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In 2006, almost 43 million Americans had no health insurance, which translates into nearly 15 percent of the American population. This might be attributed to the fact that health care costs can be very expensive, and the cost of even the most basic care is steadily rising.Today, the amount Americans spend on health care is four times as much as the government spends on national defence. So it's no surprise that along with increased health care cost comes increased health insurance premiums. Employers typically bear the brunt of the expense for health insurance, but individuals are paying more and more each year as well. In 2006, employer insurance premiums increased 7.7 percent, twice the rate of inflationHow insurance works in US:-Group InsuranceThe majority of people under the age of 65 have medical insurance through their employers' group insurance. According to the National Coalition on Health care, in 2005, over 80 percent of employees were eligible for employer-group insurance and 83 percent of those who were offered, opted for these types of plans. This is usually because employers and other organizations can get better rates because they have a large number of people to cover. The insurance company sees it as good risk because they'll probably end up paying out very little for many people in the group, while collecting premiums from everyone. Normally, this translates into premiums that are much lower than those found in individual health insurance plans and are the same price for everyone in the group regardless.Individual Health InsuranceIndividual health insurance is the most expensive option for people who don't have coverage (or don't have enough coverage) through employers. Physical exams and questionnaires are usually a part of the application process, so poor health can really make a difference in the cost and eligibility. Types of insurance plans include fee-for-service plans, PPOS, HMOs and Catastrophic insuranceMany companies offer health insurance for individuals and specialize in short-term coverage to fill in between employer coverage.National Health insuranceThe federal Government also has health insurance programs for those who are eligible. Medicare is health insurance for people age 65 or older, those who are under age 65 with certain disabilities, and people of all ages with end-stage renal disease (those with permanent kidney failure requiring dialysis or a Kidney transplant). Medicare includes hospital insurance (Part A), medical insurance (Part B) and prescription drug coverage (Part D).Medicaid is a state-administered health insurance program available to certain low-income individuals and families who fit into a recognized eligibility group. You must meet very specific requirements and considerations that include age, pregnancy, disability, blindness, income, resources, and U.S. citizenship or a lawfully admitted immigrant.These rules can vary from state to state.If a family earns too much to qualify for Medicaid, they may still qualify for State Children's Health Insurance (SCHIP). Another state-administered program, SCHIP covers uninsured children under the age of 19 whose families earn up to $36,200 a year (for a family of four). For little or no cost, SCHIP pays for doctor visits, immunisations, hospitalisations and emergency room visits.Commercial insurance companies:Right from the start of the campaigning trump has attacked obamacare for its inefficiency.Health insurance soon became a vital aspect of the elections.People of US even potraited the clash as “Obama care Vs Trump care”lets look on to what trump has to say about this.“We’re going to have insurance for everybody.”-President Donald TrumpHe mainly emphasised on the point of universal coverage.As on date if we look at the top commercial insurance companies in terms of market Cap are:United Healthcare (UNH)$91.8 billionWellpoint (WLP)$34.3 billionAetna (AET)$29.8 billionCIGNA Corp. (CI)$26.8 billionHumana (HUM)$21.1 billionHumana is one of the largest and best-known health insurance companies in the United States. It offers health care services for individuals, business owners and military personnel.Best for Heads of families, senior citizens, employeesAetna has been providing health insurance to Connecticut residents since 1853, and today covers people in all 50 states. It is a pioneer in health care legislation and is responsible for making coverage of genetic testing and counseling an industry standard.Best for Heads of families, senior citizensUnited Health Care is the largest single health care carrier in the United States. It currently covers approximately 70 million Americans and contributes large amounts of money to medical research every year.Best for Senior citizens, heads of families, employeesCigna is a worldwide health insurance organization that covers individuals, families and employers. It has been in business for over 30 years.Best for StudentsAs of now it would not be possible to predict the result with accuracy because of the following reasons;1.Insurance business is regulated. No one knows what president will come up with2.The profits are low when compared to other businesses3.A recent survey has people have put the fact that employees are spending a growing share of their income on health insurance costs which means insurance costs are directly proportionate to income growthFinally to conclude with,it’s the point of universal coverage which is emphasised by the president so the insurers with the “most coverage expansion” is expected to grow and make more operating profits under the presidency of Mr.Donald Trump.

