Got my health insurance increase notice today

[BTDretire]

  I got notice today my families health insurance went from $854 to $936 a month.
That's a 9.6% increase. My yearly payment is $11,232.
 I have had a $10,000 deductible for 6 years, the insurance company has not paid for any
of my families expenses. OK, that's not true, since Obamacare, they have bought my daughters birth control,
and paid for a yearly physical, although I think my doc coded that wrong for a few years and I paid for it.
Actually I paid for it either way, those added Obamacare expenses are why my premium increased $438 a month in March 2012 to $936 in 2017.
2012- 19.4% increase
2013- 21% increase
2014- 18.8% increase
2015- 9% increase
2016- 10.2% increase
2017- 9.6% increase

 I'm mad as hell and I'm going to continue to take it, damn it!
             

[VeggieGirl]

I'm with you, mine increased too. Every freaking year it goes up... at least the % increase has gone down.

[Zamboni]

My rate increases are similar (insurance is through my employer). You have my sympathy.

[webguy]

I wish I had your problem. Ours was up about 80% this year for a self-employed family of 3. We had no other option than to pay the increased premiums.

[Lagom]

This is not the ACA, but our terrible healthcare system in general at work here (which the ACA did not do nearly enough to fix). It shouldn't take much research to be convinced you do NOT want Trumpcare to replace it, though, especially if anyone in your family has preexisting conditions (and since you have kids, you will because just having children counts under his plan, it seems). Maybe one day congress will actually do something to address the broader issues but in the meantime this is just business as usual for the insurance industry.

[WhiteTrashCash]

That seems like a lot of money to pay for minimal care. Do you live in a state that expanded Medicaid to reduce costs and actively recruited insurers or do you live in a red state? That plays a big role in the cost of ACA plans. Where I live, ACA plans are relatively inexpensive, especially if you accept a large deductible.

[Ocelot]

This is not the ACA, but our terrible healthcare system in general at work here.

Exactly. No other developed country relies on private, for-profit health insurance as an essential part of the health system - and that's why Americans have some of the most ridiculously expensive healthcare in the world. 

[adjunctprof]

This is my biggest worry as a FIRE topic.  Hard to retire when one major essential cost is so unpredictable.

[beltim]

This is not the ACA, but our terrible healthcare system in general at work here.

Exactly. No other developed country relies on private, for-profit health insurance as an essential part of the health system - and that's why Americans have some of the most ridiculously expensive healthcare in the world.

Well this is straight-up false.  Switzerland runs essentially all of its health care spending through private insurance companies.

[BTDretire]

That seems like a lot of money to pay for minimal care. Do you live in a state that expanded Medicaid to reduce costs and actively recruited insurers or do you live in a red state? That plays a big role in the cost of ACA plans. Where I live, ACA plans are relatively inexpensive, especially if you accept a large deductible.

 
 Not sure if this response is to the original poster (me) but I'll respond.
 

Do you live in a state that expanded Medicaid to reduce costs and actively recruited insurers or do you live in a red state?

Seems as your starting point is, you want more people living off the the backs of hardworking taxpayers.
"let's put two married adults without children on the dole, (medicaid).
   I'm not on an ACA plan, I have a grandfathered plan that I have had for 15 years. It had some forced changes (increases), from ACA regulations. They say one free physical each year, no, it is paid for by increased premiums. I get a free colonoscopy every 5 years, no, it is paid for by increased premiums. Free birth control, no, it is paid for by increased premiums. You get the point.
   I just went to the ACA site and put in my family and AGI, the cheapest plan is $16,975, with a $14,300 Dedectible and OOP.
 The cheapest HSA plan is,$17,479 with a $12,700 Deductible and OOP.
And the best part (from your point of view) is the insurance is so expensive the government is going to force hardworking taxpayers to pay me $15,144 as a subsidy, so I can afford to pay for my ACA plan. Do you have any idea what will happen to the subsidy when 50% of the population is on the ACA.

Where I live, ACA plans are relatively inexpensive, especially if you accept a large deductible.

I'm curious about the cost of an ACA plan comparable to what I can get in my terrible red state vs your
sweet and generous blue state.
  What county of what state do you live in, I'll compare the two states. btw, I'm in Fl.

[Laserjet3051]

This is not the ACA, but our terrible healthcare system in general at work here (which the ACA did not do nearly enough to fix). It shouldn't take much research to be convinced you do NOT want Trumpcare to replace it, though, especially if anyone in your family has preexisting conditions (and since you have kids, you will because just having children counts under his plan, it seems). Maybe one day congress will actually do something to address the broader issues but in the meantime this is just business as usual for the insurance industry.

Patently FALSE!

This is a combination of our "terrible healthcare system," coverage requirements for ACA compliant policies, and a shift in insurance risk pools.  Anyone who has bothered to do a little research will understand the causes are multifactorial.

[Heart of Tin]

Since you're in FI I assume that this is an individual policy. In that case, one of your rating factors is your age and the age of your family members. Your rates go up every year, partially, due to your increased age and increased expected health costs. Here is a table I put together using the 2018 age curve put out by CMS:



If you're 47-58, then age rating increases your portion of the premium by 4 - 5% annually. Similarly, if you have a child that just turned 15, then their portion of the premium increased almost 9%. This doesn't account for all of your premium increases, but it is one factor of premium increases on the individual market that always seems to be forgotten.

