Wednesday, November 6, 2013

It's the control, stupid.

The Wall Street Journal published the best editorial I've read to date on Obamacare last week. Forget the "glitches", there are bigger issues at stake:

For all of the Affordable Care Act's technical problems, at least one part is working on schedule. The law is systematically dismantling the individual insurance market, as its architects intended from the start.

The millions of Americans who are receiving termination notices because their current coverage does not conform to Health and Human Services Department rules may not realize this is by design. Maybe they trusted President Obama's repeated falsehood that people who liked their health plans could keep them. But Americans should understand that this month's mass cancellation wave has been the President's political goal since 2008. Liberals believe they must destroy the market in order to save it.

Until this month, consumers who weren't insured through their jobs were allowed to buy insurance that provides the best value based on their own needs. One of every 10 private policies is sold through the individual market, covering about 7% of the U.S. population under age 65.

Some states have ruined this market through regulation and price controls, and in others costs can be high. But the individual market works well for millions of people, who can choose from many plans—from Cadillac coverage to cheaper protection against catastrophic illness.

The political problem for the White House is that these choices are a threat to ObamaCare. If too many people keep these policies instead of joining the government exchanges, ObamaCare could fail. HHS has thus reviewed the decisions of people in the individual market and found them wanting. HHS believes as a matter of political philosophy that everyone should have the same kind of insurance, and in the name of equity it wrote rules dictating the benefits that all plans must cover and how they must be financed.

In most cases these mandates are more comprehensive and thus more expensive than the status quo, but the ObamaCare refugees aren't merely facing higher costs. The plans they want and are willing to pay for have been intentionally outlawed. Ponder that one.

Liberals claim the new insurance should cost more because it's better, at least as defined by liberal paternalism. But the real reason they want policies to cost more is to drive as many people as possible out of this market and into the subsidized ObamaCare exchanges.

The exchanges need these customers to finance ObamaCare's balance sheet and stabilize its risk pools. On the exchanges, individuals earning more than $46,000 or a family of four above $94,000 don't qualify for subsidies and must buy overpriced insurance. If these middle-class ObamaCare losers can be forced into the exchanges, they become financiers of the new pay-as-you-go entitlement.

The political press corps is reporting this as a shocking discovery, and we suppose it is if you believed Mr. Obama's promises. NBC News even reports as a "scoop" that the White House knew all along that millions would lose their policies. But HHS's trail of purpose has been there for anyone willing to look.

The text of the Affordable Care Act said that none of its language "shall be construed to require that an individual terminate coverage" that existed as of March 23, 2010, or the date the law was enacted. But as early as June 2010 HHS published a regulation reinterpreting this "Preservation of Right to Maintain Existing Coverage" to obviate that promise.

Even minor policy changes, such as increasing a copay by as little as $5, means that a plan cannot be renewed without rewriting it to obey all of ObamaCare's regulations. In HHS's "regulatory impact analysis" published in the Federal Register, the department estimated that between 40% and 67% wouldn't qualify as a permitted plan, and this was the point—to prevent such policies "from being bought and sold as a commodity in commercial transactions." HHS knew that lightly regulated policies might be popular, especially compared to the restricted choices in the exchanges.

Next, HHS applied very prescriptive mandates to all plans, including those sold outside the exchanges. The law's 10 very broad categories of statutory benefits like hospitalization, prescription drugs or maternity care were construed so that 79.6% of current individual plans didn't meet the targets, according to HHS's own analysis. The rule even put floors under cost-sharing to prevent consumers from paying out of pocket.

HHS wrote that the purpose was to offer merely "a small number of meaningful choices." Letting people make tradeoffs for themselves "would have allowed extremely wide variation across plans in the benefits offered" and "would not have assured consumers that they would have coverage for basic benefits." Forced equity again trumped individual choice.

