Schadenfreude: New York's Cultural Elite Loses Their Health Insurance
Many in New York’s professional and cultural elite have long supported President Obama’s health care plan. But now, to their surprise, thousands of writers, opera singers, music teachers, photographers, doctors, lawyers and others are learning that their health insurance plans are being canceled and they may have to pay more to get comparable coverage, if they can find it.
They are part of an unusual informal health insurance system that has developed in New York in which independent practitioners were able to get lower insurance rates through group plans, typically set up by their professional associations or chambers of commerce. That allowed them to avoid the sky-high rates in New York’s individual insurance market, historically among the most expensive in the country....
The predicament is similar to that of millions of Americans who discovered this fall that their existing policies were being canceled because of the Affordable Care Act. Thecrescendo of outrage led to Mr. Obama’s offer to restore their policies, though some states that have their own exchanges, like California and New York, have said they will not do so.
But while those policies, by and large, had been canceled because they did not meet the law’s requirements for minimum coverage, many of the New York policies being canceled meet and often exceed the standards, brokers say. The rationale for disqualifying those policies, said Larry Levitt, a health policy expert at the Kaiser Family Foundation, was to prevent associations from selling insurance to healthy members who are needed to keep the new health exchanges financially viable.
Siphoning those people, Mr. Levitt said, would leave the pool of health exchange customers “smaller and disproportionately sicker,” and would drive up rates.
Alicia Hartinger, a spokeswoman for the Centers for Medicare and Medicaid Services, said independent practitioners “will generally have an equal level of protection in the individual market as they would have if they were buying in the small-group market.” She said the president’s offer to temporarily restore canceled polices applied to association coverage, if states and insurers agreed. New York has no plans to do so.
Donna Frescatore, executive director of New York State of Health, the state insurance exchange, said that on a positive note, about half of those affected would qualify for subsidized insurance under the new health exchange because they had incomes under 400 percent of the poverty level, about $46,000 for an individual.
I still do not understand how anyone could consider it a "positive" that 50% of people who were previously self-reliant now become wards of the state.
Rick Caird:
Well, it depends on whether more wards of state can translate into more votes.
December 13, 2013, 1:53 pmskhpcola:
"I still do not understand how anyone could consider it a "positive" that 50% of people who were previously self-reliant now become wards of the state."
The entire existence of the D-00shbag party and leftist ideology is premised on making every American--and a bunch of illegal immigrants--wards of the state. They see that as a *good* thing.
December 13, 2013, 1:56 pmMatthew Slyfield:
"premised on making every American--and a bunch of illegal immigrants--wards of the state."
Do you really believe that they intend to stop there?
December 13, 2013, 9:22 pmskhpcola:
I'm not certain that I understand what you mean. After we are all dependent, what difference does anything that they do make? They (and by "they," I include the leftist RINOs) might institute a $25/month stipend to cover our living expenses, such as Cuba has done. They could have all of us eating bark and grass to survive. None of that matters, once we cede our liberty and willingly give them the leash to our collar.
December 13, 2013, 9:55 pmRoy:
"to their surprise".... The future direction of the country depends at least in part if not mostly on whether those "surprised" learn from getting burned when they touched the stove.
December 13, 2013, 11:03 pmMatthew Slyfield:
No, I mean they will move on to having us support the rest of the world.
December 14, 2013, 12:09 amJohn O.:
Essentially what they're trying to do is buy votes by offering something with "government money" and making it seem you're getting a better deal than before. Which leads me to this line:
"They'll turn us all into beggars 'cause they're easier to please!" sung in the song titled Government Cheese by the Rainmakers.
December 14, 2013, 12:35 ammesaeconoguy:
Getting millions more people onto government assistance is the goal, along with creating the new mentality that government should be involved in not only subsidizing your healthcare insurance, but also giving you free birth control (yes, including condoms too) and just about anything else they deem “necessary.”
The more people become used to dependence, the easier it is to control them, the health insurance marketplace, and healthcare delivery in general. It is benevolent totalitarianism.