[BTDretire]

I appreciate the chart, I thought it would be a gradual increase with age, although I understand the 15 thru 21 yr old large increases. I'm not sure I understand the decrease at 62. The point, yes, I understand rates go up with age.
 My kids are 22 and 25, so they don't account for much of the increase.
 I will add, before the ACA I never had a 9% increase, after the ACA I had 19%, 21% and 18.8% increases.
Now every increase is an increase on that 71% increase. It's not a 9% increase on $1, it's a 9% increase on $1.71+.
 Also until the ACA my insurance company never paid anything, my $10k deductible always covered our expenses. Now the insurance company has to pay for yearly physicals, birth control and a few other ACA induced
coverages.

[Lagom]

This is not the ACA, but our terrible healthcare system in general at work here (which the ACA did not do nearly enough to fix). It shouldn't take much research to be convinced you do NOT want Trumpcare to replace it, though, especially if anyone in your family has preexisting conditions (and since you have kids, you will because just having children counts under his plan, it seems). Maybe one day congress will actually do something to address the broader issues but in the meantime this is just business as usual for the insurance industry.

Patently FALSE!

This is a combination of our "terrible healthcare system," coverage requirements for ACA compliant policies, and a shift in insurance risk pools.  Anyone who has bothered to do a little research will understand the causes are multifactorial.

Huh? I literally said it's not just the ACA but also that the ACA is not close to perfect. So what is patently false? Or is your claim that rising health costs are 100% tied to the ACA?

[Heart of Tin]

The inflection point in the age curve at age 62 is an artifact of the age rating bands put in place by the ACA. Currently insurers cannot charge people in the 64+ age band more than three times the rate for a 21-year-old who is otherwise equivalent (same location, same smoking status, same coverage level, same plan), and there is standardization to rating children under 15. Young adults are, consequently, charged a higher rate than they would be assessed based purely on risk and 62+-year-old people are charge a lower rate. Additionally, the cost of young children is mainly absorbed by the young adult cohort. Here's a graph from a 2013 paper put out by the Society of Actuaries regarding age curves and the impact of 2013 CMS guidelines:



The dotted grey line reflects the CMS age band regulations as they were in 2013 (most substantial change since then is in rating 15- to 20-year-olds with 0- to 14-year-olds). You can see that this line trails off for 62- to 64-year-olds at the far right of the graph.

[ketchup]

Mine went up about 50% for this next year, but some of that is due to changes in how my employer's rates are set (less tied to age than it was before, and being 26 I was overly benefiting before).  Shitty, but not much I can do about it.  It's still a good amount less than I'd be paying without my employer's help.

[Lagom]

Sure, the ACA makes healthcare more affordable for seniors and people with preexisting conditions at a cost of some taxes, and also increased premiums for certain segments of the population. You have to pay for it some way, after all. But that hardly means that the ACA is an unequivocal failure that categorically made healthcare more expensive for everyone, as anyone who has bothered to do a little research would understand. Why do you think congress has had such a hard time coming up with a viable alternative so far? The Republicans control everything, if they knew a magic solution shouldn't it already be in place?

ETA - Anyway, sorry for the derail. Carry on disagreeing with me if any of you do, or we can move further arguments to the ACA thread.

[GU]

Most of what is referred to as "health insurance" in the U.S. would more properly be called "cost insulation". I'm in favor of government-provided catastrophic health insurance (I.e., real insurance).  There should not be any such thing as insurance for routine medical and health expenses—these are not insurable risks, they are costs of living which are pretty predictable.

But "healthcare is a right" and our infantile public can't be expected to have an emergency fund, or even plan for routine expenses, so we have the system we have. (Oh and lots of lobbying from insurance companies and protectionism from the medical profession also contributes)

[Blonde Lawyer]

I'm part of committees that review legislative health care issues.  There are a lot of problems with ACA but the current short term increases are expected.  They just weren't well publicized for obvious reasons.  In the long run, costs are going to go down, way down, likely to below pre ACA rates.  In the short term they are going to go up because insurance companies are allowed to adjust their premiums annually to see a profit (also agreed that this is a problem).

So, the basic philosophy is health insurance costs a lot because health care is expensive.  Health care is expensive because the cost charged to the insured must provide enough of a buffer to provide care to the uninsured too.  Hospitals are required under EMTALA to care for the uninsured in emergencies.  They do not get this money back 99% of the time.  It is a lot cheaper to provide someone preventative heart medication than it is to treat the emergency heart attack.  In the short term, the years where everyone, including the very ill, get insured for the first time, rates will go up, way up.  As health care facilities start having all insured clients, as they are non-profits and can't earn a profit, their rates will go down.  When their rates go down, insurance rates will go down.  It just takes time for this to all go to work.

I get that as a healthy family this doesn't make a lot of sense.  Is this an employer sponsored plan or a marketplace plan? I'm not sure it meets the definition of "affordable" in the ACA unless you have a high income.

[BTDretire]

All this change and only 20 million are covered, 50% of those are not on an ACA policy, but are on Medicaid.
(10 Million)
Another 21% are young adults who got to hang onto their parents policy, Most young adults could have gotten a fairly inexpensive policy without the ACA. (4 million)
 How many are on the ACA because they lost their employer sponsered healthcare?
That has eliminated a large portion of those advertised as being helped by the ACA. Really it's Medicaid!
 Here's an article with lots of detail, but rather difficult to understand.
https://www.americanactionforum.org/insight/20-million/
 I still don't see how many people that had no way to help themselves got covered by the ACA vs those
that got a cheap ride when they could have paid for themselves.

