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I was paying around $1200/month last year (a little under that with subsidy).
This year I'm paying $2100/month for a family of five, on a roughly equivalent plan. Except, none of the options in my state allow me to visit the PCP I switched to this year (since none of the plans last year covered my PCP from the year before).
So I guess I'm on a primary care physician merry go round :D
I am at least able to have my main specialty doctor and the drug I take to keep me in remission from Crohn's disease, and my kids' pediatrician is covered.
But I can't imagine what people have to sacrifice to keep any kind of coverage (with high deductible and horrible coinsurance and prescription drug coverage) for their families if they don't have a decent income :(
> But I can't imagine what people have to sacrifice to keep any kind of coverage (with high deductible and horrible coinsurance and prescription drug coverage) for their families if they don't have a decent income :(
These increases are specifically a lapse in subsidies for high earners -- those with a "decent income." People under 400% of Federal Poverty Level still qualify for the subsidies. And it's a relatively recent policy change to roll back; we didn't have this subsidy from 2010-2020.
I'm so, so sorry to hear this. Can you share which state you're in?
You go without coverage of course. Unfortunately.
(It's getting late, Jeff. I'm heading to bed myself.)
I take Remicade for UC on a monthly cadence. From $500 to now $1300/m for 2 in TX, and an added bonus of a 10% lab coPay + All kinds of fees.
I am Blessed running a good startup but I've always felt this deeply.... "But I can't imagine what people have to sacrifice to keep any kind of coverage (with high deductible and horrible coinsurance and prescription drug coverage) for their families if they don't have a decent income :("
my premium actually went down because my carrier left aca, but there are no longer any carriers with a decent network in the exchange.
the networks in the illinois aca suck if you live in the chicago area.
> This year I'm paying $2100/month for a family of five,
blink
Top cover in Australia for a family is about USD$400 per month.
Excuse me, but how in the world were you able to afford 1200/month, you know that's like cheap rent right?
You're still allowed to visit the same PCP although it might not be covered, or covered out-of-network with a higher patient responsibility.
>Allen is herself a casualty. While she used to pay $487.50 a month, her new healthcare plan, with reduced coverage, has monthly premiums of $1,967.50.
Brutal.
Meanwhile the White House calls it all "fake news".
> Meanwhile the White House calls it all "fake news".
The truth is a lie and only government lies are the truth. Orwell would be so proud.
Guy from Poland here. What happened to ObamaCare? I thought you got finally a primary healthcare for all?
It's always cost ~$2k a month, the only difference is the previous administration thought everyone else should be "temporarily" paying for her plan.
I feel like we need a perpetual PSA here that moving money from person A to person B obviously doesn't make anything cheaper.
Mine has tripled, but last year, I was actually getting some govt help. Not this year. I am fortunate to be able to afford it, but it’s just less than my mortgage.
This month is when all hell breaks loose, because people will get their first invoice at the new rate. They already know how much, but seeing it in the form of a demand, will drive it home.
Obamacare is like the NHS, in the UK. Everyone likes to bitch about it, but woe unto the politician that messes with it.
The equally insidious thing is that when they get hit with the new premium anyone who took better coverage, like a silver plan for the ACA, will likely be "forced" to downgrade to a lower (bronze) plan, which means that when they actually get services their costs will further skyrocket (higher deductibles and out of pockets).
Talking about all hell breaking loose... Marjorie Taylor Greene announces her resignation specifically because of rising health care costs (yeah, I'm cynical,there's maybe more to it). Mamdani gets elected on a platform that's essentially "shit costs too much." Maybe folks on both sides are starting to wake up. A guy can dream...
Isn’t obamacare what caused all these problems in the first place? NHS is public. Obamacare was just a blank check to private companies
One thing that I’ve been trying to understand about this discourse:
Is the sum of the increase in costs some people are now paying greater than the subsidies that previously existed?
In other words: was there always a massive bill to be paid here, but it was just previously socialized and hidden in the form of taxes/ public debt? Or does the act of subsidizing it actually decrease the total?
Yes to both. High costs were previously partly hidden by subsidies for some consumers purchasing individual or family policies on state ACA exchanges, and now many of them will be forced to pay something closer to the true market price. But just like with college tuition, when the government throws money at a problem that ends up causing costs to explode without permanently improving affordability.
There's a third piece too, which is that insurers are ramping price much faster than inflation. Our (unsubsidized) premiums increased 20% year-over-year, after also increasing faster than the rate of inflation the last few years.
Since premiums never decrease, one can pretty easily plot out that in the next ~decade we will see family premiums larger than the median salary. The economics of all this are going to get very weird in the near future.
Year-over-year increase in GDP in the U.S. right now is almost exclusively “production” output from the healthcare industry, whose profits are stratospheric and rising. So there’s two useful datapoints here: first, the bill must be paid, or U.S. GDP growth year-over-year falters, not because healthcare costs this much; and second, household debt continues to increase year-over-year to permit continued wage stagnation. Whether insurers end up lowering their profits (and thus prices) as the subsidy expires centers around whether banks extend further debt as a household wages subsidy. As of right now, that seems to be continuing, even though some of that debt market is in the midst of a small crash, so insurers (who have no regulatory limits on profit levels) are unlikely to lower their profit targets as subsidies end.
So long as the political will of U.S. leadership supports that continued profit, and either government and/or banks subsidize worker wages to cover the increased profits, then we’ll continue seeing growth in costs on paper before subsidies. This growth in profits/prices could not be sustained on wages alone, given the continuing decline of inflation-adjusted worker earnings; and so to answer your question, yes: the act of subsidizing is what’s enabling the prices being charged; but, no: the costs of providing healthcare to any one person of a given age are not increasing due to subsidies; just the profits.
