Six Years In and Starting to "Get" Obamacare, the LA Times
It's not really "news" except for the fact that it appears in the LA Times, which is a huge step forward for consumers. Reporters Melody Petersen and Noam N. Levey wrote an article on 7/16/2016, "California Obamacare rates to rise 13% in 2017, more than three times the increase of last two years," http://www.latimes.com/business/la-fi-covered-california-rates-20160718-snap-story.html.
That's right, belying the years of "success" reporting, merely two years after the well-timed-after-2012 elections draconian provisions of Obamacare started kicking in, the LA Times is reporting that their exchange rates are going up to the tune of 13% for the coming enrollment year AND they're not blaming the bogeyman Republicans, but focusing on the law itself.
Still, there's work to be done to begin to address the healthcare crisis Americans face often unchanged and also worsened by the law. Fix or repeal, even for Obamacare fans it's becoming undeniable (though some still do) that the law itself far from a well-meaning healthcare reform for citizens was and is a not-so-new codification of some of the worst insurance practices in our country that helped create the "healthcare crisis," to begin with and that all the law did was make those practices law thereby sealing our healthcare destiny into our indefinite future.
It is the very motivation of Obamacare that should have chilled Americans as the government partnered with insurance companies and political scammers misled the American people about Obamacare rendering the law a monument to one of the greatest scams designed to save government and insurance company payers money off the backs of people who depend on their products for physical and financial survival in times of illness rather than being a law that tried but failed valiantly in an attempt to address a crushing citizen crisis.
For California consumers, who perhaps believed all the "feel good it's working" stories the LA TIMES has published including an ongoing maddening commitment by fanboy Michael Hiltzik, the 13% increase might be the opportunity to break through the cycle of less than honest reporting about the law. But it's going to require a lot of language self-control to keep political slant from clouding the issues surrounding Obamacare. The following are serious errors in the article.
Not group insurance, Not Negotiation: The President likes to refer to Obamacare exchanges as "group insurance," using his facility for lying with language, though not quite lying. Sure a group of people will be insured, but NOT group insurance as we know it but merely a salesman's twist of words. Exchanges do not offer "group" insurance but rather insurance to an undefined group--those eligible to enroll.
Group insurance, the concept where insurance companies, employers, unions would NEGOTIATE with insurance companies eager for their business because of the number of people, customers they would get supposedly would help those insurance companies to come up with the best plan for the best price. On their part insurance companies would use that same potential pool of paying customers to NEGOTIATE with providers to accept their somewhat lower payments and become participants in their plans in order to access those paying customers.
Two negotiations--between customer group representatives, whether employers or unions and the like looking for the insurance company offering the best plan AND between the insurance company and providers looking to access the customers represented by a specific group that had chosen a certain insurance plan. It's easy to see that Obamacare, that forces customers without representation to purchase a health insurance product or face a penalty (individual mandate) is NOT a negotiator on behalf of a customer group but instead is guaranteeing insurance companies access to the customers by LAW, without those companies having to compete for business.
It's also obvious that there is NO incentive for insurance companies to negotiate with providers to accept lower rates in order to make their product more attractive to customers choosing a plan, because we, the customers, MUST choose a plan, so insurers more than ever take the view "If they want more options they can darn well pay for them or else accept what's being offered."
We know that the individual mandate which eradicated the need and talent for negotiation of GROUP insurance therefore, was as is proven, an insurance company created provision--See AHIP, the insurance company lobbyists' pre-Obamacare (2008] document, "Health Plans Propose Guaranteed Coverage for Pre-Existing Conditions and Individual Coverage Mandate."
In the LA TIMES, the writers of the above story fall into the Obama language trap and in touting the 4% and 4.2% increases on California's Covered California exchange for 2016 and 2015 respectively, stating that 2015 was "the first year that exchange officials NEGOTIATED with insurers." (emphasis added)
Obamacare was NEVER about NEGOTIATION and the writers contradict their own language when they quote those same "exchange officials," explaining that the 13% increase this year is due to "expensive specialty drugs and the end of a mechanism that held down rates for the first three years of Obamacare." Negotiation was NOT the mechanism.
That mechanism they refer to is also referred to as the three Rs, which I've written about extensively but briefly include three programs offered up in the law that were designed to create a no-lose situation for insurance companies so that they would participate in the exchanges, September 2014, "Fool us Once…Risk Corridors and Elections," http://conoutofconsumer.blogspot.com/2014/09/fool-us-oncerisk-corridors-and-elections.html.
As I wrote in 2014:
The REINSURANCE and THE RISK CORRIDORS ARE SUPPOSED TO LAST THROUGH 2016…that would be a meaningful year in the world of elections. After that, those federal dollar programs would gradually expire (as funding was no longer provided).
