I've gone through the bill to try to ascertain why the CBO estimates public plan premiums in the Exchange to be slightly higher than private plan premiums in the same Exchange. Here is my (tentative) interpretation.
I'll start by stating what the CBO does NOT claim. They do NOT state that if a public plan is compared with a private plan offering exactly the same benefits and services, the public plan will be more expensive. In fact, it should be less expensive.
What they are estimating (read "guessing") instead is that those who choose a public plan will on average opt for a particular plan that is slightly more generous than a comparable private plan, and therefore slightly more expensive.
The public option will offer a range of plans in each locality - basic, enhanced, premium, and in some cases "premium plus", with each additional step providing more benefits and lower subscriber cost-sharing, but of course with a resultant higher premium cost. Private insurers can do the same, but all must offer at least the basic benefits package. Within each category is some slight room for flexibility in terms of cost sharing and other variables, although the basic package must always meet certain minimum standards. If private insurers refrain from going above the basic or the basic plus enhanced level, they will attract consumers interested in paying the least (possibly in some cases the healthiest consumers). Even if they offer all categories, they may still attract a disproportionate share of subscribers to the lower cost plans, but it would remain true that at each individual level of benefits, the public plan would be no more expensive and probably cheaper than the comparable private plan.
As I see this, the basic point is that a public option will always be a force for cost reduction on the part of the private insurers, assuming that the basic plans do in fact provide all essential services and benefits. If the "essential benefit package" (not yet defined) is inadequate, public plans could still outcompete private plans at the enhanced or premium levels, but an inadequate basic plan would force some consumers to pay more than would be desirable because they would have to purchase a higher level plan. For example, the higher level plans entail less cost sharing by subscribers and might be sought by individuals with pre-existing conditions eager to avoid excessive out of pocket expenses.
Surprise, surprise.
People who are eligible to purchase insurance in the exchange constitute the highest-risk portion of the public not covered by Medicare or Medicaid. So we create a public option that is only available to them, then tie it's hands so that it cannot use it's full buying power to achieve lower costs.
In the article referenced above, the CBO estimates 6 million people will choose the public option. The CBO also notes that "The public plan would have lower administrative costs than those private plans but would probably engage in less management of utilization by its enrollees and attract a less healthy pool of enrollees."
Whee! Let's all party like it's 1993.
What a train wreck, this "reform"....
Meanwhile, the libertarians are busy enumerating $540 billion of revenue in the text of the bill that will come from taxes on ordinary people (not the super-rich, contrary to the shameless lies of Pelosi) and taxes on small businesses.
And yeah, I can totally see how a more expensive "consumer option" will be a force for cost reduction in private plans. That makes as much sense as the rationale for the reform itself (but it won't stop left-wingers from believing it as if it was an 11th commandment).
Lalo, I'll give you a few minutes to make an effort to understand why public option plans with a higher average premium cost might not only reduce the costs of private plans but also be less expensive in every instance than a comparable private plan.
I infer that mathematics is not something you have done much of lately, and so you don't quickly intuit the concept of weighted averages, but if you try out some hypothetical examples, you'll see how the public option can save money for every subscriber even if the cost of premiums averaged over all its plans exceeds that of the private plans.
Give it a try, and if you still have trouble, I'll help you out.
Fred, better yet - gimme a break. I know you're great at hypotheticals.
However, here in the real world, the private plans will take the young, healthy and rich and dump the poor and the sick to the public option. So yeah - the private plans will cost less and the public option will cost more.
And that's what this was all about?????
It's not a matter of dumping. In the Exchange, no plan, public or private, can "dump" anyone - no-one can be turned away or charged discriminatory rates based on health status. Anyone who is poor or sick can choose the cheapest plan possible, if he or she so desires, and if that's the basic level plan, the public version will be cheaper than the private version.
I don't think you can lump "the poor and the sick" together, because the poor (above Medicaid level) would probably choose the cheap, basic plan, and pay less for the public version than the private version. Those with health problems might choose an enhanced or premium plan because of its lower cost sharing. Here too, the public version would be cheaper than the private version. However, if more ill individuals chose these enhanced versions (presumably preferring public to private versions because they are cheaper), the "average" public plan premium would end up higher. Note, however, that this would do absolutely nothing for insurer profits, because in each category they would have to compete with the public version.
