My thoughts, too. I honestly don’t see how we could get the data. Maybe the best we could hope for is some sort of statistical sampling.
That doesn’t really contradict her key points though, that she will lose access to the unique range of medical choices she had under her previous policy.
I should note several things about the article:
-It mentions it is not accounting for subsidies. Sundby’s husband is a former high ranking executive at IBM, they almost certainly will not qualify for any subsidies thus they are irrelevant.
-It does not know anything about what Sundby actually pays for health insurance. Instead it makes a series of assumptions based solely on supposition and no direct knowledge of the specific plan in which the Sundby’s were enrolled or what their premiums were.
-The article itself concedes the plans they mention would only get her coverage at UCSD, and that she would have to spend a large amount of money out of network to get coverage from Stanford and MD Anderson. The only plan UCSD offers is en EPO, which provides no coverage for out-of-network treatment unless it is emergency care. Her current PPO, if it’s a typical PPO, probably has a 60% coinsurance for out-of-network versus an 80% co-insurance for in network. At her rate of spend she probably hits her plan’s maximum out of pocket every year, so those percentages eventually matter less under her PPO.
Under the EPO that UCSD accepts I don’t believe there is ever a cap on her out of pocket maximums if she’s going out of network (there is for in network.)
So as a matter of fact the article demonstrate very little to contradict anything Mrs. Sundby said–who in her own words has spent months with an insurance adviser navigating her options. It only seems to mention that coverage that would deny her much of the care she has been receiving might be cheaper than a hypothetical plan ThinkProgress speculates might be representative of what the Sundby’s currently have. It doesn’t at all contradict what Mrs. Sundby said in her WSJ Op-Ed, that to get the same care she has now she will probably spend 50-60% to find coverage that will at least allow her to go out of network, but that would probably exclude UCSD which only accepts the EPO plan (which has no regular out of network coverage.)
If she still wants to receive treatment at UCSD, Stanford, and MD Anderson there is no plan offered on the insurance exchanges that offers that coverage, so she will spend far more than she spends now.
Unless I am mistaken, mention is clearly made that the Sundby’s have spent their money. Mr. Sundby’s previous state of employment is of no consequence. If that is the case, then those subsidies are indeed relevant, and not subject to off-handed dismissal.
And UHG made the business decision not to offer it - in fact, to exit the California market all together. I used to work for UHG. We blamed a lot of “business decisions” on regulation that weren’t regulation driven at all - they were profit driven. Often, a change in regulation allowed us to have the excuse to drop less profitable policies and plans.
Who said otherwise? Without access to the exchanges UHG made the business decision that they could not profitably operate in the California market. No insurance company can operate at a loss in an entire business market, it makes no sense to do so. But to deny it is related to the PPACA is asinine, the limited size of exchange offerings is a how they are designed to work to keep pools large. But that means less choice for consumers.
You can make the argument less choice is required for social engineering purposes, and whatever ills it causes are still for the best in aggregate–I won’t debate that point one way or another as it is 100% not germane. But it’s impossible to deny Obamacare is reducing choice, even for plans that pay out good coverage (Sundby has received over $1.2m in coverage from UHG.) I don’t see why ACA supporters have problems admitting what is self-evident–the PPACA means less choice.
The President and his staff have all but admitted they knew this, and the only reason they glossed over it is they assumed all the cancelled plans would be replaced by much better exchange plans. Without hard numbers we have no idea what the numbers are. But the White House was banking the Sundby’s and others who lost good coverage would be the small (and politically irrelevant) minority, and that the majority of those who lost coverage wouldn’t care because the exchange coverage would be much better.
Without numbers we have no idea whether or not that is true. But we certainly know some people have lost good coverage and have to replace it with inferior exchange coverage given their unique circumstances. Which is not a surprise, PPACA tries to narrow down choice to reduce costs, but that means people will inevitably get cut on the margins.
And it is certainly as shame that Obama has declared that no adjustments will be made, ever, under any circumstances, to accommodate these problems. I don’t have that quote right at hand, perhaps you will provide it?
Not germane, you say? One hundred percent? Well, that certainly settles that!
And this “social engineering” of which you speak? A ghastly prospect, to be sure, unless its just a pejorative term for “helping people out”. Still, just the sort of thing Hitler would do. Or Stalin. Same thing.