December 14, 2013, 8:24 amskhpcola:
In a way, we largely do that already by providing a military umbrella over a lot of social democracies, which then use the money saved to further create entitlement cultures. Good point!
December 14, 2013, 4:45 pmskhpcola:
You're trying to get FelineCrapburger all exercised about the condom issue again, ain't you? You could have video of Sebelius giving a case of Trojans to Ozero, with an assurance that the ACA will give them to you, too...and FCB would still keen about how it all liiiiiiieeees! Pretty funny, actually.
December 14, 2013, 4:49 pmmesaeconoguy:
The whole thing is preposterous.
She, and everyone else knows that pretty much everything is covered, irrespective of what the directives say at this time.
Hell, we still don’t even know exactly how many people have fully enrolled in this disaster, or how many more will lose their existing coverage (adjusted to comply with initial guidelines, and avoid the Cadillac tax, like mine).
We anticipated most of the economic problems earlier
http://devilish-details.blogspot.com/
but I had no idea the botched rollout would go this piss-poorly.
These are the most incompetent people in the world, and their defenders are sickening, and will be punched in the face, and more.
December 14, 2013, 5:17 pmCapnRusty:
"The rationale for disqualifying those policies . . . was to prevent associations from selling insurance to healthy members who are needed to keep the new health exchanges financially viable."
Quick! Get rewrite in here!
"The rationale for disqualifying those policies . . . was to prevent people who are younger and who take care of themselves and are therefore healthy, who thus pose a lower financial risk to a health insurance company, from organizing on their own and utilizing the free market to obtain health insurance at a lower rate, because the government needs more of their money to subsidize people who will vote to keep the current administration in power."
There. Fixed it for you.
December 15, 2013, 6:53 amEric Hammer:
I was going to comment on that too. This whole thing has nothing to do with "what's best for you", and everything to do with their system getting implemented how they want it, regardless of legislation. An excellent example of lawless government.
December 15, 2013, 8:23 amZachriel:
"The rationale for disqualifying those policies . . . was to prevent associations from selling insurance to healthy members who are needed to keep the new health exchanges financially viable."
Just curious, what do you think should happen to those who are not young and healthy as regards to paying for medical care? When they run out of money, should they do without?
December 15, 2013, 8:35 ammesaeconoguy:
Yes.
Next question.
December 15, 2013, 9:32 ammesaeconoguy:
Let’s try this:
Accepting for the moment that the “old” system was “broken” (it wasn’t), do you believe that replacing that system with Obamascare, which is clearly broken, was a wise choice, or even the only choice?
Do you believe that instead of a few people having insufficient care under the “old” system was inferior to many, many more people now having insufficient and much more expensive care?
Just curious.
December 15, 2013, 11:38 amRick C:
You know that won't stay. They'll dismantle the military to pay for social programs.
December 15, 2013, 5:40 pmobloodyhell:
}}} I still do not understand how anyone could consider it a "positive" that 50% of people who were previously self-reliant now become wards of the state.
I think most liberals would classify that as a major plus.
December 15, 2013, 6:29 pmZachriel:
mesaeconoguy: Accepting for the moment that the “old” system was “broken” (it wasn’t), do you believe that replacing that system with Obamascare, which is clearly broken, was a wise choice, or even the only choice?
It certainly wasn't the only choice, but apparently the only politically viable choice that could move the system towards universal coverage.
mesaeconoguy: Do you believe that instead of a few people having insufficient care under the “old” system was inferior to many, many more people now having insufficient and much more expensive care?
You are assuming your conclusion. Most analysts believe that the new system, once stabilized, will provide quality care, but at lower prices than what would have been available otherwise.
December 16, 2013, 6:13 amZachriel:
Zachriel: When they run out of money, should they do without {medical care}?
mesaeconoguy: Yes.
Well then.
December 16, 2013, 6:15 amMNHawk:
When we run out of doctors, as we only seem to graduate Poli Sci retards who fancy themselves "analysts," should they do without medical care?
