Why is There No Regulation on Health Insurance Premiums?
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The health insurance companies are getting rich off of us! My friend has cobra and pays $680 per month for a $1500 deductible and a $3,000 max out of pocket. With Obama care a plan that is $5.8000 deductible and $5,800 max out of pocket is $640!!! Why aren’t there controls on these premiums? I have been getting my own insurance for years and when you have these high deductibles the insurance companies never pay out. Most people don’t use the high amount. If the premiums were reasonable many people wouldn’t need the subsidies.
Marina
The ACA should be modified on the following points: regulation on premiums, removal of subsidies, and removal of punitive mandate/penalty tax. The main issue and problem is the inflation of and outrageously high monthly premium prices. Holding the insurance companies more accountable in setting premium prices which are reasonable, affordable, effective, and allow for real choice for consumers is crucial. If this were done consumers would not have to resort to the humiliating experience of either applying for subsidized insurance plans or forgoing health insurance altogether and being slapped with a tax penalty. The first removes the dignity of a consumer and puts the government in the position of health insurance monitor tasked to control consumer choice by digging into consumer financial information in order to shell out subsidies (government funds) to help consumers while making them feel beholden to the government. The second, the penalty tax, would be a moot point if health insurance premiums were reasonable, affordable as offered by the insurance companies from the get go.
What is needed is to curb premium inflation, pure and simple. By doing so the consumer is truly given choices and restored dignity by not having to get government assistance or going without health insurance and then having to pay a penalty tax. The government would save money by eliminating subsides.
Lastly COBRA should either be eliminated. It’s a boondoggle and a bankrupting device in its present state. Solution: Wage increases adjusted for inflation/cost of living should be mandated of employers instead of having to provide health insurance to employees. Put the money in the pocket of your employees and empower them as consumers. It takes the burden off both the employer and the employee; and thus making healthcare insurance separate from work and portable and not tied to the job. Too many people stay in miserable demoralizing and no growth jobs just because they have health insurance. Take the leash off employees please so that if they quit or get laid off, they continue with their self chosen, self paid reasonably priced and affordable health insurance and are not beholden to no one. Let’s stop gouging, bankrupting, and humiliating people and begin respecting their intelligence instead of aiding and abetting Health Insurance Companies’ greed and obscene profits. Now, that is an affordable solution. Regulate premium prices.
Paul Rein
That is so ridiculous. The Health Insurance Industry loves the ACA. Their profits are guaranteed by ACA. Then I look at what the profit margin is of the ACA and I get sick. They have no conscience about ripping us off and the Federal Government does nothing at all. Why? You regulate utilities so its affordable, yet you will not regulate Health Insurance. I am a physician and then I get the blame, and I’m not making $25,000,000 a year like the heads of those companies. Oh yeah I’m not a Congressman who doesn’t have his or her insurance taken out of salary. Stuff it Federal Government. Stuff it Health Insurance Industry. I can’t wait til you are one of my patients
Marina
Bravo Dr. Rein! Perfectly stated. Thank you.
Fred
Plans offered to individual purchasers are much more expensive an have much higher copays and coinsurance costs than superior plans purchased through employers. I completed a comparison and found that the 0 deductible, 0 coinsurance, policy that my company purchased for 830 dollars per month is not available from the same insurer. The best plan that I can purchase from the insurer as an individual has a 250 deductible and 10% coinsurance with 1500 dollar max out of pocket at a cost of over 1400 per month. Less coverage – 68% higher cost. Concerning shopping for lower cost services, this is not possible. The prices are fixed, having been negotiated by insurers and providers. The deductible and coinsurance amounts merely serve to dissuade the insured from obtaining medical services, thereby reducing costs to the insurer. The only solution possible is either extensive regulation or a single payer system.
Nan
You are kidding right? $640.00 for $5800 Deductible and $5800 Max OPM? I’LL TAKE IT!!!!!! Have you even looked at the plans and premiums being currently offered? If I want low end health insurance with high deductible it will run me between $970 and $1080/per person/per month. A good plan with a lower deductible and lower OPM is running up to $1375.00/person/month. My husband and I are a small business. We are slighly over the $67,000 income per year so we do not qualify for any subsidy. We are definitely being beat up for working hard and paying taxes.