I can, if anyone wishes, illustrate this with some sample numbers, but it always comes out that any subscriber can save money by choosing a public version over a private version at any level - basic, enhanced, or premium - and this keeps insurers from charging too much.
What it comes down to is that the higher "average" cost of public plans is a statistial artefact unrelated to the fact that whatever particular set of benefits one seeks, it would always be possible to save money by choosing the public version, and no insurer can prevent anyone from choosing what he or she wishes.
And Fred wins the debate! Facts beat histrionics every time (except on Fox News).
Here's the solution: Eliminate the age limits of 'over 65' on the Medicare bill. Problem solved.
Pass H.R 676, the 50 page health care bill that will make health care costs drop dramatically. Problem solved. Take the middle man, the insurance corporations out of the equation. Problem solved.
Don't like these proposals? How about this bill's policy of letting children stay on their parent's insurance policy til age 27 and then lowering the age of Medicare to age 28. LOL, PROBLEM SOLVED!
Lately I've been musing over whether CBO gets the size of the exchange right. (Link needs a click twice.)
Here's what CBO says about the public plan. As far as I know it's all they say.
Under the proposal, certain employers could allow all of their workers to
choose among the plans available in the exchanges, but those enrollees
would not be eligible to receive subsidies via the exchanges (and thus are
shown in Table 2 as enrollees in employment-based coverage rather than as
exchange enrollees). CBO and JCT expect that approximately 9 million
people would obtain coverage in that way in 2019, bringing the total
number of people enrolled in exchange plans to about 30 million in that
year. Roughly one-fifth of the people purchasing coverage through the
exchanges would enroll in the public plan, meaning that total enrollment in
that plan would be about 6 million.
That estimate of enrollment reflects CBO’s assessment that a public plan
paying negotiated rates would attract a broad network of providers but
would typically have premiums that are somewhat higher than the average
premiums for the private plans in the exchanges. The rates the public plan
pays to providers would, on average, probably be comparable to the rates
paid by private insurers participating in the exchanges. The public plan
would have lower administrative costs than those private plans but would
probably engage in less management of utilization by its enrollees and
attract a less healthy pool of enrollees. (The effects of that “adverse
selection” on the public plan’s premiums would be only partially offset by
the “risk adjustment” procedures that would apply to all plans operating in
the exchanges.)
In other words, it would probably do less to deny procedures to patients and probably would attract a sicker population. Thus, higher premiums.
Here's my take on the ambiguous CBO claims, in light of what's in the bill. All insurers, public and private, must offer a basic package of the same essential benefits. The public option will also offer an enhanced plan with more benefits and lower cost-sharing but higher premiums, and a premium plan that goes even further in the same direction. Private insurers can do the same if they wish, again meeting the same criteria for benefits and cost-sharing.
The CBO seems to be assuming that young, healthy, low risk individuals unconcerned about the probability of medical problems, will gravitate mainly to the low premium basic plans, with high cost-sharing percentages, whereas groups with more health concerns might in some cases choose the enhanced or premium plans. For illustration, let's assume an extreme example in which private plans attract the low risk individuals only into the cheap, basic plans, whereas the public option is evenly split, at 33.3 percent in each of the three categories, in covering its subscribers with slightly higher average risk, so that a significant fraction are in the higher cost plans. Assume that the private basic plan costs $10,000 annually, while the public plans cost $9600, $11,600, and $13,600 for their basic, enhanced, and premium versions. The "average" cost of the private plans will be $10,000, while the average cost of the public plans will be $11,600. That's a higher average, but for a basic plan, the public version is a better bargain.
In this oversimplified example, one could ask, "why would anyone buy a private plan for $10,000 when they could save $400 with the public version?" In fact, reform opponents are making exactly that charge in claiming that a public option would drive private insurers out of business. The CBO, however, is assuming that in the basic plan category (and the other categories as well), the benefit packages, which have yet to be defined in the legislation, will be required to meet some specific criteria, but will probably vary in other details, including premium costs. For that reason, some individuals may prefer private versions even if they average out overall to slightly higher costs. It seems clear to me that much guesswork is going into these estimates, but no evidence has been offered to indicate that if two plans offer exactly the same benefits, the public one won't be cheaper, nor does the CBO make that claim.
Finally, even if the private plans garner more of the basic plan market and leave the public plans with more of the enhanced and premium plan market, there is nothing in the legislation that would make this disproportionately profitable for private insurers. Even at the low premium end, they would still have to compete with a public plan that would probably offer lower premiums on average. To undercut the public plans, they would have to operate at a loss.
