TheHealthCareCritic

A very simply but accurate depiction of U.S. Healthcare Reform.

The United States government has figured out a very twisted way to take over the health care sector in the United States without buying any of the existing companies, without starting its own, and without explaining how precisely the cost curve will be ‘bent’. It made no investment and it now controls 16% of the GNP. It was all done with unprecedented maneuvers for a legislation with this level of complexity. This poisoned the political well. Acrimony and recrimination have replaced discourse and bi partisanship. The full consequences will be felt in November, 2010. In the meantime we deal with political strategies that ignore the national welfare.

The OBAMA administration was quick to declare victory and its own version of “Mission Accomplished”. The scene on the 23^rd of March, 2010 was celebratory at the White House. It took place while the rest of the country was wondering about the details of a bill that was not read by most of those who voted on it.

The takeover of health care will be achieved through intrusive regulatory intervention that limit the freedom of the citizen and that will burden society for decades to come. The effects are broad indeed and they are far from uniform. They extend from the soup kitchen, to kitchens in every household, to every Board room, to the employed, underemployed and unemployed, to every company regardless of size and nature of product and service, and to every insurance company in America whether for profits or not. It will apply to every American whether he/she approved or not, whether he/she is a member of Republican Party or the Democrat Party, or is a tea bagger or coffee drinker. It applies to rich and poor alike and all those in between, to those who want to reallocate wealth and those who fear it, to ideologues and common folks who just want to be left alone, and to those who dwell in cities and the most remote parts of the United States. It applies to the young and the old and to the sick and the healthy. Everyone must carry insurance and the United States government will create 150 agencies, commissions and bureaus to see it enforced. Those who dare not to tow the line will be monitored by an expanded IRS (an additional 17,000 agents at a cost that could approximate $10 Billion a year).

It appears that the CBO had not taken these administrative costs of the ‘reform’ into consideration. Had they done so, the budget deficit reduction forecasted (erroneously as it looks at six years of spending and ten years of taxation and cuts) to be $130 billion over ten years, or $13 billion per year, would instantly disappear.

This all comes from an administration that wants to lower the administrative costs of medical care and to bend the cost curve.

We now look at how invasive, manipulative and dangerous the legislation is.

We start with one of the principal arms for its implementation: THE EXCHANGES. We look at their structure and how they are intended to deal with the insurance companies and their unnatural clientele manipulated by the absence of choice created by government.

The Exchange (s) is a case of: quality control, price control, type of policy control, clientele control (e.g. no one will be excluded for any reason), eligibility control, penalty control, coverage control in the form of tiers, participation control (what insurance company will be allowed to enter the market- any interested insurance company must bid to enter the exchange), admissibility control (e.g. elimination of preexisting condition, etc) and risk control (e.g. high risk individuals will be sold a government issued policy). It will also cap the profits of the insurance companies (it imposes medical loss ratio requirement of 85%) and will impose taxes on choice insurance policies such as the Cadillac plans (40%) in an attempt to discourage their purchase and to further redistribute wealth.

The Exchange will revamp the individual and small business health insurance markets. The exchange will be the “exclusive market place” for all individual policies. A separate exchange will trade group health care policies for small business (less than 50 employees).

All of the above will be under the supervision of the soon to be created Health Choices Administration (HCA). This agency will have more powers that the SEC currently has on the financial markets. While the average citizen may never see or deal with the SEC, America will know the HCA. Financial investments are optional, but the health of the nation is not.

The exchanges are created for certain individuals and for small business (up to 100 employees) to buy health insurance policies that come with different tiers (packages) of benefits (coverage). The sellers must be approved by the HCA, and the health insurance plans must be qualified (meet government dictates). Therefore, the US government will determine who sells insurance, the level of the coverage, and who can buy insurance. Further the government decides on the level of subsidy it will provide to each buyer depending on income starting with 133% of the poverty level ($29,327 in income for a family of four) going up to 400% on a sliding scale. In fact, the government determines that certain individuals not covered by their employers or by existing government programs MUST buy insurance, and that they cannot be denied the possibility no matter their medical condition. So, technically, one can buy insurance as he is entering the hospital for a major operation.

The level of coverage and its components could become very costly to the insured and to the government alike. The latter will be subsidizing whatever the costs are. But, these costs are not based on economic considerations but rather on political ones. To illustrate this point further, the entire health care bill (a trillion dollar commitment) just passed congress and was signed by the President at a time of historic budget deficits that all political parties have expressed concerns about.

Political jurisdictions at all levels could add to the components of the coverage. Some may wish to have abortions covered, others may want to include some forms of plastic surgeries, some may well include a foreign option, some may want the insurance to have no copayments or deductibles, etc. If all the political consideration are included we can bankrupt the United States.

Had the OBAMA administration listened to the voices of the majority, it would have been able to truly proclaim: “Mission Accomplished”, and America would have been better off for it.