[Lagom]

All this change and only 20 million are covered, 50% of those are not on an ACA policy, but are on Medicaid.
(10 Million)
Another 21% are young adults who got to hang onto their parents policy, Most young adults could have gotten a fairly inexpensive policy without the ACA. (4 million)
 How many are on the ACA because they lost their employer sponsered healthcare?
That has eliminated a large portion of those advertised as being helped by the ACA. Really it's Medicaid!
 Here's an article with lots of detail, but rather difficult to understand.
https://www.americanactionforum.org/insight/20-million/
 I still don't see how many people that had no way to help themselves got covered by the ACA vs those
that got a cheap ride when they could have paid for themselves.

Wow, an article by a political group that's purpose is to "research" and promote "center-right" issues and that strongly supported Trumpcare, thinks the ACA sucks? Well that's all the convincing I needed!

Seriously, though, even that very article notes that the Medicaid expansion was a provision of the ACA so I'm not sure of your point about that. Then they have some lazy reasoning at the end about how "probably" a lot of those medicaid folks would be covered by any new plan (so I guess offering them the expanded coverage in the first place was a good idea, huh? Thanks Obama!), and "many" adults under 26 "likely" had other insurance options but preferred for their parents to pay their premiums (those darn moocher millennials!). It also mentions with no citation of evidence other than it's own articles complaining about the cost of the ACA that "a few million" supposedly lost their employer-sponsored coverage, and (presumably?) could not find a reasonable replacement on the exchange. Then it concludes that "only" 13-14 million (i.e. a fair bit more than "a few million") people would experience a negative impact from an ACA repeal, but of course Trumpcare is going to help those people, right? Besides, those 13-14 million were actually worse off under the ACA anyway because...reasons.

Dude, that article was not hard to understand and it was clearly a biased spin job with no convincing evidence whatsoever that the ACA is a disaster. It's own data admits that many millions benefited from the ACA. And these guys loved Trumpcare, which most other pundits and think-tanks (conservative and liberal alike) agree was a disaster, hence why it hasn't even been up for a vote.

As for your own interpretation of the article, you are spinning their spin! Those 10 million on Medicaid have that coverage because of the ACA. The 4 million young adults you cite was actually 3.8 in the article and all they say is that "some (but not all) of whom are also benefiting from the “under 26” provision," so even if we take them at their word the number is far below 4 million.

I'm sorry you have seen your premiums rise but you need to reread Blonde Lawyer's post and provide insight from more objective research articles providing data-backed conclusions if you want to sound at all convincing.

[RedwoodDreams]

My heavily subsidized employer-sponsored BCBS plan (no ACA in sight) premiums went up 50% this year.

Given our current income (long term disability), an ACA plan would actually be more affordable (cost less) for us, but I can't use an ACA plan unless my employer dumps me or I resign. I'm reluctant to do that while the future of the ACA is so uncertain, so cling to it I shall, and be grateful to have insurance for a pre existing condition and not have to contemplate living in my car to retain health insurance coverage.

[lifeanon269]

It doesn't matter what our medical insurance industry looks like or what policies are in place, if we're a sick nation our costs are going to reflect that. Two thirds of people are overweight/obese, 1 in 3 will have diabetes in their lifetime, and a majority of our top 10 killers are preventable diseases related to diet. PWC did an independent analysis into the leading drivers of our increased insurance costs and found that the main reason is simply because we're using our insurance more and more. It doesn't help that our medical care only treats symptoms instead of the causes of diseases themselves, effectively keeping sick people alive longer. Until we all take control of our own personal health, costs will never go down.

[runewell]

The ACA is definitely a big factor; you can't just allow a flood of insureds with pre-existing exclusions to join the rolls and then be surprised when insurance costs go through the roof.  Insurance without pre-existing conditions really isn't insurance, it's just a social program that we are all going to pay for.

Having worked in the health insurance sector, I would also agree that the system is broken.   There is no competition in the system; health insurers make money by performing procedures and have little incentive to cut costs for fear that they might miss something, so the costs go up. 

Insurance and company subsidies also insulate us from the true cost of the services.  My company is generous and I spend a relatively low amount of $ on health contributions but I know the premiums are expensive.  If I had to pay those myself I would get a drastically different plan.  If people had to pony up the money for every procedure it would be a great awakening in America.

[BTDretire]

Just to add to the fun, I picked up a regular prescription today, the price jumped 50%!
 Luckily the price only went from $10 a month to $15 a month.

[rantk81]

Data-point at my employer, comparing the medical plan (Single, Employee only) when I started working here in 2004, and 2017 (13 years):

Deductible increase 8.75x
Out of pocket max increased 3.125x
Payroll deduction for plan increased 5x
Co-insurance went from 90% to 80%
Separate policy that covered prescriptions separately: eliminated
Annual physical with routine lab-work is now included for free, provided I make a few calls every year after-the-fact to get everyone to re-code the medical visit properly.

[BTDretire]

All this change and only 20 million are covered, 50% of those are not on an ACA policy, but are on Medicaid.
(10 Million)
Another 21% are young adults who got to hang onto their parents policy, Most young adults could have gotten a fairly inexpensive policy without the ACA. (4 million)
 How many are on the ACA because they lost their employer sponsered healthcare?
That has eliminated a large portion of those advertised as being helped by the ACA. Really it's Medicaid!
 Here's an article with lots of detail, but rather difficult to understand.
https://www.americanactionforum.org/insight/20-million/
 I still don't see how many people that had no way to help themselves got covered by the ACA vs those
that got a cheap ride when they could have paid for themselves.

Wow, an article by a political group that's purpose is to "research" and promote "center-right" issues and that strongly supported Trumpcare, thinks the ACA sucks? Well that's all the convincing I needed!

Seriously, though, even that very article notes that the Medicaid expansion was a provision of the ACA so I'm not sure of your point about that.