The RISK ADJUSTMENT, the provision that transfers money from lower risk plans to higher risk plans is supposed to be permanent (in other words spreading the money around evenly). ( Reinsurance, Risk Corridors, and Risk Adjustment Final Rule http://www.cms.gov/cciio/resources/files/downloads/3rs-final-rule.pdf).
In other words, a government payout program to insurance companies to "incentivize," "bribe," whatever word you choose, called the Reinsurance and Risk Corridor TEMPORARY programs, are expiring and that's one of the reasons the "exchange officials" are explaining the 13% increase.
The language was in the law from the start, it's referred to as TEMPORARY in the law from the start, and it is a Federal government payout that was included for 2014-2016--Not negotiation, a provision of the law.
Since the deal was put in place and paid for by the federal government and absent the deal the rate increases are exploding, obviously NEGOTIATION was NOT part of the skill set California's exchange officials use.
The second justification for the rate increase, "expensive specialty drugs," is a failure of insurance companies to negotiate with drug providers--the same problem as above--Obamacare erased negotiation by forcing everyone to purchase a health insurance plan regardless of its inadequacy which in turn DISINCENTIVIZES negotiation between insurance companies and the pool of potential customers AND between insurance companies and providers including drug providers for their insurance plans.
The Silver Plan Debacle: Same old less coverage/higher prices
The writers go on to explain that "For consumers, the impact will depend on whether they get taxpayer-supported subsidies for their premiums and whether they are willing to switch to less-expensive plans that may come with higher co-pays and deductibles," the persistent insurance company approach of reducing coverage as a phony means of reducing prices for consumers, which at best only works comparatively--As all prices go up, if you want to pay less in any year you must sacrifice coverage.
But it is the subsidies angle that the writers miss even though they accurately explain that consumers will have to pay more for less. The subsidies are a mask, disguising the FACT that Obamacare codifies into law the scam insurance companies have used for decades: "Sure, we'll charge you less of an increase if you take less coverage." That practice is NOT solved but is instead CODIFIED by Obamacare which chose to MASK its compliance with insurance company wishes by offering premium assistance to the merely 11 million people who get entitlement dollars from exchanges. Insurance companies don't care who pays them--the government premiums or the consumer dollars, as long as they get paid.
The problem is that INSURANCE COMPANIES KEEP RAISING THEIR PRICES--While the exchanges were laggards in inflicting this blow on consumers, (those with employer sponsored insurance were hit immediately) it still took only a single year for exchange consumers to realize that we were now bound by a law the does NOTHING to curb increases in what we're charged by insurance companies. While these increases were masked for exchange consumers who receive government entitlement dollars, the exchange plans are nevertheless impacted by the real world because the costs to consumers of the plans on exchanges are linked to the second most expensive silver plan equivalent in a region.
Therefore, in the mere two years of exchange enrollment, the government already saw that individuals enrolling on exchanges were choosing the cheapest plans available even with the masking of the true cost through payouts of government dollars for premiums. Further, exchange users joined the rest of the country in realizing that the old cover less approach had become incentivized by Obamacare which left insurers free to increase copayments, coinsurance and deductibles and provide limited choices of providers with the government cooperation in setting ever-increasing out-of-pocket maximums which are for 2017 the obscene amounts of $7,150 for self-only coverage and $14,300 for a family.
Wishful Thinking, Blundering Ignorance or Partisan Blindness: It's hard to believe that in the article, Jamie Court, the President of Consumer Watchdog in Santa Monica only offered the most obvious and decades old predatory health insurance complaint, "We're paying more for less." These results were and are part and parcel of Obamacare, from the beginning, not surprises nor are they unexpected consequences.
Even more stunning, the article quotes another "It's Working" fanboy who happens to be the Executive Director of Covered California who resorted to the scam/myth of "a very competitive marketplace."
The authors also talk about Hillary Clinton's rescue plans, choosing to mix apples and oranges by focusing on her idea of "allowing" people to buy into Medicare. It's unclear why the authors chose to ignore Hillary Clinton's published goals for Obamacare with the intention of further kowtowing to insurance companies.
Clinton proposed to not only increase the handout entitlement for exchange enrollees (who at BEST represent 11 million Americans) by allowing for a $5,000 government credit for Obamacare exchange users leaving out the MAJORITY of Americans who are not on exchanges from her planned handout, but she also plans to defy the provisions of the law in order to create a new pool of customers by allowing anyone REGARDLESS OF IMMIGRATION STATUS to join. See: "Hillary Clinton: Middle Class Employees will be Gutted to Pay for Obamacare," http://conoutofconsumer.blogspot.com/2016/03/hillary-clinton-middle-class-employees.html, and https://www.hillaryclinton.com/issues/health-care/.
