Obamacare

Uh-oh: Obamacare's Target Audience Doesn't Particularly Want It.

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carpediem blog

Over at Investor's Business, the always-interesting John Merline sends word of a troubling development when it comes to Obamacare: The very people it was supposed to help the most—the uninsured—don't seem to want the damned thing.

After looking at a series of slides posted by Health and Human Services (HHS) that lay out the department's marketing plan to reel in new customers, IBD's editorial board notes,

It turns out that the Democrats and the Obama administration apparently didn't bother to investigate who these uninsured people actually are before they forced through a $1.8 trillion plan to help them.

What they've learned since is that more than half of the 48 million who the government says are uninsured aren't interested in health insurance, which is why they don't bother to buy it in the first place….

The biggest market segment identified by HHS, in fact, is what it describes as "healthy and young," who make up 48% of the uninsured population.

They have "a low motivation to enroll" because they are in "excellent to very good health" and so "take health for granted."…

Then there are the "passive and unengaged," which make up 15% of the uninsured and also have a "low motivation to enroll" because they "live for today." They also cite cost as a key factor.

The problem, of course, is that ObamaCare will make insurance vastly more expensive for many of those who fall into these groups by larding on new benefit mandates and placing limits on premium-lowering deductions and co-pays. It will also introduce insurance market rules that force the young and healthy to subsidize premiums for those older and sicker.

HHS

Read the whole thing.

Obamacare backers pushed the plan as a way to cover the 50 million Americans who didn't have health insurance coverage (and let's be clear that having health insurance isn't the same thing as having good health). After the law passed, they chucked the idea that 50 million people were going to get covered, usually dropping the number down to around 30 million. Which off the bat is a tell of some sort: Why are we spending trillions of dollars and creating a new, untested program to cover 30 million people (while leaving another 30 million out at sea)? If basic insurance coverage was the goal, wouldn't giving people some sort of voucher or payment ticket to buy insurance be a cleaner, easier solution (and one that could have been implemented overnight)? Not that such a system wouldn't have caused all sorts of unintended havoc on the status quo, but it wouldn't have created an tsunami of uncertainty and guaranteed rate hikes that are everywhere around us.

Here's HHS's latest fact sheet on the uninsured.

Back in 2008, Reason TV revealed a bold new health care plan that would have covered about half of the uninsured. Take a look:

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  1. “The very people it was supposed to help the most – the uninsured – don’t seem to want the damned thing.”

    I remember when ObamaCare was supposed to help people who couldn’t afford to buy health insurance, too. When that “help” came in the form of siccing the IRS on them for not buying it, it’s no wonder a lot of them decided that maybe ObamaCare wasn’t for them.

    “The biggest market segment identified by HHS, in fact, is what it describes as “healthy and young,” who make up 48% of the uninsured population.”

    That was a feature–not a bug.

    If you’re going to put 20 million more people on Medicaid, which is a net money loser for hospitals (driving inner city hospitals, especially, to close their ERs or go out of business), then you’re gonna have to let the providers gouge that lost money from private insurers somehow.

    …and who else better to make up for the insurers new shortfall than “healthy and young” patients, who aren’t likely to use much of the healthcare they’re being forced to pay for?

    That was the plan. That’s why the Obama Administration argued that ObamaCare would collapse without the individual mandate for so very long.

    1. The other important thing is covering people who already sick without having them pay for their expected costs. A noble goal, perhaps, but very expensive. That money has to come from somewhere, and it comes from charging a lot of the young and healthy more than the insurance is worth to them.

      Defenders then reply that for a lot of these people, it’s cheaper after the subsidies. But the subsidy money has to come from somewhere.

      1. Most young healthy singles won’t be eligible for much or any subsidies anyway. A single 25-year old adult making $36,000 will get no subsidy per this calculator: http://healthreform.kff.org/subsidycalculator.aspx

        The subsidies only really help families because the income thresholds are much higher and the premium costs are higher.

