Clinton says (text and video at that second link):
"I think it’s important for you to tell the people why we’re doing all this outreach, because this only works, for example, if young people show up and even if they buy the cheapest plan, they claim their tax credit so it won’t cost them much — 100 bucks a month or so. We’ve got to have them in the pools, because otherwise these projected low costs cannot be held if older people with preexisting conditions are disproportionately represented in any given state. You’ve got to have everybody lined up..."Now, I might suspect him of slyly undercutting Obama's grand plan. He's almost coming out and warning young people that the old are exploiting you, you should take alarm, and you can free yourself from this plot by saying no, I'm not jumping into that pool, I'm not lining up for my own destruction.
But Obama is sitting right there next to him. They're side-by-side in 2 big, upholstered Clinton Global Initiative armchairs. Obama restates Clinton's point:
"What happens is, if you don’t have pools that are a cross-section of society, then people who are already sick or more likely to get sick, they’ll all rush out and buy insurance. People who are healthy, they say, ‘You know what, I won’t bother.’ And you get what’s called adverse selection."You can get snookered in a comfy chair.
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65 comments:
Sadly, young people have been snookered for 3 years now. It is amazing to me that most young people didn't realize that the entirety of the ACA depends on a huge wealth transfer from the young to the old, in the form of insurance subsidy.
This is the story of modern liberalism, over and over and over. These supposedly brilliant people can't seem to understand that their intentions do not control the results of their actions. We'll just raise the minimum wage to make sure everybody has a good-paying job. What could go wrong? We'll just count on young people who don't need health insurance buying it. What could go wrong? We'll just remove as much incentive for hard work as we can. What could go wrong?
What baffles me in all of this is why they don't simply raise the amount of "tax" (thanks again Justice Roberts) they charge people without insurance, so that it *is* cost-prohibitive not to participate. You might say they'd have to go through Congress, but that hasn't been the Obama administration's position on anything else.
Proof of the snookering is the obvious false claim "it won’t cost them much — 100 bucks a month". What young person things $100/month isn't much?
"What happens is, if you don’t have pools that are a cross-section of society, then people who are already sick or more likely to get sick, they’ll all rush out and buy insurance. People who are healthy, they say, ‘You know what, I won’t bother.’ And you get what’s called adverse selection."
And everyone who was paying attention knew this is what would happen. Obama treated all of the uninsured as one monolithic block with the same interest in "access" to health care through insurance, when reality is much different. There are at least two main divisions of the uninsured -- the voluntarily uninsured and the involuntarily uninsured.
The involuntarily uninsured will flock to the exchanges because they will take more than they pay in premiums. It is in their financial self-interest to jump into the pool.
The voluntarily unisured are that way by choice and see the current system as bad for them. There is not enough coercion in Obamacare to force these people into what is STILL a bad deal for them. It is not in their interest (economic or otherwise) to jump into the pool filled with old, fat, sick people.
And that eventually screws the old and sick who need the young and healthy to subsidize the cost of their care. So they jump in and need others to jump in, too.
Obama's about to get a lesson in human nature and the collective result of what happens when individuals act in their own self interest. The major insurers know this and that's why most are staying away from the exchanges to the extent possible.
It'll eventually be hooked to their student loans or debt. Speaking of rhetorical trades, how about we provide the free world's defense since we have the infrastructure, and they provide our healthcare?
Unless we opt out of course.
I pick the Sweden and Canada HMO.
From top to bottom, beginning to end, ObamaCare is predicated on businesses and individuals acting irrationally against their own interests. And when (surprise) that does not work, they are fully prepared with 16,000 new IRS agents and many other elements of coercion.
If they really believed government health care was superior -- instead of just another means to exert control -- they'd have made Medicare, Indian Health Services, and the VA health system such shining examples of success, efficiency, and compassion that people would be clamoring to be included under those programs.
Instead, the have to force seniors into Medicare by threatening loss of Social Security benefits if they "choose" not to sign up at age 65.
It's not selfishness that will doom Obamacare. It's laziness. Young people have better things to do than find a doctor.
