(11-11-2013 08:22 AM)RiceLad15 Wrote: I'm not trying to demonize this healthcare company, but instead try to illustrate a point I have been trying to make on this thread since my first comment, and perhaps I should have been more clear.
FTR, I didn't mean to imply you did. MANY certainly do. It was part of how Obamacare was sold.
Quote:When I first saw this article, it was being touted by many as basically the "Obamacare is going to kill me article." When I read it with that in mind, I was expecting to find some piece of the legislation where a specific rule had deemed the high-end insurance illegal, thus reducing the woman to finding someone else to provide her care. But what I found was an article about a company who is dropping the coverage of all individuals in California for an unspecified reason.
Unspecified reason? Really?
Quote:Instead of immediately assuming that it was unprofitable to cover those 8,000 individuals now (because Hambone, as you said, it may have already been unprofitable, and if so, why were they doing it in the first place?) I wanted to investigate and understand why the company would discontinue covering individuals, but not large groups and businesses in California.
When did I say it may have already been unprofitable? Whether they actually made money at it or not, certainly you'd agree that they THOUGHT it would make money. Now they don't. What changed? Of course, it COULD be mere coincidence, but if so, why did they cancel the policies rather than sell them to another company offering similar/competitive policies? The insurers have contracts with the doctors and those contracts have value. The company cancelled the contracts rather than sell them. It makes zero sense that they would make a decision to close a business unit and then not try and sell/consolidate the assets of that unit, unless "overhead" wasn't the problem.
Quote:And this is where I got confused. Ham, as you have now stated in two separate posts, businesses wouldn't engage in actions that intentionally cost them real money, but since they are now dropping the coverage, they must have been engaging in actions that intentionally cost them money. Wait, what?
Yes, exactly wait, what? I never said anything like that. They're dropping the coverage now because they can no longer make money at them (if they did already) or they no longer see a WAY to make money at them (if they didn't already).
Quote:And since I haven't read an article that discusses the pre and post finances of United Healthcare and the rational behind removing themselves from the individual market in California, I will continue to be interested in why they made such a decision, and not make a foregone conclusion that it was because it was so unprofitable.
First, my comment about profit was in direct response to your comment that "they were in the business of helping people". No they aren't. They are in the business of making money. Why else would you think they would stop offering a product? You may not accept the obvious reason, but I seriously can't think of another rational one.
They stopped offering these policies because they no longer believe they can make money at them... whether it is because the policies no longer meet the minimum requirements (unlikely given the individual's circumstances, but still possible) or because it changes the math to profit or because it changes the size of the potential market.
If they had simply changed their minds about being able to penetrate the market, they would have sold the contracts to a competitor who already had penetration.
Quote:I'm not a gigantic fan of the mandate in the ACA (I'm all for getting rid of preexisting conditions, allowing you to stay on your parents insurance until 26, and capping the amount one can spend on insurance in a year), but I'm certainly not against it. Instead, I'm pretty much someone who better understands why the ACA was passed as opposed to why it wasn't. There are probably better healthcare alternatives out there (as Owl69/70 often points out), but perhaps I don't fully comprehend the effects of this law yet, and that's why I am not fully in one corner or the other.
You understand the "feelings" and "excuses" behind the ACA. It appears that you don't understand the realities of it at all.
When talk of the ACA first came about, even under CLinton... all anyone talked about was how we didn't have enough PCPs for our population. How can you deliver more healthcare to people if you don't have more doctors? What does the ACA do about this?
Nothing.
While certainly, lifetime caps affect real, live individuals... in aggregate, they amount to LITERALLY a few dollars (my best math says <$3, but I'll allow that it might be $10) on every policy.
If you look at a standard individual policy before and a standard individual policy today, the differences to cover these PECs should have been a few hundred billion dollars per year... Instead, we're paying more than a trillion per year. PECs are generally covered in corporate policies as a matter of course and account for the vast majority of the difference between what was, and what is now in individual policies.
Keeping kids on your policy isn't always a financial positive. SUre, if you have 5 kids it is, but not if you have one. Why? Becuase "family" policies generally assume 1 male and 1 female child for a set cost. If you have more, you get a break. If you have fewer, you are probably better off with an individual policy for them. All the individual mandate is is a way to keep healthy, financially stable people from skipping the insurance that they don't need. It's an out-and-ought tax on healthy, young, financially stable people. There's an old rule that what you tax, you get less of... so I'm wondering why this is a "good" feature of Obamacare?
One other thing the ACA doesn't do is encourage responsible behavior and "wellness". It rewards doctors for treating symptoms of things like heart disease and obesity and can actually hurt them significantly if they tell people to eat less bacon and fried foods, stop smoking and drinking, cut out the sodas and exercise and lose weight.
Seriously, exactly WHAT is good about the ACA? That it uncaps policies? That could have been fixed in 3 words. No policy limits. That it covers PECs? That could have been fixed by turning individual policies into what corporate policies are... 4 words. No exclusions from coverage. Keeping kids on until 26? Not always the best financial decision... but fine. How many words would THAT have taken?
Nothing else in the thousands of pages is "positive" for healthcare.... and they didn't address the two major ones...
1) numbers of doctors and
2) encouraging "wellness"
How would you do this? Instead of funding all the crap, fund more residency slots. Simple and straightforward... but expensive. You COULD copy Europe and demand 2- 4 yrs of PCP or emergency practice in exchange for this... or they can fund it themselves.
Instead of purporting to cover "everything" which we clearly don't have the money or manpower to do which means some form of rationing... either literal or merely functional (so many hours in the day and so many docs)... we could have had a "hole" in the middle... where sniffles and wellness are covered, as are serious diseases... but if you sit on your hands and let a cold turn into the flu, or do stupid things like on ******* and get hurt, or need fluids because you got so drunk you almost vomited yourself to death, or if you smoke or dip and get lip cancer... you don't get HAMMERED, but you DO have to pay more out of pocket for those stupid decisions... which discourages those activities and encourages
(11-11-2013 10:05 AM)OptimisticOwl Wrote: united Healthcare used to cover 8k people in California.
now they don't .
what changed? what is the difference between now and then?
Seems pretty obvious.