Healthcare Questions

[AENeuman]

Every year I take on the Sisyphean task of doing a healthcare unit in my econ class. I could use some clarifying help:

1. It seems about half of working adults and their families get health care from an employer. So, all this healthcare talk, other than the keeping kids on until 26, is not really about this group?

2. It seems another 1/3 is covered for being poor, child, disabled, veteran, and/or old?

3. The big question: is all this healthcare reform and talk really about this relatively small working poor and private/individual business owners?

4. Finally, wouldn't incentivizing preventive care be a free market approach? For example, I know I get physically sick watching the dodgers play, shouldn't I be held accountable for participating in such a lewd act?

[Logan]

Unfortunately it's not that simple where you can strip out groups. Pick an insurance company...what they will need to charge me and/or my employer for my family plan will depend very much on what they charge the "poor/uninsured", who they are required to accept, what will be covered, etc.

[cartman]

Originally Posted by AENeuman

4. Finally, wouldn't incentivizing preventive care be a free market approach? For example, I know I get physically sick watching the dodgers play, shouldn't I be held accountable for participating in such a lewd act?

We are helping one of our clients on a project that touches on this. They have signed some contracts with employer health care groups to help patients with diabetes (either Type 1 or Type 2). They are given cellular connected glucose meters and are supplied the test strips at no charge to the patient.

We receive the readings as they are done, and we have a monitoring program called a Clinical Decision Support System. There are a set of parameters that if the reading falls outside of certain ranges, actions are taken. Like if a single glucose reading is really high or really low, a call center is alerted and a nurse tries to reach the patient. Or if there is a trend detected of readings being out of the norm X times in 7 days, then a diabetes coach calls them.

With this data, we know how many times per day people are testing, and if it is on a frequency prescribed by their doctors. The idea is that people who are managing their diabetes well should have fewer and/or lower insurance claims than people who are not managing their diabetes.

[Butter]

Originally Posted by AENeuman

4. Finally, wouldn't incentivizing preventive care be a free market approach? For example, I know I get physically sick watching the dodgers play, shouldn't I be held accountable for participating in such a lewd act?

Some health plans do cover "preventive" visits at 100% with no co-pay required, or no deductible requirements.

So that is already at work in a lot of insurance.

[Radii]

Originally Posted by AENeuman

1. It seems about half of working adults and their families get health care from an employer. So, all this healthcare talk, other than the keeping kids on until 26, is not really about this group?

While not the primary focus, Obamacare did mandate that employers with 50 full time employees or more must offer insurance coverage. Full time defined as 30 or more hours a week. There were stories about companies cutting hours to keep people under 30 to avoid this mandate when all of this was first happening. I believe there are/were tax breaks intended to encourage small businesses to cover their employees. I don't know any details there, but it may be a thing worth looking up along the way.

Obamacare also created the definition of a "qualifying plan" and mandated a minimum level of services provided for insurance. I *think* that impacted employer sponsored plans as well.

2. It seems another 1/3 is covered for being poor, child, disabled, veteran, and/or old?

Be careful with "old". 65+ is just different b/c Medicare. I would consider veteran insurance more akin to employer sponsored than obamacare related.

http://www.gallup.com/poll/190484/un...ear-trend.aspx

So in Q1 of 2016 31.2% of Americans had insurance that they paid for themselves or that was Medicaid sponsored. So I think your intent in saying 1/3 here is correct.

3. The big question: is all this healthcare reform and talk really about this relatively small working poor and private/individual business owners?

I find it impossible to answer this question without a political bent coming into it immediately. The issue is with the phrase "relatively small"

We can avoid some politics by ignoring the individual mandate and its impact on young americans. The gallup study I linked above shows that at the end of 2013 18% of americans age 35-64 were uninsured. Q1 2016 that number was 10.7%.

To me neither of those numbers feels small. But that's immediately a politically charged answer. Those are the numbers, make of them what you will.

4. Finally, wouldn't incentivizing preventive care be a free market approach?

Education about health and preventative care in this country is horrible. Our entire system is to deal with things once they've happened with fuck all done for anything else.

For example, I know I get physically sick watching the dodgers play, shouldn't I be held accountable for participating in such a lewd act?

Kodos started a thread about personal responsibility awhile back. It did not end well. Personally, I'm ok with cigarette taxes and soda taxes. Most of that discussion and the one I expect to start from this statement end up in weird places so I'll stop there too and aim for factual information.

Maybe I'll hop back in later depending on where this goes