Hard to believe, but at the time liberals complained that this HHS "essential health benefits" rule wasn't restrictive enough. Pediatric services stop being required at age 19, not 21, and what about speech therapy, medical foods or lactation services?

Liberals needn't have worried. Once customers are herded into the exchanges, HHS has the power to further standardize benefits, further limit choices by barring certain insurers from selling through selective contracting, and generally police the insurers to behave like the government franchises they now are. The state-run exchanges in Vermont and the District of Columbia have already barred individual coverage outside their exchanges.

None of this is an accident. It is the deliberate result of the liberal demand that everyone have essentially the same coverage and that government must dictate what that coverage is and how much it costs. Such political control is the central nervous system of the Affordable Care Act, and it is why so many people can't keep the insurance they like.

32 comments:

Anonymous said...

Obamacare is a hybrid of government and insurance. Government control of healthcare is faced with the competition of the many interests who have 'controlled' the industry. American medicine is very closely controlled by the drug industry which is demonstrated by the recent Johnson & Johnson settlement. Much of the decades litigation is based on the hazards of American medicine. The English and Europeans distrust much of the American medical literature due to the influence of industry. TV medicine commercials are 'exhibit A'. The industry and profession has a lot to be desired that is at the heart of why the government needs to set in as a regulator.

Anonymous said...

The industry and profession has a lot to be desired that is at the heart of why the government needs to set in as a regulator.

Gag.........

Anonymous said...

Nancy Pelosi said, "We have to pass this to see what is in it."

That is the definition of a stool specimen.

Anonymous said...

Just a few quotes from years ago come to mind

"Our government has no power except that granted it by the people. It is time to check and reverse the growth of government, which shows signs of having grown beyond the consent of the governed."

"Government is not the solution to our problem, government is the problem."

"We the People tell the government what to do, it doesn't tell us."

“As government expands, liberty contracts."

Anonymous said...

Doctors (and attorneys) have only their trust and authority to sell. When they are control the three branches of government, how can Liberty expand? Consider a doctors exchange where they post their services, prices, and an independent rating? When we get that kind of transparency we will know that we have a free healthcare market.

The doctors don't want that because it erodes their authority and exposes their errors. No, they really prefer to have insurance companies and lawyers mediate all that for them. The AMA and insurance supported Obamacare, remember? They need insurance.

Anonymous said...

9:46 - Amen! Only wish he were here today to help.

"I want you to know that also I will not make age an issue of this campaign. I am not going to exploit, for political purposes, my opponents' youth and inexperience."

Such a great man.

Anonymous said...

To 10:16

The AMA wanted Obamacare because they were to get paid to sell some of the insurance projects. AMA membership represent only approxiamately 17% of US physicians. Many physicians cancelled their AMA membership in protest of this travesty. The expansion of the concierge madel in medicine shows how physicians can do better financially without the interference of the insurance market and govt with less paperwork and no middle man to drive up costs. Might be fine for general care but not subspecialty care with complicated and expensive procedures. There are already some independent rating systems out there for physicians and they are woefully inaccurate.

President Barack "Dishonesty is a Virtue" Obama said...

Let us see if "the Ladd" runs this ProPublica story. Though don't be surprised if she doesn't because it doesn't have a water carrying agenda.

A must read.

ProPublica: Obama Cult Members in San Francisco Involuntarily Bent Over and Screwed

I’ve been skeptical about media stories featuring those who claimed they would be worse off because their insurance policies were being canceled on account of the ACA.
.....
So I tried to find flaws in what Hammack told me. I couldn’t find any.
.....
I asked Hammack to send me details of his current plan. It carried a $4,000 deductible per person, a $40 copay for doctor visits, a $150 emergency room visit fee and 30 percent coinsurance for hospital stays after the deductible. The out-of-pocket maximum was $5,600.
.....
The letters said the couple would be enrolled in new Kaiser plans that would cost nearly $1,300 for the two of them (more than $15,000 a year).

