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Obamaca;s Silver Surprise

There was some surprisingly good news this month about the cost of insurance under Obamacare.  It will be cheaper than expected.  But it remains to be seen – will cheaper insurance satisfy Obamacare doubters on either the left or the right?

I doubt it, but first let’s take a look at the details.

A few months ago, the Wall Street Journal warned of health insurance sticker shock when the Obamacare insurance exchanges open for business in another ten weeks. 

There could be an up-to-50 percent increase in health insurance premiums, the Journal warned.

But a report this month from the Department of Health and Human Services Office of the Assistant Secretary for Planning and Evaluation (ASPE) brought a surprise. 

Based on data from the first eleven states reporting actual premium numbers, ASPE now says that insurance costs for Obamacare “silver” plans for individuals will be 18 percent lower than originally projected by CBO.

Premiums for the least expensive plans were averaging around $321 per month – before income-based tax credits were subtracted from those costs.

And in five states plus the District of Columbia reporting small group plan numbers, insurance premiums for the all-important “second lowest cost” silver level plans will range from 6 percent to 36 percent less than they would have been if Obamacare were not the law of the land.

What makes a plan a “silver” plan?

Despite what you might assume from the headlines, plan categories are not based on insurance premiums.  They are based on the percentage of the total cost of health care that the plan will pay for everyone in the plan, versus what the plan’s policyholders will pay out-of-pocket.

There are four categories of plans – bronze, silver, gold, and platinum.  All plans will provide coverage for the same group of essential benefits.  But bronze plans will cover 60 percent of the cost of these benefits, silver plans will cover 70 percent, gold plans will cover 80 percent, and platinum plans will cover 90 percent.  Policyholders will pay the rest.

This does not mean that if you have a silver plan, at the end of the year you will have paid 30 percent of your total health care costs and your insurer will have paid 70 percent. 

Those are just the averages, and everyone’s individual experience will vary from the average at least somewhat.

There are two reasons that the cost of the silver plans will get so much attention.

The first is that, along with gold plans, they will be the most widely-available plans.  The second is that the tax subsidies built into Obamacare are based on the projected cost of the second-lowest-cost silver plan.

But not all silver plans will be alike.

One silver plan, for example, may charge a higher premium than another silver plan.  But that plan might cover 75 percent of hospital costs, while the other pays only 70 percent.

Other silver plans might be less expensive than some bronze plans – particularly if they provide less “first dollar” coverage for care – or more expensive than some bold plans.

But while the premium costs of the silver plans may dominate the news and public policy analysis in the coming months, I don’t think that how good you feel about Obamacare is ultimately going to be based on the cost of a silver plan. 

Here’s why.

Deductibles, co-pays, and uncovered health expenses also factor into how satisfied we are with our insurance.

If you believe that being expected to absorb, on average, 30 percent of your health care cost burden when you already have insurance is too big a price to pay, then you will not be happy with a silver plan.  You will either hope you or your employer can afford to pay extra for a gold or platinum plan if one is available, or you will complain as much as you do today about your lousy coverage.

And you will dream again of government-sponsored health care for all.

Conversely, if you think that Obamacare goes too far in requiring insurers to cover at least 60 percent of the health care costs of the people they insure, then you may decline to participate in the system at all and pay the small fine.

And you will join Eric Cantor in the march to health policy irrelevancy by asking the U.S House to repeal Obamacare for a 40^th time.

Paul Gionfriddo via email: gionfriddopaul@gmail.com.  Twitter: @pgionfriddo.  Facebook: www.facebook.com/paul.gionfriddo.  LinkedIn:  www.linkedin.com/in/paulgionfriddo/

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Six Reasons Why Health Reform Won't Be Repealed

Now that the election is over, those who voted for change because they wanted health reform repealed had better prepare for disappointment.  Here are six reasons why it’s not going to happen, no matter what campaigning politicians may have said.

First, no politician is going to vote to reopen the Medicare donut hole again.  The one millionth $250 rebate check was mailed out in August, and the 2 million plus who will eventually get them are not about to give them back. 

The donut hole will start closing in earnest in 2011, and the scores of people in every Congressional district who will benefit from lower out-of-pocket drug costs will remind members of Congress that they’re paying attention and they vote.  No newly elected member of Congress is going to risk offending these voters right from the start.

Second, people don’t want insurance companies to be able to deny them coverage all over again for their pre-existing conditions when it took so long to win this battle legislatively. 

