? I don't like the idea of the government paying for me but I like the idea of being penalized for not buying something I can't afford at all a whole lot less. I won't be unemployed forever and may not even be unemployed at the start of next year.

I do hope this helps people out but I can't fight the feeling that some people are going to get coverage in a ridiculously disproportionate amount compared to what they are contributing (and always will) while others will pay into the system and see very little out of it because the random luck of never being really sick or injured. I feel like the whole "well you have to have it just in case" is just a cover to get more people to buy in, especially now that people can no longer be denied because of pre existing conditions. We're going to be taking better care of the sick and that's great, but I'm not sure I want to see it happen on the backs of the slightly above subsidy line income people.

I feel like this is one of those benefits outweigh the drawbacks situations, but there are serious drawbacks and not everyone will be better off because of it. People who may not necessarily be able to afford it may see their costs rise while people denied insurance before will now be able to get care. I guess it's just a matter of perspective. For me right now it would be good, but once I get back on my feet with a job who knows. I may have to work part time because if I was full time the higher cost of insurance would be prohibitive to actually hiring me. It's just a wait and see game for me right now.

 

[ivysaur12]

I'll be on my mom's insurance until I'm 26 -- by then, hopefully I'll be able to qualify for insurance through my union or through a California exchange.

I would have been abysmally screwed without Obamacare since I graduated college considering some of the random health problems I've had to deal with. It's been a financial life saver.

 

[gohepcat]

Tax financial transactions

So force people to have health insurance through taxes....so single payer universal healthcare.

 

[I am Michael Bolton]

The fact that the insurance companies fell in love with the bill should have been a huge warning sign.

Fell in love with it? Not sure you were watching the same debate and discussion that I was.

 

[Feep]

It's just math, isn't it?

If insurance companies make money in any capacity, that means their average client loses money in the long term. As I am almost certainly healthier than their average client, it mathematically doesn't seem to make sense for me to have it. And I don't care much for "peace of mind".

This is probably way too simple an outlook. Oh well. I have the cash, so I have a plan. But if I didn't...

 

[gohepcat]

The fact that the insurance companies fell in love with the bill should have been a huge warning sign.

but I get the impression that you would have freaked out if the "government" took over the healthcare industry so we were left with no options.

 

[daycru]

For those crowing about not purchasing health insurance because it's simply not worth it (not because of financial hardship):

Wait till you get something that is entirely out of your control. My dad developed pancreatic cancer, and he did not drink or smoke. He ate homecooked meals three times a day, almost every day of the month (we ate out once a month). He worked out every day, to the point that he was doing heavy construction work on his own at home at the age of 70 and it barely phased him. He cycled every weekend that he could. He juiced vegetables and fruits 3 times a day. He put on sunscreen and made sure to go to the doctor regularly.

He still got cancer. It still killed him. If he had not been wise and taken out extensive life insurance along with supplementing his Medicare with employer provided health insurance, we would have been in the poor house. It is thanks to him and his foresight that I can attend an excellent university and have prospects for a good job so that I can take care of the family.

If he had not had health insurance along with other protective measures, we'd have lost the house and been out on the streets. One experimental operation that he had cost $120,000 alone.

If you give one SHIT about your family, friends, and loved ones, you get health insurance. I have health insurance through my university, and I go in for regular check ups because I want to avoid a repeat of this situation for my family. I plan on getting some one way or another upon getting a job.

Going to start writing checks?

 

[Vicetrailia]

You do pay a 1.45% payroll tax (and really it's double that since employers shift their portion onto workers). So you do pay about 2.9% of your income on it every year or close to 0.25% every month.



Maybe you can. What is your age and how much do you earn, if you don't mind stating.

26 @ 21120

 

[Balphon]

Put bluntly, if the crux of your grand policy initiative involves convincing a bunch of 25-year-olds to buy something they (a) don't think they can afford and (b) don't think they'll actually use, you may be setting yourself up for failure.

 

[ivysaur12]

Put bluntly, if the crux of your grand policy initiative involves convincing a bunch of 25-year-olds to buy something they (a) don't think they can afford and (b) don't think they'll actually use, you may be setting yourself up for failure.