December 16, 2013, 8:54 amQuincy:
"Most analysts believe that the new system, once stabilized"
Two things:
1. Cite *which* analysts believe this, please.
December 16, 2013, 9:55 am2. The assumption that the system can stabilize under the ACA is a big gamble. I'd love to see evidence that this will not spin wildly out of control. I haven't yet.
mesaeconoguy:
Your original question is a non sequitur.
No one went without healthcare, as hospitals are required by law to treat people.
The question is, should we have localized, smaller-impact failures, or widespread, more distributed larger failures.
We have opted for the latter, foolishly.
December 16, 2013, 12:12 pmmesaeconoguy:
False.
“Most” analysts say no such thing, rather what is happening right now is less coverage at higher cost.
December 16, 2013, 12:13 pmmesaeconoguy:
Also, you seem to believe universal coverage is good.
At what cost would you deem it unacceptable?
Or is "universal" coverage (which isn't truly universal) a good to be obtained at any price, even if it means more death and higher costs?
December 16, 2013, 1:03 pmZachriel:
mesaeconoguy: you seem to believe universal coverage is good.
Generally, people should have access to health care. You have already stated that if they can't pay, they should do without.
mesaeconoguy: At what cost would you deem it unacceptable?
Systems with universal coverage cost less.
December 16, 2013, 5:03 pmmesaeconoguy:
Generally, people should have access to health care. You have already stated that if they can't pay, they should do without.
Those 2 statements are entirely unrelated. Glad you started drinking early.
Generally, people did have access to health care, prior to Obamascare/UCDA. Now they have less
access, at higher cost. Pretty bad “solution.”
They never had to “do without,” only suffer potential adverse financial consequences.
Systems with universal coverage cost less.
No, they do not.
December 16, 2013, 5:09 pmZachriel:
mesaeconoguy: Those 2 statements are entirely unrelated.
They are indeed related. They express your position and ours.
mesaeconoguy: Generally, people did have access to health care, prior to Obamascare/UCDA.
Many U.S. citizens delayed basic healthcare needs due to financial constraints. Easily treatable diseases left untreated can lead to serious health consequences or death.
mesaeconoguy: No, they do not.
Most of the developed world has universal health care, and pay less per capita for comparable health care results.
December 17, 2013, 4:53 amZachriel:
You could start with the Director of the CBO, Doug Elmendorf, who has said “The slowdown in health care cost growth has been sufficiently broad and persistent to persuade us to make significant downward revisions to our projections of federal health care spending.”
December 17, 2013, 4:56 amZachriel:
mesaeconoguy: No one went without healthcare, as hospitals are required by law to treat people.
One of the laws you would reject. In any case, emergency care isn't sufficient for good health. Hospitals are only required to stabilize patients, not provide the type of care that addresses underlying causes.
December 17, 2013, 4:59 ammesaeconoguy:
Why would I reject that (especially since I used to work in emergency services)?
Further, your leap that preventative care addresses underlying causes – specifically annual checkups – is medically untrue.
Is this the basis for your seizure of 1/6th of the economy? Bad information?
December 17, 2013, 5:57 ammesaeconoguy:
They are indeed related. They express your position and ours.
No they are not related, and as stated before, no one went without care. You are an exceptionally poor reader, like all leftists.
Many U.S. citizens delayed basic healthcare needs due to financial constraints. Easily treatable diseases left untreated can lead to serious health consequences or death.
See above. Preventative care does not achieve what you think it does.
Most of the developed world has universal health care, and pay less per capita for comparable health care results.
The part of the “developed world” which has “universal” coverage may have lower dollar cost, but they have worse outcomes, longer wait times, lack of services etc. Those costs are not factored into your poor analysis.
Your statement is false.