As an example of the guesswork I referred to, the CBO seems to be guessing that within a category, say basic plans, there will be latitude such that a private plan might often offer a managed care package that would cost them less, allowing them to offer lower premiums, whereas a public plan would frequently offer subscribers more provider choices ("less management of utilization") that would make their premiums more expensive. Given that the exact benefit requirements remain to be specified, I'm nost sure why the CBO assumed this, nor is there any obvious reason why it should be true, except perhaps by analogy with Medicare (government run) which is based on a fee for service model, in contrast to Medicare Advantage plans run by private insurers, that often utilize an HMO type system.
Sorry but I have no idea why you are saying this. As far as I know, the only thing the CBO says regarding its rationale is the following:
The public plan would have lower administrative costs than those private plans but would probably engage in less management of utilization by its enrollees and attract a less healthy pool of enrollees.
That leaves open a very wide margin for interpretation. Your scenario could be true, but so could another one: namely, the public plan just attracts a uniformly sicker population and engages in uniformly more liberal policies regarding paying for services, generating uniformly higher premiums. I go with Occam's razor.
The problem is that for the proposed Exchange, public plans don't exist in full detail, nor do private ones - merely the outlines. We know that in general, they will be required to offer the same set of essential services in their basic level plans, and similar equalization requirements will apply to the higher cost plans. Therefore, I don't see what it is about the public plans in the basic category that would indicate that the "public plan attracts a uniformly sicker population and engages in more liberal policies", since the plan(s) haven't yet been formulated. Rather, I see the CBO as guessing that private plans will devote only modest efforts at best trying to attract subscribers to the higher cost plans, leaving those subscribers mainly for the public plans. That would raise the "average" premiums, but should not deprive the public plan of subscribers at the basic level. My point is that private insurers concentrating on the low risk, low premium market will still have to compete with public plans for that market, and since they won't be permitted to offer less than the minimum benefit package, they can't save money and charge low premiums by offering less than the public plans are required to offer, nor can they save money by excluding anyone who wishes to subscribe, since they are required to accept all comers. That's what the bill says, and I didn't find anything in it that imposed unique requirements on public plans at the basic level that would impair their competitiveness. The one difference is that the public option must also offer the higher level plans, while private insurers are not required to, and those are the plans that might attract some individuals with health problems. However, those higher level plans can charge higher premiums so as to recoup their costs, allowing the basic plans to keep their premiums at or below those of private insurers, thereby preventing the private insurers from excessive profiteering.
Fred, I suppose a good analogy would be cars.
Suppose I want to buy a Mustang and the dealer has three models matching my color and interior wants. The first model is the economy one.
The economy model uses a fuel efficient design that uses low-grade gasoline for better mpg for both highway and city driving. Comes with a standard 4-speed transmission. The overall weight is less and comes with smaller tires on rims with hubcaps. The interior is pleather and the instrument panel is composed of the basic idiot lights. It's tacky, but looks cool - nothing to be ashamed of. My out-of-pocket cost for insurance is well within my budget and the yearly cost for gasoline for the year isn't a budget buster neither.
The middle model is more refined. It has a few more horseys under the hood. The engine is designed for using the mid-level grade gasoline and it's mpg is very close, but less than the economy model. The transmission is a 5-speed and the tires are more aggressive on sporty rims. Front disc brakes with are standard, but anti-locking are an add-on feature.The interior is more leathery looking than the economy pleather and the instrument panel boasts a few gauges in place of idiot lights. Extremely nice piece of machinery. My out-of-pocket cost for insurance is while isn't a budget buster, does push the limits on my budget and the yearly cost for gasoline for the year might make me budget my driving habits depending on fuel costs.
Finally, the top-of-the-line model is a dream car. The engine's got power and torque coupled with a 6-speed transmission and a premium set of tires on light-weight designer rims. It uses the premium grade of gasoline and it's mpg while impressive is lower than both the economy and mid-level cars. It has disc brakes all around as well as anti-sway bars and a hefty suspension system. The car screams power. The interior is elegant, real leather and walnut burl panels, with a complete set of instrument gauages and very few idiot lights. My out-of-pocket cost for insurance most probably be that budget buster and the yearly cost for gasoline for the year will make me budget my driving habits regardless of fuel costs.
The health insurance plans work the opposite way. The basic plan has the highest out of pocket expense rates, and the premium plan the lowest. That is one of several reasons why it's "premium".
