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View Diary: HCR Part II:  Where Do We Go From Here, Sweet Child 'O Mine? (53 comments)

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  •  Well (1+ / 0-)
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    Don't you think if someone had a $5,000 deductible, they might think twice about having their baby delivered at a teaching hospital rather than a non-teaching hospital, which would be much, much cheaper?  On the other hand, I do agree with your point that a family that faces a $5,000 deductible is much, much less likely to take their teenage daughter to the shrink when all she does all day is lies in bed, doesn't go to class, etc.  [Let alone whether a $5,000 deductible policy is a good idea for a waitress with a diabetic child.]  In other words, with high cost-sharing policies, people cut out both the good and the bad.

    While there is significant savings from providers in order to rein in health care costs, it isn't significant.  If you have no premiums or cost-sharing, everyone is going to race for health care services, and people are going to have to wait a year just to have their hip replaced, etc.  That's not something I believe this country is ready to tolerate, although we somehow tolerate how difficult it is to get a doctor when our child is vomiting a 8:00 p.m.  If eliminate premiums and cost-sharing, then we have to have utilization limits, as UCLA health economist Tom Rice (my father oversaw his dissertation), a single-payer enthusiast, advocates.  I don't know how ready this country is for that.

    •  There are some junky policies (1+ / 0-)
      Recommended by:
      jim bow

      sold on the Connector.

      •  Absolutely (0+ / 0-)

        With the minimum actuarial value of the Bronze Tier set at 56%, there are going to be some junky policies on the Connector.  Even worse, the "young invincible" (YI) policies have annual maximum coverage limits at $50,000.  If you're left quadriplegic after a skiing accident, and have a YI policy, then you're totally, totally @$#$%#.

        Thankfully, my plan sets the minimum actuarial value at the plans on the Connector's Gold Tier (0.93 AV).  It's going to be really rough on young people, but I don't know how else to care for those with chronic conditions who hit the out-of-pocket cap every single year.

    •  My opinion is that a deductible (0+ / 0-)

      of more than about 50% of your readily available funds is too much.

      I also think that unlimited coverage is overstressed at the expense of good quality initial coverage.

      A few million dollars was spent on a Florida woman who had a worthless mass of cells for a brain.

      We could have saved 1,000 people their $3,000 deductibles instead.

      •  Your example, I believe, ... (0+ / 0-)

        ... is more a matter of comparative effectiveness research.  I'm not going to tell someone with Crohn's disease that we can't afford to let them live because they cost too much money to take care of.  But I will say that we're not going to pay $100,000 to extend your life another six weeks when we've got a long line of diabetic children who would have a much longer future than you have.

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