Obamacare is actually a 20,000 plus page list of rules and regulations that affect one sixth of the United States economy. Very few in government understand what’s in the bill and as with everything run by the federal government, giving legislation a name “Affordable Care Act” doesn’t make it so. How is the War on Poverty, War on Drugs, etc. going?Obamacare didn’t sign up the group of Americans who needed to sign up. 170 million Americans already have great insurance through their employment. 55 million Americans have Medicare which is subsidized by the payments to doctors and hospitals from the 170 million. America’s poor have always had Medicaid.What was needed was the young healthy working Americans who did not work for larger businesses to buy insurance on the individual market to subsidize the older sicker Americans in that market. To make the older sicker Americans’ insurance more affordable, the government decided to make the younger healthy Americans pay a lot more for their insurance. If the analogy is car insurance, it’s like making the safe driver pay a lot more so that the unsafe driver can pay a lot less.Smart healthy Millenials did the math and sat out. Only sick Americans enrolled. So the only thing that happened was that in the individual market, insurance premiums and deductibles rose a lot while choices for doctors and hospitals became much more limited. And don’t forget that about 11 million Americans lost their individual plans when Obamcare kicked in and were thrown to sink or swim in these individual government exchanges.The only meaningful growth of enrollees in Obamcare was in Medicaid, the plan for the poor. For the first time, healthy single working Americans were put into the plan for the poor and disabled. That doesn’t work out because there are not enough doctors and clinics for them. So what do they do for care? They all go to the most expensive place in the world for their care, the United States emergency rooms. One more Obamacare lie; emergency room visits have gone up not down. Contrary to goals, ER visits rise under ObamacareObamacare isn’t sustainable. Medicare runs out of money in 2029, Social Security a few years after that and Medicaid costs are exploding. American debt is at a record $20 trillion.So what happens now? The dreaded but predicted Obamacare death spiral. It’s laughable that Pelosi and Schumer are whistling in the dark and pretending that all is well in the Obamcare world. Of course, America’s liberal major media outlets are giving them their full throated biased reporting with all pretensions of objectivity thrown out the window as they all try to out-Trump Trump.On healthcare, the Republicans are not demonstrating any kind of profiles in courage, aside from John McCain and who would have expected anything less for him?.So much for draining the swamp as both sides suck up the lobbying dollars from insurance companies, pharmaceuticals, the hospital associations and the AMA.It’s hard to exaggerate the alchemy of distortions that are turning ObamaCare into such a pending disaster that big insurers like Aetna , Anthem, Humana and UnitedHealth Group, once supporters, can’t cut back their participation fast enough.ObamaCare was always going to be a questionable deal for taxpayers if the only people who signed up were poorer people whose premiums were largely paid by taxpayers. That was fine as far as insurers were concerned. They can make a profit even if taxpayers are the only ones paying.For insurers, the problem lies elsewhere: ObamaCare policies have proved so unattractive that even customers eligible for subsidies are turning away unless they also happen to be seriously or chronically ill. That’s because deductibles and copays keep going up with each successive renewal period. For a family of four on a bronze plan, the deductible is now above $11,000. This is the equivalent, in the case of routine illness or injury, of not being insured at all.And the problem only gets worse as insurers, to stem their losses, keep hiking premiums, copays and deductibles. With each turn of the wheel, ObamaCare becomes an insurance program that appeals only to those who already know they face large health-care costs.From Day One, defenders of the Affordable Care Act pooh-poohed the “death spiral” predictions that sober analysts, being realistic about the law’s incentives, voiced. Yet the outcome was always implicit in the program’s design. The death spiral would have been a non-birth spiral if ObamaCare hadn’t originally offered direct, temporary subsidies to insurers to offset their losses. ObamaCare wouldn’t be with us today if insurers weren’t hanging on in quiet expectation that Washington somehow will come up with more funding to keep the jalopy going. Indeed, even as Aetna, one of