By out of pocket, I refer to costs that insurance won't pay. Of course, the insurance premiums are higher for the premium plan.
I've gone through the bill to try to ascertain why the CBO estimates public plan premiums in the Exchange to be slightly higher than private plan premiums in the same Exchange. Here is my (tentative) interpretation.
I'll start by stating what the CBO does NOT claim. They do NOT state that if a public plan is compared with a private plan offering exactly the same benefits and services, the public plan will be more expensive. In fact, it should be less expensive.
What they are estimating (read "guessing") instead is that those who choose a public plan will on average opt for a particular plan that is slightly more generous than a comparable private plan, and therefore slightly more expensive.
The public option will offer a range of plans in each locality - basic, enhanced, premium, and in some cases "premium plus", with each additional step providing more benefits and lower subscriber cost-sharing, but of course with a resultant higher premium cost. Private insurers can do the same, but all must offer at least the basic benefits package. Within each category is some slight room for flexibility in terms of cost sharing and other variables, although the basic package must always meet certain minimum standards. If private insurers refrain from going above the basic or the basic plus enhanced level, they will attract consumers interested in paying the least (possibly in some cases the healthiest consumers). Even if they offer all categories, they may still attract a disproportionate share of subscribers to the lower cost plans, but it would remain true that at each individual level of benefits, the public plan would be no more expensive and probably cheaper than the comparable private plan.
As I see this, the basic point is that a public option will always be a force for cost reduction on the part of the private insurers, assuming that the basic plans do in fact provide all essential services and benefits. If the "essential benefit package" (not yet defined) is inadequate, public plans could still outcompete private plans at the enhanced or premium levels, but an inadequate basic plan would force some consumers to pay more than would be desirable because they would have to purchase a higher level plan. For example, the higher level plans entail less cost sharing by subscribers and might be sought by individuals with pre-existing conditions eager to avoid excessive out of pocket expenses.
October 30, 2009 1:27 PM | Reply | Permalink
Surprise, surprise.
People who are eligible to purchase insurance in the exchange constitute the highest-risk portion of the public not covered by Medicare or Medicaid. So we create a public option that is only available to them, then tie it's hands so that it cannot use it's full buying power to achieve lower costs.
In the article referenced above, the CBO estimates 6 million people will choose the public option. The CBO also notes that "The public plan would have lower administrative costs than those private plans but would probably engage in less management of utilization by its enrollees and attract a less healthy pool of enrollees."
Whee! Let's all party like it's 1993.
October 30, 2009 1:28 PM | Reply | Permalink
What a train wreck, this "reform"....
Meanwhile, the libertarians are busy enumerating $540 billion of revenue in the text of the bill that will come from taxes on ordinary people (not the super-rich, contrary to the shameless lies of Pelosi) and taxes on small businesses.
And yeah, I can totally see how a more expensive "consumer option" will be a force for cost reduction in private plans. That makes as much sense as the rationale for the reform itself (but it won't stop left-wingers from believing it as if it was an 11th commandment).
October 30, 2009 2:06 PM | Reply | Permalink
Lalo, I'll give you a few minutes to make an effort to understand why public option plans with a higher average premium cost might not only reduce the costs of private plans but also be less expensive in every instance than a comparable private plan.
I infer that mathematics is not something you have done much of lately, and so you don't quickly intuit the concept of weighted averages, but if you try out some hypothetical examples, you'll see how the public option can save money for every subscriber even if the cost of premiums averaged over all its plans exceeds that of the private plans.
Give it a try, and if you still have trouble, I'll help you out.
October 30, 2009 4:00 PM | Reply | Permalink
Fred, better yet - gimme a break. I know you're great at hypotheticals.
However, here in the real world, the private plans will take the young, healthy and rich and dump the poor and the sick to the public option. So yeah - the private plans will cost less and the public option will cost more.
And that's what this was all about?????
October 30, 2009 7:43 PM | Reply | Permalink
It's not a matter of dumping. In the Exchange, no plan, public or private, can "dump" anyone - no-one can be turned away or charged discriminatory rates based on health status. Anyone who is poor or sick can choose the cheapest plan possible, if he or she so desires, and if that's the basic level plan, the public version will be cheaper than the private version.
