Posted on 12/27/2013 8:56:09 PM PST by 2ndDivisionVet
I’ve been working professionally in health policy since 1979 when I was hired to write the consumer contracts and other communications in plain English for the Blue Cross Blue Shield plan in Maine. I neither knew nor cared anything about health care before that.
Rewriting contracts turned out to be a pretty good way to learn a whole lot about the business very quickly, I went from there to the research department and then to government relations. Before I left the Blues I was heading the state relations department for the national association in Washington. Then I went on to organize a trade association of health insurance companies that were interested in promoting free market solutions in health care.
I was surprised at how naïve the executives of these companies were when Clinton proposed his own health reforms. These were quiet, unassuming people who were happy to pool risks and pay claims and feel good about their work. They never expected to become the villains in Hillary’s ambitions, had never been political, and didn’t know how to cope with it.
So, understand that I am a man of the insurance industry. I am not a lawyer, have never worked for any government or politician, not an economist, don’t have an advanced degree in any field, and obviously have never cared for a patient. My sole qualifications are that I’m a good writer and a dogged researcher.
What has happened to the insurance industry has me stunned.
Now, I am no apologist for the industry. I have been one of its biggest critics. Its dalliance with Managed Care after the demise of ClintonCare was an enormous mistake that took its mission away from financial protection into health services management – something it was never qualified to do. The industry not only did a poor job of it, but it alienated and embittered the only people who really matter in health care – doctors and patients.
Granted, Managed Care pleased employers for a few years. It restrained their costs in the mid-1990s. But employers don’t really know anything about health care, either. What they do know is the morale of their workers, and Managed Care was the biggest morale-killer ever. Employees were furious that care was being denied by insurance company bureaucrats in Hartford, Connecticut, and they let company HR departments know it.
Employers started looking for other ways to restrain costs while preserving patient choice, and came to embrace “consumer-directed” health care (CDHC) in the early 2000s. This approach has been enormously successful and has exceeded the expectations of even its advocates like me. It has lowered costs and increased patient involvement in health care decision-making.
As an insurance guy, I liked that it was moving insurers away from their misguided notion of being the big boss in health care and back to the role of financial protection.
But the industry didn’t much like that aspect of it. Sure, they would sell the products because employers demanded it, but they were losing control as banks entered the market to manage the first few thousand dollars of expenses of a patient’s contract. The banks were still focused on financial protection and didn’t have ambitions to become health care managers.
So when Obama came along with an offer to require all Americans to buy their products, it was an offer they couldn’t refuse. Especially when the products he had in mind were comprehensive, cover-everything health plans. No more bank involvement. We’ll really be in the catbird seat now!
The naivety I had witnessed during the Clinton Wars was still in force. Many of us tried to warn the industry that they would regret this arrangement. Yes, they might be assured of modest profits, but the cost of sacrificing their autonomy would be far too high. They would become little more than public utilities. They would lose all control over benefit design, marketing practices, and rate setting. They would have no idea of the risks they were enrolling and would have to set premiums blindly.
It has become much, much worse than I ever imagined. Obamacare is not even fully in effect yet and already we are seeing the President playing with the carriers like a toddler plays with toy trucks –
•Employers will be mandated to buy your policies for 2014
•(Oops, employers are angry)
•Employers won’t be mandated until 2015 – if then
•Small employers will give workers a choice of health plans through the SHOP program in 2014
•(Oops, we can’t get the web site ready in time)
•Small employers won’t have to offer a choice of plan until – sometime later
•You must cancel these individual policies
•(Oops, public backlash)
•You must reinstate these policies
•(Oops, many insurance commissioners won’t allow it)
•You must continue to cover providers and drugs even for cancelled policies
•The deadline for enrollment will be December 15, 2013
•(Oops, web site problems)
•The deadline for enrollment will be December 23, 2013
•(Oops, too much traffic)
•The deadline for enrollment will be December 24, 2013
•Never mind, there is no deadline
•First month’s premium must be received by December 31, 2013
•(Oops, back-end problems with the web site)
•First month’s premium must be received by January 8, 2014
•Make that January 10, 2014
How can anyone run a business this way? This is worse than being a federal agency. No federal agency would be expected to stop and start on a personal whim like this. These aren’t rules, they aren’t regulations, they are dictates based on nothing more than Kathleen Sebelius’ momentary feelings.