December 17, 2013, 6:02 ammesaeconoguy:
Here’s one that says otherwise:
http://online.wsj.com/news/articles/SB10001424052702304403804579260603531505102
And another:
mercatus.org/expert_commentary/no-grounds-claim-affordable-care-act-lowers-health-care-costs
And another:
http://www.thecollegefix.com/post/15561/
And another:
http://johnhcochrane.blogspot.com/2013/12/chris-demuth-on-obamacare.html
December 17, 2013, 6:06 amQuincy:
In reading behind the quote, it assumes all the cost-containment measures in the ACA will work. The projections change if those cost containment measures fail. That's the real issue here. When (not if) those cost containment measures fail, the ACA will be the cause of another crisis in health care.
All of the so-called cost containment measures do nothing to address increasing utilization of health care without an increasing supply of providers (actually, a narrowing supply of providers). The ACA actually makes the utilization side worse with its plan designs covering more services than before.
Excluding Medicare and Medicaid, the insurance companies are facing an upward cost spiral. While the the individual mandate is supposed to increase the quality of the risk pool, the ACA plan designs increase exposure to that risk pool by a great degree. The premium and deductible increases show that insurers are already struggling to manage that increased exposure.
So, the evidence from the real world is that we're already heading for a cost containment failure. A CBO quote from before any of this occured does nothing to change that.
December 17, 2013, 10:07 amZachriel:
mesaeconoguy: No they are not related, and as stated before, no one went without care.
And as we pointed out previously, people put off care, often with serious health consequences.
mesaeconoguy: The part of the “developed world” which has “universal” coverage may have lower dollar cost, but they have worse outcomes, longer wait times, lack of services etc.
Life expectancies are comparable in most of the developed world.
December 17, 2013, 3:59 pmZachriel:
Quincy: In reading behind the quote, it assumes all the cost-containment measures in the ACA will work.
That is not correct. His statement is explicitly based on results so far. Some of the slowdown is due to the weak economy, but some of the slowdown is due to structural changes occurring in the health care industry.
December 17, 2013, 4:01 pmZachriel:
mesaeconoguy: Why would I reject that (especially since I used to work in emergency services)?
That's what you said.
Z: When they run out of money, should they do without {medical care}?
m: Yes.
mesaeconoguy: Further, your leap that preventative care addresses underlying causes – specifically annual checkups – is medically untrue.
Preventive care means controlling blood pressure in people at risk of heart attacks, rather than waiting for them to need emergency services. It means controlling blood sugar in diabetics, rather than waiting for their circulatory system to collapse.
December 17, 2013, 4:09 pmmesaeconoguy:
That is not what I said. I said patients without money should “do without,” which never happens.
Again, you have a major reading comprehension problem.
Preventive care means controlling blood pressure in people at risk of heart attacks, rather than waiting for them to need emergency services. It means controlling blood sugar in diabetics, rather than waiting for their circulatory system to collapse.
So you believe a centralized system is necessary for that to occur.
December 17, 2013, 4:53 pmmesaeconoguy:
Even if people “put off care,” it was not in the negative magnitude of impact of what we are seeing with both loss of coverage, and increased cost under Obamascare.
There is currently no evidence that this will improve, or stabilize.
Life expectancies are comparable in most of the developed world.
No, they are not, especially for catastrophic diseases like cancer.
For example, you are significantly more likely to die in Britain of cancer than you are here.
https://coyoteblog.com/coyote_blog/2009/08/us-medicine-best-in-the-world.html
And, there’s this little problem –
http://www.telegraph.co.uk/health/healthnews/10099856/Hospitals-need-to-be-closed-to-save-NHS-doctors-warn.html
You are in extreme error.
December 17, 2013, 4:56 pmZachriel:
Zachriel: Life expectancies are comparable in most of the developed world.
mesaeconoguy: No, they are not
Life expectancy by country
December 17, 2013, 6:28 pmhttp://i.huffpost.com/gen/1478324/original.jpg
Zachriel:
mesaeconoguy: That is not what I said. I said patients without money should “do without,” which never happens.
No one is ever out of money when it comes to medical care? You're not making sense here. Certainly some people are destitute and in need of medical services.
mesaeconoguy: So you believe a centralized system is necessary for that to occur.
