There’s going to be a press conference today @ 2pm to announce the results of negotations with insurers for the health care plans to be offered by the “Connector,” the board charged with implementing the new health care plan. Gov. Patrick, A&F Secretary Leslie Kirwan, and Connector Exec. Director Jon Kingsdale will all be on hand. Unfortunately, due to prior commitments I can’t make it, but I gather they wanted to get this out in time for tomorrow’s papers.
I’m told that the lowest-cost plan will cost $175/month, which includes some form of prescription drug coverage. This would be down considerably from the $380 figure that had been floated earlier. But as always, the question is what’s covered. If you’re making people pay even $175 for garbage coverage, there’s not much point. So we’ll see what comes up this afternoon.
I could offer a plan for $1/month, with no deductible. How does that sound? Your co-pay? 100% of any and all expenses. I’ll probably lose money because of the cost of billing and collecting a buck, but, hey, such a deal!
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It seems to me we need a standard way of measuring what such plans actually cost the consumer.
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$175/month = $2,100 per year.
$380/month = $4,560 per year.
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Savings? $2,460 per year unless you actually use the insurance. Then what are the savings? Depends on the deductible and co-pay, obviously. But, we must know what the average Massachusetts resident uses in health care services, so why not run both plans through a “typical” taste test and see which one is actually cheaper. Or affordable, for that matter.
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If the insurance companies’ actuaries are doing their job, these plans should be identical for the average citizen. Insurance companies, after all, are not charitable, public service organizations. Their goal is to make an acceptable return on their capital. Perfectly natural, normal, and expected.
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The problem comes in when they try to wring more profit out of the system by limiting certain coverages, etc. Then the paperwork becomes overwhelmingly costly. We all know the outcome of that — 30% to 40% of premiums go to administration. There’s gotta be another way to run the zoo!
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You can’t average averages. The average (“typical”) doesn’t really make sense. Lots of things are positively correlated (with one comes the other), and more importantly the distribution is neither uniform nor normal — meaning that the mean (total value of all claims divided by number of insured) is nowhere near the mean (the annual claim where half of the annual claims were lower and half were higher) and that’s not likely to be near the mode (the most common annual total claim).
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So, if 95% of total claims are $1000 and 5% are $1,001,000, the mode and median are a very affordable $1000 — but the mean is $51,000. The insurance company really only cares about the mean, but individuals don’t — the mean doesn’t really exist. You either had $1000 in claims or over a mil.
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I agree, it would be nice to compare different plans. But, with so many variables (how much of each of x different procedures are covered, how much of y different drugs are covered, deductibles, co-pays, annual charges, discounts, in-plan vs. out-of-plan coverage, emergency coverage, etc), it’s impossible to reasonably compare two different plans unless one is as good or better than the other at all conceivable categories.*
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but I was using the word “average” in a less formal sense. I think you’ve ducked the question, which is how can we compare plans?
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You do admit it would be nice to do, then throw in the sponge. I don’t think that’s an acceptable solution. But you do get to the heart of the matter:
except that I would finish the sentence with some comment about how ridiculous it is that we have so very many options.
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Imagine the time and energy spent on just figuring all this stuff out — what a drag on economic productivity! And, no wonder it’s so expensive to administer such a nightmare of tangled rules and regulations.
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It’s time we started thinking about healthcare as a public good, not as a commoditiy available only to those who can afford it. I think we are moving in the right direction, but I worry that the entire system will collapse before we get where we need to be.
I didn’t duck the question, I pointed out that the question is ill-posed at best. It simply can’t be answered, precisely because comparing two complex entities accurately isn’t possible without a far more precisely worded criteria.
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Don’t think that’s acceptable? The alternative is either (a) you asking a much better question, or (b) receiving a bunch of lies for answers, of the “lies, damn lies, and statistics” variety.
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Furthermore, you find it “ridiculous that we have so many options.” Really? Choice is bad? That’s a really dangerous tack to take. If you don’t want to analyze more than 5 choices, than just consider 5 (at random or otherwise). To argue that more choices is bad just seems strange to me, since competition in this complex market would seem likely to both (a) provide the coverage that most closely fits individuals wants and needs, and (b) results in lower prices due to heavier competition.
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If you don’t want to spend “time and energy” figuring this stuff out, don’t. Randomly choose a plan, or compare two, or three, or whatever. Suggesting that others who may be interested in being more precise with their comparisons shouldn’t be able to do so even if there’s a market willing to provide those choices seems silly, especially since there isn’t a single reasonable metric that is useful for each one of use to compare the different plans, precisely because their offerings and our needs are both quite complex and vary so widely.
I’m adding that as a chapter to my forthcoming book on economic myths. (No time to find citations right now, but some recent research suggests that too many choices can be very inefficient and actually decrease people’s overall satisfaction.)
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Your faith in the Market God is touching, I don’t share it.
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I also don’t see how “our needs are both quite complex and vary so widely.” I think we all need basic, high-quality healthcare. Let’s stop farting around with complex insurance plans and focus on health care delivery. Medicare for All is a good model.
Rates follow, but details are coverage aren’t posted. Source
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Eastern Region:
Neighborhood Health Plan: $144; $175; $347
Fallon Community Health Plan: N/A
Tufts Health Plan: $206; $242; $461
Blue Cross Blue Shield of Massachusetts: $212; $275; $504
Harvard Pilgrim Health Care: $147; $288; $414
Health New England: N/A
ConnectiCare: N/A
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Central Region:
Neighborhood Health Plan: $126; $154; $308
Fallon Community Health Plan: $128; $176; $304
Tufts Health Plan: $192; $225; $428
Blue Cross Blue Shield of Massachusetts: $198; $256; $470
Harvard Pilgrim Health Care: $132; $257; $369
Health New England: N/A
ConnectiCare: N/A
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Western Region:
Neighborhood Health Plan: $126; $154; $305
Fallon Community Health Plan: N/A
Tufts Health Plan: N/A
Blue Cross Blue Shield of Massachusetts: $198; $256; $470
Harvard Pilgrim Health Care: $148; $289; $415
Health New England: $201; $238; $377
ConnectiCare: $202; $246; $379
As much as I loathe Wal*Mart, their prescription drug plan, including $4 for lots of generics, may make these lower cost plans even more affordable. Why? Because, according to gary‘s source,
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So, low monthly pay, at the cost of higher prescription drug costs, which (IIUC) will cost $4 at WalMart, not $25. Of course, thanks to a little competition, WalMart’s drop in prices may help to drive down prices at other large pharmacies throughout the state.