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      2. Yeah, the way to make healthcare inexpensive for people with preexisting conditions sure as hell isn’t to force insurers to cover them and drive up premiums for them–and everyone else, in the process…

        Perhaps the very worst part of ObamaCare, from an affordability standpoint, is the requirement that insurers spend 85% of the premiums they collect on healthcare.

        If you can’t profit as much by cutting your costs (and keeping ALL of the difference between what you spend and what you collect in premiums), then why would you cut your costs? Why wouldn’t you just raise premiums instead?

        The government has driven potential competitors out of the insurance market through regulation, etc., and then they destroyed 85% of the incentive to cut costs for profit–and now they wonder why insurance premiums are rising instead of falling?!

        If I were uninsured becasue I had a pre-existing condition (and, by the way, that’s been me for the last nine years), I wouldn’t want the government driving up insurance premiums by destroying 85% of the insurers’ incentive to cut costs. I wouldn’t want them to do that and then force me to buy a policy, either.

        I’d want a good old-fashioned competitive market where providers compete on price for my money. But that seems so far out of reach, right now.

      3. People with no assets have no need for insurance. Period. Seems like we could give docs (hospitals, nurses, etc.) a dollar for dollar tax credit for pro bono work up to 100% of their non-payroll tax burden and get better results all around.

        1. “People with no assets have no need for insurance. Period.”

          I have absolutely no problem with that statement whatsoever.

          I’ve even argued that way about it on auto insurance around here–for years. You’re responsible for your own property. Using the government to make other people pay to insure your car for you is wrong. Driving a car around is an inherently risky activity, and if you want to insure your car against uninsured drivers, you have an easy and affordable way to do that.

          It’s the same thing with healthcare. In line with what I wrote above, the ultimate reason for ObamaCare (although now one ever mentions it) is to save Medicare and Medicaid.

          Providers lose money on both of those programs, and they have to gouge private pay patients to make up for the losses. …which is another way of saying that the government is forcing everyone that buys insurance to insure other people on the government programs.

          It’s the ultimate cause of the problem.

          1. Driving a car around is an inherently risky activity, and if you want to insure your car against uninsured drivers, you have an easy and affordable way to do that.

            Auto insurance isn’t to protect you, its to provide an asset-pool for when you inflict shit on somebody else. Given the scale of relative power (force = mass x acc..blah-blah) you possess driving a car, and the fact driving a car (as the nannies so often say) is not a ‘right’ but a ‘privilege,’ the liability insurance shtick is warranted.

            The nannies would seize on that model to tax the shit out of guns the same way, but guns are indeed a ‘right.’ Though the Commerce Clause probably could be interpreted to ‘fix’ that quibble at this point.

            1. I hate it when people say that driving a car is a “privilege”. Why would owning private property and using said private property be a privilege? Is riding a bike a privilege? I’ve seen some pretty nasty bike collisions, perhaps bikers should be required to have insurance now too. Also walking is dangerous and people are really bad at it (have you walked through Costco?).

        2. “Seems like we could give docs (hospitals, nurses, etc.) a dollar for dollar tax credit for pro bono work up to 100% of their non-payroll tax burden and get better results all around.”

          About half of the providers out there are non-profits already.

          And all of them do write accounts off that weren’t paid against revenue.

      4. won’t the young and healthy just pay the penalty rather than buy the insurance since they can’t be denied for a pre-existing condition when they do get sick? This will pull the young and healthy out of the insurance market, meaning the old and sick will have to pay even more for their insurance. That’s a subsidy for the young and healthy paid for by the old and sick.

        1. If the penalty is small, yes.

    2. I always thought Obamacare was supposed to help big corporations from the get-go. Was I wrong?

    3. Medicaid as a net loser? That’s a big part of the lie that got us into this mess.

      Take a look at this:

      http://surgerycenterofoklahoma…..t-you-hear
      Contrast what you see with what you are hearing. Hospitals are going broke. They can’t make ends meet. The uninsured are breaking the hospitals’ backs from emergency room over-utilization. Hospitals won’t survive unless Medicaid is expanded (funny that they want this expansion yet this is a program they simultaneously claim underpays them and justifies their cost-shifting to others!). These are the lies that are primarily responsible for bringing us Obamacare.

