Gov. Paul LePage was the subject of a glowing editorial in the May 31 Wall Street Journal. It praised him and the Republican majority in the Legislature on the passage last year of the health reform law, PL 90. But the editorial neglected to account for what could amount to a cost shift.
Maine’s dominant insurer, Anthem, is planning for some premium rates under its new HealthChoice Plus product to be as much as 69 percent less than than its previous HealthChoice product.
For example, an 18-year-old woman with one child would have paid $968 per month under HealthChoice, with a $2,250 deductible. But under HealthChoice Plus she is estimated to pay $297 per month, with a $2,000 deductible.
As the Wall Street Journal stated, any premium decrease is remarkable. That’s true, but it’s not the whole picture. Anyone looking to join a health insurance plan knows to examine not just premiums but what procedures and services are covered and whether the deductible is affordable.
Under the new HealthChoice Plus product, the deductible reaches as high as $24,000 for a family. While the deductible for a family was $30,000 under the old product — and therefore the new product is a decrease — a possible $24,000 deductible is still extremely high for an average family.
At the same time, the new plan proposes to cover only a certain percentage of the cost of medical service once the deductible is met. The co-insurance under the old plan was 100 percent. And, there’s a reduction in covered benefits under the new plan, including no maternity coverage and more restrictions on drugs and services.
The Wall Street Journal based its praise of Maine’s deregulation effort on the projected premiums of one company, without a full comparison of Anthem’s products. It also did not fully examine what might happen to Maine’s older population as a result of the state’s health reform law.
The law aims to draw in more younger, healthier, uninsured customers, for whom companies don’t have to pay out as much. But where are the younger people, and would they really pay rates like the ones Anthem is projecting? The premium might be proposed to drop from $616 to $233 per month for a 25- to 29-year old, but that’s still a hefty sum of money for a person just starting a career, especially when considering the $2,000 deductible.
What could happen instead is that the costs will shift to older, often poorer, people living in rural areas. This is especially true because Maine’s new health law allows insurers to base rates more on age, in addition to geography and tobacco use. Sure, Anthem is planning to lower its premium rates. But at what cost? And for whom?
Uninformed editorial. Once again Dem talking points. Hey, maybe some real journalism could give us the real facts and your editorial opinion may be different. I think the facts show that about 94% of rating classifications had rates go down. But it’s easier to just publish those talking points.
Uninformed comment by blackbearfalcon is more like it. The facts are right here in black and white at http://www.maine.gov/pfr/insurance/consumer/indhlth.htm . The editorial is spot-on.
How much did yours go down? Do you have insurance? Most of the people I know gave it up as too expensive. I would like to know what kind you have so we can share that with others who don’t have it now.
You claim that the editorial is uninformed and just talking points but, unlike the editorial, you FAIL to offer ANY empirical data to support your position. Let’s look at a simple fact-while rates may have gone down, deductibles have gone up and covered services have been reduced. Your idea, on the other hand, is like buying that can of coffee that is marked 5 cents less, not noticing until you get home that it has 15 less ounces in it-the coffee company just slipped through a price increase while making you think you got a “bargain” and their laughing at you all the way to the bank.
The BDN editor should be held to a higher standard than a random poster.
BDN editorials just plain hate Governor Paul LePage!!
They arn’t the only ones!
Truth hurts don’t it.
—–
Hmmmm. Tough choice here: Which paper to trust for the truth……BDN or WSJ?
Hint – one of them is NOT owned by Rupert Murdoch!
The insurance companies are a large part of the problem and virtually none of the solution.
One of these days we the people will demand universal single payer like every civilized country on the planet. If nothing else, we could save between 25 and 30 cents of every dollar spent for healthcare right off the top. We have been hornswoggled(again).
Socialized medicine? Single-payer plans are just as bad as what exists now.
Look at the logistics pointed out in the article. The obviously logical truth is, if these insurance plans covered ABSOLUTELY NOTHING, then Mainers would be better off, because pricing would drop to a level the consumer can afford.
That would also provide a medical solution too. Mainers would be healthier if they never went to see a doctor. The vast majority of these doctors are quacks who run their business based not on the needs of any patient, but instead based on what some insurance underwriter tells them to do. Quack, quack…
The problem is not health care costs.
The problem is insurance-driven health care -does not work-. Insurance-driven health care is nothing but a vast, societal-wide swindle.
Healthy lifestyle choices are the only thing that works.
Under any insurance plan, those who are forced to buy insurance are going to have to pay for the poor lifestyle choices of a bunch of fools who wasted their lives away, and, for a lot of worthless insurance-driven medicine too.
The free market should rule. Forget mandatory health insurance. It will not work.