ObamaCare’s biggest cheerleaders, was throwing in the towel this week on plans to expand its ObamaCare exchange business, its chief, Mark Bertolini, was full of ideas for how taxpayer money could be used to make the business profitable.There are rational ways to subsidize health insurance for the needy (and stop subsidizing the non-needy). There are rational ways to compensate insurers for taking on the uninsurable, i.e., those with pre-existing conditions.All this could have been done without loosing perverse and uncontainable incentives of the sort that already make U.S. health care so problematic. Alas, non-Rube Goldberg is not Congress’s métier.So we come to last month’s reductio ad absurdum. In a lawsuit, UnitedHealth Group, the country’s biggest health insurer, charges that American Renal Associates , one of the biggest providers of kidney treatment, supplied charitable “donations” to pay for ObamaCare policies (average annual premium $4,800) so patients could patronize American Renal’s dialysis treatment (average annual cost $100,000).What’s more, United claims many of these patients, for which American Renal billed $4,000 per session, were eligible for Medicare or Medicaid, which pays less than $300 per session.OK, modulate your outrage for the fact that American Renal vehemently denies the allegations—and for the fact that Medicare and Medicaid keep themselves afloat partly by underpaying for services like dialysis, knowing providers will make up the difference by charging higher prices to private customers.State and federal regulators increasingly face this problem and are in a deep quandary. After all, ObamaCare is supposed to cover those with pre-existing conditions, and hospitals and other providers have every incentive to sign up their sickest patients for ObamaCare to make sure they get paid. How can anyone complain about charity?All this cost shifting and gaming of our payment systems is inevitable because long-term U.S. policies have created a customer, i.e. patient, at the point of sale who has little skin in the game financially once insurance kicks in. The same patient also tends to be relatively passive on the question of whether care is medically necessary once someone else is paying.During the 2008 campaign, President Obama stated a deceptively insightful vision of health-care reform: If health insurance were a good deal, nobody would have to be forced to buy it. He was specifically rejecting, of course, Hillary Clinton’s proposed individual mandate (which he would later adopt). But his original concept was a good one. By now, nobody who has paid attention fails to grasp all the ways our system rewards providers for delivering excessive care at excessive and uncompetitive cost.Many Democrats, it’s no secret, see these perversities as a feature and not a bug—bringing closer the day when Washington will take charge of health care entirely. It’s their article of faith, impervious to experience, that the solution to government screwing up health care is to give government more power over heath care. ObamaCare Death Spiral Update7 Key Promises Obamacare Broke

Nah. These aren’t the problem. In fact, genetic therapies like Spinraza have relatively good health system economics, because they avoid very high long-term costs of care for these patient populations. Also, the patient populations are very small, so the systemic cost is not high. That latter fact is how insurance companies ultimately get comfortable reimbursing such high-priced therapies - a state Blue Cross or Aetna may only have a dozen covered lives across their whole plan. And even indigent patients with orphan diseases can nearly always get therapy via patient assistance programs.The greater systemic problem is expensive *chronic* therapies, in therapeutic areas with large patient populations. TNF-alpha inhibitors, branded triple-combination HIV therapies, synthetic insulin and weekly dialysis - these are far larger pieces of the healthcare spending pie.Our pricing / payment model is *cruel,* but not unsustainable. It’s a legitimate choice for a wealthy nation, with an aging population, to spend a larger proportion of GDP on health care. Everyone complains, but we always choose heroic measures in the last weeks and months of life for our family members, when that is financially an option. We also repeatedly choose expensive chronic therapies that are incrementally more effective than older, cheaper generics.People who have good coverage (which in America is about 80% of the population, if you count Medicare/Medicaid) resist any changes that would limit their therapeutic options or otherwise ration care.The downside, of course, is that if you don’t have good insurance or Medicare/Medicaid eligibility, your health and financial risks skyrocket.