 The point is, none of the increased premiums go to pay for the 10 million people put on the Medicaid roll.
Now we are left with 10 million with ACA coverage, those 4 million young people that are on their parents policy didn't necessarily need government help to get health insurance.
  That leaves about 6 million people, but then how many of those lost their employer sponsored health insurance because of the ACA?
  Also, I have a non ACA policy, why did my rates have such a dramatic increase. The insurance company didn't
add anyone to the pool, anyone sick (expensive) would have moved to the ACA for the cheaper plan and the subsidy. I should have got my $2,500 reduction, or was that a lie?

[marielle]

Wow...I'm always shocked at how much a family premium is. I'm single so my insurance is about $38 every pay period (two weeks) for health and dental. For a family, it's over $400 which is similar to the prices here.

[radram]

My heavily subsidized employer-sponsored BCBS plan (no ACA in sight) premiums went up 50% this year.

Given our current income (long term disability), an ACA plan would actually be more affordable (cost less) for us, but I can't use an ACA plan unless my employer dumps me or I resign. I'm reluctant to do that while the future of the ACA is so uncertain, so cling to it I shall, and be grateful to have insurance for a pre existing condition and not have to contemplate living in my car to retain health insurance coverage.

Don't think for a minute that the fear you have isn't a planned by-product of killing ACA. Can you believe how close we actually came to not clinging to our jobs for fear of our loved ones dying due to the inability to obtain health insurance. I am glad that is quickly coming to an end. </sarcasm>

[beltim]

It doesn't matter what our medical insurance industry looks like or what policies are in place, if we're a sick nation our costs are going to reflect that. Two thirds of people are overweight/obese,

This is true but misleading.  All-cause mortality is lower for those with a BMI of 30 (solidly in overweight) than a BMI of 20 (exact middle of "healthy"): http://www.bmj.com/content/353/bmj.i2156
Furthermore, there is only a fairly small difference between the US obesity rate (34%) and that of similar countries with much better health systems, like New Zealand (29%), Australia, (29%), the UK (28%), and France (28%).

a majority of our top 10 killers are preventable diseases related to diet.

This is just false.  Which 6 of these are preventable diseases related to diet?
• Heart disease: 614,348
• Cancer: 591,699
• Chronic lower respiratory diseases: 147,101
• Accidents (unintentional injuries): 136,053
• Stroke (cerebrovascular diseases): 133,103
• Alzheimer's disease: 93,541
• Diabetes: 76,488
• Influenza and pneumonia: 55,227
• Nephritis, nephrotic syndrome, and nephrosis: 48,146
• Intentional self-harm (suicide): 42,773

From https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

[lifeanon269]

It doesn't matter what our medical insurance industry looks like or what policies are in place, if we're a sick nation our costs are going to reflect that. Two thirds of people are overweight/obese,

This is true but misleading.  All-cause mortality is lower for those with a BMI of 30 (solidly in overweight) than a BMI of 20 (exact middle of "healthy"): http://www.bmj.com/content/353/bmj.i2156
Furthermore, there is only a fairly small difference between the US obesity rate (34%) and that of similar countries with much better health systems, like New Zealand (29%), Australia, (29%), the UK (28%), and France (28%).

a majority of our top 10 killers are preventable diseases related to diet.

This is just false.  Which 6 of these are preventable diseases related to diet?
• Heart disease: 614,348
• Cancer: 591,699
• Chronic lower respiratory diseases: 147,101
• Accidents (unintentional injuries): 136,053
• Stroke (cerebrovascular diseases): 133,103
• Alzheimer's disease: 93,541
• Diabetes: 76,488
• Influenza and pneumonia: 55,227
• Nephritis, nephrotic syndrome, and nephrosis: 48,146
• Intentional self-harm (suicide): 42,773

From https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

It is well known in medical studies that being overweight is one of the most significant risk factors for health complications and disease. Trying to use BMI to discredit this fact with a study that fails in so many places to properly control for various factors is ridiculous. They didn't even control for age (we generally lose weight in our later years when we're at most risk of passing away).

As far as causes of death:
Heart Disease, Cancer, Stroke (which is really just another form of cardiovascular disease), Alzheimer's/Dementia, and Diabetes are all largely preventable through diet. That is over 1.5 million deaths every year that are largely preventable. That's equal to well over half of the total of the top 10 killers. You could even include respiratory in that category since that is largely preventable by quitting smoking and some studies have even shown improved respiratory function when consuming a healthy diet among those who suffer from chronic respiratory diseases.

[beltim]

It doesn't matter what our medical insurance industry looks like or what policies are in place, if we're a sick nation our costs are going to reflect that. Two thirds of people are overweight/obese,

This is true but misleading.  All-cause mortality is lower for those with a BMI of 30 (solidly in overweight) than a BMI of 20 (exact middle of "healthy"): http://www.bmj.com/content/353/bmj.i2156
Furthermore, there is only a fairly small difference between the US obesity rate (34%) and that of similar countries with much better health systems, like New Zealand (29%), Australia, (29%), the UK (28%), and France (28%).

a majority of our top 10 killers are preventable diseases related to diet.

This is just false.  Which 6 of these are preventable diseases related to diet?
• Heart disease: 614,348
• Cancer: 591,699
• Chronic lower respiratory diseases: 147,101
• Accidents (unintentional injuries): 136,053
• Stroke (cerebrovascular diseases): 133,103
• Alzheimer's disease: 93,541
• Diabetes: 76,488
• Influenza and pneumonia: 55,227
• Nephritis, nephrotic syndrome, and nephrosis: 48,146
• Intentional self-harm (suicide): 42,773

From https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

It is well known in medical studies that being overweight is one of the most significant risk factors for health complications and disease. Trying to use BMI to discredit this fact with a study that fails in so many places to properly control for various factors is ridiculous. They didn't even control for age (we generally lose weight in our later years when we're at most risk of passing away).

