patrick.net

Here is the data on 2015 price changes for Region 7, which is Santa Clara County (basically all of the South SF Bay Area/Silicon Valley from Palo Alto to San Jose and Milpitas)

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Carrier %Enrollment %IncreaseWeightedAverage %IncreaseRange
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Anthem PPO 56.1% 1.5% 1% to 4%
Anthem* HMO 4.7% 6.4% 6% to 10%
Blue Shield PPO 10.7% 6.0% 6%
Health Net EPO 4.5% 7.5% 6% to 9%
Kaiser Permanente* HMO 21.0% -5.6% -11% to -5%
Valley Health HMO 2.9% 0.4% 0% to 3%
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Here is a more readable table

Obamacare is not ideal but it is a step in the right direction. A single-payer system would make more sense, but I doubt it is achievable in the foreseeable future.

Peter P says

Obamacare is not ideal

Having a fist shoved up your rectum isn't ideal either, but it's a step towards sexual intercourse so it's good ...???

Peter P says

A single-payer system would make more sense

You REALLY need to have spent time in the military to 'experience' a single payer system. Nothing better than walking down a line, single file, and having a line of medics/technicians/nurses giving you a shot in the right arm, followed by the next person giving you a shot in the left arm, next person the right arm, etc. If you go to commercial animal raising farms you will see the same thing. The animal goes down a shoot and the farm hand (usually with the gun that is used to inject the whatever) gives the animal a shot, followed by the next farm hand giving another shot. Single payer SUCKS. Why do you think those who can afford it (in single payer countries) pay out of pocket to get real medical care.

i don't need numbers or data. i just have to try to make an appointment.

justme says

If you are going to argue for or against Obamacare, at least be armed with some numbers.

any increase at all is too much.
IT was to much ten years ago, when incomes were on average 20% more.

mmmarvel says

You REALLY need to have spent time in the military to 'experience' a single payer system. Nothing better than walking down a line, single file, and having a line of medics/technicians/nurses giving you a shot in the right arm, followed by the next person giving you a shot in the left arm, next person the right arm, etc.

Check with any Briton, Frenchman, Northern European, heck, just about any European, if this is how single-payer works. The answer is NO. The above is an illustration of how the MILITARY works, not how single-payer works.

justme says

MILITARY works, not single-payer.

And the military is not a single payer?? Since when??

justme says

Check with any Briton, Frenchman, Northern European, heck, just about any European

And ask them if they love the wait times that they encounter? Hey, when it finally happens, it's okay, not terrific (although it's often not terrific here in the USA either). It's adequate, it's ... really basic health care. No reason for me to think it's fantastic, cause it's not. Oh, and you didn't address the issue of those who can, pay for private. If single payer is all that and a bag of chips, why would they pay for private???

mmmarvel says

If single payer is all that and a bag of chips, why would they pay for private???

It is often a mix of convenience, vanity and urgency. I know someone who got a hip replacement operation privately because she chose not to wait 3 months. It was non-urgent, or else the public system would have done it right away.

mmmarvel says

justme says

MILITARY works, not single-payer.

And the military is not a single payer?? Since when??

I will rephrase to remove any smidgen of ambiguity:

The above is an illustration of how the MILITARY works, not how single-payer works.

mmmarvel says

Why do you think those who can afford it (in single payer countries) pay out of pocket to get real medical care.

And there should be a private system for those who can afford it. Problem solved.

mmmarvel says

Oh, and you didn't address the issue of those who can, pay for private. If single payer is all that and a bag of chips, why would they pay for private???

Probably for the same reasons the wealthy are willing to pay 5x - 10x as much to fly first class. More comfort and better service.

... And Kaiser for the win. I imagine the defections will be numerous and many, especially since they've lowered rates. Their biggest challenge is to keep up the quality as they continue scaling up.
@justme, thanks for tracking this info down. It's pretty clear that Kaiser will become our NHS. Still liking the competitive multi-payer marketplace with government oversight.

EBGuy says

.. And Kaiser for the win.

Maybe. Last year they were actually considerably higher than Blue Shield in my area (North Bay). I think they were afraid of just what you mentioned scaling up to deal with lots of new patients. I stayed with Kaiser even though I could have saved money with another carrier. I have been very satisfied with their system, not perfect but good.

Peter P says

Obamacare is not ideal but it is a step in the right direction. A single-payer system would make more sense, but I doubt it is achievable in the foreseeable future.

