The Statistics of Health Care

This Vox Article explains the pros and cons of the Affordable Care Act debate about to ensue in the coming congressional session. What I saw in the article, however, was a statistical game being played.

On the one side, The Affordable Care Act has increased costs for young people:

One constant Obamacare gripe from Republicans is that the health care law mandates too big of a benefit package. This drives up premiums, they argue, and scares off some healthy and young enrollees who want to buy a skimpier plan.

There is some truth to this argument. Obamacare’s marketplaces have struggled to attract young adults at the level the White House had initially hoped (the Obama administration originally said it wanted one-third of the marketplace to be people between 18 and 34 but, right now it’s only about a quarter).

On the other hand, the Paul Ryan plan would decrease costs for young people, but, you guessed it, increase costs for the elderly:

[Under Paul Ryan’s plan insurers will be allowed] to charge their oldest enrollees five times as much as young enrollees. Right now, insurers can only charge the oldest enrollees three times as much as the youngest.

The nonpartisan RAND Corporation has modeled the effect of this switch. It found that premiums for a 24-year-old would decline from $2,800 to $2,100. But premiums for a 64-year-old would rise from $8,500 to $10,600.

In other words, statistics will be on the side of republicans because the rise in young people getting cheaper insurance might offset many elderly folks who will be priced out of insurance.

However, we must remember that the kind of care given to young people under the new possible Ryan Plan will probably cover less:

But it’s important to keep in mind: These are not the same plans currently offered under Obamacare. Enrollees will pay less but also get less.

And while young people might have cheaper premiums and an easier ability to enroll, older Americans could struggle to purchase coverage in this market, where their costs would rise. These are people who tend to have more urgent health care needs and could be in a worse position without health care than a young adult might be.

And this worries some Obamacare supporters, who say the goal of insurance reform isn’t just expanding coverage — it’s expanding coverage to people who really need health coverage.

Americans need to be informed and consider these issues before doing a wholesale repeal. Americans need to consider whether they want to keep playing this statistics game with health care. As long as there is no mandate for a single payer system or some other mechanism that levels the playing field so that everyone has to pay their fair share of health care costs, we will continue to fight this uphill battle of rising health care costs.

The real answer, in my opinion, is a universal health care system that does away with such statistical gamesmanship. I know that people don’t want more government in their lives, but such a system would be incentivized to keep costs down because there would be one system that all Americans would understand.

Please note that I am not suggesting that this will somehow lower costs. Just as under the Affordable Care Act, prices will continue to go up. But under a governmental system, we can regulate and control the prices rather than allowing some sort of faux free market oligarchy control it.


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