      Also keep in mind that while the hospital spokesmen claim that they have to take everyone regardless of their ability to pay, they get paid even when they don’t get paid, throught the uncompensated care scam. As I’ve written previously, as the hospitals wave the charity flag with one hand they are fleecing the taxpayers through this scam with the other.

  2. “YOLOS NO GO TO ENROLL”

    1. You’re just upset because someone got to the top of the thread before you.

  3. Can we please just call this disaster what it really is… Smoot-Hawley II.

  4. but but but….we voted.

    And isn’t that the most important thing.

  5. Obamacare was not designed to insure the uninsured. It has two goals:

    1. Provide Democrats and other statists with more power over the economy and our lives, increasing our dependence on them.

    2. To fail, so that single-payer can be instituted, which is the ultimate goal of the people in number 1.

    1. 2. To fail, so that single-payer can be instituted, which is the ultimate goal of the people in number 1.

      Single payer? Paid with what….Skee Ball tickets? The country is broke.

      1. The left firmly believes that we do not have a spending problem and are far from broke. The evil 1% are hoarding money and not paying their “fair share” in taxes…if only they would do their patriotic duty all would be well.

        Any gaps that remain will be covered by printing more money…

        QE…To Infinity and BEYOND!

        1. The left firmly believes that we do not have a spending problem…

          That the “left” (hi T o n y) is populated with sociopathic morons hasn’t been in doubt for a long time.

        2. Of course the rich are not paying their fair share! They’re rich! How can they pay their fair share and still be rich? They can’t! So as long as they are rich we know that they haven’t paid their fair share!
          Circular logic is fun!

        3. Put your money in rubles. The Russians learned a lesson after investing 13% of their foreign reserves into the US mortgage market, so now they’re buying gold.

      2. You are not allowed to say that. Paulie Krugnuts says it is not true. We have not declared bankruptcy yet and that’s all in the future, so therefore does not exist.

    2. Yep. They look across the pond and see Europeans who are absolutely dependent on the graciousness of their rulers to get even basic medical care, and they are frustrated that they don’t have that kind of authority here.

  6. It turns out that the Democrats and the Obama administration apparently didn’t bother to investigate who these uninsured people actually are before they forced through a $1.8 trillion plan to help them.

    Yes we did! The uninsured are those people with the thing on the shoulder that goes up.

  7. There’s no way the US can go broke. Didn’t some lefty say that recently?

    Besides, we still have printing presses, don’t we? Just print more money.

    1. Like I said….Skee Ball tickets.

    2. “There’s no way the US can go broke. Didn’t some lefty say that recently?”

      They bitch incessantly about “Too Big To Fail”, yet that’s historically precisely how they’ve always envisioned their ideal government.

  8. Be nice if they provided a link to these slides that are supposedly somewhere on the HHS website. (The report you linked is not the slides.)

  9. You don’t understand. It’s a moral issue. It’s not about expanding coverage. It’s about profits going to the rich.
    Rich capitalists profit off of health care, and that’s not fair. That’s why we need single payer.
    Government doesn’t waste money on profits to the rich. That makes government more moral than capitalism. So what if it does a poorer and less efficient job, and obtains its funds through coercion instead of voluntary exchange. The fact that it doesn’t give profits to the rich outweighs all of that.
    Feel the envy. Let your hatred for the rich grow and control you. Then you will understand that it is better to allow a sick person to die than to allow a rich person to profit from healing them.

    1. I wish I had written that!

      1. Sorta paraphrasing Darth Vader there.

        1. Palpatine actually… Sorry, my nerd is showing.

          1. good catch. I also would have conceded to the J. Peterman trump card…

            “The very people it was supposed to help.” sorta sounds like “The very pants I was wearing.”

            1. “You may call it Myanmar, but it’ll always be Burma to me.”

              I’ll take Peterman as well.