These are only the “glitches” that have been made public. God knows what orders and threats are being issued in closed-door meetings.
How long will the insurance industry abide being treated like shoe shine boys? Mr. Obama will not be in office forever. His regime is already coming to an end. What will these companies do then? He will no longer be around to grant or withhold bailout (“risk corridor”) money. No other president, Democrat or Republican, will ever be as arrogant or irrational.
It is well past time for the industry, supposed Titans of Wall Street, to grow some spine and start thinking about the best interests of their customers and shareholders.
They all live in india now
I wouldn't count on that...
Nope, they are Indian programmers working in Canada for the Canadian outfit who received lions share of contract to build the web site. It helps that a VP in that Canadian outfit is college friend of FLOTUS, Michelle.
Nope, they are Indian programmers working in Canada for the Canadian outfit who received lions share of contract to build the web site. It helps that a VP in that Canadian outfit is college friend of FLOTUS, Michelle.
Another provision to add is that the policies are total POS.
Just perused the NYS ones and they are largely useless with high deductibles. 50% copays on virtually everything and no out of network coverage whatsoever.
I’d rather go for a catastrophic plan to at least prevent a bankruptcy from a hospital stay but those are no longer allowed.
They will have to limp along this way until Obama decides it's time to discard them for single payer.
Their only hope for survival is a Republican victory that repeals Obamacare and installs a deregulated system. But the moment they support that, the IRS and FEC will be on them like white on rice. They are well and truly screwed and only have themselves to blame.
HMOs were the worst plan to ever come down the pipe. You couldn’t get in even to see a doctor. They are also the real reason the Doctors of United Healthcare quit(they were not fired). I believe they and their patients were very happy with the PPOs; but meddling ended that.
I wonder how people are going to feel when they discover they have no healthcare much less coverage. That is exactly what Obamacare is designed to do.
bookmark
IIRC, under Obamacare, insurers' profits are limited to a percent of sales. They can't increase profits by delivering a higher quality product at a lower cost. They can increase profits by producing an inferior product at a higher cost.
If here was ever an economic scheme designed with its incentives backwards, this one is it. But no, why would insurets say "enough"? The US spends about 17.6% of GDP on health care. The way for insurers' profits to double is to go along with Obamacare, and let the US spend 35% of GDP on health care.
It's the consumers who should be grabbing their torches and pitchforks!
>>I wouldn't count on that...<<
Agree. Obama established awful precedents that disemboweled our constitution. They will be there, sitting on a shelf, ready for use by future tyrants. Unless we act fast, it is adios to the great American, republican experiment.
Socialists complaining about totalitarians? Who’da thunk it?
In regards to the driving force behind the “Patient Protection and Affordable Care Act of 2010 - all this law says to me is that I have to pay some company a few hundred dollars a month for the right not to be a criminal in the territory once known as “the United States of America”.
The insurance companies that still will be writing “health insurance” coverage will soon find themselves skirting at the very edge of economic disaster, if not already subject to criminal prosecution.
He will try to blame insurance companies and republicans.
Insurance companies are going to take it up the azz. They will spend 2 dollars on back office clerical work for every dollar in premium first quarter, then start making an avalanche of claim payments. By September’s they will announce that that are not participating in 2015. That’s when Obama will have Holder start screwing them.
The Dictators in the Democrat Party will make all the decisions about our healthcare. We will be bullied and forced to like it.
America keeps getting in the government vs business is the enemy fight when they are working together against us all.
How can anyone run a business this way?
There is what they may regard as an upside to wit: I, who have never purchased health insurance must now do so by law or suffer fines...
“It is well past time for the industry, supposed Titans of Wall Street, to grow some spine”
Forty years of PC conditioning ensures their continued silence. THAT was always the true point of PC.
“Their only hope for survival is a Republican victory that repeals Obamacare and installs a deregulated system”
Boy, you think a lot of those Republicans!
Thanks for posting.
I just included that ...
I created a site last week for factual stories about Obamacare that don’t see the light of day in the MSM, where they hate a fact almost as much as humblegunner hates a blog pimp.
It’s not a blog, it’s a news aggregation site like Drudge or RCP, but dedicated to Obamacare solely. So it’s not an ode to my wonderful thoughts and feelings, and hence, I will not post them here.
At the risk of waking the HumbleGiant, does anyone object if, within this thread rather than as its own obnoxious vanity, I note the site?
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.