Obamacare Pushers' Big Guesses Were Wrong
Michael Barone writes in the WSJ that that rush of uninsured people who were supposed to be signing up for Obamacare is more of a trickle:
A McKinsey & Co. survey of those thought to be eligible for ObamaCare health-care exchanges found that only 11% of those who bought new coverage between November 2013 and January 2014 were previously uninsured.Two small insurance companies told Wall Street Journal reporters for a Jan. 17 article that only 25% and 35% of those purchasing their policies were previously uninsured. Larger insurers don't yet have numbers, but it seems that far fewer of the uninsured than expected are signing up. The latest Kaiser Family Foundation poll reported that only 24% of uninsured under 65 had a favorable view of ObamaCare while 47% had an unfavorable view.
One reason may be that ObamaCare requires policies to cover not just the expenses of catastrophic illness--the sort of thing auto and home insurance policies cover--but routine medical expenses and procedures that many individuals will not need. To that extent ObamaCare policies are not insurance but prepayment of routine expenses. Apparently many of the uninsured aren't interested in prepaying for health insurance any more than they are interested in prepaying their credit cards.
A second assumption of ObamaCare's architects is that health insurance will make people healthier. That assumption has been tested in Oregon. In 2008 the state government, with limited Medicaid funds, held a lottery to determine which people who were eligible for Medicaid would be enrolled. The result was an unusual randomized control trial of similarly motivated people with and without insurance. The results, reported in the May 2013 New England Journal of Medicine, were that after two years there was no significant difference between insured and uninsured in blood-sugar level, blood pressure and cholesterol levels--although those with Medicaid saved money and were less likely to suffer depression.
Emergency room use was also supposed to go down under Obamacare. But in an Oregon study, "those with Medicaid were 40% more likely to go to emergency rooms than those without insurance."
Barone explains that there's been a disconnect between those who think they know what's good for us -- comprehensive coverage for all (to the point that post-menopausal women have maternity and prenatal care) -- rather than letting people have the freedom to choose what's good for them.
"To that extent ObamaCare policies are not insurance but prepayment of routine expenses."
Ha! I've been saying that in your comments since Obamacare was first proposed. That we shouldn't look at this as an insurance model (shared risk), but as a prepaid medical plan model (economy of scale, prepaid payment of certain treatments.)
But that's also why ACA should have just jettisoned the insurance companies out the airlock instead of trying to preserve the insurance model.
jerry at February 4, 2014 1:38 AM
Prepaid plan? no way. It's a scam.
You have to pay your insurance, several thousand dollars for many many people, and then the deductible of another several thousand dollars before you see one cent of insurance money.
You'd be better off socking that money away, and then paying cash to the providers of your choice instead of being told whom you may see.
I R A Darth Aggie at February 4, 2014 6:18 AM
I'll keep saying it: That 40 million uninsured? They don't exist. Never did. Just like the supposed 20 million homeless. The Left made it up out of whole cloth, got their lackeys in the MSM to run with it, and now it's yet another one of those things that "everyone knows" but isn't actually true.
I forget where I saw it yesterday, but it was a great comment: The insurance industry dreamed of customers being forced to participate in a command economy, with government-guaranteed profits. But, oddly enough, the customers who were supposed to have been herded and corraled by the ACA resisted being treated like cattle. Unexpectedly!
Cousin Dave at February 4, 2014 7:14 AM
I think the uninsured who supported the ACA thought they were going to get insurance for free/ a nominal fee. If a single man who makes $40,000 a year wasn't willing to pay for insurance when it was under $150 a month (because he felt like he "couldn't afford it", why would he be willing to pay for it now that it costs the same, or more money?
ahw at February 4, 2014 10:01 AM
How anyone thought that the government could run the health insurance after seeing the quality of USPS, IRS and Departments of Ed and Energy is beyond any logical comprehension.
And the latest and greatest is that they want the USPS running banking services for the poor. How scary is that?
Jim P. at February 4, 2014 10:32 AM
AHW: As a single man in his 30s who makes $40,000 (more or less, depending on hours), I am exactly what you say. Didn't buy insurance because I didn't feel I could justify $150+/month for services I didn't use. (Perhaps that wasn't the wisest course, but it's too late now.)
I also didn't make $40K until 2 years ago...it was just over $30K previously.
I DID seriously consider buying catastrophic insurance - it made good sense to me - but that was after I found out it existed. (Didn't know of it until recently.) By then it was too late; Obamacare axed the catastrophic option since I'm over 30.
The cheapest option I can find is Anthem Blue Cross at $238/month. For services I don't need, and a value I won't see unless something serious crops up. This I simply cannot justify.
I'm waiting this out; the next couple months should be very telling. It may be that I'll need to downgrade my work hours/reduce my income in order to qualify for a subsidy. Or just take the penalty for now.
Chris at February 4, 2014 11:55 AM
Wait, so you are saying the people who could not afford insurance before cant afford it now that its even more expensive?
lujlp at February 4, 2014 3:09 PM
"To that extent ObamaCare policies are not insurance but prepayment of routine expenses."
I don't know whether to laugh or cry at how long it is taking others to determine what I saw at a glance.
No one should be paying into this plan - this way. The idea that anyone should pay for a service which is not rendered is crazy.
Radwaste at February 4, 2014 10:13 PM
Have you seen what the requirements for employer-based health insurance are?
It's summarized quite succinctly by Intuit.
To qualify, your employer plan must either cost you more than 9.5% of your annual income, or not cover on average 60% of your medical costs.
Yeah. Good thing this is based on serving the patient, isn't it?
Supporter? Idiot!
Radwaste at February 6, 2014 6:22 PM
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