Don–I totally agree that we cannot understate the importance of healthy lifestyle choices. I would not go so far as to say it is the ONLY thing that works however. We are subjected to a plethora of unhealthy factors in our daily environment and the human body is actually quite frail, increasingly so with age. Illnesses and accidents happen and even those of us who agree that insurance driven health care is a swindle need medical attention occasionally. A system that rewards wellness and penalizes risky lifestyles may be incentive for many but won’t eliminate the need for healthcare. True free market economics are great for producing widgets but it is a license to steal when it comes to essential services. Medicare for all is what we need and I support strong wellness incentives to be included in it.
I’ll make this post again, though I have made similar posts before.
I am sixty-two. I have not seen a doctor in over thirty years. I take no medications.
Having lived longer than my own father by some eighteen years, I can most assuredly live out my life without ever having to see a doctor again. I have looked over the mountain.
That said, understand, I plan to live into my nineties.
Five nights a week I swim two miles in the 25 yard pool at the high school.
This is me swimming-
http://www.youtube.com/watch?v=sq-y68xrZgw&feature=youtu.be
Some will respond, -Oh, Don, it is so nice you are so physically fit, but not everyone can do that!
And the real truth is, it is all too often I swim in that pool -all by myself- because our cultural ethic is such that neither the young nor the old think very much about keeping physically fit. Look at the video. You will note, I am the only one swimming. Everyone else is just socializing.
Medical care means NOTHING, if everyone is so focused on avoiding the healthy maintenance of their life.
Keep smoking those cigarettes. Keep drinking that beer. Keep dousing yourself with all that soda. Drive that car at 85 on the expressway. Dope? Well, Hell, legalize that. The doctor has a cure for you! It is called, dying a horrible death in crushing poverty.
The expenditures that are being forecast for this medical swindle under this health-insurance-mandate are ridiculous and impoverishing for both government and the individual.
Get a life, people. I am sixty-two. I have health insurance. But I do not need it. And no doctor on earth can do anything for you that will restore your health to the level of health I MAINTAIN FOR MYSELF at age sixty-two.
oh please, the healthiest person in the world can still get hit by a bus
Yes, the healthiest person in the world can get hit by a bus.
BUT HONESTLY, how much medicine goes on in this country treating patients who are hit by a bus? or anything similar to that? Not a very large percentage of the whole.
And as such, you only have reinforced my point. Medicine in this country is a boondoggle. The medical establishment is so busy looking for government handouts and mandates, they have completely forgotten the patient, and, what the patient needs and can afford.
Get in shape people, because no matter whether there is mandatory health insurance or not, you cannot afford to deal with these “health professionals”. And if you really want to be healthy, you don’t want to deal with them anyway, -except as a last resort, -if you get hit by a bus.
The situation is very similar for me except that I have to make the choice between eating, paying my unsecured debt, or paying for health insurance that I can not afford to use anyway. No cigs, no booze, no life outside of working and coming home to worry about what I can not afford. Oh and by the way, I house my mother in my own home, and my sometimes employed sometimes laid off brother who feels that it is unfair to ask him to pay his way when he is not working.
Force me to pay for insurance? With what?!?! Everything and more goes into just paying for my place in the world…Without any services, or anything that resembles what our governor calls “ENTITLEMENTS?” What does he call his guaranteed health care? What does he call his full retirement pay after he is gone?
I feel that I am healthier by not letting doctors invade me with useless treatments and pills that would only make me sicker. That is not to say that I will not be sick or injured later, but that is the chance we all take every minute. For now the only thing keeping me going is luck!
Instead of the “insurance expense” folks would find they would be healthier if they eat right, live right and moderate. If you instead put your hard earned dollars into an occasional visit to a chiropractor plus get a deep tissue massage you will be healthier and wealthier. Most of the insurance criminals don’t cover these visits, they realize the benefits and the lost revenue of doing so, it’s all about …..“nothing but net” Swisssssh.
I agree that people should take responsibility for their health. But some of us are born with conditions that can not be cured. As we get older, we suffer more. There’s just no way around it!
France has the best health system in the world. It is private, but regulated by the government and everyone is required to have it. If the French are so smart, you’d think we Americans could come up with something better than what we keep screwing up!
I understand your point totally and agree. That’s why I think the public option would give us the kind of care we all will need. But many cry socialism as soon as it’s mentioned, as if the current system of thieves and con-men is doing those who need care any good. One must admit the good it does certainly serves the CEO’s well as they continue to fleece the rest of us.
Our daughter lives in Mass. she has wonderful healthcare at a fraction of the cost in other states. Way to go Mitt, as you run from your success.