Not Improved Care: The authors also resort to the Obama lie that any insurance improves health care thereby coming up with the phony claim that health insurance and health care are equivalents. This lie was seemingly based on a study of Medicaid, which is a program of virtually FREE health insurance and virtually FREE health care, a far cry from what anyone gets under the Affordable Care Act exchanges, even if they maximize the handouts of premium assistance and cost-sharing, because they're still subject to out-of-pocket maximums, they're still often subject to paying something of their bills for health services.
That study of free health insurance and free health care, Medicaid can be found at 2012 research, “Mortality and Access to Care Among Adults After State Medicaid Expansions,” by Benjamin D. Sommers, Katherine Baicker, Arnold M. Epstein, New England Journal of Medicine, online July 25, print September 13, 2012, that found that “…expanding Medicaid to low-income adults leads to widespread gains in coverage, access to care, and—most importantly—improved health and reduced mortality.”
Yet this article is about a 13% increase in premiums for exchange plans, different from the free health insurance/free health care model of Medicaid. The article also ignores some developments in our health CARE stats, the death rate in US rose for the first time in a decade (search exactly that), medical error is the third leading cause of death in the US (search exactly that), the US ranks 43rd in life expectancy (http://www.infoplease.com/world/statistics/life-expectancy-country.html).
But the article, in spite of its weaknesses is progress, especially for the LA TIMES and the authors at least give a nod to some of the realities of Obamacare including its failure to contain "few controls on overall costs," which should have been clarified as costs to consumers since we've already learned how the government and insurance companies ARE saving money per capita (that means on actual people rather than spending on themselves) which is by REDUCING COVERAGE and REQUIRING MORE OUT OF POCKET SPENDING by consumers.
That's right, belying the years of "success" reporting, merely two years after the well-timed-after-2012 elections draconian provisions of Obamacare started kicking in, the LA Times is reporting that their exchange rates are going up to the tune of 13% for the coming enrollment year AND they're not blaming the bogeyman Republicans, but focusing on the law itself.
Still, there's work to be done to begin to address the healthcare crisis Americans face often unchanged and also worsened by the law. Fix or repeal, even for Obamacare fans it's becoming undeniable (though some still do) that the law itself far from a well-meaning healthcare reform for citizens was and is a not-so-new codification of some of the worst insurance practices in our country that helped create the "healthcare crisis," to begin with and that all the law did was make those practices law thereby sealing our healthcare destiny into our indefinite future.
It is the very motivation of Obamacare that should have chilled Americans as the government partnered with insurance companies and political scammers misled the American people about Obamacare rendering the law a monument to one of the greatest scams designed to save government and insurance company payers money off the backs of people who depend on their products for physical and financial survival in times of illness rather than being a law that tried but failed valiantly in an attempt to address a crushing citizen crisis.
For California consumers, who perhaps believed all the "feel good it's working" stories the LA TIMES has published including an ongoing maddening commitment by fanboy Michael Hiltzik, the 13% increase might be the opportunity to break through the cycle of less than honest reporting about the law. But it's going to require a lot of language self-control to keep political slant from clouding the issues surrounding Obamacare. The following are serious errors in the article.
Not group insurance, Not Negotiation: The President likes to refer to Obamacare exchanges as "group insurance," using his facility for lying with language, though not quite lying. Sure a group of people will be insured, but NOT group insurance as we know it but merely a salesman's twist of words. Exchanges do not offer "group" insurance but rather insurance to an undefined group--those eligible to enroll.
Group insurance, the concept where insurance companies, employers, unions would NEGOTIATE with insurance companies eager for their business because of the number of people, customers they would get supposedly would help those insurance companies to come up with the best plan for the best price. On their part insurance companies would use that same potential pool of paying customers to NEGOTIATE with providers to accept their somewhat lower payments and become participants in their plans in order to access those paying customers.
Two negotiations--between customer group representatives, whether employers or unions and the like looking for the insurance company offering the best plan AND between the insurance company and providers looking to access the customers represented by a specific group that had chosen a certain insurance plan. It's easy to see that Obamacare, that forces customers without representation to purchase a health insurance product or face a penalty (individual mandate) is NOT a negotiator on behalf of a customer group but instead is guaranteeing insurance companies access to the customers by LAW, without those companies having to compete for business.
It's also obvious that there is NO incentive for insurance companies to negotiate with providers to accept lower rates in order to make their product more attractive to customers choosing a plan, because we, the customers, MUST choose a plan, so insurers more than ever take the view "If they want more options they can darn well pay for them or else accept what's being offered."
We know that the individual mandate which eradicated the need and talent for negotiation of GROUP insurance therefore, was as is proven, an insurance company created provision--See AHIP, the insurance company lobbyists' pre-Obamacare (2008] document, "Health Plans Propose Guaranteed Coverage for Pre-Existing Conditions and Individual Coverage Mandate."