If Obama really wanted to save the exchanges he'd cut off kids at age 12. That would move a whole lot of healthy teenagers into the market and their terrified parents would pay.
Actually, insurance does not require a cross-section.
If a plan is set up so that any group receives more benefits than they pay, they'll sign up. If a plan is set up so any group pays more than they receive in benefits, they'll attempt to stay out.
In other words, the only economically viable plans that don't require force charge each identifiable group pretty much what said group receives in benefits. And that doesn't require a cross-section.
It does, however, require that you charge sick and old people more and that you don't charge young healthy people very much.
Unless, of course, said young people have money yet lack the ability to compare two amounts of money.
Good luck figuring out what these guys actually believe.
"You've got to get everybody lined up" Somehow, no matter the context of that statement, it doesn't sound good.
Perhaps the bigger flaw here will be failure to get insurance companies to price their insurance on the assumption that lots of young people will buy their product.
How many insurers are going to price their insurance aggressively, knowing that the losses will be ruinous if not enough young people buy in?
I'd guess the answer is, few to none. With the result that prices for this so-called "affordable care" are producing a huge sticker shock.
(Yes, I know, the apparent remedy for this is the lack of income verification for the gov't subsidies- just encourage mass cheating.)
Obama is so f-ing stupid. I wonder how many times he had to have adverse selection explained to him?
Obamacare is not only a wealth transfer from young to old, it's a transfer from men to women. Women as a group live longer than men so they pay lower life insurance premiums. Young women as a group have fewer accidents than young men so they pay lower auto insurance premiums. Women as a group consume more health care services but it's illegal to charge them higher health insurance premiums. Why the difference? As a result, men have to pay higher health insurance premiums to artifically lower women's premiums.
Welfare. People were relieved of their responsibility to charitable causes.
Social Security. Medicare. Children were relieved of responsibility to their parents.
Abortion. Parents were relieved of their responsibility to humanity.
There is an observable pattern of corruption.
Obamacare. Government obfuscates inflation in order to continue fleecing the People. It conflates contributory and non-contributory entitlements and thereby sponsors corruption.
BarrySanders20 said most of what I wanted to say, and said it better. For some strange reason, the young, healthy, and relatively poor uninsured aren't terribly keen after all to step up to be piggy banks for the older, sicker, but usually wealthier people whose insurance needs shoring up. Who'd've guessed?
"Let's make you pay three times more than your accurate actuarial risk suggest, because there are other people who could really use the money. Like your mother. You wouldn't want to disappoint your mother, now, would you?"
The thing is, the young people aren't buying it, because they know insurance systems that take risks and benefits into account. Most of them drive, for one thing, so they're familiar with rates that differ by age, sex, type of car, ZIP code, driving record, &c. Higher risk, bigger premium. But that's because car insurance is insurance, not a transfer-payment program in disguise.
Bryant Likes said...
Proof of the snookering is the obvious false claim "it won’t cost them much — 100 bucks a month". What young person things $100/month isn't much?
9/25/13, 12:01 PM
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No kidding. And he's saying that's after their tax credit, which you get at the end of the year.
As a reminder, Obama was making about $250,000/year during the time to which he used to refer in his speeches about his financial struggles. The ones he used to sell Obamacare.
I think both men are setting up an excuse in case Obamacare fails.
Blame the GOP for scaring young people.
OK, I don't know much about Obamacare since I am on Medicare. This idea the "old" people will cost more is what confuses me. I thought that almost all (except those on Medicaid) have Medicare and will not be on Obamacare. I do believe that our supplemental plans cost will rise considerably though.
Remember, as has oft' been pointed out (including, I believe, here at Althouse): Obamacare wasn't designed to succeed!
It is a) a foot in the door to nationalization of healthcare on the reasonable assumption that once we go down this path we won't go back and b) designed to fail so that government will "fix" it by moving on to single-payer or some other fully nationalized scheme.
All is going according to plan.
I think Obamacare is based on the idea that it will not work as it is. After this has been proved, we can get a single payer system like Canada.