A 6% difference in obesity rate does not lead to a 100% difference in health care costs.

As far as causes of death:
Heart Disease, Cancer, Stroke (which is really just another form of cardiovascular disease), Alzheimer's/Dementia, and Diabetes are all largely preventable through diet. That is over 1.5 million deaths every year that are largely preventable. That's equal to well over half of the total of the top 10 killers. You could even include respiratory in that category since that is largely preventable by quitting smoking and some studies have even shown improved respiratory function when consuming a healthy diet among those who suffer from chronic respiratory diseases.

Please stop lying.  At best 35% of Cancer is related to diet (let alone preventable by a change in diet): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2515569/
Alzheimer's is not caused by diet.
Smoking does not count as diet.

[GU]

It doesn't matter what our medical insurance industry looks like or what policies are in place, if we're a sick nation our costs are going to reflect that. Two thirds of people are overweight/obese, 1 in 3 will have diabetes in their lifetime, and a majority of our top 10 killers are preventable diseases related to diet. PWC did an independent analysis into the leading drivers of our increased insurance costs and found that the main reason is simply because we're using our insurance more and more. It doesn't help that our medical care only treats symptoms instead of the causes of diseases themselves, effectively keeping sick people alive longer. Until we all take control of our own personal health, costs will never go down.

Increased use of insurance is certainly related to health (and age). But there is also more use of insurance because there is no incentive to economize or make trade offs. It can be almost impossible to even get a price quote for a lot of services and procedures. With no price mechanism disciplining people, of course they use more, whether it's needed or not. If you're paying, I'll have the filet mignon.

[PDXTabs]

This is my biggest worry as a FIRE topic.  Hard to retire when one major essential cost is so unpredictable.

Yup, when I FIRE it won't be in the USA. It will be in one of the many developed nations that provide affordable health care to all their citizens.

[BTDretire]

Wow...I'm always shocked at how much a family premium is. I'm single so my insurance is about $38 every pay period (two weeks) for health and dental. For a family, it's over $400 which is similar to the prices here.

  I'm shocked to see a family get care for $400 a month, as I recorded above a cheap HSA plan on the ACA is $1,452 month for my family.
  I'll try  a zipcode in Charlotte  NC and see what the difference is.
 WOW!!!
I compared the first 3 policies for Bay County Fl.
to (Merklenburg county) Charlotte NC.
 I used my family of 4-- 62, 57, 25 and 22 yrs old. $68k MAGI.
First thing that shocked me is Merk, county gets a subsidy of $2,756 a month or $33,072 a year,
vs Bay county at $1,266 or $15,192 a year. I thought I did something wrong, so I did it again.
Same answer. So I proceeded to policies.
 First Merk policy is $0/mo to the holder, but $2,704 per month to the taxpayers.
Second policy is $0/mo to the holder but $2,735 per month to the taxpayers.
Third policy is $35/mo to the holder and $2,791 to the taxpayers.

First Bay Co. policy is $148/mo to the holder, but $1,414 per month to the taxpayers.
Second policy is $180/mo to the holder but $1,446 per month to the taxpayers.
Third policy is $190/mo to the holder and $1,456 to the taxpayers.
 Bay county is almost 1/2 the cost of Merklenburg.
I don't know if there is something special about Merklenburg, it was the first zipcode when I searched
Charlotte NC. zipcodes.
 Huge difference.

 Here's the link to compare policies, it's a little difficult to find.
https://www.healthcare.gov/see-plans/
 I used 32405 and 28105 as zipcodes in case you want to check my work.

[marielle]

Wow...I'm always shocked at how much a family premium is. I'm single so my insurance is about $38 every pay period (two weeks) for health and dental. For a family, it's over $400 which is similar to the prices here.

  I'm shocked to see a family get care for $400 a month, as I recorded above a cheap HSA plan on the ACA is $1,452 month for my family.
  I'll try  a zipcode in Charlotte  NC and see what the difference is.

It's not $400-something per month, it's per pay period. Also, this is through my employer which is in South Carolina in a very rural area. A lot people in this area don't have insurance at all until they start work here.

[BTDretire]

Wow...I'm always shocked at how much a family premium is. I'm single so my insurance is about $38 every pay period (two weeks) for health and dental. For a family, it's over $400 which is similar to the prices here.

  I'm shocked to see a family get care for $400 a month, as I recorded above a cheap HSA plan on the ACA is $1,452 month for my family.
  I'll try  a zipcode in Charlotte  NC and see what the difference is.

It's not $400-something per month, it's per pay period. Also, this is through my employer which is in South Carolina in a very rural area. A lot people in this area don't have insurance at all until they start work here.

OK, sorry missed that, every two weeks.
That doesn't relieve the shock that someone with an MAGI of $68,000 (probably income close to $100,000)
would get a $33,000 subsidy from the taxpayers.
 Don't you think that is just a little bit messed up?

[Blonde Lawyer]

My heavily subsidized employer-sponsored BCBS plan (no ACA in sight) premiums went up 50% this year.

Given our current income (long term disability), an ACA plan would actually be more affordable (cost less) for us, but I can't use an ACA plan unless my employer dumps me or I resign. I'm reluctant to do that while the future of the ACA is so uncertain, so cling to it I shall, and be grateful to have insurance for a pre existing condition and not have to contemplate living in my car to retain health insurance coverage.

