Thursday, June 13, 2013

California Dreamin': How much is too much?

I find this sad:

That's a snapshot of how a new ObamaTax "Silver" plan is likely to look (at least in the Golden State). It's sad because it's really no different than how insurance worked before the train-wreck. Too often, individuals focus on the co-pays (for doc visits and meds) without looking at "the big picture." I can't tell you how many times I've presented a High Deductible (HSA) plan only to be asked "what's my co-pay?"

Remember, too, that (for many, perhaps most, folks) any subsidies to which one might be entitled are for the premium which, in this case, represents only about a third of what the total potential out-of-pocket might be. There are few (if any) subsidies for co-pays, deductibles or co-insurance. That's strictly "out-of-wallet."

And even this may vastly understate the problem; as FoIB Jeff M reports, "Kaiser Permanente has offered some of the highest rates in the California health exchanges."

Now why would they do that? The article says that KP itself denies any market-rigging motivation, although it notes that:

"Some experts say Kaiser intentionally bid high to avoid drawing too many customers next year who are sick or who have been uninsured for years and may be costlier to treat."

See, that's just good business sense: we already know that the large majority of folks who actually bother to sign up for (first-time) coverage are those with the most motivation to do so: pent-up needs held back by lack of resources (ie a third party to foot the bill). And who can blame them? On the other hand, had I been the KP spokescritter on this, I would have been sorely tempted to answer the charge with a very simple "d'unh!"

But then, truth often hurts.
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