On 10/13/2013 1:51 PM, Ed Pawlowski wrote:

Looks like his plan is to take from the middle class and give to the
poor. If your income is low, the premiums are lower, but still stiff
for what you earn.

If poor people, who can't afford insurance, have a major problem now
they wind up in an emergency room. That is a real expensive way to
provide medicine. And the hospital raises its rates to cover the cost.

The same is true for people who can get insurance and don't - like young
adults. Then they can't pay for huge medical costs. The hospital raises
its rates to cover the cost.

The cost of uncompensated care is a major part of the medical cost for
the rest of us. If you have insurance you are already paying for
providing medical care for other people. If everyone has insurance that
cost goes away, which means medical costs go down. (That is the reason
for everyone to get insurance.)

Minnesota has had a program to get affordable insurance for people who
can't get it on the open market. It was financed by something like
surcharges to hospitals. Because people were insured the uncompensated
medical costs went down, which helps hospitals. As a result hospitals
liked the program. Some of these people can get insurance on the
exchanges because preexisting conditions no longer count. Some other
people have been moved to the extended Medicaid(?) which states can opt
into.

The county I live in has a pilot program to provide medical care to
homeless people (if I remember right). They then don't get routine care
in emergency rooms. And routine care is far cheaper than allowing
medical problems to escalate. The program is pretty new but the costs
look good. It may be funded by extended Medicaid(?).

Exchanges are a republican idea to use competition to lower costs. The
plans are easily comparable, which was not very easy now. There are 4
levels of insurance with lower premiums and higher copays at one end.
The Minnesota exchange has some of the lowest cost plans in the country.