A huge percentage of Americans now has at least one chronic condition.  The one in three who has hypertension, the one in ten who has diabetes, the one in ten who has cardiovascular disease, the one in seventeen who has a serious mental illness, and the one in thirty who has cancer simply don’t trust their insurance companies to insure them without a government mandate.  It matters to them that reform gave them the right to coverage, and they will not be happy if their newly-elected representatives take it away again.

Third, people don’t want insurance companies to be able to cancel their coverage when they get sick or reach annual or lifetime caps.  They hate it when insurance companies cancel their homeowners insurance after they file a couple of claims.  How do you think they feel when it’s their health and well-being at stake?  Does anyone really think politicians will wear pink and then vote against breast cancer patients?

Fourth, parents want their kids to be able to stay on their policies while they’re in their early and mid-20s.

Young people just starting out in entry level jobs with limited benefits can’t afford to buy health insurance on their own, and small employers also often can’t afford to provide it.  Allowing young adults to stay on parents’ policies benefits both young people and small businesses.  Politicians may be willing to risk a vote against one of these constituencies, but not both. 

Fifth, early retirees worry a lot about health insurance, and absent the opportunity to buy into Medicare love the provision that allows them to stay on their employers’ plans after they take their retirement.  The average retirement age in the United States is now 62, and many Americans have five to ten years between retirement and the start of their Medicare benefits. 

Think these people don’t need their health insurance?  Think again.  Almost 3,000 employers applied to the government to offer reimbursed coverage to retirees as of the beginning of October, including large and small private employers, state and local governments, educational institutions, and nonprofits.  Will members of Congress take on all these groups at once?

Sixth, people know premiums are already too high, and they’re not going to vote for someone who assures that they will go even higher.  Remember, the savings associated with health reform were front-loaded. 

Repealing popular provisions of health reform will load significant costs onto health care in the short term, while reaping few benefits.  Think it was tough running for re-election after voting for health reform in 2010? Imagine running for re-election in 2012 after taking away its benefits as health care costs and premiums rise out of control again for two more years.

People’s desire for decent, affordable health care didn’t disappear with this year’s elections.  In fact, it’s just the opposite.  If anything, they still think health care costs too much, and they expect more from their government, not less.  Public officials who don’t care won’t last long in public office. 

So what might happen, as public officials scramble to figure out what to do next while under pressure from the right and the left to fix reform?  I would guess that the so-called “individual mandate,” which assesses a higher income tax starting in 2014 on people who don’t buy insurance, will stand in as a surrogate for health reform, and some members of Congress will make a serious effort to target that one provision for repeal. 

Since this will affect no one between now and the 2012 election, it will be a safe debate for the new Congress to have, and give the appearance of doing something while accomplishing nothing and offending no one.  Winning or losing won’t really matter, so it’ll be a perfect issue for an otherwise deadlocked Congress.

Source : http://pgionfriddo.blogspot.com/

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How Eric Cantor is Missing It

Discussing health reform over the weekend, House Republican leader Eric Cantor told the New York Times that “it is my intention to begin repealing it piece by piece, blocking funding for its implementation and blocking the issuance of the regulations necessary to implement it.”

Congressman Cantor’s Problem

To which “it” does Congressman Cantor refer?  The “it” creating a new long term care insurance program so that elders will be able to fund nursing or home care as they age?  Or the “it” creating a new catastrophic care insurance plan so that healthy young people will be able to afford some insurance coverage as they age out of their parents’ plans?  Perhaps it’s the “it” that provides new grants to community health centers, or the “it” providing new training for primary care physicians to recognize and treat chronic conditions, or the “it” creating thousands of needed new jobs in the health care workforce. 

Congressman Cantor’s problem is that there isn’t an “it” to be repealed piece by piece. 

He seems to confuse the health legislation itself with its substantive parts, as if it were like one giant private corporation that could be cut up into its constituent parts and sold off piece by piece until nothing remained.  The substantive components of the health reform bill, however, are more like dozens of small businesses, each independent of the other and every one of them providing a product that meets a consumer demand.

Consider the real implications of Mr. Cantor’s position:

·         Is he proposing to block the regulations that will reduce costs to the Medicare program over the next ten years, thereby raising the cost of federal government?  That’s hardly fiscal conservatism; it sounds like wasteful spending to me.

·         Or is he proposing to block the funding that will reimburse state governments for new costs to their Medicaid programs, thereby pushing a new unfunded mandate onto the states? 

·         Or does he hope to delay implementation of the provisions of the legislation that will add 30 million people to the insurance rolls, and replace these provisions with the proposal he backed that would insure only a small fraction of them?