    2. “…Good, I can feel your anger. I am defenseless. Take your weapon. Strike me down with all of your hatred and your journey towards the dark side will be complete!”

      Feel the anger toward the rich and your journey will be complete.

      1. “Your libertarian friends, out there on the radical right, are walking into a trap…an entire legion of bombastic smear pieces awaits them!”

        Obamugabe

    3. One death is a tragedy. One million deaths is a statistic.

  10. a troubling development when it comes to Obamacare: The very people it was supposed to help the most -the uninsured -don’t seem to want the damned thing.

    Isn’t this basic marketing? Isn’t one supposed to do surveys and studies to determine whether a market exists for a proposed product before actually investing in it?

    I guess not if you are a TOP. MAN. who is funded by taxes instead of a businessperson looking to turn a profit.

    1. They did do those studies. The market they are in is not health insurance though. It is vote-getting. And it turns out a market exists for votes from naive liberals that think Obamacare will fix the healthcare industry.

  11. My surprised face is getting really worn out.

      1. Not anymore.

    1. I’m guessing it resembles Grumpy Cat now.

  12. Nick, you know what your target audience wants? Alt-text.

    1. And good alt-text at that!

  13. People who are likely to spend less than paying for something themselves than paying for insurance premiums don’t want insurance? But… it’s health insurance. It’s an absolute necessity to live even one day. Who wouldn’t want that?

  14. Question for Tony or any statist regarding Smoot-HawleyII aka Obumcare. We know you think politics[kind\caring] trumps profits[evil!!!]. What if Mitt had won and flipped on repeal and made Sarah Palin the head of HHS?

  15. I haven’t read every post but to me ObamaCare sounds a lot like Social Security. The young pay for the old and probably won’t get anything for all the money they’ve paid in when they do finally need it.

  16. Adam Smith, BABY!

    Increase demand for a product/service, for instance, health care, and watch the price go up up up.

    You probably heard that 25 times back when all of this was decided. Now that we’re closer to doomsday, think about it. See if it doesn’t unfold so. The only way this would work, and only for a decade, is under communism; then corruption would take over.

    What a joke it all is.

  17. They’ll like what they’re told to like. *THE PEOPLE* have spoken.

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  19. Most of these uninterested folks will either enroll in some government program (medicaid, most likely) or wait until last minute to buy insurance. Because you know hospitals can’t reject them.

    If your mom and dad are insurance, you can piggyback on their plan.

    I’m not buying insurance. My parents aren’t buying insurance. None of my illegal (I’m not AP) friends are buying insurance. If you’re actually making enough money to support yourself, you can opt out by paying a penalty. Or just not pay the penalty, because who’s gonna come after you? The IRS?

  20. Is the Supreme Emperor really supposed to give a damn whether or not his lowly dirty subjects want what he forcibly “gives” them?

    Hahaha!!!

  21. Obamacare…designed to fail, a stepping stone

    Single payer, also a financial disaster

    Control, domination, dependence…NOW WE’RE TALKIN!!!

  22. my classmate’s mother makes $86/hr on the laptop. She has been fired for 6 months but last month her paycheck was $12984 just working on the laptop for a few hours. Read more here http://www.great90.com

  23. People with no assets have no need for insurance. Period. Seems like we could give docs (hospitals, nurses, etc.) a dollar for dollar tax credit for pro bono work up to 100% of their non-payroll tax http://www.celinebagsaleuk.com/ burden and get better results all around.

    1. Wait. Part of the purpose of the Nationalized Health Care plan is to eliminate private practice — doctors are not meant to “choose” to do anything. [Excepting private treatment for the political class and their cronies.]

  24. “Fascist Health Plan to Complement the Fascist Police/Surveillance/Security Apparatus, Fascist Educational Gulag and Fascist Military-Industrial Machine.”

  25. up to I saw the paycheck saying $6065, I didn’t believe that my neighbours mother was really erning money part time at there labtop.. there friend brother has done this for only 8 months and recently paid for the dept on there cottage and purchased themselves a Land Rover Range Rover. go to,
    http://BIG76.COM

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