If this healthcare bill passes, can costs only go up?

As usual, do you have any cite, besides a mindless “faceless corporations are evil?” Note the low profitabilityof insurance companies.

Forgetting about the insurance companies for a minute: You have a relatively fixed supply of doctors and nurses. You’re about to add millions of people to the demand for their services.

The result will be an increase in the price of health care. Basic supply and demand.

Here’s what I expect will happen: Doctors will start charging more. This will be seen as ‘price gouging’. There will be bills to cap doctor’s salaries. Then you will have a shortage of doctors.

The only way this wouldn’t happen is if the people who will be covered by insurance will not use the system any more than they did when they weren’t covered, or if their increased demand is met by a decrease in demand by others.

As for the penalty for not being insured - isn’t this really just a form of insurance? If an insurance plan for my family costs more than 2.5% of my salary, and I can’t be refused insurance whenever I seek it out, why would I ever buy insurance for more than 2.5% of my salary? I’ll just wait until I get sick, then demand to be insured.

I suspect we’re going to see an amazing number of defaults of the 2.5% penalty - primarily by young people just out of college or the working poor who don’t have insurance now and won’t be able to afford it anyway once it’s ‘mandatory’. So suddenly you’ll be filling the court system with ‘insurance deadbeats’. If you’re a young person with a wife and a child, and you make $25,000 per year, what are the odds that you’re going to be able to cough up $625 at the end of the year for your health care penalty?

The plan is unworkable - which I suspect is a feature in the minds of the Democrats. They see these problems coming, and see it as an opportunity to pass the health care reform they really wanted - single payer or a public option. Next year before the midterms there will probably be a flurry of new health care legislation intended to remedy the flaws in this one - and the only remedy will be a public option.

Note also that insurance stocks went way up after this was approved. That doesn’t jibe with decreased revenues and margins.

Don’t you think a lot of people will be smart enough to consider the possibility where they break their leg resulting in $50,000 in hospital bills? There’s no such thing as retroactive insurance.

Your article says they’re up 120% over almost an entire year, about double the S&P’s gain. It also offers the most logical explanation I can think of:

First of all you have to ask yourself, WHY are people losing insurance, some fall between the cracks and some choose not to get it. In California, according to Fortune magazine, 20% of the people without insuarnce, make over $75,000/year. I know CA is expensive to live, but it shows, people will go without insurance, and buy cable TV or cell phones.

This is not a solid thing I realize, but you can’t issue a blanket statistic and say “people are losing insurance.” The correct statistic must be people who can’t afford health insurance, and lack the ability to buy it. A persona with a cell phone, cable TV, and all sorts of extras can dump that stuff and after they get to a minimum THEN you can see the true statistics.

Second hospitals don’t have to treat you. Only if it’s life threatening. I had a kidney stone in my youth and misfortune to not have insurance, hospitals told me to leave. They said it wasn’t life threatening. It hurt a lot but it did pass.

And if you’ve had a kidney stone you can be in pain a lot of pain, and you’re just out of luck.

The current bills still leave a lot of room for exceptions. Anywhere from 19 - 26 million depending on whom you will believe will be left uninsured. That is a lot. So your problem with treating the uninsured is still there.

Unless you make certain that all people will have basic health care and be able to use it you’re screwed.

The penalty for being not insured is ridiculous 'cause the ones likely not to pay are the ones who you can’t collect from anyway. What are you gonna do put someone in jail for not paying? Oh great then they get free medical courtesy of the penal system :slight_smile:

Finally the fact that these plans won’t be implimented till long after Mr Obama leaves means they are worthless, even if passed. What can be passed today, can be undone tomorrow.

Which is what I understand least in all of this. 2013 is far too far away for the Democrats to get any electoral credit for this, and it makes it far too easy to undo.

If these benefits existed when the Democrats had a solid majority, they’d become part of the system and become impossible to undo, no matter how hard the GOP jerked it to Dead Ol Ron (see: Medicare).

But the way it is now? I don’t see anything ever coming into actual practice.


Yeah. The centrist Democrats are idiots.

But it won’t be undone. It’ll be just as hard to undo as it is to do, and there’s a lot more political will going for the bill than there will be going against it.

Anyway, the experience of Massachusetts suggests that costs may go down, but it’s not entirely foursquare. Mass. did two parts of what the current bill is doing in two steps – first they made it impossible to discriminate, then they introduced the mandate. When they did the first, costs went up, when they did the second, they started going back down. As noted above and on other threads, the mandate makes the young invincibles get coverage; they’re cheap to insure, so they broaden the risk pool and will tend to lower prices. (Because as noted, the insurance companies compete aggressively on price, as it happens; it’s just transparent to the average person.) And of course, when some percentage of that population gets cancer, or hit by a bus, they’ll be awfully happy to have insurance, instead of going into bankruptcy, or maybe just dying from their lack of insurance.

Anyway, as noted there are a lot of cost controlling measures in the bills – I think I heard like 2/3ds of the language is on that, although I may be wrong.

Also, Sam Stone’s fear about supply and demand is a temporary problem at worst, because if demand is really that high, more people will go to medical school, and more medical schools will be opened. It’ll take a few years, but the same predictions of supply droughts were raised when Medicare and Medicaid were proposed, and they didn’t particularly materialize except somewhat in the short term.


