ObamaCare Clusterfuck: FDL's Jon Walker on why exchanges won't work
(That is, "work" in any other way than further enriching health insurance parasites. To my knowledge, this is the first time a prominent poster at a "progressive" blog has ever said that ObamaCare's problems are architectural, hence cannot be "fixed.") Jon Walker:
Two numbers from the report really stick out. The survey found 54 percent of workers would prefer not to be more in control over their health insurance expenses and options because they will not have the time or knowledge to effectively manage it.
Parallel to the 410(k) scam. The rentiers take a cut for "managing" our plans, but the market is such a lemon market for us that management isn't really possible. So they shift risk onto our shoulders, take a cut, and then to add insult to injury, structure our "choices" so we get nothing for the cut they take. Note also that "the paradox of choice" shows that too many choices make people unhappy.
This is completely understandable. Selecting the best insurance plan requires not only significant knowledge about every component of insurance, but also the ability to accurately predict the likelihood of future medical needs.
"Well, I think I'll postpone that kidney transplant a couple of years; kidney futures aren't looking so good right now...."
The other important number is 89 percent, that is the number of workers who choose to stick with the same plan year after year. This is in large part because many find the process so daunting.
A market where very few have the knowledge of what is the best bargain and where almost no one ever even tries to shop around simply can’t be effective. Looking at other countries where there is a “market” for health insurance indicates this will be a real problem. In Switzerland almost no one ever changes plans even though standardization makes it much easier to comparison shop* than it will be here under Obamacare.
The way the “technocrats” claim the exchanges will be used and the way they will actually be used is likely to be very different. Health insurance plans are extremely complex, and expecting millions of people to every year to successfully spend days researching/shopping for their best plan is simply not believable.
If that was indeed the "expectation," as opposed to the rationalization for another decade or two of looting, which, under The Sachs Conjecture, is what it would be. In general, technocrats and "progressives" tend to assume good faith on the part of all actors, as Walker does here.Pas si bete.
NOTE * If I understand this correctly,
citizens consumers will comparison shop in the health exchanges on the basis of actuarial values, which though expressed in dollar terms, really are not commensurate in terms of services delivered.
NOTE "Patient engagement" -- another form of risk-shifting -- has similar problems.
UPDATE Adding, Walker is assuming people don't understand that health insurance is a defective product. But if I had insurance, and if it had worked at all for me, I wouldn't change, because the odds would be that the good plan is the exception, not the rule.