Well, if your parents have health insurance, I don't understand why a 25 year old wouldn't just stay on that plan?

 

[daycru]

Put bluntly, if the crux of your grand policy initiative involves convincing a bunch of 25-year-olds to buy something they (a) don't think they can afford and (b) don't think they'll actually use, you may be setting yourself up for failure.

And even if they do use it, it's still thousands of dollars more. It doesn't make sense. If I wind up a cancer case or something, I'm fucked anyway. It doesn't matter.

 

[Balphon]

Well, if your parents have health insurance, I don't understand why a 25 year old wouldn't just stay on that plan?

I'm sure they would, but that obviously isn't the case for everyone.

 

[ivysaur12]

I'm sure they would, but that obviously isn't the case for everyone.

Hence the "if your parents have health insurance" qualifier.

 

[mugurumakensei]

Most of the people in my age group(mid to late 20s) have health insurance through their employer. Salaries of my friends and I range from $20k to a little over 100k for the ones that do have insurance. The only person I know in my age bracket without insurance works retail and makes slightly over 14k a year.

 

[gohepcat]

If I wind up a cancer case or something, I'm fucked anyway. It doesn't matter.

How does it not matter?

You are still going to get treatment, but we are all going to pay for it though increased premiums or increased taxes.

Also...you can survive cancer.

 

[Balphon]

Hence the "if your parents have health insurance" qualifier.

I'm not sure I understand your point. Yes, increasing the age at which children can no longer be covered under their parents' insurance gives 18-26 year olds more options when it comes to acquiring health insurance. And yes, that fact has decreased and will certainly continue to decrease the number of uninsured aged 18-26. However, it won't zero that number out, and ultimately does little to solve the fundamental problem surrounding the ACA the article highlights: convincing largely healthy, low-income young people to buy insurance.

 

[Black Mamba]

26 @ 21120

You could enroll in a silver plan for around $90-115 a month (give or take).

Or you could enroll in the bronze plan for around $50-70.

Or you could enroll in the catastrophic coverage which will be less than $50 per month.

Depending on your state these numbers will vary and we won't know exactly the numbers til around Oct 1st.


If you don't buy insurance, you'd be taxed $210 for not. I won't say you can afford to buy insurance because I don't know your situation, but at the above numbers it might be something you could be able to do. And in 2015, the tax ($420) will be approaching how much bronze coverage costs.

Good luck to you.

 

[Zaraki_Kenpachi]

It's just math, isn't it?

If insurance companies make money in any capacity, that means their average client loses money in the long term. As I am almost certainly healthier than their average client, it mathematically doesn't seem to make sense for me to have it. And I don't care much for "peace of mind".

This is probably way too simple an outlook. Oh well. I have the cash, so I have a plan. But if I didn't...

This is just such an awful notion if this is what you reduce things too.

 

[derder]

Yep, my wife and I literally cannot afford what they're trying to push on us. So in the end we'll be poorer thanks to Obamacare and still not have insurance. Whee.

What sense does it make to pay $250 a month or whatever and then have to pay thousands in deductibles on top of that? I can go uninsured to a bunch of places for most things.

If something catastrophic happens I'm fucked either way, so it doesn't make sense for me.

It would make sense if you and your wife were saving that $250 and putting it towards some sort of emergency medical fund. You're not.

 

[Black Mamba]

I'm not sure I understand your point. Yes, increasing the age at which children can no longer be covered under their parents' insurance gives 18-26 year olds more options when it comes to acquiring health insurance. And yes, that fact has decreased and will certainly continue to decrease the number of uninsured aged 18-26. However, it won't zero that number out, and ultimately does little to solve the fundamental problem surrounding the ACA the article highlights: convincing largely healthy, low-income young people to buy insurance.

The subsidies will hopefully do that.

here is what the WSJ doesn't tell you:

The overwhelming number of young people 18-35 without employer provided insurance are under 200% of the poverty line and will qualify for large subsidies or medicaid. That graph is 18-35 without employer insurance.

In Cali, a 22 year old who makes $20k would only pay $50 for a silver plan insurance, which is really fucking cheap and costs like 3-4 times that right now.