What this idea ignores, is that Canada's system only works because people in Canada who really need care can come to the US to get it (and pay for it, of course).
I have read that already, clinics in San Diego are moving to Mexico.
Meaning that Mexico is becoming the new US as far as medical care is concerned.
I think a lot of what's hoped for is that young people, after the transition's happened, won't have any idea what health insurance would cost if it were actuarially priced, so they won't know that they're being overcharged to subsidize the old and sick. They'll just think -- "wow, health insurance costs more than my student loan payments!" There's also a pitch to emphasize the "net" price (in today's Tribune -- a young person earning $20,000 is the example, to show the impact of subsidies).
Yes, women use 187% of the healthcare men do because of perinatal care, hysteria and hypochondria.
Furthermore, it's mostly men who climb Everest, sail around the world or backpack through South America, where neither Obamacare nor Medicare is available, although the men are still liable for paying premiums or penalties as long as they have residency in the USSA.
And once again, it is men who get the worst of the deal. Specifically, young men between 18-35, who are least likely to participate in even employer-funded health insurance, and who are by far the least consumers of health care. Without them in the insured pool, the cost of coverage to the insurance companies goes through the roof. And the dems knew this fatal weakness to their plan, and bulldozed it through anyway.
A lightbulb goes off in JAC's head - I hope he is a leading indicator for his generation.
Women consume more medical services, mainly, because they live longer. Women are old and sick for longer than men are old and sick.
Yes, women use 187% of the healthcare men do because of perinatal care, hysteria and hypochondria.
If it's true (and not even to that degree), that women use disproportionately more healthcare, then they should in fact pay more. This is akin to young men paying more than car insurance.
Of course women, out of selfishness, would never admit to this inequality and will fight tooth and nail to keep the inequality in place.
The National Health Service of the United Kingdom was established in 1948 and today - 65 years later - fighting over the NHS still takes up half of the time on "Prime Minister's Questions" every Wednesday when Parliament is in session.
It is not working all that well.
Obviously, parents will have to twist their kids arms to sign up, and will have every generational incentive to do so.
By letting kids stay on their parent's policy until age 26, that carries them through the danger years of dropping out in their rebellious early twenties.
Then the birth control dangle to keeps the young women interested.
It is ingenious, if it works. It has worked here in Massachusetts, so it could work.
And if it doesn't work, there is always single payer. So Republicans who don't want single payer have every incentive to help make it work, even if they won't admit that publicly.
RE: $100 is a LOT to a young person..
NO SHIT - that was my first thought when I read that. I lived paycheck to paycheck for YEARS after college - $100 is a hefty slice of your income when you are starting out. Guess Bill has been hitting the bong in his post-presidential years; that's the only rational explanation I can come up with for that asinine statement.
> I thought that almost all [old people] (except those on Medicaid) have Medicare and will not be on Obamacare.
Obamacare was funded with a lot of money taken from Medicare. (And that number was double-counted to produce a phantom savings due to Obamacare, but I digress.)
Oh, and there's the up-coming expiration of the "doc fix", which is the only thing keeping a lot of MDs in the system. Yup, the "savings" from its expiry was counted as savings as well.
If Medicare doesn't get a lot of additional money from somewhere, Medicare premiums will go up and/or the benefits will go down.
The medicare tax on capital gains will provide some, but this year is likely to be the most lucrative as I can't be the only person figuring out how to adjust.
FWIW, this tax is yet another way that Obamacare financially penalizes marriage.
ken in sc said...
I think Obamacare is based on the idea that it will not work as it is. After this has been proved, we can get a single payer system like Canada.
I keep hearing it but it makes no sense. Let me see if I have it right - "Our last program didn't work so that's why you should let us develop an even bigger program." If they keep failing, why should they get to keep progressing? I call this "failing forward."
Doug said...
And once again, it is men who get the worst of the deal. Specifically, young men between 18-35, who are least likely to participate in even employer-funded health insurance, and who are by far the least consumers of health care.
Except for accidents, most young men are very low consumers of health care. When I was that age, I doubt if I averaged going to any doctor once a year. I just didn't need it and my case was pretty common among the men I knew.
