by AgentR11 » Sun 11 Nov 2012, 13:00:07
ETA to NHS equivalent.. 12 years. Regardless of whether D or R's control the show. 2012 was the ONLY repeal opportunity that could avoid doing catastrophic damage to the health care services provided to the upper 20% (and even then it would have been much messier than people suspect). From here on out, its only a matter of tweaking controls and incentives at most.
The 80% rule is that 80% of premiums collected must go to paying for health care services. Sounds quite good on the surface and is very hard to argue against in any form, so it will not be going away, and might even be yoinked even tighter. But pause for a moment and think about it in terms of management and shareholders of a corporation selling health insurance. In the past, you had competing incentives to deliver shareholder value, you can find an efficiency to reduce overhead, and you can enforce policy restrictions and audit apps of people who suspiciously get really sick right after signing up, along with normal sales and price competition. The 80% rule turns this on its head; regardless of efficiency improvements, your after COGS income can be no more than 20%. Add to the mix that your client base will gradually decline over the coming short term (lt 10yr), and you end up with only one way to improve the shareholders return on investment. You increase COGS and premiums along with it. This makes the 20% peice of the pie bigger. Folks would then suggest, "but your competitors will out price you". But they won't. The people remaining on real private insurance are not particularly price sensitive; as the price sensitive ones are also the ones getting dropped to part time, and thus no longer customers of the insurance company.
So how do you drive up COGS and create some customer loyalty?
You, as the insurance provider, advertise, to your customers, for expensive, "nifty cool" stuff, that they can have done in the name of "health care".
It is completely backwards of what it should be if medical care was ever desired to be "affordable" and equitable. IE, we just bought the health care systems of Latin America, with the tech and resources of the first world. The gap between care provided to different classes of people is about to get MUCH larger.
As to tax increases for Obamacare subsidies... No way to know really, and we'll never know. Most of the tax will be buried by the Fed churning tbills. We'll get a small tap, maybe $2k-4k a yr, to make us think we're paying for it; but the bulk of it will just be piled right onto the deficit without a care in the world.
Yes we are, as we are,
And so shall we remain,
Until the end.