If they can't convince these people to do it, then that's a problem. But I don't think it will be a problem. The total above is 25 million people and the Obama Admin thinks it only needs to sign up just under 3 million of them (granted a lot of those in the above chart will go on medicaid). But 3 million out of almost 15 million is doable.

 

[ToxicAdam]

Young people will just choose to forgo other 'luxuries' like car insurance, life insurance or costly dental care. Just another expense that will encourage/force them to stay at home (until they are 27).

 

[NYCmetsfan]

Except you didn't have to shell out a few hundred dollars every month to be on Medicare.

You do understand how medicare is funded? You pay your working life for benefits when you're older. That payroll tax? That's the few hundred you say doesn't exist. Medicare isn't free.

 

[Slavik81]

How did they write an entire article about people not signing up without mentioning the individual mandate?

It's just math, isn't it?

If insurance companies make money in any capacity, that means their average client loses money in the long term. As I am almost certainly healthier than their average client, it mathematically doesn't seem to make sense for me to have it. And I don't care much for "peace of mind".

This is probably way too simple an outlook. Oh well. I have the cash, so I have a plan. But if I didn't...

The expected value is negative, of course. The trouble is that expected value isn't the whole picture. For example, the marginal utility of additional cash is on a curve. A $100,000 loss may be more than 100x worse than a $1000 loss.

 

[Marda]

So confusing. I'm probably going to be living in shelters for a few months in a couple months and I'll be working full time, what are my options? I can't afford to put $100 a month toward health insurance, with making less than 15,000 a year I can go for the $50 a month one, correct? Or is the yearly fee only $96, and how much does of an increase does "dramatically" entail?

 

[I am Michael Bolton]

So confusing. I'm probably going to be living in shelters for a few months in a couple months and I'll be working full time, what are my options? I can't afford to put $100 a month toward health insurance, with making less than 15,000 a year I can go for the $50 a month one, correct? Or is the yearly fee only $96, and how much does of an increase does "dramatically" entail?

FYI you may qualify for medicaid. Not sure.

 

[Fnord]

but I get the impression that you would have freaked out if the "government" took over the healthcare industry so we were left with no options.

Probably. I fall squarely into the libertarian realm politically. That doesn't mean that I can't point out warning signs.

 

[Fnord]

Fell in love with it? Not sure you were watching the same debate and discussion that I was.

The insurance companies started off in vehement opposition to it. But after their "input" was taken into account in molding the bill, they were giddy.

 

[I am Michael Bolton]

Probably. I fall squarely into the libertarian realm politically. That doesn't mean that I can't point out warning signs.

So how would you fix the system if you had an opportunity?

 

[Black Mamba]

So confusing. I'm probably going to be living in shelters for a few months in a couple months and I'll be working full time, what are my options? I can't afford to put $100 a month toward health insurance, with making less than 15,000 a year I can go for the $50 a month one, correct? Or is the yearly fee only $96, and how much does of an increase does "dramatically" entail?

You are right at the line for medicaid if your state accepts the expansion, it seems, so you could get on medicaid. I'd have to know what state you're in to confirm this.

If not, you may be able to pay $0 for a bronze health insurance plan, depending on your age. According to Kaiser's calculator, a silver plan would cost $25 a month if you're 23.

http://kff.org/interactive/subsidy-calculator/

 

[Fnord]

So how would you fix the system if you had an opportunity?

Honestly, I'm not completely sure. I do know that I would have started by doing some of the things that could have been done without completely restructuring the entire system and mandating people purchase something. The first thing I would have done would have been to have taken down the interstate barriers to health insurance. It never made sense that they existed in the first place. That would have increased competition which, theoretically, would have driven prices down across the country. I certainly would have (and do) supported prohibiting the cancelling of policies when claims are made and the support the prohibition of exclusion based on pre-existing conditions. Though neither of those two things do much in the way of addressing costs.

That's where I would have started. And they are things that could have been done without being tied to other legislation.

 

[timetokill]

It would make sense if you and your wife were saving that $250 and putting it towards some sort of emergency medical fund. You're not.

