“So I pass a signature piece of legislation where we finally get health-care for all Americans, something that Democrats had been fighting for a hundred years, but because there was a provision in there that they didn’t get that would have affected maybe a couple million people, even though we got health insurance for 30 million people and the potential for lower premiums for a hundred million people, that somehow that was a sign of weakness and compromise. …people will have the satisfaction of having a purist position and no victories for the American people.”
The reforms?
Expanded Medicaid, is a true reform, but one affecting AIHIP and PhRMA not in the least. There was no potential for the new Medicaid clients to be profitable to the health insurers, so they allowed them to be dumped on taxpayers.
People can no longer be denied coverage due to preexisting conditions, but it isn’t the health insurance companies that offer that coverage. People formerly turned down for coverage are still turned away, but sent to state exchanges. Those exchanges suffer from adverse selection, and so offer lousy coverage with high premiums. People are staying away in droves – when the premium subsidies finally come through, low-income people will be able to get this coverage, and the health insurance companies will be paid to manage the exchanges, but will not actually face risk exposure.
Preventive care must be covered, indeed a real reform, good public policy. We who have insurance can now go to a doctor for a physical, or a man-ogram, and the insurance company has to pay for it. Here’s how my insurer, Anthem Blue Cross, handled this matter: They now cover preventive care, as required by law, but no longer cover any other office visits of any type.
Frankly, this is the worst possible outcome for our health coverage crisis – fake reform. Democrats told us that we should take what was offered because we could always come back and fix it later. Not on this planet – there will never again be an opportunity like that, and their squandering of that chance is an historic betrayal of their mission and constituency.
There are other parts of the bill that might benefit us, but it is all done under the hovering shadow of AHIP and PhRMA. Before passage of the bill, typical private insurer overhead was 20% – Wall Street watches this number very carefully – if “medical losses” exceed 80% of premiums, stock prices go down. (A Harvard study found that total medical overhead in this country is 31% – that other 11% is hospitals and doctors share of the burden). The Obama bill, in a striking reform, mandates that their overhead not exceed …. 20%. There was a push at one time to get that number down to 15% … it disappeared in the reconciliation process.
Yes, we will have health insurance. We’ll be required to buy it, and if we can’t afford it, the government will pay … the insurers. There’s very little in the bill regarding quality of coverage – deductibles and co-pays, policy premiums – all of that untouched. Lifetime coverage caps are gone now – perhaps that is the one thing that the insurers did not like, as it introduces a wild card feature into their rate structure – they cannot precisely define their risk. But it all gets built into the premium structure anyway, and so will not affect their bottom line, as they are free to charge whatever they feel they need as a buffer.
Screw you, Democrats, screw you, Obama. You are worthless. We cannot afford your good works, don’t need that kind of help anymore. The tragedy of business-run America is that as bad as the Democrats are, and they are truly bad, our only other choice is worse.
Piece of Mindful 