And the Hits keep on rolling in: Sickness scores surged for UnitedHealth Medicare Advantage patients: WSJ

[somarco]

I mean, I'm good with just being your VP - I'm sure we can hash a plan out.

I actually was not even thinking of the 5k as a deductible.

I was thinking - insurance does not pay on any line item under 5k.

Vance is better looking than you, or me . . .

Nothing wrong with a $5k deductible other than no one will buy it. But letting the providers hash out the billing implies no repricing, and no "coverage".

Insureds see a deductible and think "no coverage". They never factor in the repricing discount which is worth a LOT . . . 50% discount or more.

The HDG $2600 deductible equates to $20k billable charges or so before discount and the 80% (Part B) paid by Medicare.

HDG delivers more value than any other Medigap or MA plan, but again, no one will buy it and agents don't have a workable business model selling HD plans.

Insurance doesn't pay is not the same as a $5k deductible. Insurance doesn't pay = not a covered expense.

 

[annon123]

When cost-sharing increases - if it's quite literally across the board, regardless of age or income - i.e. everywhere, insurance is banned from paying for anything under $5,000 - then (a) providers would be forced to charge reasonable and transparent fees, (b) people (you and me and grandma) would start saving and putting money aside (this behavior change would take time - and yes, this is the hard part), and (c) prices would go down for medical care (it would have to).

UHC / Aetna / Humana / etc would tank in profits but where would that money go.... back to us. Insurance would no longer be $1,750/mo for a family of 5.

The government subsidies would greatly decrease. Who benefits there?

'Merica.

Tax Payers.

Sounds good to me.

The part you forgot is that many seniors would then be unable to afford much in the way of care if they had to pay $5K up front (of course many with MAP's and lots of health problems get hit with at least that amount on the back end with MOOP but at least they can get health care up front and if they use a facility that doesn't sue or cut off care for medical debt in collection then likely they will still be OK). And in the context of your comment, other poorer people too.

Of course if the goal is to kill the poorer elderly to save on Medicare A, subsidies for other parts (B, MAP, D, etc), SS, SNAP, senior hud and Medicaid if they are that broke then this could likely accomplish that end.

Already people who just miss being dual eligible (or if younger Medicaid in a state that expanded that) through 400% of the poverty line already have trouble paying for their medical care if they need much of it. As a result you'd likely cause some of the younger people die younger too.

 

[renee15]

The part you forgot is that many seniors would then be unable to afford much in the way of care if they had to pay $5K up front (of course many with MAP's and lots of health problems get hit with at least that amount on the back end with MOOP but at least they can get health care up front and if they use a facility that doesn't sue or cut off care for medical debt in collection then likely they will still be OK). And in the context of your comment, other poorer people too.

Of course if the goal is to kill the poorer elderly to save on Medicare A, subsidies for other parts (B, MAP, D, etc), SS, SNAP, senior hud and Medicaid if they are that broke then this could likely accomplish that end.

Already people who just miss being dual eligible (or if younger Medicaid in a state that expanded that) through 400% of the poverty line already have trouble paying for their medical care if they need much of it. As a result you'd likely cause some of the younger people die younger too.

I attempted a similar reply last week--- Seniors who get 2K monthly SS benefits, sure as heck can't pay the first 5K in medical costs

 

[annon123]

I attempted a similar reply last week--- Seniors who get 2K monthly SS benefits, sure as heck can't pay the first 5K in medical costs

I think part of the problem is that many people who have never been poorer have no idea what kinds of choices need to made by people in lower socioeconomic groups in order to pay even basic bills. As a result while 5K may not sound undoable to most who make enough for all their needs and a lot of their wants, it is a lot to people who even hesitate to eat at a fast food place once a month due to a tight budget. Also for people who don't yet need to spend a lot on medical bills, they aren't spending that amount yet so it isn't "real" to them yet (similar of the problem of I'm on a MAP, now am hitting my MOOP and now want to change to OM and G as it will cost me less overall with the added problem of a high chance of failing medical underwriting and so can't).