And for that higher amount, what would they get? A higher deductible ($4,500), a higher out-of-pocket maximum ($6,350), higher hospital costs (40 percent of the cost) and possibly higher costs for doctor visits and drugs.


Like her deceitful lying leader "the Ladd" is probably lying to the interns right now as I write.

Burke said...

I assume you will be going to press with today's WSJ editorial blasting Jim Hood.

Anonymous said...

I have a question:

For those of us on employer sponsored plans, if those plans have changed in any way (coverage, premium, etc) since Obamacare was passed, will we receive cancellation notices as well once our extension runs out? If the answer is yes, why isn't the media harping on that story? This would impact most of the country it seems.

Anonymous said...

12:25 I never heard of the AMA selling health insurance, so Obamacare wouldn't affect them that way.

What they did extract from the government was an agreement to let them keep their monopoly on CPT codes (i.e., billing codes) that are used by every health insurance company in the country to process claims filed by physicians. They are copyrighted and a rich source of income for the AMA.

Try to keep up. The AMA does sell life insurance to its members, but Obamacare doesn't affect that.

Anonymous said...

@2:53, Obama delayed the employer mandate for 1 year. That's why you are only seeing some scream about their insurance. The rest of the Obamacare nightmare will hit in October 2014 when the employer mandate goes into affect. It was extremely important to defund Obamacare. Now those who would not stand up to stop this train wreck and the same ones who don't even have to be included in it.


And by the way, Obama has helped the unions, again: “Weeks after denying labor’s request to give union members access to health-law subsidies, the Obama administration is signaling it intends to exempt some union plans from one of the law’s substantial taxes,”

Sebelius was on the stand again today and acknowledged that it would be possible for a convicted felon to become an Obamacare navigator — one of the workers responsible for helping people deal with the ins and outs of the healthcare law.
“Isn’t it true there is no federal requirement for navigators to undergo a criminal background check, even though they will receive personal information from the individuals they help to sign-up up for the Affordable Care Act?”

“That is true,” Sebelius replied. “States could have an additional background check and other features, but it is not part of the federal requirement.”

Anonymous said...

The American healthcare model is centered on employment which is the greatest hindrance to a modern system. It is the product of the postwar, full employment days as well as the golden age of the American Empire. The mandate came from the Commonwealth of Massachusetts where both the insurance and biotech industry is headquartered. All that's history.

The Supreme Court gave the states the opportunity to craft a state system to draw in the uninsured, but very few states have the capability or expertise to make one out of whole cloth.

Governor Bryant nor the state lawmakers were savvy enough tackle it so it devolved into the legal battles we recently saw. My prediction is that Bryant with the help of Brunini, St. D, independent docs, and Blue will roll out a state plan next session.

Anonymous said...

Its nice to know a brain trust exists here. What about the new governor of Virginia, Terry McAuliffe? He has the Clintons behind him ,but is probably just going to get Richmond to back the Medicaid expansion.

Everywhere the free clinics will continue to play a significant role.

The Libertarian said...

Bryant dawdling on a state exchange still doesn't change the fact that this attempt to "make sure everyone is insured" is actually an attempt to crash the middle class so they too can rely on the all providing, all loving father government to sustain us. If you're not an 18 hour a week McDonalds employee, you pay through the nose. What's wrong with my current employer provided healthcare program? Well, it doesn't cover abortions, maternity or birth control....which isn't a concern for me in that I'm a guy, but whatever excuse commie boy can use to screw the "rich man"

Pugnacious said...

Haley Barbour, too, has connections to the the new governor of Virginia,the former chairman of Green Tech Automotive which had promised to build that $2,000,000,000 Wang-Wagen automobile plant in Tunica county. It was reported in 2011 that the SEC was conducting an investigation into the financing of the scheme.

Anonymous said...

Any word yet out of Gregg Harper condemning the special Obammycare exemptions for his sorry ass and the rest of Congress?