Right on the money!

rdm said: Maybe. Last year they were actually considerably higher than Blue Shield in my area (North Bay). I think they were afraid of just what you mentioned scaling up to deal with lots of new patients.
That was definitely a concern when I talked with folks who work there. They didn't want to be flooded with patients who were both needy and had lower reimbursement rates. I imagine they'll keep taking share each year until a credible alternative emerges from the belly of the beast (that would be the Sutter hospitals + Sutter Medical Foundations + insurance arm to be named later).
@rdm, According to the booklet that justme posted, Kaiser is looking pretty competitve with BS for 2015. Is that your experience?

rdm says

EBGuy says

.. And Kaiser for the win.

Maybe. Last year they were actually considerably higher than Blue Shield in my area (North Bay).

I think indeed Kaiser was extra careful in 2014, which made rates higher than others. However, the Kaiser rates are still much lower than the high-risk pool rate, by a factor of about 2x. Also keep in my mind that the ACA mandates refunding money to the insured if the Medical Loss Ratio is below 80% of total premiums paid.

I think it is a good bet that Kaiser CoveredCA subscribers can expect a refund check for 2014, sometime in 2015.

There has already been 8.5 million refunds averaging $100 each for year 2012:

http://www.whitehouse.gov/blog/2013/07/18/refund-your-health-insurance-company-thank-affordable-care-act

Kaiser is making HUGE strides to cut the fat in their system while keeping the quality gains they've made over the years. I know first hand that it's as a result of a multi-payer system (i.e., market competition) that Kaiser is forcing itself to undergo this transformation. If we went single payer, the fat would return just like it exists in any monopoly (e.g., government).

Like EBGuy said, keep the multi-payer system and have gov't oversight. Obamacare is a great move forward.

justme says

Check with any Briton, Frenchman, Northern European, heck, just about any European, if this is how single-payer works. The answer is NO. The above is an illustration of how the MILITARY works, not how single-payer works.

Correct. Single payer would basically be Medicare for all.

It makes too much sense, right ? IT already covers a huge percentage of the big stuff.

We could throw the insurance companies a bone and let them sell supplemental policies.

This is one thing that pisses me off about Obama. His experts said that this is too much, and that he wouldn't be able to make it happen. Probably more like the plutocrats nixed it because of the tax hit they would take.

justme said: I think it is a good bet that Kaiser CoveredCA subscribers can expect a refund check for 2014, sometime in 2015.
I weep for the poor GOP candidate that will have to campaign against the refund checks (still wondering how they work for subsidized CoveredCA participants). Mitch McConnell has promised to pull up ObamaCare "root and branch", but still maintain the state exchanges. Oh, that should be fun...

EBGuy says

.. And Kaiser for the win. I imagine the defections will be numerous and many, especially since they've lowered rates. Their biggest challenge is to keep up the quality as they continue scaling up.

I'd easily go with Kaiser. Only problem is that I can't do a HSA with them, which I need for my dental expenses.

The best option for smart, healthy young capitalists like myself is too opt out and pay the fine

zzyzzx says

EBGuy says

.. And Kaiser for the win. I imagine the defections will be numerous and many, especially since they've lowered rates. Their biggest challenge is to keep up the quality as they continue scaling up.

I'd easily go with Kaiser. Only problem is that I can't do a HSA with them, which I need for my dental expenses.

Actually you can select a high deductible, HSA-qualified plan with Kaiser...but that's only if your employer offers it:
http://info.kaiserpermanente.org/html/deductibleplans/detailedproductshsa.html

debyne says

Actually you can select a high deductible, HSA-qualified plan with Kaiser...but that's only if your employer offers it:

Yes, I think a HSA can only be part of an employer-based plan, and not an ACA/CoveredCA plan.

EBGuy says

@rdm, According to the booklet that justme posted, Kaiser is looking pretty competitve with BS for 2015. Is that your experience?

Yes Kaiser is more competitive than last year. My Kaiser policy has about a 3% increase this year. It looks like BS has had considerably higher increases but is still a bit below Kaiser (on my policy)

justme says

I think a HSA can only be part of an employer-based plan, and not an ACA/CoveredCA plan.

I believe when I was looking at the plans, Kaiser does offer an HSA plan through Covered CA. for individuals. Now I dont know if that is a State wide offering or not and I didn't look at the details. It can be checked out on the Covered CA. web site which seems to be functioning pretty well (unlike last year)