I don't think you can lump "the poor and the sick" together, because the poor (above Medicaid level) would probably choose the cheap, basic plan, and pay less for the public version than the private version. Those with health problems might choose an enhanced or premium plan because of its lower cost sharing. Here too, the public version would be cheaper than the private version. However, if more ill individuals chose these enhanced versions (presumably preferring public to private versions because they are cheaper), the "average" public plan premium would end up higher. Note, however, that this would do absolutely nothing for insurer profits, because in each category they would have to compete with the public version.
I can, if anyone wishes, illustrate this with some sample numbers, but it always comes out that any subscriber can save money by choosing a public version over a private version at any level - basic, enhanced, or premium - and this keeps insurers from charging too much.
What it comes down to is that the higher "average" cost of public plans is a statistial artefact unrelated to the fact that whatever particular set of benefits one seeks, it would always be possible to save money by choosing the public version, and no insurer can prevent anyone from choosing what he or she wishes.
October 30, 2009 8:14 PM | Reply | Permalink
And Fred wins the debate! Facts beat histrionics every time (except on Fox News).
October 30, 2009 10:26 PM | Reply | Permalink
Here's the solution: Eliminate the age limits of 'over 65' on the Medicare bill. Problem solved.
Pass H.R 676, the 50 page health care bill that will make health care costs drop dramatically. Problem solved. Take the middle man, the insurance corporations out of the equation. Problem solved.
Don't like these proposals? How about this bill's policy of letting children stay on their parent's insurance policy til age 27 and then lowering the age of Medicare to age 28. LOL, PROBLEM SOLVED!
October 30, 2009 7:36 PM | Reply | Permalink
Lately I've been musing over whether CBO gets the size of the exchange right. (Link needs a click twice.)
Here's what CBO says about the public plan. As far as I know it's all they say.
In other words, it would probably do less to deny procedures to patients and probably would attract a sicker population. Thus, higher premiums.
October 30, 2009 8:11 PM | Reply | Permalink
Here's my take on the ambiguous CBO claims, in light of what's in the bill. All insurers, public and private, must offer a basic package of the same essential benefits. The public option will also offer an enhanced plan with more benefits and lower cost-sharing but higher premiums, and a premium plan that goes even further in the same direction. Private insurers can do the same if they wish, again meeting the same criteria for benefits and cost-sharing.
The CBO seems to be assuming that young, healthy, low risk individuals unconcerned about the probability of medical problems, will gravitate mainly to the low premium basic plans, with high cost-sharing percentages, whereas groups with more health concerns might in some cases choose the enhanced or premium plans. For illustration, let's assume an extreme example in which private plans attract the low risk individuals only into the cheap, basic plans, whereas the public option is evenly split, at 33.3 percent in each of the three categories, in covering its subscribers with slightly higher average risk, so that a significant fraction are in the higher cost plans. Assume that the private basic plan costs $10,000 annually, while the public plans cost $9600, $11,600, and $13,600 for their basic, enhanced, and premium versions. The "average" cost of the private plans will be $10,000, while the average cost of the public plans will be $11,600. That's a higher average, but for a basic plan, the public version is a better bargain.
In this oversimplified example, one could ask, "why would anyone buy a private plan for $10,000 when they could save $400 with the public version?" In fact, reform opponents are making exactly that charge in claiming that a public option would drive private insurers out of business. The CBO, however, is assuming that in the basic plan category (and the other categories as well), the benefit packages, which have yet to be defined in the legislation, will be required to meet some specific criteria, but will probably vary in other details, including premium costs. For that reason, some individuals may prefer private versions even if they average out overall to slightly higher costs. It seems clear to me that much guesswork is going into these estimates, but no evidence has been offered to indicate that if two plans offer exactly the same benefits, the public one won't be cheaper, nor does the CBO make that claim.
Finally, even if the private plans garner more of the basic plan market and leave the public plans with more of the enhanced and premium plan market, there is nothing in the legislation that would make this disproportionately profitable for private insurers. Even at the low premium end, they would still have to compete with a public plan that would probably offer lower premiums on average. To undercut the public plans, they would have to operate at a loss.
October 30, 2009 10:37 PM | Reply | Permalink
As an example of the guesswork I referred to, the CBO seems to be guessing that within a category, say basic plans, there will be latitude such that a private plan might often offer a managed care package that would cost them less, allowing them to offer lower premiums, whereas a public plan would frequently offer subscribers more provider choices ("less management of utilization") that would make their premiums more expensive. Given that the exact benefit requirements remain to be specified, I'm nost sure why the CBO assumed this, nor is there any obvious reason why it should be true, except perhaps by analogy with Medicare (government run) which is based on a fee for service model, in contrast to Medicare Advantage plans run by private insurers, that often utilize an HMO type system.