Of course not.

You see. Harper et al will never hold Obama accountable because he is also breaking the law.

Anonymous said...

Employer group health coverage means you are not underwritten individually and you have only a part of the premium to pay yourself. Its usually got a low deductible and is a very good plan. Like the plan the members of congress have.

As time goes on the features of group and individually written policies will be more aligned. The right of health care will be more accepted and not just a lucky break due to one's group coverage.
Obamacare will eventually work to the great dismay of the political leaders who just don't like any form of social insurance.

Anonymous said...

"The right of health care will be more accepted and not just a lucky break due to one's group coverage. "

Uh, it's not a "right", and it's not due to "a lucky break". It is something that is EARNED by WORKING.

I suspect you hear the phrase "Get a job!" a lot but don't understand what people are saying to you. This philosophy has been in vogue for quite a long time in some circles:

2 Thessalonians 3:10 (1611 King James Bible)


For euen when wee were with you, this wee commanded you, that if any would not worke, neither should he eate.

Anonymous said...

What is the answer to 2:53's question? Will employer sponsored plans be cancelled by insurers the way individual plans are being cancelled now?

Cassandra said...

11:02 The largest insurance company in Pennsylvania has started cancelling group policies for small businesses:

http://www.philly.com/philly/blogs/inq-phillydeals/Lawyer-IBC-is-cancelling-small-business-policies.html


The way I interpret this, they are giving companies a chance to renew policies now, so they will be in effect until Dec 31, 2014, instead of expiring as scheduled on Mar 31, 2014. Then the premiums will increase dramatically due to mandatory additions in coverage (e.g., coverage for prostate cancer treatments in policies sold to females - see today's Market Ticker on JJ's home page for the details).

Anonymous said...

Get your personal financial houses in order because Obamacare is going to tank the economy. You simply don't forcibly extract so much money from middle class households without disastrous effect.

It won't be long before Obama starts posting huge photos of himself on the sides of federal buildings like despots dictators have done throughout history.

Anonymous said...

Libertarian, you are too funny!

How is " the rich man getting screwed" ?

First the middle classes were screwed and now it's the lower upper classes getting screwed.

There's a reason the wealth of our Nation is now in the hands of less than 2% and more flowing to a smaller percentage every day. The rich aren't being screwed but are screwing with you. Our elected officials lined their pockets to help on both sides of the aisle.

Instead of reading politically slanted drivel, why don't you get the numbers? The wealthy aren't paying taxes at top rates as they get deductions and credits and can create trusts and put relatives and living expenses on the business payroll.

Government regulation is often written by large corporations and given to legislators by lobbyists to create regs they know their small competitors can't afford to meet. Then, those same corporations pretend to voters like you in ads and with PR that they are being hurt.

Start by looking at where the wealth is and who owns the large media outlets.

If you become a threat, you'll just be bought or legislated out of existence.



Anonymous said...

An editorial is just an opinion.

It isn't " news". It wasn't on the front page.

Editorial opinions aren't fact checked by the few media outlets that bother to fact check news anymore.

Very few editorials or editorial columnist have any expertise in the subject matter.

It's an opinion,not news, not facts, one person's opinion.

But, who cares about facts when our Nation is in trouble? Let's just go with what we want to be true instead of what is true.

Anonymous said...

Editorial opinions aren't fact checked by the few media outlets that bother to fact check news anymore.

You need a reality check and mental health evaluation if you think the Wall Street Journal doesn't fact check.

Very few editorials or editorial columnist have any expertise in the subject matter.

You just ruled out 95% of the editorials published by the Jackson Free Press. Thanks!

Anonymous said...

If a hard working person who gets group coverage for which the employer pays a large fraction--its really compensation and should be taxed. That worker's health risk is 'socialized' while mine is fully born by myself in a individually written policy.