No, because we don't necessarily have $250 extra laying around every month. Which is why I said we couldn't afford it anyway.

That said, we do set aside some money each month, but not for an emergency medical fund. It's for a "emergency anything" fund. You know, in case there are other kinds of emergencies, unemployment, etc.

Sorry we're not pulling in enough to have a specialized "emergency medical fund" though.

 

[Marda]

You are right at the line for medicaid if your state accepts the expansion, it seems, so you could get on medicaid. I'd have to know what state you're in to confirm this.

If not, you may be able to pay $0 for a bronze health insurance plan, depending on your age. According to Kaiser's calculator, a silver plan would cost $25 a month if you're 23.

http://kff.org/interactive/subsidy-calculator/

Thanks for the link.

I'm in Arizona.

 

[I am Michael Bolton]

Honestly, I'm not completely sure. I do know that I would have started by doing some of the things that could have been done without completely restructuring the entire system and mandating people purchase something. The first thing I would have done would have been to have taken down the interstate barriers to health insurance. It never made sense that they existed in the first place. That would have increased competition which, theoretically, would have driven prices down across the country. I certainly would have (and do) supported prohibiting the cancelling of policies when claims are made and the support the prohibition of exclusion based on pre-existing conditions. Though neither of those two things do much in the way of addressing costs.


That's where I would have started. And they are things that could have been done without being tied to other legislation.

If you get rid of the state restrictions whats stopping all the companies from taking refuge in a state with the lowest amount of regulation and the highest cost? You're basically gutting one of the strongest protections that exists and thats the office of the insurance commissioner that exists in each state.

 

[Black Mamba]

Thanks for the link.

I'm in Arizona.

You're lucky, Jan Brewer fought hard and got the Medicaid Expansion. Rule is if you are at or below 138% of the poverty line, you will qualify for free Medicaid.

At $15k, you're like right at the line so I don't want to guarantee you'd have it but I think you will (seems like $16k will be the cutoff next year).

That would mean you get insurance for free you didn't have prior. You could also go the bronze or silver route at probably a low cost as I mentioned earlier, but you were specifically targeted by the ACA in terms of getting either free or very low cost insurance.

When October 1st comes around, talk to someone who is paid to help people with Obamacare. This is not something you should pass up on!

 

[Phoenix]

Young people will just choose to forgo other 'luxuries' like car insurance, life insurance or costly dental care. Just another expense that will encourage/force them to stay at home (until they are 27).

That appears to be one of the statistics of the millennial demographic. Spent some time reading the research on this generation and it is fascinating how different they are from the generation before.

 

[Marda]

You're lucky, Jan Brewer fought hard and got the Medicaid Expansion. Rule is if you are at or below 138% of the poverty line, you will qualify for free Medicaid.

At $15k, you're like right at the line so I don't want to guarantee you'd have it but I think you will (seems like $16k will be the cutoff next year).

That would mean you get insurance for free you didn't have prior. You could also go the bronze or silver route at probably a low cost as I mentioned earlier, but you were specifically targeted by the ACA in terms of getting either free or very low cost insurance.

15k was a high estimate, 13-15k is right. Thanks man, and IAMB.

 

[Black Mamba]

15k was a high estimate, 13-15k is right. Thanks man, and IAMB.

I don't what IAMB means, but you're welcome!

It's important that people know their options. Lot of information out there that people right now don't know and frankly, who could blame them (and FWIW, I still don't know a lot about it)? The big challenge coming up is making sure people know their options accurately.

 

[antipode]

No, because we don't necessarily have $250 extra laying around every month. Which is why I said we couldn't afford it anyway.

That said, we do set aside some money each month, but not for an emergency medical fund. It's for a "emergency anything" fund. You know, in case there are other kinds of emergencies, unemployment, etc.

Sorry we're not pulling in enough to have a specialized "emergency medical fund" though.

I don't mean to pry on your situation - but if you and your wife are married, and around the age of the people in the article - wouldn't it seem likely that you might have a kid in the next 10 years?