El Pollo Raylan said...
Yes, women use 187% of the healthcare men do because of perinatal care, hysteria and hypochondria.
If it's true (and not even to that degree), that women use disproportionately more healthcare, then they should in fact pay more. This is akin to young men paying more than car insurance.
I know that charging women more for health insurance is illegal in Colorado. IIRC, Obamacare makes it illegal everywhere. Men will have to pay more than necessary so women can pay less. Somehow, that's considered "fairness."
ObamaCare is predicated on businesses and individuals acting irrationally against their own interests.
How is not having insurance rational in any sense. Even if you are a 25 year old who is invincible, it is ridiculous to forgo medical insurance. Do you have any idea how much routine surgery is, including those that are likely to be needed by young people. When I tore my ACL skiing in 1997, the surgery was over $30,000, I bet it has more than doubled since then. Heck, a trip to the emergency room for stitches is going to set you back $1000 plus.
While we're at it, there's this article with links to an online calculator that shows the marriage tax aspects of Obamacare. Many couples will be better off getting divorced and shacking up than staying married.
Via Insty:
MEET OBAMACARE’S WEDDING TAX: “Better off divorced and shacking up.”
buwaya,
Women consume more medical services, mainly, because they live longer. Women are old and sick for longer than men are old and sick.
Well, there's that, and there's perinatal care. And it's probably a good idea not to skimp on funding the latter too much. Pyramid schemes like Social Security and Medicare really don't work without a steady stream of new customers at the base.
As for "women are old and sick for longer" ... not so sure that's the case. Old, definitely; sick, not so much. Why do you think women live longer in the first place? A really serious illness is as apt to kill an old woman as it is to kill an old man. Women are, mysteriously, less likely to get fatal illnesses in old age.
I was struck by the difference in their speaking styles.
Clinton uses grammatically correct, complete sentences: We’ve got to have them in the pools, because otherwise these projected low costs cannot be held if older people with preexisting conditions are disproportionately represented in any given state.
Clinton seems to form his thoughts and then speak. Read his sentence and you'll see that it's all there. Start to finish, his sentence includes complete thoughts and details. Disagree with him or not, his sentence holds together.
Obama talks in childish fits and starts: People who are healthy, they say, ‘You know what, I won’t bother.’ And you get what’s called adverse selection.
Obama dives in, stops to clarify (People who are healthy, they say...), uses imaginary dialog to fill in (You know what, I won't bother), and finishes with an sentence that starts with "and," as if he cannot pull his conclusion into a sensible form. Anyone who thinks he knows what "adverse selection" means is not really listening. They need to go back and listen to him try to explain auto insurance.
I like neither of these men as politicians but Clinton could speak and make sense.
And about getting snookered, you have this guy, you know which one, people say he's smart. People who read his book, they say "You know what? I bought it." And then he was elected twice.
Since the whole thing is legal because Justice Roberts considered it a tax, we should name it the Youth Tax.
Obama snookered...again.
Meanwhile, Mr Obama is one happy camper. The more chaos, the merrier. His message: Think twice before you launch your next fleet of slave ships.
(talk about 'water on the brain')
Ah yes, why am not surprised? So blame women because they have a biological imperative to bear children. Seriously the misogyny displayed by male commenters continues to spin out of control. And yet they don't want to be called whiners.
100 bucks a month for a young, healthy person?
That's about what Kaiser cost, last time I looked, for that demographic.
And they weren't running out to buy private coverage, either. (Reasonably rationally, as young, healthy people are the ones who least need health insurance!)
But that plainly can't be relevant, since it's actual revealed preference from market data...
Ha ha ha ha! He thinks "100 bucks or so" isn't a lot of money!
Bill and Bobo have been extraordinarily successful at getting people to trade votes for Valuable Stuff Free (TM). It remains to be seen how successful they will be at getting people to trade Actual Real Money for nothing.
Oh my, let them pay for it because they voted him in. Hillary had a better and well thought out plan as part of her campaign but of course, there was no hope and change there for the idiots. Let them suffer.
