Health-care law benefits must be limited to ensure affordability, panel says

[alp227]

Source: Wash. Post

An advisory panel of experts on Thursday recommended that the Obama administration emphasize affordability over breadth of coverage when it comes to implementing a key insurance provision of the 2010 health-care law.

Obama officials charged with stipulating what “essential benefits” many health plans will have to cover should make it a priority to keep premiums reasonable, even if that means allowing plans to be less comprehensive, counseled the committee of the National Academy of Science’s Institute of Medicine (IOM).

“The question is what is the fairest, most transparent way to get a reasonable set of benefits and still keep it affordable for both the user and for the taxpayers,” said committee member Marjorie Ginsburg. “We don’t want to say that one is more important than the other. . . . But the limiting issue obviously is affordability.”

The findings highlight the difficult balancing act the administration faces in carrying out one of the the health-care law’s most sweeping, yet ambiguous, mandates. The statute sets out 10 general categories — ranging from hospitalization to prescription drugs — that all new insurance plans for individuals and small businesses must offer starting in 2014. It also states that the scope of the essential benefits package should be equal to that of a “typical employer plan.”

Read more: http://www.washingtonpost.com/national/health-science/health-care-law-benefits-must-be-limited-to-ensure-affordability-panel-says/2011/10/06/gIQA3K5URL_story.html

[redixdoragon]

1. Affordibility and/or profits...

...over people


disgusting.

[Faux pas]

2. That's the definition of capitalism for the last 30 years. Shocker.

[xchrom]

3. Limiting tests, etc I suppose. Great if you don't need them -

Sucks if you do.

[deminks]

4. How about a panel that considers the affordability of war

before we are thrown into the next one.

The lackeys of the 1%ers spend entirely too much time worrying about whether the 99%ers get coverage for something for which they haven't fully gouged.

[area51]

11. +1

Since we can afford multiple wars of choice, we can afford health care for all citizens.

[jerseyjack]

5. Who cares if they die. Just keep the health care costs down so

we can continue to pay for the military.

[sybylla]

6. They should have worried more about affordability when they passed the fucking mandate

My healthy family of four was facing over $10,000 a year in premiums for high-deductible health insurance in '08.

Bastards.

[Vinca]

7. If benefits are limited, the end result will be the same.

People will get sick, use their mandated policy, and end up bankrupt because they still have thousands of dollars of medical bills to pay. What a fucked up country this is.

[Yo_Mama]

9. But that's already baked in

If you are forced to coverage on the exchanges, all but the very poor will face substantial out of pocket costs.

Using the Kaiser health-care calculator, a family of 4 with an income of 48K and an insured member age of 47 in a medium cost area would:
http://healthreform.kff.org/SubsidyCalculator.aspx

Be expected to pay $3,106 in annual premiums, with an actuarial coverage ratio of 73%, meaning that on average the family will have to cover 27% of their medical costs out of pocket.

But the annual out-of-pocket expense is limited to $6,250, not including the premium, for a total of over $9,000 in possible annual medical costs.

And don't tell me that a family of four could pay that much a couple of years running without having to file BK.

Now if this family can get coverage through their employer, they may do better, but getting coverage through their employer is contingent on the employer being able to afford to pay most of the cost. The fee charged to the family as their cost is required to be not more than 9.5%, or about $4,560. But the coverage only has to be comparable to what is offered on the exchanges, and Kaiser estimated that the actual cost would be over $15,000, so the employer would be paying over 10K. A lot of employers can't do that.

The idea that this plan was going to change things hugely for most people was never realistic. The more basic coverage that is mandated, the less actual treatment is going to be covered. If the employers can't pay for coverage, they will pay a fine and then the public would have to pick up a subsidy bill of over 12K for this family. Clearly we can't afford that.

[Owlet]

8. Here's all I need to know

From the story at the link:

"Karen Ignagni, president of America’s Health Insurance Plans, an industry trade group, said the recommendations were 'very helpful to the discussion.'"

[Yo_Mama]

10. The panel was hired by HHS to advise HHS on how to set coverage

Realistically, the public can't afford to pay for cadillac health care for most people, so the new coverages will be limited somehow.

PS: This is the same institute that recommended free contraception for women.
http://commonhealth.wbur.org/2011/07/influential-panel-recommends-free-contraceptives-for-women-under-health-law/

[plumbob]

18. Yes, we can afford "Cadillac" coverage for every single person in this country.

The preventative care alone would save trillions over the next decade. Health care does not cost; it pays.

War, on the other hand, total loss, and only loss.

Will we give up war? Nah. Will the current health plan do anything good for people? Nah. All it does is change the sign that used to read "Shitty or no care" to "Affordable care." Regular people don't count for shit in this country and have not for a while.

But that doesn't make it right - just that the fix is in, as usual - welfare for the high earners, gravel for the rest of us.

[BlueIris]

14. Yeah, really. Lame.

Oh, I mean, "real, meaningful change."

[closeupready]

12. Could really make health care affordable by repealing the law altogether.

Then nobody would have to buy it.

[pnwmom]

15. How will that make health care affordable? n/t

[customerserviceguy]

13. Did everybody think that the AHA was going to be a free lunch?

I sure didn't. Basic healthcare is something I support, but that means that we've got to limit some things.

Anybody here ever belong to one of the Western old-time HMO's, like Kaiser or Group Health? They've practiced this kind of rationing for so very long, they could write the book on it.

[pnwmom]

16. We do have to bring costs down.

And it won't just be enough to reduce profit margins. With the rate of increases over the last couple decades, we could be looking at health care costs rising to half our GNP -- which is obviously ridiculous.

[No Elephants]

17. Death panels?