[ceejayoz]

> Why would heavy users of health services be concentrated in the minority cohort that is dissatisfied with their insurance?

"Why would people who drive a lot care the most about gas prices?"

The more you use health insurance, the more chances you have to run into the kafkaesque bits. Someone who sees a GP once a year and thinks their premium is $50/month because that's the bit they have to chip in while their employer covers the rest is largely gonna go "this is fine!"

[tptacek]

Right but there's no such selection effect for whether or not people have employer-provided coverage, and the cohort of households that do strongly approve of their current insurance coverage. I don't see how the argument you're making could hold up statistically. There are a lot of chronically ill people with employer-provided coverage; in fact, most non-senior chronically ill pts fall into that bucket.

[ceejayoz]

> Right but there's no such selection effect for whether or not people have employer-provided coverage…

False. Someone with significant medical issues may well need a higher acuity plan than the employer offers. I, for example, was on the exchanges until last year, for this very reason; my employer's coverage would not have made financial sense.

> There are a lot of chronically ill people with employer-provided coverage…

The chronically ill are less likely to be employed.