And why would BC wholeheartedly endorse this train wreck when he knew his wife had a better plan? And this other guy, he explains to us adverse selection.. yeah we know, we anticipated it, but you didn't -- what are YOU going to do about it?
Inga whines: Seriously the misogyny displayed by male commenters continues to spin out of control.
I predicated my point on simple actuarial fact. I even hinted that jimbino's number may be inflated. But if you think it's true that women consume exactly the same healthcare hours as men than say so and undo the reasoning that way.
Oh and more and more women are opting out of children or delaying motherhood until later and later thus driving up the costs enormously.
They've been SNOOKERED! BAMBOOZLED!!! RUN AMUCK!!!!!
I recall data that showed Medicare costs for chronic conditions was overall > End of Life costs - which were enormous over @ the last 6 months of life, but not the bulk of total Medicare.
Its all the old age steady state maintenance costs that are blowing costs up. And the older the more costly. I think the sex ratio for 80+ olds is something like 7F:4M
For the past 100 years, Democrats and other so-called progressive politicians have relied upon young, naive, low-information people to get them elected, and to uncritically support their big spending/taxation/deficit/program policies. It appears that at least one young person possessing critical thinking skills is starting to question this big con. Many other youngsters should, since they will be paying for it for the rest of their lives.
Some data -
LYOL (Last Year of Life) Medicare costs are about 25% of the total. The bulk is "maintenance".
http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/2004GenderandAgeTables.pdf
I could only find 2004 numbers for total medical spend (not just Medicare), but these should be proportional - Per capita annual costs for 65+ Men 13,809, Women 15,493 Total spent on 65+ Men $203B Women $323B
Inga said
Ah yes, why am not surprised? So blame women because they have a biological imperative to bear children. Seriously the misogyny displayed by male commenters continues to spin out of control. And yet they don't want to be called whiners.
I guess in Inga's world, misogyny is pointing out a fact that women don't like. If it's fair and reasonable that women can't be charged more for health insurance than men, why isn't it also reasonable for men to pay the same car and life insurance rates as women? If "whinnying" is pointing out inequities, then women are the biggest whinners of the past 50 years. If you're interested in equitable treatment for all, then why not stop the petty "heads I win, tails you lose" childish misandry and discuss how we can change things for the better. Otherwise, you're just another sexist bigot.
Inga trots out misogyny... Yes, and I suppose actuarial tables are "cold and unfeeling." Sheesh.
Cluster f**k. Ted Cruz and the House Republicans tried to save us from a monumental cluster f**k.
I don't get those who believe obamacare was planned to fail so the democrats could get single payer system. After this massive f*ck up, who in their right mind will let democrat's even talk about healthcare reform for another generation?
You'll have to go single payer because how do you go back to the free market when you've kicked people with preexisting conditions off of their insurance?
"Oh, sorry. You had insurance, but we took it away to try something out. Didn't work. whoops! Now you'll have to reapply."
My husband and I were on different insurance plans. We've both been booted.
An unfortunate side effect of Obamacare is likely to be to discourage healthy young people, particularly males, from buying health insurance.
When I was a young man (I turned 21 in 1964), my father encouraged me to buy what was essentially major medical insurance -- it was cheap, but it would protect me if something really bad happened. But for routine medical expenses, plan to pay for them yourself, he said.
Obamacare is taking that option away from young people; they either have to buy expensive insurance or none at all.
Roughcoat said...
"Ha ha ha ha! He thinks "100 bucks or so" isn't [much] money!"
It depends upon what the meaning of the word "much" is.
A couple of points-
A young person participating but having low income and subject to a high subsidy, doesn't help the math in balancing the death spiral risk. They need the high income young that are not covered by employer insurance is where they need the participation.
As to Andy Freeman's comment on old people, it is the age 55-64 old group that technically benefits from the rule where the highest rate cannot be more than three times the lowest rate. The Medicare age (65) has not changed, at least yet.
All of the rates suffer from the bloat of mandated coverage for chemical dependency and mental health issues, besides the costs built-in for wellness coverage and doctor visit co-pays that are not usually part of a major medical or catastrophic coverage plan.