Insured Consumers Pay for the Uninsured 

It’s most likely delay Mr. Cantor has in mind, but while it might be good politics to argue for “piece by piece” repeal as he had done, or “repeal and replace,” like his colleague, Rep. Paul Ryan, our health policy matters to us more than just as taxpayers or health care consumers.  This is because everyone’s cost of care is connected to everyone else’s.  None of us sits on a health care island. 

One of the biggest hidden prices we pay each year is the portion of our health insurance premium that pays for people who have no insurance.  Since someone has to pay for the care we all receive, it stands to reason that the smaller the number of people who are insured, the higher the costs will be for those of us who are – unless, of course, the government were to pay more than its fair share of health care costs.  But it doesn’t. 

Historically, Medicare has paid less for the same health care than private insurers do, Medicaid has paid even less than Medicare, and uninsured “self-pays” pay the least.  Who makes up the difference?  We do, to the tune of over $1,000 per year in excess premium costs on our insurance.

Protecting Deadbeats?

Governing by sound bite may strike a chord in the short term, but the fact is that when the guy next store who can afford health insurance decides not to buy it, those of us who do have it are the ones paying to help cover him. 

Remember this when you hear people talking about getting rid of the mandate, or covering fewer people.  The bottom line is that they care more about the deadbeat than they do about you.  And to add insult to injury, the deadbeat probably doesn’t even vote, either.

So “it” isn’t as simple as Mr. Cantor’s chorus and Mr. Ryan’s refrain. 

We need more than this from our new Congressional leaders.  We need them to remember that health care policy in this country has evolved considerably over the last hundred years, that we provide and pay for health care in a uniquely American way, and that what’s best in our system – the quality of our care – has come about because of partnerships between the public and private sectors, and not in spite of them.  There’s plenty of room for improvement, but only if they make a real effort.      

 Will they be up to the task?

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A look at Sauna Services Products

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Fit For Life: A Healthy life-style - begin Walking

More than five hundredth of all Americans area unit overweight or weighty. These area unit conditions that contribute to the risks of chronic health conditions. These conditions embody high pressure, polygenic disease and coronary heart condition. America's increasing lack of physical activity has helped create this downside a weighty issue.

There is excellent news. you'll begin to try and do one thing to place physical activity into your day. It will begin with one thing as straightforward as a walk round the block.

If you're probing for the gold normal of exercises walking is it. It uses nearly two hundred muscles, it is safe, cheap and it's a fun activity that almost anyone will do.

The benefits of walking include:

* Helps you change state and keep the load off

* will increase your energy state

* it's an excellent time to be with a companion or to be alone - your alternative

* scale back your level of stress

* will increase your cardio fitness

* permits you to keep up your current weight

* Reduces your risk of developing serious health issues

* permits you the chance to attain a additional quiet sleep

* Tones your muscles

* causes you to feel great!

Tips to urge Started

Going from doing nothing to beginning a walking regime will feel overwhelming. It doesn't have to be compelled to be thus if you begin with some straightforward techniques. whereas they will seem basic bear in mind that the majority of us merely don't participate in any of the subsequent suggestions.

When safe and on the market use the steps versus the elevator or escalator. Walking and support climb, an amazing combination.

Take a walk throughout your lunch hour.

Make your dog happy - take Fido for a walk. No dog? Walk the neighbors dog. you will each profit.

Don't grab the most effective area within the parking zone, grab the one farthest from the door then walk. A facet advantage of this strategy is a smaller amount door dings as you may possible have many area to park!

Incorporate a walk into a business discussion. contemporary air could inspire contemporary ideas.

March round the area whereas on the phone, or a least pace.

Walk in place whereas you're observance TV.

Eat a healthy dinner so skip the couch. Head out the door for a walk.

Are you a bus or subway commuter? Get off one stop early and walk the remainder of the method.

Great family activity: arrange a hike or physical outside games along with your family.

Walk to refer to colleagues within the workplace versus vocation or email.

So arrange a walking schedule that features 30-60 minutes of movement per day to attain health advantages. Set goals, write those goals down and obtain moving. begin walking slowly with a 3-5 minute tune-up so build speed and distance as you are feeling easier. finish every walking session with a 2-3 minute cool-down of slow walking. This relax permits for your pulse and pressure to step by step come back to traditional. when your walk may be a nice time to try and do some light-weight stretching.

Always confer with your doctor before any new physical activity program.

Get moving America - there is not any higher day to begin than today!

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