I don’t know about large company plans, but small business plans all seem to be age-banded. So any coverage available to an employee above the age of 55 or 60 will be, by this definition, a Cadillac plan. But for young employees, the $8K limit would have zero effect as an incentive.
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I believe age-rating still applies to all small-business plans — but not member-association plans. I recently retired as a small-biz consultant for 40 years, and founded a local small-biz group in the 70s for healthcare and general group purchasing.

We need to appreciate how our employer-based system discriminates against the vast majority of American workers who work in small business. It’s not just the rates, smaller businesses cannot manage more than two choices. That was the focus of my year 2000 general election campaign for Washington State Insurance Commissioner.

That’s why the insurance exchanges COULD be super (without all the dumb regs). I would expect the small employer to have well over 50 different plans — a lot more than government and big-corp employee.

On that insurance commissioner race — by hindsight, I would have won if I hadn’t run as a Libertarian. (When you’re done laughing …..)

>>>>So … what do you suggest as incentive in place of a mandate?

Tell me the issue where mandates now govern, and I can show you an incentive.

Carrot and stick. Which is more effecftive with you at your job — incentives or threats?

>>>Should we deny people without insurance admission to the emergency rooms?

That’s not as big a mnadate as you may think. The federal government reimburses hospitals for unpaid ER treatment.

>>>Deny them care when they get sick?

I’ll assume you mean deny them insurance when they get sick. I’d be a fool not to.

My Dad died yesterday. I rushed out to buy life insurance on him, to pay for his funeral. Those greedy insurance companies only care about their damn profits. Every single one of them turned me down, which PROVES they are corrupt.

If people can buy insurance AFTER they get sick, why should anyone buy it BEFORE they get sick?

This proposed mandate should not be replaced with an incentive. It should be dropped. If you offer people an incentive to rip off their fellow man, don’t be surprised when some of them do it.

>>>Let them die when that can’t afford medication?

There is no mandate on that

>>>Limit (ration) health care only to the insured? “Too bad, you should have bought insurance when you had the chance.”

Forget healthy care. Wal-Mart rations FOOD. They make me pay for it.

We need to deal with people who may be uninsured from changing jobs, or being temporarily unemployed. And we need to separate these people from the ones who would intentionally avoid insurance until after they get sick. Tell me how YOU would do that and I’ll show you an incentive that will work better.

>>>>Talk about pulling the plug!

Let’s review. You asked me a question. You provided answers. Then you judged ME based on YOUR answers.

How long have you been in office, Congressman?

Thanks for the opportunity to clarify. I may have tried to squeeze too much here. I mean the effects of Community Rating on — say — a 25 year old vs a 55 year. That’s how both parties sabotaged prepaid HMOs a quarter-century ago, when they had a 25-30% price advantage over third party insurers.

Two ways to illustrate the principal here. In the direct examples I’ve found so far, the 55-year-old has premiums 5-6 times higher than the 25-year old.

With Community Rating everyone pays the same. The younger guy’s rates increase sharply, to offest much lower rates on the older guy. (I’m 67, in Medicare)

That’s what I meant about younger people seeing massive rate increases under Obamacare. As a Heritage reader, I’m sure you’ve seen all sorts of academic level arguments against Community Rating, none of which connect with the average American.

When I tell young people how their rates will skyrocket, they sit up and take notice.

EVERYONE takes notice when I describe Community Rating as Robin Hood in reverse: taking from younger (generally healthier) people and giving to older (generally wealthier) people.

“For this we need liberals?”

If you don’t mind, I’d like to critique your next statement. GREAT point, but I’ve done a lot of candidate coaching on how to best frame issues.

Bart Ingles sez: I’d decline to guess what percentage of GDP is appropriate to spend on health care.

In a free society, whatever we choose.(That was too easy!)

Bart Ingles:If we were a poor nation that spent most of its income on subsistence, then I could imagine a very low number.

BINGO! One of the least understood facts I believe. I’m researching an entire blog post on the issue. Consider expanding your opening statement instead of this next part ….

Bart Ingles: But as it is, with all the other crap we consume, from 4,000 sq. ft. McMansions to SUV’s to every kind of consumer gadget imaginable, who’s to say that 15 or 20% is excessive?

A lot of people are insulted by that. If you wish to persuade people — and you seem the type to persuade instead of scream — dont’t attack them for owning an SUV. Persuasion is a lost art in these days of bipartisan hate fests.

Enough babble (mine). I like attention getters. We spend more on healthcare for the same reason Bill Gates has more disposable income than a homeless guy. No insult, and you can expand your point about spending less on subsistence.

Bart Ingles : Neither the absolute level of spending, nor the rate of change (except where they apply to unfunded government obligations) should be the primary concern in health care “reform.” Just make sure that the spending is not shielded from market forces.

Quite true, Bart. But we still need to deal with these issues in the political arena. The public believes market forces have failed. So don’t use the term or you’ll raise a needless side issue, and may not even know it. Like what we call a “hidden objection” in sales.

We – economic libertarians — keep talking numbers, which is why we keep losing. Liberals talk about people. Who gives a damn if Canada has so many fewer MRIs and CAT scanners?

Think like a salesman: Sell the sizzle and not the steak. Let’s recall how von Mises titled his magnum treatise on market economics: Human Action.

It’s about people – how and why we act. Not machines. We know this. But do we practice it?

Here’s what I found on a Canadian Health web site.

The number of Canadian women receiving mammograms is 10% LESS than in the United States.

I’ve told that to a dozen women in the past week or so. I owned them – got their rapt and immediate attention Most of them are not engaged at all in politics. (Yet).

And none of them asked me about machines!

Canadians CAN’T pull the plug on grandma. They don’t have enough plugs to start with.

Sell the sizzle; not the steak.

http://www.PoliticallyHomeless.net

Talk about pulling the plug!