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Some commentators despair at the thought that government could ever avoid favoring its own public plan, which implies that the only options are all government or no government. I do not take that pessimistic view
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Some commentators despair at the thought that government could ever avoid favoring its own public plan - which implies that the only options are all government or no government. I do not take that pessimistic view.
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There is a concern that Obama's pledge of affordability will inevitably lead to spending controls. I am interpreting his plan as not implying affordability for the government but rather enough subsidization so that coverage and care are affordable (however that termis defined) for lower-income households.
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There is a concern that Obama's pledge of "affordability" will inevitably lead to spending controls. I am interpreting his plan as not implying affordability for the government but rather enough subsidization so that coverage and care are affordable (however that termis defined) for lower-income households.
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Indeed, if the tax credit is made available for people who would buy any kind of individual insurance, the attractiveness of individually purchased managed care or indemnity plans would be enhanced relative to [spell, CHP/medical savings account (MSA) plans, which currently get an exclusive subsidy. On the other hand, it appears that the consumer can qualify for the credit even if buying a low-premium plan with a high deductible or aggressive managed care. Some critics of the plan point out that the credit is less than half of the premium for a typical comprehensive plan, and they incorrectly infer that people may remain uninsured because they will not pay the other half. However, the credit is a very large fraction of if not equal to the premium for less costly plans. So the net result should be almost everyone with coverage, but the coverage being somewhat limited. This is not ideal, but it is better than having people remain totally uninsured, and probably better than having fewer
-
Indeed, if the tax credit is made available for people who would buy any kind of individual insurance, the attractiveness of individually purchased managed care or indemnity plans would be enhanced relative to [spell] (CHP)/medical savings account (MSA) plans, which currently get an exclusive subsidy. On the other hand, it appears that the consumer can qualify for the credit even if buying a low-premium plan with a high deductible or aggressive managed care. Some critics of the plan point out that the credit is less than half of the premium for a typical comprehensive plan, and they incorrectly infer that people may remain uninsured because they will not pay the other half. However, the credit is a very large fraction of if not equal to the premium for less costly plans. So the net result should be almost everyone with coverage, but the coverage being somewhat limited. This is not ideal, but it is better than having people remain totally uninsured, and probably better than having fewer people with more generous coverage. On the trade-offs here, see M. Pauly and B. Herring, "Expanding Coverage via Tax Credits: Trade-Offs and Outcomes," Health Affairs 20, no. 1 (2001): 9-26.
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From the, 6 December
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From the Massachusetts discussion before the legislative compromise: "The state's principal business associations remain adamantly opposed to the policy prescription [employer mandate] House leaders insist will prove salubrious for many of their members." S. Lehigh, "The Burden of Mandated Health Care," Boston Globe, 6 December 2005.
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From after the compromise: "The current measure imposes a per worker levy of just $295. ...That more modest assessment helped explain why most of the business community is actively backing the bill." P.W. Johnston and N.C. Turnbull, "A Bold Insurance Experiment," Boston Globe, 16 April 2006.
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If we assume that the higher loading (difference between premiums and expected costs) for small-group insurance raises premiums about 10 percent above average, the additional cost borne by small employers would be about $300 for worker-only coverage - the same order of magnitude as the vestigial penalty in Massachusetts for employers who do not arrange coverage.
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If we assume that the higher loading (difference between premiums and expected costs) for small-group insurance raises premiums about 10 percent above average, the additional cost borne by small employers would be about $300 for worker-only coverage - the same order of magnitude as the vestigial penalty in Massachusetts for employers who do not arrange coverage.
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Social concern is presumably strongest for lower-income people who, in a perfectly risk-rated insurance market, would, over time, be subject to reclassification risk: the risk that because of the unexpected onset of a chronic condition, all future premiums will become much above average
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Social concern is presumably strongest for lower-income people who, in a perfectly risk-rated insurance market, would, over time, be subject to "reclassification risk": the risk that because of the unexpected onset of a chronic condition, all future premiums will become much above average.
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M.V. Pauly and R.D. Lieberthal, "How Risky Is Individual Health Insurance?" Health Affairs 27, no. 3 (2008): w242-w249 (published online 6 May 2008; 10.1377/hlthaff.27.3.w242).
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