Babhadfad12 t1_j1uqkz3 wrote on December 27, 2022 at 3:32 PM

Reply to comment by JRZane in Why are NJ doctors, especially those in family medicine all joining for-profit, multi-specialty medical groups? Those groups do are deteriorating the good doctor and patient communication/relationship that use to exist. by Eastcoastpal

> I live in NJ and the same plan from Horizon BCBS costing $700/month for a couple (2500 deductible, $20/$50 copays) costs $1500 in Delaware with Highmark BCBS because of the difference in income-driven costs.

What are income-driven costs? I have not seen differences that big between states.

https://www.kff.org/health-reform/state-indicator/average-marketplace-premiums-by-metal-tier/

> We all know the best way to keep premiums down is to enlarge the pool of customers. One way the insurances ruin that strategy is to hack us into groups (not allowing cross-state plans).

This was not because of “the insurances” by the way, this was upper middle class and pretend upper middle class people that forced this issue. White collar workers that worked for well funded and established businesses balked at their insurance premiums going up to pay for poor and unhealthy people.

People are, unfortunately, very tribal.

JRZane t1_j1uuc8y wrote on December 27, 2022 at 3:58 PM

Most "marketplace" plans take into account income to determine how much insurance plans are subsidized. Each state determines their own scale. In NJ and DE, the scales are significantly inconsistent with one another. These numbers are made up, but just for illustrative purposes, a person making 100k in NJ may qualify for 25% subsidies while that same 100K qualifies for 5% subsidy in DE.

And to your other point about this being class driven, I have no doubt there was that type of mentality in there, sure. BUT it wouldn't have actually happened if it didn't benefit the insurance company. and it wouldn't have been ALLOWED to happen if legislatures had the good of all people in mind.

We have a mentality that in the USA that people who are poor and underserved are deservedly so, and that it is their own fault for being in that position in the first place. I can point to several social perspectives that boil down to that single factor. Its situation vs disposition phenomena at its finest.

Babhadfad12 t1_j1uxn7p wrote on December 27, 2022 at 4:21 PM

> And to your other point about this being class driven, I have no doubt there was that type of mentality in there, sure. BUT it wouldn't have actually happened if it didn't benefit the insurance company. and it wouldn't have been ALLOWED to happen if legislatures had the good of all people in mind.

Possibly, health insurance companies are going to benefit regardless if everyone was required to purchase health insurance. Theoretically, it makes no difference to them if an employer is involved.

I just specifically remember people up in arms about removing employers from the equation and being dumped onto healthcare.gov where the risk pool would have caused them to pay more.

People are still upset at health insurance costing more than pre ACA, even though it covers a lot more (no benefit maximum, no denial due to pre existing condition, no underwriting for one’s specific health risks, etc.).

And of course, the fake religious “insurance” that is not really insurance or complaint with ACA had to be allowed, and that was not due to insurance companies.

KaliGracious t1_j1w1sxd wrote on December 27, 2022 at 8:48 PM

Health insurance is a country is a fucking disaster. Let’s just start at that. It is insane that we cannot get politicians who will come in and fix this disaster. Republicans have absolutely NO solution for this problem and democrats barely know what they are doing.

This is what happens when you have politicians running a county. We need to get money the fuck out of politics.

JRZane t1_j1uwp0e wrote on December 27, 2022 at 4:15 PM

also, regarding the "average" chart, have you seen a chart showing MEDIAN? this is clearly a situation of restricted range with some folks paying very little and some folks paying the higher end. sure the average may be $400, but that doesn't illustrate the difference between person 1 paying $10/month and person 2 paying $800.