I don't think your info is accurate.  I think you can get a marketplace plan even if you have an employer available plan.  You just won't qualify for subsidies if your work plan is considered legally affordable.

https://www.healthcare.gov/have-job-based-coverage/options/

[Laserjet3051]

Wow...I'm always shocked at how much a family premium is. I'm single so my insurance is about $38 every pay period (two weeks) for health and dental. For a family, it's over $400 which is similar to the prices here.

  I'm shocked to see a family get care for $400 a month, as I recorded above a cheap HSA plan on the ACA is $1,452 month for my family.
  I'll try  a zipcode in Charlotte  NC and see what the difference is.
 WOW!!!
I compared the first 3 policies for Bay County Fl.
to (Merklenburg county) Charlotte NC.
 I used my family of 4-- 62, 57, 25 and 22 yrs old. $68k MAGI.
First thing that shocked me is Merk, county gets a subsidy of $2,756 a month or $33,072 a year,
vs Bay county at $1,266 or $15,192 a year. I thought I did something wrong, so I did it again.
Same answer. So I proceeded to policies.
 First Merk policy is $0/mo to the holder, but $2,704 per month to the taxpayers.
Second policy is $0/mo to the holder but $2,735 per month to the taxpayers.
Third policy is $35/mo to the holder and $2,791 to the taxpayers.

First Bay Co. policy is $148/mo to the holder, but $1,414 per month to the taxpayers.
Second policy is $180/mo to the holder but $1,446 per month to the taxpayers.
Third policy is $190/mo to the holder and $1,456 to the taxpayers.
 Bay county is almost 1/2 the cost of Merklenburg.
I don't know if there is something special about Merklenburg, it was the first zipcode when I searched
Charlotte NC. zipcodes.
 Huge difference.

 Here's the link to compare policies, it's a little difficult to find.
https://www.healthcare.gov/see-plans/
 I used 32405 and 28105 as zipcodes in case you want to check my work.

If what you report is true, then that is completely insane and unsustainable. Do you have some inclination as to why/how the Merk family policies are unfathomably expensive? Its so hard to believe.

[lifeanon269]

A 6% difference in obesity rate does not lead to a 100% difference in health care costs.

Quote me where I said that. I never said that nor implied it.

Please stop lying.  At best 35% of Cancer is related to diet (let alone preventable by a change in diet): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2515569/
Alzheimer's is not caused by diet.
Smoking does not count as diet.

I'm not lying. I never said that all those 1.5 million cases were preventable. I said that they were largely preventable by diet. That means that a large percentage of those deaths could have been prevented. I don't have the time to debate that with you, so you can choose to believe that or not.

Diet is strongly correlated with Alzheimer's prevention. Furthermore, many cases of Alzheimer's are misdiagnosed dementia cases which is even more preventable through a proper diet.

I never said smoking counted as diet. Read what I said. I said that among those with chronic respiratory diseases, a proper diet can help improve lung functionality...which would thus go a long way toward care for those individuals (reducing medical costs which is what this whole debate was about).

It is hard to debate someone who keeps putting words in my mouth. Look, I'm not going to defend our health insurance industry. There are many things wrong with it. All I am saying that for those looking for cheap health insurance among a population of sick people, policy will only go so far.

[BTDretire]

Wow...I'm always shocked at how much a family premium is. I'm single so my insurance is about $38 every pay period (two weeks) for health and dental. For a family, it's over $400 which is similar to the prices here.

  I'm shocked to see a family get care for $400 a month, as I recorded above a cheap HSA plan on the ACA is $1,452 month for my family.
  I'll try  a zipcode in Charlotte  NC and see what the difference is.
 WOW!!!
I compared the first 3 policies for Bay County Fl.
to (Merklenburg county) Charlotte NC.
 I used my family of 4-- 62, 57, 25 and 22 yrs old. $68k MAGI.
First thing that shocked me is Merk, county gets a subsidy of $2,756 a month or $33,072 a year,
vs Bay county at $1,266 or $15,192 a year. I thought I did something wrong, so I did it again.
Same answer. So I proceeded to policies.
 First Merk policy is $0/mo to the holder, but $2,704 per month to the taxpayers.
Second policy is $0/mo to the holder but $2,735 per month to the taxpayers.
Third policy is $35/mo to the holder and $2,791 to the taxpayers.

First Bay Co. policy is $148/mo to the holder, but $1,414 per month to the taxpayers.
Second policy is $180/mo to the holder but $1,446 per month to the taxpayers.
Third policy is $190/mo to the holder and $1,456 to the taxpayers.
 Bay county is almost 1/2 the cost of Merklenburg.
I don't know if there is something special about Merklenburg, it was the first zipcode when I searched
Charlotte NC. zipcodes.
 Huge difference.

 Here's the link to compare policies, it's a little difficult to find.
https://www.healthcare.gov/see-plans/
 I used 32405 and 28105 as zipcodes in case you want to check my work.

If what you report is true, then that is completely insane and unsustainable. Do you have some inclination as to why/how the Merk family policies are unfathomably expensive? Its so hard to believe.

I posted the info, so you can check it.
https://www.healthcare.gov/see-plans/
 I have been through the website so many times I can put in the info in less than a minute.
 I used my family of 4-- 62, 57, 25 and 22 yrs old. (M, F, F, M)   $68k MAGI.
 I used 32405 and 28105 as zipcodes in case you want to check my work.
I don't know about Merklenburg Co. NC, Just the first zipcode I found on a Charlotte NC zipcode search.
We do have a member from NC, maybe the cam chirp in.