The Supreme Court looked at mandated health insurance premiums thru the lens of taxation. Its true that healthcare is NOT a legal right yet, but its not a stretch really for legal minds like Chief Justice Roberts. A healthcare policy is a very complicated legal contract that statutes like Obamacare hope to simplify and universalize.

Anonymous said...

Okay, let's do some fact checking for those who think that Congress has some "special healthcare insurance." They do not. They have pretty much the same one every other federal employee has. There might be one or two differences in the exact plan you choose, but it's the same for all federal employees. I get it through my spouse, so I have the advantage of knowing the facts. Then again, Obamacare is sooo great, even Congress doesn't want it......

Anonymous said...

from Re. Michael McCaul in the liberal Houston Chronicle:

http://www.chron.com/opinion/outlook/article/Congress-doesn-t-need-health-subsidies-4879300.php

"Americans, regardless of their political leanings, are upset that Congress, through an administrative ruling, was given special treatment under Obamacare. It is the height of hypocrisy for Congress to be exempt from any law that applies to everyone except itself.

In 2009, during debate over the new health care law, legislative language was adopted that very clearly states that, as of Jan. 1, 2014, the only health insurance plans members of Congress and their staff can have are plans "offered through an Exchange" established under Obamacare. The intent behind this effort was to expose members of Congress to the health care experience they imposed on their constituents through the new law.

Currently, members of Congress and their staff receive health coverage through a federal program, which is administered by the Office of Personnel Management. Basically, members of Congress and their staffs pick the coverage they prefer from a menu of competing insurance policies and their employer, the federal government, contributes an amount toward the premium in the form of a subsidy.

Under Obamacare, the Office of Personnel Management no longer has the authority to provide this premium subsidy. In other words, there is no legal basis for the personnel office to rule that Congress can receive health coverage under its premium plan after Dec. 31.

It was therefore shocking to me that while the Office of Personnel Management had initially ruled Congress would have to forfeit its premium contributions under Obamacare, that decision was later reversed to allow Congress to continue to receive generous subsidies despite the law.

This alone is emblematic of this administration's penchant for unilaterally changing federal law without approval from the legislative branch. The president has carved out waivers to shield unions and big businesses from Obamacare's employer mandate, and delayed important procedures to shield taxpayers from fraud and protect against identity theft."
==================================

So, Obama ignored the law and granted Congress and their staffers a subsidy that the law did not grant to them.

One law for his favored few; another for us minions who are supposed to pay taxes and shut up.

Anonymous said...

One more time...

If my employer sponsored health insurance was modified in any way after the passage of Obamacare, will I be receiving a cancellation notice next year like those in the individual market are receiving now? This really is a simple question. Yes or no.

Anonymous said...

YES (again)

Anonymous said...

@2:09
Yes. And there is something else called the "Cadillac tax". Cadillac refers to the type of insurance plan you have. If your current policy is deemed a "Cadillac" policy, Obama is going after your employer with the "Cadillac tax". Basically, if your current employer sponsored insurance plan is a good plan, your employer will be hit over the head quite severely. Then your employer has to figure out what in the world to do to stay a float. If they can't pay the cadillac tax, then they have to change your insurance or you get to go to Obamacare.

Heck, the White House itself said that tens of millions in the employer-based market will loose their insurance and your choice will be--tada---obamacare.

Obamacare objective is called a single-payer (which means everyone is on government insurance). No choices, no nothing, government insurance. It also doesn't hurt them that the website also has a register-to-vote page (imagine that).

Are folks now understanding why we were fighting so hard to defund this?

Now that the sticker shock and reality is hitting, WHO REALLY LIED TO YOU?

Was it the folks screaming and fighting to defund and stop this train wreck from occurring
OR
was it the folks who kept getting mad at the ones standing and fighting to defund this?

The Libertarian said...

Yo, 6:46....by "rich man" I mean us, the alleged "disadvantaged" call middle class people "rich"....that's how they target and demonize.



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