Short Takes On News & Events

R.I. Woman Among First To Enroll In Obamacare Exchange

By Phil Galewitz

October 2nd, 2013, 3:36 PM

Uninsured for more than five years, Leslie Peters says she was “chompin’ at the bit” to get coverage to afford regular medical care that she often has gone without.

That’s why as soon as HealthSource RI, the Rhode Island online health insurance exchange, went live  Tuesday, she enrolled. “I was so excited,” said Peters, who lives in Tiverton, R.I.

Rhode Island's Health Source RI -- their health insurance marketplace.

She chose a “gold” tier Blue Cross and Blue Shield of Rhode Island plan that would have the lowest co-pays and deductibles. Her monthly premium will be $217 a month, including the federal subsidy she received based on her projected $19,000 annual income for 2014.

Rhode Island is one of 14 states enrolling people into its own Affordable Care Act exchange. The other states are relying on the federal exchange at

Peters is one of 252 people who have applied for coverage as of noon Wednesday, exchanges officials say.

Peters said she found the enrollment process easy. “I was really pleasantly surprised,” she said. Peters had two companies and 11 health plans to choose from on the site. She said it took her 15 minutes to fill out information on the HealthSource web site, though she needed more time on the insurer’s web site to examine what doctors and hospitals were in the health plan networks.

Despite reports about health plans offering few doctors and hospitals, she said the plan she selected had a wide range of providers, including the ones she needed.

Peters, who had a long career in radio, lost her consulting job five years ago and was unable to find new coverage because of pre-existing conditions including food allergies and previously having taken anti-depressants.

She paid her premium by providing her checking account information to the exchange, and can track the status of her enrollment on the portal.

Without coverage for several years, Peters said she only sought care at a local clinic when she had to and avoided preventive services such as mammogram.

“It feels great to know I will soon have insurance and not have to worry about this anymore,” she said. “Not having insurance is something I worried about all the time.”

3 Responses to “R.I. Woman Among First To Enroll In Obamacare Exchange”

  1. harold says:

    thank you for sharing the successes
    everybody else wants to talk about failures. It starts slowly, it builds, success is earned one step at a time. what’s most important in all of this is people understanding that it is a good thing and they can also participate. It will work

  2. Michele says:

    It is nice to hear something positive about all of this…I think that the ability for everyone to have health insurance is a great idea..

  3. Lance says:

    “…For 75 years, it was said that Roosevelt’s New Deal saved capitalism. By softening the rough edges of the free market capitalism with reforms such as social security and unemployment insurance, FDR may have prevented adoption of much more radical changes.

    75 years from today it is unlikely that anyone will think Obama saved market-priced medical care. Rather, he only prolonged it, and that will not be thought of as a good thing. In the developed world, market-priced medical care still exists only in the USA. It is only a matter of time until market-priced medical care joins communism, slavery, racial segregation and fascism as systems that no longer exist in developed nations.

    The USA is the last holdout with market-priced medical care not because of any inherent conservative or free market ideology. Rather, as the wealthiest nation that ever existed we are the last ones who can afford it. Switzerland was one of the last advanced economies to abandon market-priced medical care. It is arguably a greater bastion of conservatism than the USA. Switzerland’s women were not granted the right to vote until 1971.

    During the debate as to whether Switzerland would abandon market-priced medical care there was considerable concern about how it would affect the major Swiss pharmaceutical giants such as Hoffmann-La Roche (RHHBY) and Novartis (NVS) which was Sandoz prior to the merger with Ciba in 1996. However, it was then realized that the Swiss pharmaceutical giants made much of their profits in the American market.

    The reason that no nation, including the wealthiest can allow markets to set the prices of medical care indefinitely is that demand for medical care is inelastic. Demand for a good or service is inelastic if a percentage increase in price results in a smaller percentage decrease in the quantity demanded. Basic economics tells us that sellers facing inelastic demand will continuously raise prices until prices reach the elastic portion of the demand curve. Consequently in every developed country in the world, all goods or services with inelastic demand have their prices regulated by government. Medical care in the USA being the only exception.

    Health care is one of the very few things for which the sellers face inelastic demand. The prices of all other goods and services facing inelastic demand in the USA are regulated by government. Retail electricity service providers face inelastic demand. Consequently, their prices are strictly controlled by all governments worldwide, including the USA.

    The inelasticity of retail electricity is obvious. If Consolidated Edison (ED) or any other electric utility were to triple retail service prices, people might be a little more careful about turning off the lights. Turning off their refrigerators? Watching less television? Not likely. Thus, tripling the price would result in only a small reduction in kilowatt-hours sold. Almost all other goods and services are price elastic. That includes non-medically necessary elective cosmetic and lasik surgery whose prices have actually relatively decreased over time. Medical care in the USA is the only instance in any developed country where any product facing inelastic demand is not substantially price regulated.

    Medical prices are controlled in various ways in the rest of the developed world. In Japan, the land of $100 melons and tiny $10,000 per month apartments, all medical care prices are listed in a book, thicker than the Manhattan telephone directory. The prices set in the book are usually less than a third of those in the USA. An MRI that costs $1,200 in the USA costs $88 in Japan. Japanese insurance companies are private as are most doctors. Japan spends less than a third per capita on medical care than America. However, the Japanese are greater consumers of medical care than Americans. They visit doctors and hospitals more often, have much more diagnostic tests such as MRIs. They also have better health outcomes as measured by all metrics such as life expectancy. They also wait less for treatment than Americans do as Japanese doctors work much longer hours for their much lower incomes.

    Japan’s explicit price controls are roughly emulated in other countries via the use monopsonistic systems. Monopsony, meaning “single buyer” is the flip side of monopoly. A monopolist sets prices above free market equilibrium. A monopsonist sets prices below free market equilibrium. It does not matter if there is an actual single payer or many buyers (or payers) whose prices are set by the government or by insurance companies in collusion with each other. More competition among sellers generally leads to lower prices. However, more competition among buyers leads to higher prices. In the health insurance industry the beneficial effects of more insurance companies competing for patients are far outweighed by the adverse effects of insurance companies competing for doctors and hospitals in their HMO plans. This was completely misunderstood during the recent debate on health care reform. With health care, more competition among insurance companies on balance results in higher prices.

    Focusing attention on the insurance companies, which are simply intermediaries between the doctors and the patients, was a tragic error. It would like trying to solve a problem of high energy prices by focusing on gasoline stations. Only if the government sets prices can health care prices be controlled. Controlling prices does not automatically result in longer waiting times. Japan and Switzerland generally have shorter waiting times to see doctors than does the USA. Additionally, if prices were controlled there would be no such thing as “in-network” or “out-of-network” since all doctors would accept all insurance plans.