[Postscript] I should have perhaps advised readers new to political intrigue (prior to diving into this piece) that deception in politics is of high quality and multileveled. Of course politicians lie all the time! They cannot serve two masters, the public and the financiers, at once. Beyond that, behind the scenes, there are no “parties” and all the sniping at each other that goes on in public is checked at the door when they work in private. Obamacare was decades in the making. It was put in place to stay in place permanently, a financial straightjacket, a massive new corporate subsidy just like Medicare D. The idea that Trump represents something new and different is hogwash, and the notion that he has the power, let alone the desire, to make changes to a long-running and achieved goal like Obamacare is just a political stage play. The purpose of this stagecraft is to convince people that Obamacare is something worth keeping. After all, if Republicans hate it … it must be good, right? We are witnessing mere reverse psychology.
There are rumblings now, and have been since the “election” of Trump to the presidency, that changes are going to be made to “Obamacare.” I seriously doubt it. That bill, also known as “ACA,” or the Affordable Care Act, put us in an economic straight jacket. It gives insurance companies power over us that they will never relinquish voluntarily. If anything, Congress and Mr, Trump are now engaged in a ritual known as the Kabuki Dance, or a staged presentation where all the players know the final outcome.
There might be insignificant changes to surface features of Obamacare, done to placate reactionary right wingers who constitute the bulk of the Republican Party. But there will be no substantial changes, and this will satisfy the clueless do-gooders who imagine that the bill actually improved our health care system. We call them “Democrats.”
I am going to use a hypothetical here to give some substance to my use of the words “economic straight jacket.” This varies depending on our age. Let’s say, for example, that you are self-employed, age 40, have a spouse and two children and want to protect yourself from health catastrophe. You are given only one way now, and that is to purchase a health insurance policy. There is no public option, so it has to be from a private company. There are many choices, but oddly, the prices and coverages among them do not vary. They are, in effect, a monopoly.
You are stunned at the cost of a policy, $1,200 per month. You are also feeling the economic straight jacket because the insurance companies, acting through government, can now track you down and penalize you if you fail to buy a policy. You cannot escape unless you join the underground economy, not an option for most. So you buy a policy from Humana/Cigna/Aetna/WellPoint/BSBC … all different tentacles of the same octopus. You will now be paying $14,400 per year, and will receive in return mere access to the health care system. Not health care … access.
There is more. Health insurers introduced us to the concept of “moral hazard,” which means that we might overuse the health care system if access is made too easy. To prevent this, they have burdened us with deductibles, co-pays, “coinsurance” and policy exclusions (things they don’t cover). Each policy now carries a “max out-of-pocket,” or costs we must bear in addition to premiums, now set at $14,300 for a family (without regard to exclusions).
Here is the real “moral hazard:” Health insurers introduced deductibles, co-pays, etc., because, they say, they don’t want us abusing the system. Truth is more basic. They introduce these features because they don’t want us using the health care system. They know that if, in addition to onerous monthly premiums, we still have to fork out out-of-pocket costs to see a doctor, we won’t do it. We are already financially stressed. It’s a perfect system for them, virtually eliminating exposure to financial peril.
So now in this hypothetical situation our poor self-employed schmuck is faced with $14,400 in premiums and $14,300 max out-of-pocket, or in theory $$28,700 in health care costs before an insurance company even has to fork out $1!
Who designed such a crazy system? The health insurance industry, through OBama, of course.
We are able to avoid this situation by buying better policies. I did extensive research back around the time of implementation of Obamacare, running a set of normal health care costs through the various offerings here in Colorado. What I found was that the better the policy, the higher the yearly out-of-pocket cost for consumers. This is basic and bonehead math … higher premiums to protect us from deductible and co-pays are a losing proposition. What I found was that everyone should buy the most basic nuts and bolts policy and minimize premiums, as the max out-of-pocket was the same for ALL policies, whether bronze or platinum. (These choices, bronze, silver, gold, platinum, are cruel and ironic, as they describe the benefits to the insurance company, and not the policy holder.)
That, folks, is “Obamacare.” He didn’t dream it up. He merely enabled it. A committee of health insurance bureaucrats, headed by a WellPoint executive named Liz Fowler, wrote the bill. Fowler pretended to work for Senator Max Baucus during the Kabuki Dance known as the “debate,” and the pretended to work for the White House during implementation. She was the industry front person in charge.
Obamacare was imposed on us by health insurers, but only after they had caused so much suffering and premature death during the “preexisting condition” regime that we fantasized they might fix the problem that they caused.
It is a sweet, sweet deal for the insurance cartel. Since that cartel, along with others, owns the congress, I foresee no changes, no loosening of our straight jacket. Just more Kabuki Dancing. We are stuck, and I do mean stuck, with OBamacare.