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Old 10-11-2018, 09:53 PM
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Default Health Insurance - "Medicare For All"

There's at least a 3% chance that by 2030 or so, the United States will adopt some form of socialized medicine similar to what they have in Europe and other regions. If that were to happen, how bad would it be for the health actuary job market?

Sorry if this has been asked before here, I did a forum and google search and didn't really find anything other than some reddit threads (and I don't trust r/actuary).
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Old 10-12-2018, 08:42 AM
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Health actuaries will find some slant as a sell to make themselves remain relevant.
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Old 10-12-2018, 08:45 AM
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I'm interested in this, too. I don't know the answer, but one thought I have is that even with Medicare there are lots of Med Sup actuaries. With how much opposition there is to Medicare for All, it's hard for me to picture a situation where there just isn't any need for actuaries beyond the relatively few who would be working for CMS.
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Old 10-12-2018, 09:01 AM
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There's just so many unknowns I think it's basically unknowable. You have to come in with many assumptions to get any sort of meaningful prediction to actuarial outcomes.
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Old 10-12-2018, 09:34 AM
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I should think the insurance and healthcare lobbies are too strong for that. You think they want to negotiate en masse with the government squeezing their reimbursements and slogging through bureaucratic arbitrary quality measures?

I'm generally pretty liberal (let's not derail into anything too political) but I'm pessimistic about anything 100% govt run. If MA plans can offer more benefits and pay their execs on Medicare dime and still turn a profit, that should speak volumes.
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Old 10-12-2018, 10:19 AM
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I should think the insurance and healthcare lobbies are too strong for that. You think they want to negotiate en masse with the government squeezing their reimbursements and slogging through bureaucratic arbitrary quality measures?

I'm generally pretty liberal (let's not derail into anything too political) but I'm pessimistic about anything 100% govt run. If MA plans can offer more benefits and pay their execs on Medicare dime and still turn a profit, that should speak volumes.
MA enrollment is also increasing substantially as a percentage of Medicare beneficiaries. Even Medicaid is being outsourced by states to managed programs to reduce costs. I don't envision that changing anytime soon.
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Old 10-12-2018, 10:21 AM
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Americans start cursing and throwing stuff around the room if they have to wait more than 2 minutes for coffee. No way everyone switches over to a socialized program.


Best case IMO everyone who can't afford insurance uses the socialized option and those who can afford premium health insurance get shorter wait times and more provider options.
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Old 10-12-2018, 11:49 AM
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tl;dr: No one really knows, but I'm confident that we will have jobs for the next 10 years regardless.

I agree with everyone pointing out that there would still be a private market.

Short term: this type of change would likely be an employment boom for health actuaries like ACA was. Change is chaos, actuaries profit off of that.

Long term: I don't think that trend would hold up like with ACA because of how deregulatory a Medicare for all move could potentially be. It could theoretically eliminate VA, Medicaid, employer insurance and Obamacare markets as entities within this space. There is still a lot of work that would need to be done regardless (I don't see any of the core payer or provider risk functions going away), but with less market fragmentation, there may be fewer distinct risk buckets to manage.

But, if you're asking whether I'd bet on government implementing that kind of efficient solution? I'm on board with the idea, but I doubt that it's politically palatable enough to get broad support in the next few years. And even if it got it passed, I'd be confident in at least 10 years of employment while getting everything set up, even if they passed a theoretically ideal plan (impossible).
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Old 10-12-2018, 12:37 PM
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Good answers so far and I'm not an expert at all, but would add to the above (sorta just adding to the second post) that if we went to some nationalized model, we would still need people with understanding of the costs and data involved, which would be a significant number of actuarial jobs (not nearly as many as today probably, but not tiny either).
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Old 10-12-2018, 12:41 PM
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Thanks everyone for your answers. I'm quite aware that it's pretty unlikely to happen (that's why I threw the 3% caveat in there) and there's a million other places where that debate is taking place so I'm happy it didn't take place here. I was however very unsure about on the condition that it did actually happen, what the health actuarial job market would look like.
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