We didn't claim that. We said that many U.S. citizens delay basic healthcare needs due to financial constraints. Easily treatable diseases left untreated can lead to serious health consequences or death.
December 17, 2013, 6:31 pmmesaeconoguy:
Incorrect, unadjusted for accident & murder rates.
December 17, 2013, 6:32 pmmesaeconoguy:
No one in need of care will ever go without emergency care
http://www.cms.gov/Regulations-and-Guidance/Legislation/EMTALA/index.html?redirect=/emtala
We said that many U.S. citizens delay basic healthcare needs due to financial constraints. Easily treatable diseases left untreated can lead to serious health consequences or death.
And therefore, a large centralized (inherently inefficient and wasteful) universal system will achieve better outcomes, allowing those with chronic illness better access.
You’re really not bright, are you?
December 17, 2013, 6:37 pmQuincy:
"His statement is explicitly based on results so far."
And, in a key quote from the deck: "The evolution of federal spending for health care appears to be more closely linked to the evolution of private spending than the authors suggest."
Consider also the data set upon which the statement was based appears to end in 2011. The ACA plan designs and exchanges hadn't yet been built out. In fact, except for a few key coverage expansions and consumer rights provisions (none of which involve cost containment), the ACA was unimplemented when the data end. So, you're using a quote about a pre-ACA measurement to convince me that the ACA system will stabilize. This is a laughable appeal to authority. Heh.
Back to the matter at hand, can you offer any evidence (not quotes from experts, but actual evidence) that one should reasonably believe that the healthcare system under the ACA will stabilize? Given the load being placed on insurance companies by the law and the inherent limitations of the insurance model for predictable events, I believe stabilization of the healthcare sector is unlikely. The health insurance sector will collapse in a spiral of increasing spending caused by coverage mandates and the law removing the industry's primary tools to manage its risk pools.
December 17, 2013, 9:51 pmZachriel:
mesaeconoguy: Incorrect, unadjusted for accident & murder rates.
The analysis by Ohsfeldt & Schneider was a simplistic regression and they admit it was not meant to be taken quantitatively. Yet the non-study keeps bouncing around the right wing blogosphere.
December 18, 2013, 6:25 amZachriel:
Quincy: And, in a key quote from the deck: "The evolution of federal spending for health care appears to be more closely linked to the evolution of private spending than the authors suggest."
That's exactly the point. The behavior of private participants is bending the curve.
December 18, 2013, 6:33 amZachriel:
There is, indeed, controversy among economists. You provided four citations, two from the Hoover Institute, one from Mercatus, one from AEI. The claim concerns what "most analysts" think. By providing links only from the libertarian right, it implies that the contrary position is only found on the libertarian right.
December 18, 2013, 6:41 amZachriel:
mesaeconoguy: http://www.cms.gov/Regulations-and-Guidance/Legislation/EMTALA/index.html
You said that if people don't have money, they should do without. The Emergency Medical Treatment Act requires emergency treatment regardless of ability to pay. Hence, you reject the purpose of the Emergency Medical Treatment Act.
mesaeconoguy: And therefore, a large centralized (inherently inefficient and wasteful) universal system will achieve better outcomes, allowing those with chronic illness better access.
We didn't say that. However, the Emergency Medical Treatment Act is a direct intrusion into the markets. It means that people without money at least receive emergency care. Unless you modify your statement above, you have expressed opposition to the Emergency Medical Treatment Act, saying that people who don't have money should do without.
Meanwhile, many U.S. citizens delay basic healthcare needs due to financial constraints. Easily treatable diseases left untreated can lead to serious health consequences or death.
December 18, 2013, 6:46 amQuincy:
"The behavior of private participants is bending the curve."
How does a law that was not yet implemented have a damn thing to do with this? Again, the statement is based on a measurement period ending in 2011. For private participants, this was still a pre-ACA environment. This change in private spending is not attributable to the ACA without a belief in magic.
December 18, 2013, 9:10 ammesaeconoguy:
Irrelevant.
Incorrect measure.
December 18, 2013, 4:24 pm