8 Comments

I like the annual cap on out-of-pocket expenses (although I'm not sure health savings accounts would help--might just mean less coverage, higher premiums, etc.) And of course Uwe Reinhardt was exactly right about prices. But the reason the prices are so high is power. Prices only approach costs in a perfectly competitive market, where by definition NO participant has market power, there is total transparency, etc. In medicine, hospitals and insurers and now "health care systems" have immense power; patients and doctors have none, with predictable results. So I vote for price controls, which could be regulated just like utility prices used to be regulated (maybe still are) providing due process per the APA, instead of the RUC. We need Medicare-for-All (not Medicare Advantage, of course), financed by taxes on employers and workers. Since disease is now chronic and predictable, everyone at some point needs care, everything medically necessary should be covered, I'm not sure why we need private insurers to provide different 'plans'. Medicare would spread medical risk over the entire population. Today's Medicare was supposed to be just the first step, but then the New Deal ended, unexpectedly, in 1968.

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CBO estimates 10-year cost of subsidies in the 300B+ range. The number of additional enrollees estimated to be 3.6M. Square those per capita costs for the incremental bump in lives covered? Where is all the money going?

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Do the math using those numbers. If the government spends $325 billion over the next ten years, that's $32.5 billion a year on average. Divide that by 3.6 million additional enrollees on average and you get $9,027 per enrollee per year. In 2023, according to the Kaiser Family Foundation annual survey of private health insurance, the average cost of an individual plan was $8,435 for single coverage and $23,968 for family coverage. It's reasonable to assume a significant portion of the 3.6 million are in family plans. But let's low-ball the number an estimate the average cost per enrollee for their plan is $12,000. The average cost of $9,027, by CBO's estimate, is about three-quarters of the total. Under this scenario, individuals buying Obamacare plans pay about a quarter or $3,000 a year. This is logical since subsidies are based on income and most enrollees in Obamacare plans are low- and moderate-income and thus qualify for heavy subsidization.

So to answer your question, where does the money go? For health insurance.

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Asking a 'Murikan to "do the math" is a losing proposition, bcoz of the absolute state of a 'Murikan edgy-muh-cation.

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Merrill:

Isn't Yuge supposed to be spelled with a Y and not an H? 😊

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Not in New York, I was amazed to find out.

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:) Just kidding . . .

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Merrill, has anyone thought about price controls recently. They seem like an idea worthy of exploring, because just the idea could knock some sense into the heads of people in all parts of the industry who follow the theory that we can go as high as the consumer is "willing" to pay. That doesn't even work for Starbucks anymore! Hi to Karen

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