The numbers are pretty stark - the medical cost of giving birth in the US without complications or surgery is around $20,000 on average. Medical costs for other pregnancies are often $30,000 or more. Even the out-of-pocket costs for insured American couples is around $3500. In fact almost 45% of childbirths in the US today have to be covered by Medicaid for pregnant women.

The fact that the ACA plans cover maternity costs - while most pre-ACA "catastrophic" plans didn't - almost guarantees that coverage makes financial sense for you over the next decade. The $3000/yr you pay in premiums you will be paid back if you have kids and don't qualify for Medicaid. If you have kids twice, it is free money.

Frankly it is a game changer. Most of the people in the OP are in denial about their expected medical costs, because they are in denial about their odds of being involved in a pregnancy in the next 10 years, which will dwarf all their medical expenditures in their life up until that point.

 

[milanbaros]

Is the American healthcare system actually set up in the patient's/society's best interest? Looking from the outside it really doesn't look like it. It seems pretty inefficient and unfair. Why not move to a nationalised healthcare?

 

[Black Mamba]

I don't mean to pry on your situation - but if you and your wife are married, and around the age of the people in the article - wouldn't it seem likely that you might have a kid in the next 10 years?

The numbers are pretty stark - the medical cost of giving birth in the US without complications or surgery is around $20,000 on average. Medical costs for other pregnancies are often $30,000 or more. Even the out-of-pocket costs for insured American couples is around $3500. In fact almost 45% of childbirths in the US today have to be covered by Medicaid for pregnant women.

The fact that the ACA plans cover maternity costs - while most pre-ACA "catastrophic" plans didn't - almost guarantees that coverage makes financial sense for you over the next decade. The $3000/yr you pay in premiums you will be paid back if you have kids and don't qualify for Medicaid. If you have kids twice, it is free money.

Frankly it is a game changer. Most of the people in the OP are in denial about their expected medical costs, because they are in denial about their odds of being involved in a pregnancy in the next 10 years, which will dwarf all their medical expenditures in their life up until that point.

Well, to play devil's advocate, for those couples that are planning their child (as best as one can), they can simply sign up during open enrollment the year they plan on having children and not bother prior.

Is the American healthcare system actually set up in the patient's/society's best interest? Looking from the outside it really doesn't look like it. It seems pretty inefficient and unfair. Why not move to a nationalised healthcare?

The American system is set up to profit big Pharma, insurance companies, and often hospitals, not to protect citizens or people. Yes, it's fucked up.

We haven't gone nationalized because we are often anti-gov't in the marketplace in general even for stupid reasons.

 

[Damon Bennet]

 

[To Far Away Times]

Is the American healthcare system actually set up in the patient's/society's best interest? Looking from the outside it really doesn't look like it. It seems pretty inefficient and unfair. Why not move to a nationalised healthcare?

We can't do nationalized healthcare. It's bad for corporations and good for the country.

 

[antipode]

Well, to play devil's advocate, for those couples that are planning their child (as best as one can), they can simply sign up during open enrollment the year they plan on having children and not bother prior.

That depends - most non-employer health insurance plans don't cover pregnancy, so only about 12% of people who purchase individual health care coverage have pregnancy coverage. That article points you than in 5 states - Colorado, Connecticut, Nevada, and South Carolina - if you are a 30-year-old woman, you simply cannot buy health insurance to cover pregnancy. Not a single provider will give you insurance. (All of that changes with the ACA mandate of course.)

 

[Black Mamba]

That depends - most non-employer health insurance plans don't cover pregnancy, so only about 12% of people who purchase individual health care coverage have pregnancy coverage. That article points you than in 5 states - Colorado, Connecticut, Nevada, and South Carolina - if you are a 30-year-old woman, you simply cannot buy health insurance to cover pregnancy. Not a single provider will give you insurance. (All of that changes with the ACA mandate of course.)

I meant once the Obamacare rules take effect in 2014.

 

[Wiktor]

The numbers are pretty stark - the medical cost of giving birth in the US without complications or surgery is around $20,000 on average.

In any normal country costs like those would be considered criminal and nobody would be able to have them legally. How the fuck can you people live like that...

 

[Black Mamba]

In any normal country costs like those would be considered criminal and nobody would be able to have them legally. How the fuck can you people live like that...