If 100 a month is a lot to these 'young people' then coveredca won't hurt them much because they will be proportionally subsidized under 40k. Ppl under 15k get rolled into medi-cal and won't be subsidized if they want to buy a plan...they'd have to pay full price.
And all you male prolifers ...remember you are subsidizing a baby with prenatal, not just the woman carrying the new little taxpayer. It's really the little tyke who is picking your pocket. Feel better now? Sorry, but reproducing the race has more value to society and takes precedence over your high risk, high insurance premium, DUI GoPro adventure years. Just ask Russia.
Inga exhibits all that's wrong with muddle-headed libtard "thinking." Which doesn't consist of thinking at all but consists instead of "feeling" her way to a desired conclusion and fixing the evidence she's exposed to to that conclusion.
Liberals do this all the time. It's their stock in trade. That's why these fools are so data averse. The liberal cannot bear to know that men routinely pay higher insurance premiums than women for life and auto, and so formulates arguments as if this wasn't true. Furthermore, Inga cannot bear to know that women actually have higher lifetime health expenditures, on average. Merely pointing out what actuaries have known for generations is evidence of 'misogyny.'
Bringing facts to a liberal's attention is like spraying Holy Water on a vampire.
It's worse than that, though, because these doddering, drooling fools do so much damage. Obamacare's trillion dollar - plus failure is the direct result of these arrogant, simpering, incompetent idiots thinking they can FEEL their way through an actuarial table, disregarding the fundamental principles of risk transfer and retention and the reality of adverse selection.
Kids who are basically paying a mortgage with student loan debt and who have no real job prospects thanks to Obama...yah, they have $100 a month to blow.
I wish we could limit the pain only to kids who voted for the fraud.
gk1 said...
I don't get those who believe obamacare was planned to fail so the democrats could get single payer system. After this massive f*ck up, who in their right mind will let democrat's even talk about healthcare reform for another generation?
Approximately 51% of America.
>How is not having insurance rational in any sense.
When said insurance costs far more than the expected value.
The arithmetic matters. If your expect costs are $1000/year, it's absurd to pay $10k.
Yes, expected costs include catastrophes that cost far more.
And, insurance really shouldn't cover maintenance. You don't have State Farm pay for your oil changes, so why should health insurance cover checkups?
As usual the government makes the mistake of insisting that one size does fit all. My sister chose insurance where she would pay more out of pocket. She paid for the well-baby appointments and birth control because she could afford to. Now her premiums have skyrocketed, but isn't she lucky the well baby appt's and birth control is included in her premiums for "free"?
I don't know how this is going to affect our tri-care. I've read speculation that military retirees will be kicked onto the exchanges.
Andy Freeman said...
>How is not having insurance rational in any sense.
When said insurance costs far more than the expected value.
The arithmetic matters. If your expect costs are $1000/year, it's absurd to pay $10k.
Yes, expected costs include catastrophes that cost far more.
And, insurance really shouldn't cover maintenance. You don't have State Farm pay for your oil changes, so why should health insurance cover checkups?
A young man can benefit from a high-deductable hospitalization plan but IIRC ObamaCare makes those illegal. So, he either has to buy more insurance than he needs for a higher price than he can pay, or he can pay the penalty. Since insurance companies can no longer refuse to sell to people with pre-exiting conditions, it probably makes sense to pay the penalty and only buy the insurance when you need it (such as after an accident). It's like buying car insurance after the wreck or home owner's insurance after the house has burnt down. Of course, that's totally stupid but that's ObamaCare for you.
> And, insurance really shouldn't cover maintenance. You don't have State Farm pay for your oil changes, so why should health insurance cover checkups?
It's more than that. You don't have State Farm pay for your gas, so why do you want health insurance to pay for, say, birth control pills? (< $9/month from walmart.)
Birth control is interesting. Health insurance doesn't pay for condoms yet is supposed to pay for pills. I forget whether it pays for diaphragms but it doesn't pay for the spermicide (and the latter is no longer eligible for flex-spending since it's non-prescription).
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