October 30, 2009 11:04 PM | Reply | Permalink
Sorry but I have no idea why you are saying this. As far as I know, the only thing the CBO says regarding its rationale is the following:
That leaves open a very wide margin for interpretation. Your scenario could be true, but so could another one: namely, the public plan just attracts a uniformly sicker population and engages in uniformly more liberal policies regarding paying for services, generating uniformly higher premiums. I go with Occam's razor.
October 30, 2009 11:10 PM | Reply | Permalink
The problem is that for the proposed Exchange, public plans don't exist in full detail, nor do private ones - merely the outlines. We know that in general, they will be required to offer the same set of essential services in their basic level plans, and similar equalization requirements will apply to the higher cost plans. Therefore, I don't see what it is about the public plans in the basic category that would indicate that the "public plan attracts a uniformly sicker population and engages in more liberal policies", since the plan(s) haven't yet been formulated. Rather, I see the CBO as guessing that private plans will devote only modest efforts at best trying to attract subscribers to the higher cost plans, leaving those subscribers mainly for the public plans. That would raise the "average" premiums, but should not deprive the public plan of subscribers at the basic level. My point is that private insurers concentrating on the low risk, low premium market will still have to compete with public plans for that market, and since they won't be permitted to offer less than the minimum benefit package, they can't save money and charge low premiums by offering less than the public plans are required to offer, nor can they save money by excluding anyone who wishes to subscribe, since they are required to accept all comers. That's what the bill says, and I didn't find anything in it that imposed unique requirements on public plans at the basic level that would impair their competitiveness. The one difference is that the public option must also offer the higher level plans, while private insurers are not required to, and those are the plans that might attract some individuals with health problems. However, those higher level plans can charge higher premiums so as to recoup their costs, allowing the basic plans to keep their premiums at or below those of private insurers, thereby preventing the private insurers from excessive profiteering.
October 31, 2009 12:44 AM | Reply | Permalink
Fred, I suppose a good analogy would be cars.
Suppose I want to buy a Mustang and the dealer has three models matching my color and interior wants. The first model is the economy one.
The economy model uses a fuel efficient design that uses low-grade gasoline for better mpg for both highway and city driving. Comes with a standard 4-speed transmission. The overall weight is less and comes with smaller tires on rims with hubcaps. The interior is pleather and the instrument panel is composed of the basic idiot lights. It's tacky, but looks cool - nothing to be ashamed of. My out-of-pocket cost for insurance is well within my budget and the yearly cost for gasoline for the year isn't a budget buster neither.
The middle model is more refined. It has a few more horseys under the hood. The engine is designed for using the mid-level grade gasoline and it's mpg is very close, but less than the economy model. The transmission is a 5-speed and the tires are more aggressive on sporty rims. Front disc brakes with are standard, but anti-locking are an add-on feature.The interior is more leathery looking than the economy pleather and the instrument panel boasts a few gauges in place of idiot lights. Extremely nice piece of machinery. My out-of-pocket cost for insurance is while isn't a budget buster, does push the limits on my budget and the yearly cost for gasoline for the year might make me budget my driving habits depending on fuel costs.
Finally, the top-of-the-line model is a dream car. The engine's got power and torque coupled with a 6-speed transmission and a premium set of tires on light-weight designer rims. It uses the premium grade of gasoline and it's mpg while impressive is lower than both the economy and mid-level cars. It has disc brakes all around as well as anti-sway bars and a hefty suspension system. The car screams power. The interior is elegant, real leather and walnut burl panels, with a complete set of instrument gauages and very few idiot lights. My out-of-pocket cost for insurance most probably be that budget buster and the yearly cost for gasoline for the year will make me budget my driving habits regardless of fuel costs.
October 31, 2009 6:35 AM | Reply | Permalink
The health insurance plans work the opposite way. The basic plan has the highest out of pocket expense rates, and the premium plan the lowest. That is one of several reasons why it's "premium".
October 31, 2009 10:46 AM | Reply | Permalink
By out of pocket, I refer to costs that insurance won't pay. Of course, the insurance premiums are higher for the premium plan.
October 31, 2009 10:48 AM | Reply | Permalink