Last I heard, the costs are going to show up before any benefits. As such, what you’ll get are a lot of Reagan worshippers screaming about nanny states and crippling gumming taxes…and there will be nothing concrete to point to as to what the money is going for.

Which will make it a hell of a lot easier to kill. Keep in mind the number of supposedly enlightened Dopers who subscribe to the “It’s my dollar and I don’t care if it’d save someone’s life, it’s MINE” philosophy.


As much as republicans would wish it people without health insurance don’t simply sit at home and die. Everyone is already getting cared for in one way or another, maybe now people will go to the doctor and get fixed for a few hundred bucks rather than end up in an emergency room and defaulting on tens of thousands.

Damn that is ignorant. Insurance companies have lots of ways to hide their profits, every corporation does. They ship the profits to stockholders, they give huge bonuses and salaries and spend every dime making themselves rich. Then when they say they are just barely making ends meet and need more money, they know the people will buy it.

I am not one of those people. On the contrary, I’m saying the government is the one engaging in anticompetitive behaviour here, by denying individuals the right to not enter a contract. It’s like a mugger pretending that their offering you a fair deal by letting you pick between getting robbed or getting beaten up instead of respecting your right to pick neither and come out no better or worse than you started.

Assume that the actual value of the service you receive is $6,500. At the current time, you are buying $6,500 of value for $6,000, giving you a net gain of $500.

Now with the implementation of this fine, with no other changes, you are receiving $7,400 worth of value: $6,500 worth of coverage and $900 of not getting ripped off by the government. Rather than letting you receive the full $1,400 net gain, the insurer can take some of it for themselves, raising their price to $6,800. You now get a net benefit of $600 for buying their product, which would be fine if not for the fact that $900 of that benefit consists solely of not getting fined by the government.

While it is not guaranteed that they will take advantage of this, I do not like the chances of your insurer seeing their product suddenly become $900 more valuable and choosing to still sell it at the same price.

What? :confused: Why on earth would you assume any of those things? Does any of the above analysis make any sense to anyone who might be willing to explain it?

If I buy a DVD $15 should I assume I’m getting $100,015 in value by virtue of the fact that I’m not being fined for pirating it? If so, that would explain why every movie I buy costs $50,015.

No, because in this situation you have three choices: buy the DVD for $15, pirate the DVD and be fined $100,000, or don’t get the DVD at all. If the DVD was being sold for $50,015, you wouldn’t decide “Hey, it’s better than being fined $100,000!” and hand over the money, you’d simply realise that gaining the DVD and losing $50,015 is worse than not gaining the DVD and not losing $50,015.

If, on the other hand, the government started fining anyone who didn’t own a copy of the DVD, then everything changes. You are no longer choosing between:
[li]Buy the DVD, lose $50,015;[/li][li]Pirate the DVD, lose $100,000;[/li][li]Don’t get the DVD, lose nothing.[/li][/ul]
Now you have to choose between:
[li]Buy the DVD, lose $50,015;[/li][li]Pirate the DVD, lose $100,000;[/li][li]Don’t get the DVD, lose $49,990.[/li][/ul]

Can you back up that claim? The only way I know of shipping profits to shareholders is as dividends. Dividends are paid from after-tax profits, so any profit numbers you see for insurance companies (e.g. the 2.2% quoted) is before any dividends. I looked up a few insurance companies (Aetna, United, Humana) and their dividends are about 0.1%, which makes them extremely low dividend payers.

Then how come companies in other industries aren’t using the same tricks to hide their profits? For example, there has been lots of people complaining about high drug prices, so why aren’t the pharmaceutical companies using those tricks to post a 1.9% profit (rather than the 19.3% they actually made) to take some heat off of themselves?

Aw, c’mon. Only companies in industries that have “Big” in front of their names are capable of this kind of maneuver. "Big Oil, Big healthcare, etc. Big Pharma had the “Big” removed from their industry when they decided to support the healthcare “reform” bill.

You’ve missed the whole point. We pay now for benefits later so that it appears that this bill is deficit neutral the first decade. Also, Obama will be reelected before the inevitable cost increases, rationing, etc. start hitting home. Dems get credit for passing healthcare “reform” but don’t have to pay the political price for quite some time. Ingenious if you ask me.

We get credit for passing reform that only adds cost until after the next election. How is that a good thing?

Not only that, but they’ll use the taxes collected next year to pay for general fund activities, making the the deficit look better than it is.

2010 is the year when the Democrats will suddenly become fiscal conservatives. You watch - they’ll start complaining about the size of the deficit and about all the things they’re going to do to balance the budget. Cap and Trade will be sold as a deficit-killing program, and Republicans who oppose it will be portrayed as fiscally irresponsible debt lovers. Some of the Bush tax cuts expire in 2010, which the Democrats will use to show that the deficit is coming down without tax increases. Cap and Trade won’t be portrayed as a tax increase, either.

Then they’ll turn their attention towards budget-neutral regulatory reform after that - Employee Free Choice Act, new business regulations, etc. The message of next year will be that Democrats are fiscally responsible, will slash the deficit, and will ‘reform’ business to look out for the middle class. Hell, it might even work, in a propaganda sense.

The reality is that next year will probably bring two very large tax increases and some major restrictions on the business sector. But they’ll pass in the latter half of the year, just before the mid-term elections, so they can make the budget numbers look much better and before their crippling effect on the economy can be seen. Then Obama will have another two years to work out of the resulting mess before the next Presidential election.