The subsidies are going down, but the base price of the plans are going way up. The plan I'm on increased from $800/month to $1150/month next year, and that is a modest increase compared to most others I've heard about. I'm switching to a maybe cheaper plan - if I use less healthcare, but if I use too much it will be more expensive due to much higher deductibles.
Insurers haven't really explained why the base prices of plans are going up so much. Perhaps GLP-1 drugs but that doesn't seem like enough (those drugs often aren't covered by ACA plans anyway due to their brand-name status). It could be a delayed effect from all the inflation a couple years ago - health care contracts are negotiated on the order of years, and a bunch could have just been renegotiated to reflect current market prices.
Yes, sort of.
ACA insurers are required to pay out N% of their premiums. This means that a really important way of keeping premiums down is to make sure that people who use less medical care are in the insured pool. But if somebody is looking at a $20,000 annual bill in premiums and is generally healthy they might look elsewhere than the ACA markets or just simply go uninsured. That person leaving the insured pool means that everybody else's premiums go up.
The ACA had two strategies to keep these people in the pool: the individual mandate and the subsidies trying to keep prices lower. The mandate was removed years ago. And while we still have subsidies below 400% FPL, the ones for people above 400% FPL are gone. A self-employed person making $75,000 annually who previously could afford insurance might now be looking at alternatives.
Where does all that money go to, though?
Is there a rich caste of doctors or pharmaceutical shareholders that don't need to work and live off these dividends? Or is the system so inefficient that most people in it aren't contributing to actual health care?
If you want to understand where the money is actually going then this Peter Attia Drive podcast episode with Dr. Saum Sutaria is the best high level overview that I've heard. Seriously it's worth listening to and will clear up a lot of the misconceptions that many people have.
Nationalize health care. Doctors should work for the government, hospitals should be owned by the government; for profit health care is a scam.
The root cause of this is, in my opinion, that in 2009 instead of getting the Healthcare system that Obama promised, we got the one that Rahm Emanuel substituted for reasons unknown. I will never forgive Rahm for this sin.
Actually socialized medicine would give us better outcomes for less spending. Instead we have a pork barrel project that has become "too big to fail".
Eventually we'll get Medicare for all, but it'll be hell in the meanwhile.
I have some questions but I don't want to offend anybody. Aren't there any methods to contract the healthcare to lower the prices down? I heard that in UK they have some requirements that the prices must not go higher than... For a given type of service. Also I read a lot of articles that giving a tablet to a hospitalised person costs 20-50 bucks and people are generally running away from ambulances to not pay
I read healthcare now amounts to buying a new car every year. (Except, of course, nothing new in your driveway, nothing to resell, etc.)
It's weird to me that americans, especially educated professional americans, have become much more quiet in their online presence due to all the crisis they are facing- what we have now is pretty different
At what point does it become a better financial decision to do telehealth and medical procedures completely in a different country?
Can you be health insured outside of the country you live?
I'm expecting all of my early social security payment plus a bit of my spouses to pay insurance next year.
This is insane.
Yeah, it sucks living in a society where the people in power have contempt for you and your family, doesn't it.
I find the US healthcare "system" to be an interesting topic. More nuanced than people think. It honestly seems like the worst way to run anything. Like I honestly cant see who its for, other than maybe US Corporations on the list of approved medical vendors. Like, putting on my "Lives in a free(ish) healthcare country" hat, it looks bonkers from that angle. But even from a more libertarian mode, the whole thing looks daft from that angle too.
stopped buying insurance when the co-pays became unaffordable
and you never find a real doctor anymore anyway
We desperately need to vastly increase the number of physicians in this country to decrease costs. The AMA is the most powerful trade union in history and has locked the number of new doctors a year for many years now. Restricting supply for a service with inelastic demand skyrockets prices and lines their pockets.
Private equity should be banned from healthcare.
What could go wrong putting a bunch of finance bros at the wheel of a "Pay this amount or suffer/die" industry?
Unpopular opinion: Evil and greedy insurers are not the biggest problem. The biggest problem is the socialized costs of sugar drinks, junk food, and sedentary life. The food industry operates like a drug cartel who starts the pipeline getting children addicted.
That combined with outrageously expensive magic pill healthcare. A situation partly caused because doctors can't tell patients they are too fat and lazy. Because feelings and hate-crime.
https://pmc.ncbi.nlm.nih.gov/articles/PMC7524435/ (I think their 27% figure is way too conservative)
It's like the worst possible combination of free market capitalism/libertarianism with social liberalism.
It should be mentioned that the US has very high wages, and even when subtracting substantial health care insurance cost, the income likely remains higher than what people earn in most other countries.
In case you are wandering where the money goes. If you need a gall bladder removed or an appendix removed the bill to you might be $10,000-30,000 but the surgeon, for all of their care and time with you, is compensated less than $100.
The root cause:
https://www.researchgate.net/figure/Healthcare-administrator...
"Healthcare administrator's growth in the US. Healthcare administrator's growth by 3200% between 1975 and 2010 compared to 150% Physician growth according to Athena Health analysis of data from Bureau of Labor Statistics, the National Center of Health Statistics, and the United States Census Bureau's Current Population survey in accordance to [26]. Admin: administration; HIPAA: Health Insurance Portability and Accountability Act; HITECH Act: Health Information Technology for Economic and Clinical Health Act; DRGs: diagnosis-related group's."
The only class of medical services that has become more affordable over the last 50 years is cosmetic procedures and laser eye surgery:
https://healthblog.ncpathinktank.org/why-cant-the-market-for...