[beltim]

A 6% difference in obesity rate does not lead to a 100% difference in health care costs.

Quote me where I said that. I never said that nor implied it.

You never said that explicitly.  You said:

It doesn't matter what our medical insurance industry looks like or what policies are in place, if we're a sick nation our costs are going to reflect that. Two thirds of people are overweight/obese, 1 in 3 will have diabetes in their lifetime, and a majority of our top 10 killers are preventable diseases related to diet

You are saying the cost difference between the US and other countries is due to our being "a sick nation."  You then listed three factors.  The first I said is true, but misleading, because it's not a significant driver of costs compared to other countries.  The second we didn't discuss, but basically is a repeat of the first.  The third is false, and when I challenged you on the fact, you said various things including that "You could even include respiratory in that category since that is largely preventable by quitting smoking."  The fact that various diseases can have their effects mitigated by a change in diet does NOT mean that they are "preventable diseases related to diet." 

Why do I care?  Because your basic attitude - that "it doesn't matter what our medical insurance industry looks like or what policies are in place" and "Until we all take control of our own personal health, costs will never go down." is wrong, and is often repeated on this forum.  Both of these attitudes are counter productive.  Are there lifestyle changes that could reduce healthcare costs?  Of course.  But that is true in literally every country. In the meantime, we're spending twice as much money as the average peer country on health care.  In other words, it is the health care delivery that makes the difference in costs, not the health of the population.

[Giro]

  In other words, it is the health care delivery that makes the difference in costs, not the health of the population.

It's BOTH.  You can't deny that our nation's diet and lifestyle choices do not affect the cost of health care. 

[beltim]

  In other words, it is the health care delivery that makes the difference in costs, not the health of the population.

It's BOTH.  You can't deny that our nation's diet and lifestyle choices do not affect the cost of health care.

Did you read that whole paragraph?

Are there lifestyle changes that could reduce healthcare costs?  Of course.  But that is true in literally every country. In the meantime, we're spending twice as much money as the average peer country on health care.  In other words, it is the health care delivery that makes the difference in costs, not the health of the population.

The difference in health care costs is talking about compared to other countries actual spending, not compared to a hypothetical minimum.  Diet and lifestyle choices increase costs in other countries too.

[lifeanon269]

You are saying the cost difference between the US and other countries is due to our being "a sick nation."  You then listed three factors.  The first I said is true, but misleading, because it's not a significant driver of costs compared to other countries.  The second we didn't discuss, but basically is a repeat of the first.  The third is false, and when I challenged you on the fact, you said various things including that "You could even include respiratory in that category since that is largely preventable by quitting smoking."  The fact that various diseases can have their effects mitigated by a change in diet does NOT mean that they are "preventable diseases related to diet." 

Why do I care?  Because your basic attitude - that "it doesn't matter what our medical insurance industry looks like or what policies are in place" and "Until we all take control of our own personal health, costs will never go down." is wrong, and is often repeated on this forum.  Both of these attitudes are counter productive.  Are there lifestyle changes that could reduce healthcare costs?  Of course.  But that is true in literally every country. In the meantime, we're spending twice as much money as the average peer country on health care.  In other words, it is the health care delivery that makes the difference in costs, not the health of the population.

Dude, stop putting words in my mouth. You're extrapolating what I said into a whole different realm. You keep going on about how the statistics I made are misleading, but they're only misleading you because you're the only one taking them for something more than what I said. I never ever compared the difference in costs of our health insurance with any other country. I'm not making comparisons between policies in different countries. I was merely stating that you can't have cheap health insurance when such large percentages of the population are sick. Can we have it cheaper than it is today? Absolutely. I was never arguing that improving administrative costs, policies, etc can't decrease the overall costs and burden of healthcare. That's essentially what you're arguing at me about and that is never anything I said or claimed.

You repeatedly put words into my mouth. I originally said:

"It doesn't matter what our medical insurance industry looks like or what policies are in place, if we're a sick nation our costs are going to reflect that."

Then when you "quote" me, you claim I said:

"it doesn't matter what our medical insurance industry looks like or what policies are in place" and "Until we all take control of our own personal health, costs will never go down."


Those are two very different statements and it seems like you're arguing with me about something I never said. I never claimed that we can't make our costs go down from where they are today by removing administrative burden and improving our healthcare policies. I merely stated that you can't have a society that is overwhelmingly sick and at the same time have cheap healthcare. Cheaper than it is today? Sure, but certainly not cheap when it comes to the true sense of the word. Nor would it be cheap relative to what insurance costs are like in other industries where the same society doesn't place the same burden on the insurance providers to provide coverage (car, home, etc). If the health of the customer base wasn't a driver of costs, then you wouldn't have employers putting in place and promoting health programs internally for their employees so that as a company they'd receive a good group rate for their insurance they receive.

Also, let's not forget that poor diet doesn't immediately make its burden on society. A lifetime of poor diet takes a lifetime to develop into a burden on society. The standard American diet came along in America well before other countries adopted many of our same poor dietary choices. Therefore, many other countries are still lagging behind a little bit in experiencing the same health burdens we are seeing today. But, make no mistake, we're not the only country seeing healthcare costs increase as a percentage of GDP. Many other countries are also seeing their costs increase as the same health consequences begin to take effect (UK, Australia, Germany, Switzerland, Canada, etc). Certainly ours is rising at a faster rate, but those countries aren't that far behind.

[Malloy]

 I used my family of 4-- 62, 57, 25 and 22 yrs old. $68k MAGI.