Healthy lifestyle choices are the only thing that works.
You’re a young person, aren’t you?
The “free market” works in healthcare systems around the world that cover everyone; systems that are more “privatized” than our own!
The difference? The “market” decides WHO delivers standardized coverage most efficiently (and compete they do! There is more “consumer choice” under these circumstances).
The “market” must NEVER be allowed to decide WHO gets covered; OR to what degree. We are letting private insurers walk away with profits from people who are going bankrupt, and taxpayers are picking up the tap. It’s wrong, and we don’t have to permit it of our publicly-chartered institutions, i.e. corporations.
Single Payer is not socialized medicine… You want socialized medicine? Take a look at the VA. Government run hospitals with government employed staff, nurses, and doctors. THAT’S socialized medicine. Single Payer eliminates the duplication in multitudes of forms, private requirements, admin costs from the range of insurers. Medicare/Medicaid admin is already in place, Medicare is immensely popular for its efficiency and coverage that those enrolled now received, eliminates confusion and admin costs for the individual doctors that hire staff to keep up with the different requirements from insurers… And Single Payer is about PAYING for treatment, not how or when treatment is dispensed.
The facts speak for themselves. Single payer is not socialized medicine by ANY definition.
Boycott the insurance companies and there will be change.
This is like the Mafia cheering on a Hitman !
Shhhhhh don’t tell the Republicans they are cutting off their nose to spite their face, they just want to get “Gubment” out of their lives. What they don’t understand is, if the unions disappear then so will any idea of a 40 hour work week, weekends, employer provided health care and decent wages but try to convince the low IQ, actually that would be average IQ in the Republican party, and they will spout the same BS you hear from Rush Limbaugh, Glen Beck, Michael Savage, et al they just don’t comprehend and never will.
The cost shifting has already occurred and is being set right. The shift occurred when young and/or healthy people had to pick up the tab for everyone else.
i always enjoy it when conservatives get screwed by the very system they so ineptly try to defend.
Democrats set up the system that robbed insurance from my employees. Enjoy away because YOU will bare the cost for substandard healthcare.
There will soon be two kinds of healthcare… the very good sort for the wealthy and the sort you need to get in line for for everyone else. There used to be three kinds… but like everything else middle class it is going away… get ready for Obama’s version.
paying the cost now, for health care and insurance gouging– its just captitalism at its best–
Not to mention costly government regulation, but we won’t bring that up will we? It doesn’t fit you half the story narrative.
That is how insurance works, you spread the cost over all types of clients. In healthcare the young and healthy help to pay for the old and sick just like in the auto insurance industry the safer drivers help to pay for the less safe drivers and so on.
Yes of course but it has been done to the extreme… pushing insurance rates up out of the reach of many small businesses.
Your analogy doesn’t work.
As far as auto insurance goes…. there are safe driver, no accident discounts and variable liability rates. That does not exist with a one size fits all health insurance.
In home owners insurance you get discounts for metal roofs hard wired smoke detectors and how close your home is to a fire hydrant.
There is no comparison to health insurance. Am obese person has the same rate as as a healthy young person. In Obama’s world a smoker has the same rate as a non-smoker.
We are all in this together! Maybe the cost went down for the young, but what is the average age in Maine? Older citizens who can no longer afford insurance will go without. If they get sick, everyone will foot the bill. That is everyone but the insurance companies.
There is no reason we should sacrifice the young because the rest of us are old. By increasing costs on the young you encourage them to leave the state enlarging the gap. Young people while they are healthy need the income that advantage of youth gives them. They need to make their mortgage payments, raise their children and perhaps even have the financial ability to start their own businesses. Just like everything my generation has done its selfish and now in our old age we demand the young sacrifice their future for us.
I agree about sarificing the young, but you are missing the whole point. When an uninsured person needs medical care, we all foot the bill. That is, all but the insurance companies. It is not realistic to think the bill just goes away. There is no insurance fairy!
I never could understand why we need to set up an entire new bureaucracy just because it is a government one and somehow that makes it cheaper. It adds to the overall cost. I don’t see how making young people sacrifice for it is somehow “fair”.
The fact is through our government programs we have 50 million on medicaid . A larger number of these folks are obese than the population at large. The additional cost is $1,100 annually per person for an obese person. I see no reason to saddle young people who are working with the cost of supporting those that are not.
If you want a society where there is no opportunity for the young. That’s what you are building.
and the young ones that have no insurance? listen on the scanner to sugarloaf during ski season on a sunday– the number of injuries , serious injuries, head, back and neck injuries that all those healthy people are having– and if they have no insurance? the rest of us that do are paying for it
Are you so nosy that you know who has insurance and who doesn’t?
