
Obamacare’s Skyrocketing Premiums? Why the Sky Isn’t Falling - davidf18
http://www.nejm.org/doi/full/10.1056/NEJMp1605913
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davidf18
The article discusses only premiums and does not discuss the overall cost of
health care to the person who has the insurance.

Some deductibles are $5000 or more. There are copays on some of the plans.

The overall costs have increased for most of the people who already had
insurance prior to the implementation of the ACA.

A lot of the increased costs are that people who have very high medical costs
have now been included on plans to be subsidized by others.

Much of the higher costs are from choices patients have made such as smoking
cigarettes or overeating.

The ACA allows for smokers to be charged premiums 50% higher than non-smokers.
But most plans do not implement this option and relatively few smokers report
that they are smokers and the information is not verified.

Instead of having people paying higher costs not only in premiums but in large
deductibles and high co-pays the ACA should have done what most developed
countries (eg, Canada, UK, France) have done which is to increase the tobacco
tax to $5.00 or more per pack (the US Federal tax is about $1). That way, it
doesn't matter if smokers lie about their smoking status or of the plan
charges the allowed 50% increase in costs for smokers.

The author is an MD PhD with the PhD has a sub specialization in Economics. He
should know (as should the editors of the New England Journal of Medicine)
that the proper economic analysis of insurance costs should include not only
the premiums but the costs of deductibles and the costs of co-pays. The fact
that this was not done suggests a political axe to grind and not giving
complete and transparent information to their readership.