It’s clearly not germane to the thread. The thread topic is about Obama’s lackeys going to the media and declaring that the cancelled plans are “crappy.” Martin Hyde asks the excellent question of “How many of these plans are really crappy and not just social engineering or otherwise due to the ACA?”
In all of these threads, I and other posters have given many examples as to why the now non-compliant plans were perfectly acceptable but no longer proper because of the social engineering aspects. The response is to ignore these posts and simply parrot the Obama line that the cancelled plans are “crappy.”
Clearly, all of these plans are not crappy and the administration and anyone else refuses to release the numbers of the plans that were truly garbage versus the ones that didn’t meet the new standards. It is simply assumed that if a man isn’t offered maternity care, then its a crappy plan. It’s not true, and I don’t think it is out of line to ask for answers.
That may be arguably true, but you guys tend to be a bit vague on what you mean by “social engineering”. Is it all “social engineering”, or just parts of it? Is anything that might be construed as “redistribution” meet that criteria? Do you even have an agreed upon criteria?
For one glaring thing, if the issue devolves down to nothing more than “social engineering”, then conceivably everything from the New Deal to the present day might need to be chucked. If that is indeed your agenda, it would be helpful to know that, in order to get a proper perspective on just how reactionary that agenda is.
For myself, I tend to roughly define a true conservative as someone who recognizes the need for progressive change but insists on caution and prudence in going forward. Someone who refuses all progressive change does not fit this criteria, as well as someone who styles himself that he fits but cannot think of any progressive agenda that he can accept. Anyone who fiercely advocates dismantling all such progress as has been achieved is a reactionary, and need not apply.
In his OP, Stratocaster challenged defenders of the cancellations to define what a crappy plan is. You use the word “substandard” in place of “crappy”, but you’ve totally ignored the question in the OP. Why don’t you tell us exactly which plans you define as “substandard”?
No, I have never seen any such ads.
I do not agree on any such thing, since I’ve no clue what you’re talking about.
If you can talk somebody into buying that load of crap, and they do so willingly, does that make the transaction legitimate? Do we approve of such behavior, do we condone and encourage that sort of thing? We won’t let someone beat you up and take your money because they are bigger and stronger than you, why do we let people steal money because they are smarter?
I’ve never heard any such stories. Moreover, I don’t think that nationwide health policy should be set purely on “stories”; I think it should be based on hard data. Stratocaster and other you’re debating against in this thread have challenged you to provide some data rather than merely stories. I’m with them. Do you have verifiable data, or only stories?
We don’t get together at our weekly cigar and scotch meetings and agree upon such definitions, no. 
But your prior post about bad faith insurance practices is well-taken, and already largely covered by state law. If those practices need better enforcement, then so be it. The problem is that the people who are suckered in by them are the type that get shit on in every other aspect of life, the ones just good enough to support themselves so as to not qualify for government assistance, but their naivety prevents them from succeeding further. Therefore, they are more likely to chalk it up as another failure and not do anything about it. As a lawyer, I would take their case on a contingency and sue the hell out of the insurance company for bad faith practices.
What you referred to is simple consumer protection laws for disclosure, oversight, and truth in advertising. I am a supporter of those laws.
Social engineering, at least in my mind, is when we go beyond such things and start to infringe upon free choice. Healthy people are glad to pay less for a policy that excludes pre-existing conditions. Men and infertile women are glad to pay less for a policy that excludes maternity care. Forcing people to pay for something that is of no benefit to them but (allegedly) benefits others who the government has deemed worthy of this benefit, is my definition of social engineering.
Clearly we need to address the pre-existing condition issue. Is the best way a transfer of the burden from the healthy to the sick? With little regards to ability to pay? A $100k/yr healthy earner pays more so a $40M/yr sick earner gets cheaper care?
That’s been discussed in other threads, but my point here was that this idea that insurance is “crappy,” even though savvy consumers who received exactly what they wanted and paid for, is not true and it is disingenuous for Obama to turn his people loose on the media suggesting that the are such.
That because the price differences are modest and/or temporary (male drivers under 25 are the most affected). There would indeed be screaming if a company refused to insure someone, at any price, because of their gender.