Erin
When the Out-of-Pocket Maximum and Deductible are the same, then that is the most you would have to pay annually for covered medical costs. It’s not added together, your deductible counts towards your out-of-pocket maximum. While that information may not solve all the financial woes, it is actually hard to find insurers with that low of an out-of-pocket maximum.
Nanc
You are kidding right? $640.00 for $5800 Deductible and $5800 Max OPM? I’LL TAKE IT!!!!!! Have you even looked at the plans and premiums being currently offered? If I want low end health insurance with high deductible it will run me between $970 and $1080/per person/per month. A good plan with a lower deductible and lower OPM is running up to $1375.00/person/month. My husband and I are a small business. We are slighly over the $67,000 income per year so we do not qualify for any subsidy. We are definitely being beat up for working hard and paying taxes.
Gabriel
Many people blame Obama for the premium and insurance rate. The (so called) Obamacare IS NOT an insurance, but just the law and the platform. Within this platform there is an open MARKETPLACE where all the options are private insurance companies that set their rates and prices. Obama has nothing to do with this. In fact, the failure of Obamacare is precisely its failure on regulating these vampires that are never satisfied on sucking people’s blood; no matter if these people are sick or dying. The sad part of all this is that, the same people that criticize Obamacare (mostly republicans) are the same that defend these insurance company, and are against government regulations and universal healthcare to people.
Chris
Exactly. All these premium increases represent are further examples of how the interests of insurers conflict with the interests of everyone else, especially their own customers. That conflict, which has long left millions without insurance, is the whole reason for Obamacare. It is not truly comprehensive — but that is precisely because of the people who oppose it and prevent establishment of single-payer or some other plan that actually is universal. Right-wing hypocrisy can be hazardous to your health.
coast2coaspaul
Obama has EVERYTHING to do with it. He wrote a plan that guarantees the profits of the Health Insurance Industry. all they had to do was place controls on prices. No one desrves to make the kind of profits the insurance companies get ripping us off.
ObamaCareFacts.comThe Author
You have a point there, had there been more price controls, there would have been less price gouging. That is one part of the puzzle, but certainly this wasn’t Obama’s fault directly and further GOP obstruction did not help the matter. Healthcare is a in many ways a bipartisan problem and the lack of fixes is a bipartisan issue.
Marina
‘’. In fact, the failure of Obamacare is precisely its failure on regulating these vampires that are never satisfied on sucking people’s blood; no matter if these people are sick or dying. ’’ Exactly! And we have the Democratic Congressional leadership to hold to the fire not just the Republicans in this regard. At the end of the day, the healthcare insurance companies, Big Pharma, and hospital corporations and their lobbyists are the culprits. And our Congress (with some exceptions) is bought lock, stock and barrel by them.
Mike123
The high deductible plans are not fun for the health care providers either. When a patient receives that big bill, they may not be in a position to pay it. Then the doctor’s office or hospital has to put time and effort into collecting that money. If they can’t or don’t pay, they lose out.
Christina
You say that high deductibles “.. incentivize the consumer to shop around and that reduces the base costs of health care in general…”. How can one shop around for medical attention when no one gives out actual prices? The places that do, which is rare, give you a ball park figure, with a thousand dollar difference between the high and low end prices, as to what the service is going to cost. Do you realize that the healthcare is the only “consumer” business that does not tell you the price before you buy? You go out to eat, you have a menu with prices (unless it is a super high class place with “market price” but if you ask our server, they tell you the price), you go buy a TV and you see all the prices for every single TV you could purchase, you go to a baseball game and see the prices for all the seats available. You go to a hospital ER because you fell off a ladder and broke our ankle and they just fix you and send the bill later. You ask for prices and it’s either “we don’t have access to that until we do it because we don’t know what it will all entail” or “it’ll be between $500 and $3500, depending on what we do”. So, how does high deductibles allow for cheaper health care? All it really does, at least in my families case, is make it so we pay monthly for health insurance we don’t use because we can’t afford to pay our outrageous deductible and out of pocket max.