Every element of the health care sector is sucking as much money out of all of us it can get. We are fools for fighting to keep the system we have. We are manipulted by political slogans and wining theives. We need to throw it all up in the air and start over. And single payer also needs to be in the toss up. A friend called what we are doing “rearranging the chairs on the Titanic.” So true.

This is a true question: What about the impact on individual insurance pricing by the move of all those people formally in lower risk group plans & thus lower premiums to the more public individual pool??? Seems this could lower premiums for all also.

I am with you. Medicare for All (MfA) fans seem to think MfA will be free. If we get it and don’t do anything to change our cost of health care, we are doomed. We have to cut our health care cost as a % of GDP in half. It is doable, but Americans are going to have to suck it up to get there.

It will take some of the following and a lot more.
1. Enforce medical home.
2. Enforce ACOs for large clinics and hospitals.
3. Enforce REAL non profits (limit CEO salaries; eliminate severance packages; limit reserves (example: 200% of statutory reserves.
4. Lower earnings for health care providers.
5. Providers charge everyone the same am’t for the same care; allow gov’t to negotiate lower prices.
6. Single insured pools per health care economic region that prevent cost/price shifting among insured groups.
7. Disengage health insurance from our jobs, but require employers to contribute to the cost of our health insurance.
8. Move to a consumer driven value/price choice system.

I sooo wish we could do health care reform smartly rather than politically. Medicare for All is a good start, but we can do better than that. Other industrialized nations pay less than half as much for their health care and they get significantly better quality outcomes than we get. What are they doing that we are not? single pool, medical home, government negotiated drug prices, no private insurance involvement in basic coverage, ACO hospital care? With so much savings in the offing, seems like we are just plain stupid. The old saying “with your eyes closed comes to mind”.

The article focuses on states that will develop their own or not develop their own health insurance exchanges. Development of state built exchanges will be frought with political arguing and pressures from insurers and insurance agents. The federal exchange will have some of that, but much less. And the HHS requirements for exchanges are very specific and robust. States will fight against those requirements also. they will ask for and probably get waivers – HHS has been pretty generous with waivers so far.

What makes more sense? Build 50 exchanges from scratch that are nearly all the same OR build one exchange (by HHS)and copy it 50 times??

Regarding HHS not having any money to build and run the exchanges. Well that isn’t exactly true. If the states don’t build their own exchanges, there will money left to build the 1 HHS exchange and the needed copies. There will probably a lot of money left over.

Secondly, the ACA does not pay states to run exchanges so no difference there. BUT the ACA does authorize the exchanges to charge transaction fees per purchase to pay for the cost of runnning the exchanges – this is no different for state run or HHS exchanges.

FDL — you need to do more research on these editorials about health care. This is the 2nd in a week that is just plan wrong. If you are a true blue liberal activist, your outrage has got to be based on truth.

I have to ask – who do you think should design the exchanges? Angry liberal activists? politicians? How about people who understand health insurance (there aren’t many around) and know what info is needed to buy and get coverage on the exchange in a single session? How about people who know how to talk about health insurance in ways that are accurate and understandable? Sounds to me like you all want a bunch of no-nothings to do the job. I am a liberal and I know a thing or two about health insurance and there has to be a balance of health insurance company folks, agents, and a couple of knowledgable individual and small group insurance consumers. What do you know about getting a health insurance exchange up and running? Huh? Please stop this knee jerk anti-everything talk – it isn’t helpful.

The exchange does not have to be complicated.

1st enter personal info; include income info if applying for Medicaid or premium subsidies; select a maximum annual out-of-pocket risk range(copays + deductibles)and modal premium frequency.

2nd see available competitive essential benefit metal plans that match selected risk range. List includes modal and annual premium, a list of available value add features and riders and consumer quality/service ratings. The consumer chooses.

3rd see available value add features and riders. Select.

4th pay 1st premium on credit card and coverage is in force. Contract is sent to policyowner via snail or e mail. Consumer has 10 days to change his/her mind. Consumer can go to the exchange and tell it No Thanks, I want my money back and by the way, I want this different insurance.

This is not rocket science. There are people who want buying insurance on and exchange to be complicated so they can make the case that health insurance must be bought through insurance agents. Some will need an agent, but many, many, many will not. Don’t let your state’s health insurance exchange be designed by those who want it to fail.