Suppose that auto insurance companies refused to insure men. Then, when men had the most serious sorts of auto accidents, the auto body shops were required by an EMTALA-for-cars law to fix the vehicles involved in the accident for free.
Without ACA, the health insurance situation is just that absurd. Substitute “persons with a preexisting condition” for men, hospitals for auto body shops, and people for cars.
As has been pointed out by several others, this isn’t relevant to the question I posed. I’m asking if anyone can substantiate the oft-repeated talking point that the cancelled individual policies may be the outcome of a broken promise, but hey, many (“lots,” “a significant number,”“numerous,” insert your preferred weasel word) of them were crappy anyway, so it’s not really so bad after all. These people should be thanking us.
For those who support this contention, how do you define crappy? Specifics please. And, more importantly to this question, what percentage of the cancelled policies fit that criteria? Again, without this it’s just unsupported grandstanding.
Martin Hyde’s first post outlined a “fill in the blanks” hypothesis. Someone fill in the blanks.
Things are going to be a bit difficult to explain to you, ITR, since you seem not to live in the same world I do, in terms of a mutually recognized set of facts that constitute reality. You’ve never heard any such things as I talk about? Going to be very difficult to engage in dialogue when the first question has to be something along the lines of “Are you shitting me?”.
Perhaps you mean that you have never heard any such thing from what you regard as a credible source?
How about Consumer Reports?
I’ve already heard most of this, so a dreary read it was. There was one note of…well, “humor” of a sort.
The article refers to one sort of health “insurance” package it refers to as a “mini-med”. Consumer Reports contacted some of the largest providers of such plans and asked for their rationale to support what appears to be “sub standard” insurance by any reasonable measure of the word. YMMV.
It should be noted that even though these “mini-med” plans are not considered acceptable under ACA standards, they remain legal through 2014…
Now, as far as this raving radical is concerned, if a full-time worker cannot afford decent health care, then some social engineering is definitely called for.
elucidator, isn’t your cite specifically contradicting the notion that such policies were eliminated in the recent wave of individual cancellations as a result of ACA? Read the second part you cited in your post. Also, aren’t many of them group plans?
Other than that, it’s exactly what I was asking for… 
Excellent suggestion! Yes, indeed, those policies should be eliminated! I am pleased that you have dropped your contrarian approach and now offer improvements and enhancements! We have every confidence in your future development as you evolve from the path of political error!
I have not responded to you in this thread until right now. Did you mean to direct this question to another poster?
I probably define it differently from some others. I would look at whether the policy is only open to healthy people and/or can only be kept by healthy people, thus putting the cost of caring for the less healthy on the rest of society. If the policy isn’t offered to people with pre-existing conditions, or has an annual or lifetime payout cap, it may or may not be crappy to a particular policyholder, but it certainly is crappy to everyone else. That’s because we all indirectly pay the critical care costs of those who cannot get insurance, or lose insurance, because of illness.
As for what percentage of individual policies socialize the costs of care for the unhealthy in one of the ways just described, that precise number seems unavailable. I believe that, prior to the first parts of ACA going into effect in 2010, it was almost all, and still is most. Even before you add in the junk plans documented by Consumer Reports.
Thanks. I’m sure you realize that’s not the definition implied by those I refer to in the OP who say the cancelled individual policies were crappy. All the talking heads, the WH spokespeople, etc. They explicitly say (though without details) that “many” of the cancelled contracts were crappy in the coverage they provided for the individual who had the policy. “Almost worthless” and phrases like that have been tossed about. So your response doesn’t substantiate the point I’m questioning, and neither does Consumer Reports.
Your alternative plan slips in an offhand acknowledgement that she can’t continue to see her current doctors – and her article emphasized that she deliberately chose her former plan because it let her see those doctors.
But, she was probably rich, so to hell with her?
Not following closely, so I could be missing something, but isn’t the question whether her out-of-pocket for the out-of-network doctors would be greater than the difference between the cost of the plans?
IOW, if she spends less than $5000 on the out-of-network doc, then she still comes out ahead, right? My napkin seems to show that she would have to spend $16,000 at the out-of-network doctor in order to break even.
Not sure this is relevant to the larger point, except to show how hard it is to compare two different insurance policies.
(withdrawn)