Who needs to invest for retirement when your life expectancy may be limited by your healthcare?
The Gov and Legislature needs to realize that the Healthcare industry is the basis for Maines economy. Then and only then can we shift jobs from the public sector to the private/public sector. Yes the marriage of Healthcare and Government minus the insurance companies may indeed be good for all Mainers not just those who can easily afford healthcare. Think of the jobs that could be created.. letters could be sent to state employees informing them that their jobs have been abolished due to a consolidation, then repost their jobs with a lower pay scale to include free healthcare! Wow…UMaine tenured professors and administrators will now be working for $38000.00 a year with 100% healthcare. Who needs retirement when you can’t afford healthcare? How does this sound…University of Network Maine Systems, a service of Eastern Maine Medical Center and the State of Maine, for the benefit of Mainers by Mainers.
Our available option based on company size is Anthem BCBS, they don’t cover office sick visits, vaccinations, medicine, etc. We pay thousands and thousands per year, and my husband and I each have a 5K per person deductible. In a rural part of Maine, we are lucky to have that at all I guess, and lucky to break even between other living expenses and the cost of insurance. If we had the money we spent on premiums, paying the deductible wouldn’t be an issue.
Health insurance reform? As long as the Health Insurance predators have anything to do with your health, you’re at risk. Any service that makes money by denying services you pay for is nothing more that a legal scam. The best Health Insurance you can have can be had by first staying as far away from the current system as possible. Just extrapolate the cost out ten years and you will discover the futility.
It makes one wonder how the hell we survived to this point after a million years of no health insurance? Better ask yourself if health insurance/healthcare is so wonderful how is it that so many are so unhealthy?
If these systems are doing us any good how is it the US ranks way down the list of healthily countries?
Real reform takes the profit out of the system, until then count me out.
WSJ owned by Fox Corp, big supprise.
In no small part one of the problems with health insurance in Maine is the lack of competition. This is due in no small part to the efforts of the Maine legislature to “tinker” and “improve” how health insurance is written in Maine. Why is Anthem the dominant insurer in Maine? The “tinkering” and “improving” made many other companies decide not to issue policies in Maine. No if and or buts just “killing” the market in Maine. When a company decides to no longer write health insurance in Maine there is no press release issued nor any headlines written. So the problem does not get better but just high lights how the last three decades of progressive policies have helped the average Mainer. All the while the BDN stood on the side lines and cheered it on.
Healthcare is not a “market”; patients do not behave as “consumers”, and insurers profit by extracting money from the healthy and abandoning the sick for taxpayers and society. There is no “competition” over who gets to cover the sick — NO ONE wants to pay for sick people!
Stop applying commodity market principles to healthcare. It will always fail.
I have cost my insurer 100’s of thousand of dollars in the last decade. They never once cut me nor denied paying a legitimate bill.
You can thank regulation for your good fortune.
Or maybe the deal I cut with my insurer.
What corporate insurer would take THAT deal, in the absence of rules? No corporation wants to lose a single dollar, and insurers even refer to payments for care as “losses”.
Perhaps your “deal” was made possible by virtue of a group plan; members cannot be dropped. Perhaps you have an individual policy bound by our laws.
Either way, you didn’t “do it all on your own”.
Whatever happened to the bit about having the freedom to buy health insurance outside the state? Is LePage working for Anthem or small business owners who wanted the ability to shop elsewhere? I’d seriously like to know.
It is and always has been a ruse. “Small business” is just two words they like throw around to make you believe they shill for “someone” other then large corporations.
Four states. LePage was going to allow us the freedom to buy health insurance in four other states? What happened to that?
The same thing that happened to his jobs, jobs, jobs agenda.
Paul Lepage’s ” Hurry up and die, you old bat” health care reform is just the kind of thing a scumbag low life like Rubert Murdock would love.
Of course… Murdoch’s WSJ editorial team — you know, the fox team that brings its viewers down so many notches in intelligence you are better off paying NO attention at all — loves that Orwellian task of doublespeak: freedom is slavery, ignorance is strength… Cheap premiums are good coverage… What else should anyone expect from an organization that bought off police, hacked a dead teen’s voicemail, virtually blackmailed prime ministers and cabinet officials… and did so for years and years, without regret, remorse, or acknowledgment of wrong by the hoary Aussie himself…?
Oh, you haven’t heard of that, huh? Must be a Faux News consumer…
We can argue all we want – the fact of the matter is that health care costs in the U.S. are outrageous, and a huge number of working people cannot afford health insurance. Until this is no longer the case, all arguments about how much “progress” we’ve made, or how biased an editorial is, are beside the point.