You're 62 and you can get family insurance for around $1000/month?  That's not bad.  I've seen employer-based plans at that rate of employee contribution, although your deductible is high.  I think that pre-ACA, you would have been lucky to find a policy on the individual market at age 62.  You've only got 3 years until Medicare eligibility.  In three years, you'll only have to insure your spouse (age 60), because your kids will have aged off the plan.

[Blonde Lawyer]

  In other words, it is the health care delivery that makes the difference in costs, not the health of the population.

It's BOTH.  You can't deny that our nation's diet and lifestyle choices do not affect the cost of health care.

Then why do the same people that want to gut Obamacare also want to cut the school healthy lunches programs/standards? Their argument is the kids won't eat the healthy food and it is getting thrown out so we should just be able to keep feeding them unhealthy food.

[GetItRight]

Insane, particularly for those of us that just want some affordable maximum cap on expenses (trauma, cancer, etc.) but to pay cash for any typical care. Thank the bleeding heart liberals (Obamacare and regulation) for how expensive health insurance and treatment is, and while you're at it thank the "conservatives" as well (Obamacare and regulation). Only a return to a free market and reduction or elimination of regulation on doctors, healthcare and insurance will bring a return to reasonable market prices. Unless that happens, crony capitalism and government favoritism will ensure insanely high profits for doctors, pharmaceutical companies and insurance companies.

[Heart of Tin]

Wexler is right on. For a family of four, your expected expenses are really high. Two people over sixty alone are very expensive to insure on average. Most employer plans have a flat family rate. If you were on an employer plan your rate would probably be smaller (for similar benefits), because you would be subsidized by smaller or younger families paying at the same group rate.

This is ths main feature of insurance. We pool risk to avoid individual catastrophe and therefore often subject ourselves to higher than average expenses. Currently each member of your family is pooled with others in your area who share their age and smoking status. Your rates are high because you have an old family relative to the population. While health insurance is a weird financial instrument that acts both as insurance and cost reduction, it does still serve that insurance function, and you shouldn't be surprised that insurance for 60+-year-old people is expensive on the individual market where age rating is pretty much guaranteed.

[beltim]

You are saying the cost difference between the US and other countries is due to our being "a sick nation."  You then listed three factors.  The first I said is true, but misleading, because it's not a significant driver of costs compared to other countries.  The second we didn't discuss, but basically is a repeat of the first.  The third is false, and when I challenged you on the fact, you said various things including that "You could even include respiratory in that category since that is largely preventable by quitting smoking."  The fact that various diseases can have their effects mitigated by a change in diet does NOT mean that they are "preventable diseases related to diet." 

Why do I care?  Because your basic attitude - that "it doesn't matter what our medical insurance industry looks like or what policies are in place" and "Until we all take control of our own personal health, costs will never go down." is wrong, and is often repeated on this forum.  Both of these attitudes are counter productive.  Are there lifestyle changes that could reduce healthcare costs?  Of course.  But that is true in literally every country. In the meantime, we're spending twice as much money as the average peer country on health care.  In other words, it is the health care delivery that makes the difference in costs, not the health of the population.

Dude, stop putting words in my mouth. You're extrapolating what I said into a whole different realm. You keep going on about how the statistics I made are misleading, but they're only misleading you because you're the only one taking them for something more than what I said. I never ever compared the difference in costs of our health insurance with any other country. I'm not making comparisons between policies in different countries. I was merely stating that you can't have cheap health insurance when such large percentages of the population are sick. Can we have it cheaper than it is today? Absolutely. I was never arguing that improving administrative costs, policies, etc can't decrease the overall costs and burden of healthcare. That's essentially what you're arguing at me about and that is never anything I said or claimed.

I guess it depends on what you mean by "cheap."  Estimates vary but about 1/3 to 1/2 of health care costs are at all "preventable."  So if we eliminated all "preventable" health care costs, we'd reduce spending by 1/3 to 1/2.  Would that then be cheap?  If not, then health care will never be cheap.

In contrast, if that is cheap (which I assumed you meant because otherwise you'd just say it is impossible to have cheap health care), then we could have the same reduction in costs if we magically, instantly adopted another country's health care system.  So you didn't explicitly compare our costs to the costs of health care in other countries, but I assumed that you are intelligent and your statements rational.

You repeatedly put words into my mouth. I originally said:

"It doesn't matter what our medical insurance industry looks like or what policies are in place, if we're a sick nation our costs are going to reflect that."

Then when you "quote" me, you claim I said:

"it doesn't matter what our medical insurance industry looks like or what policies are in place" and "Until we all take control of our own personal health, costs will never go down."

Those are two very different statements and it seems like you're arguing with me about something I never said. I never claimed that we can't make our costs go down from where they are today by removing administrative burden and improving our healthcare policies.

You did in fact say this.  Here:

It doesn't matter what our medical insurance industry looks like or what policies are in place, if we're a sick nation our costs are going to reflect that. Two thirds of people are overweight/obese, 1 in 3 will have diabetes in their lifetime, and a majority of our top 10 killers are preventable diseases related to diet. PWC did an independent analysis into the leading drivers of our increased insurance costs and found that the main reason is simply because we're using our insurance more and more. It doesn't help that our medical care only treats symptoms instead of the causes of diseases themselves, effectively keeping sick people alive longer. Until we all take control of our own personal health, costs will never go down.

I am not putting words in your mouth when you say

Until we all take control of our own personal health, costs will never go down.

That has a plain meaning and is obviously and factually false.  I have shown this with multiple citations.  Perhaps you were exaggerating.  Perhaps you meant to say "cost will never go down more than $XXX."  Perhaps you intended to say "until we all take control of our own personal health, health care will never be cheap."  But I am responding to what you said.