The Patient Protection and Affordable Care Act, better known as ObamaCare, is the 2700 page monstocity that Nancy Pelosi (D-CA) said we had to pass to see what was in the bill. Its passage has given rise to the ObamaCare waiver fiasco and now there are some new provisions cropping up.
On December 2, 2011, the medical loss ratio – a ratio that requires health insurance companies to spend a certain amount of their consumers’ premium dollars on medical care rather than overhead, marketing expenses and profit -will be raised to as much as 85%. Failure on the part of insurers to meet this requirement will result in the insurers having to send their customers a rebate check.
The Department of Health & Human Services (HHS) issues the rules of what insurer expenditures will, and will not, qualify as a medical expense for purposes of meeting the requirement. For example, HHS denied that health insurance brokers and salespeople the commissions they earn for selling an insurer’s program to consumers be included as a “medical expense” for purposes of the rules.
Rick Ungar concludes with, “Whether you are a believer in the benefits of single-payer health coverage or an opponent, mark this day down on your calendar because this is the day seismic shifts in our health care system finally get under way.” He continues, “There will always be a for-profit health insurance industry for those who want to pay for it. The only difference will be that those who cannot afford private coverage will also have an opportunity to get their families the medical care that they need. Everyone wins – except the for-profit health insurers.”
There are several things wrong with Rick Ungar’s reasoning. Here are a few (I’m sure you can think of others):
- Rich Ungar, author of the article I cite, states, “…those who cannot afford private coverage will also have an opportunity to get their families the medical care that they need.” But yet he never specifies who is going to pay for the medical care. Does he expect care givers to give of their time? And if yes, for how long? And what about the facilities and technology used to provide the care? As my mother used to say, “Don’t criticize a system if you cannot offer specific ideas for improvement.” But I guess Ungar offered what he thinks is an improvement. Rich, we have a word for what you propose: communism.
- There is another problem inherent in what ObamaCare and Ungar proposes: queues (waiting lists) and rationing. How do we know this? We need look no farther than Canada. Governments in a single-payer system ration care by using waiting lists for surgery and diagnostic procedures and by canceling surgeries.
- ObamaCare establishes “Death Panels” by paying doctors to advise patients on end-of-life care treatment options, and may include directives to authorize withdrawal of lifesaving medical treatment or, in three states, assisted suicide. “Patients will lose the ability to control treatments at the end of life,” says Elizabeth D. Wickham, executive director of LifeTree. So what did Obama do in the wake of the “death panel” controversy? On December 3, 2010, Obama issued (via Dr. Donald Berwick, admirer of Great Britain’s National Health Service, which uses an algorithm to determine whether the aged are worthy of additional expenditures for medical care and advanced treatments) a new Medicare regulationdetailing “voluntary advance care planning” that is to be included during patients’ annual checkups. The regulation, aimed at the aged, “may include advance directives to forgo aggressive life-sustaining treatment.”
- Ungar claims that no private insurance company can be profitable if they have to spend 80% of premiums on healthcare. Here is another take. There are many profitable insurance companies that have premium payout loss ratios over 100%. While that may not sound possible, consider that insurance companies have TWO sources of income: (1) premiums paid, and (2) income from investing premiums paid.
Why, you ask, reference a source with which I disagree, such as the one Ungar wrote? Two reasons: (1) always know what the other side is thinking/saying in order to be ready if an argument/exchange of ideas opportunity occurs, and (2) Ungar’s article is a great source of facts.