In the LA TIMES, the writers of the above story fall into the Obama language trap and in touting the 4% and 4.2% increases on California's Covered California exchange for 2016 and 2015 respectively, stating that 2015 was "the first year that exchange officials NEGOTIATED with insurers." (emphasis added)
Obamacare was NEVER about NEGOTIATION and the writers contradict their own language when they quote those same "exchange officials," explaining that the 13% increase this year is due to "expensive specialty drugs and the end of a mechanism that held down rates for the first three years of Obamacare." Negotiation was NOT the mechanism.
That mechanism they refer to is also referred to as the three Rs, which I've written about extensively but briefly include three programs offered up in the law that were designed to create a no-lose situation for insurance companies so that they would participate in the exchanges, September 2014, "Fool us Once…Risk Corridors and Elections," http://conoutofconsumer.blogspot.com/2014/09/fool-us-oncerisk-corridors-and-elections.html.
As I wrote in 2014:
The REINSURANCE and THE RISK CORRIDORS ARE SUPPOSED TO LAST THROUGH 2016…that would be a meaningful year in the world of elections. After that, those federal dollar programs would gradually expire (as funding was no longer provided).
The RISK ADJUSTMENT, the provision that transfers money from lower risk plans to higher risk plans is supposed to be permanent (in other words spreading the money around evenly). ( Reinsurance, Risk Corridors, and Risk Adjustment Final Rule http://www.cms.gov/cciio/resources/files/downloads/3rs-final-rule.pdf).
In other words, a government payout program to insurance companies to "incentivize," "bribe," whatever word you choose, called the Reinsurance and Risk Corridor TEMPORARY programs, are expiring and that's one of the reasons the "exchange officials" are explaining the 13% increase.
The language was in the law from the start, it's referred to as TEMPORARY in the law from the start, and it is a Federal government payout that was included for 2014-2016--Not negotiation, a provision of the law.
Since the deal was put in place and paid for by the federal government and absent the deal the rate increases are exploding, obviously NEGOTIATION was NOT part of the skill set California's exchange officials use.
The second justification for the rate increase, "expensive specialty drugs," is a failure of insurance companies to negotiate with drug providers--the same problem as above--Obamacare erased negotiation by forcing everyone to purchase a health insurance plan regardless of its inadequacy which in turn DISINCENTIVIZES negotiation between insurance companies and the pool of potential customers AND between insurance companies and providers including drug providers for their insurance plans.
The Silver Plan Debacle: Same old less coverage/higher prices
The writers go on to explain that "For consumers, the impact will depend on whether they get taxpayer-supported subsidies for their premiums and whether they are willing to switch to less-expensive plans that may come with higher co-pays and deductibles," the persistent insurance company approach of reducing coverage as a phony means of reducing prices for consumers, which at best only works comparatively--As all prices go up, if you want to pay less in any year you must sacrifice coverage.
But it is the subsidies angle that the writers miss even though they accurately explain that consumers will have to pay more for less. The subsidies are a mask, disguising the FACT that Obamacare codifies into law the scam insurance companies have used for decades: "Sure, we'll charge you less of an increase if you take less coverage." That practice is NOT solved but is instead CODIFIED by Obamacare which chose to MASK its compliance with insurance company wishes by offering premium assistance to the merely 11 million people who get entitlement dollars from exchanges. Insurance companies don't care who pays them--the government premiums or the consumer dollars, as long as they get paid.
The problem is that INSURANCE COMPANIES KEEP RAISING THEIR PRICES--While the exchanges were laggards in inflicting this blow on consumers, (those with employer sponsored insurance were hit immediately) it still took only a single year for exchange consumers to realize that we were now bound by a law the does NOTHING to curb increases in what we're charged by insurance companies. While these increases were masked for exchange consumers who receive government entitlement dollars, the exchange plans are nevertheless impacted by the real world because the costs to consumers of the plans on exchanges are linked to the second most expensive silver plan equivalent in a region.
Therefore, in the mere two years of exchange enrollment, the government already saw that individuals enrolling on exchanges were choosing the cheapest plans available even with the masking of the true cost through payouts of government dollars for premiums. Further, exchange users joined the rest of the country in realizing that the old cover less approach had become incentivized by Obamacare which left insurers free to increase copayments, coinsurance and deductibles and provide limited choices of providers with the government cooperation in setting ever-increasing out-of-pocket maximums which are for 2017 the obscene amounts of $7,150 for self-only coverage and $14,300 for a family.
Wishful Thinking, Blundering Ignorance or Partisan Blindness: It's hard to believe that in the article, Jamie Court, the President of Consumer Watchdog in Santa Monica only offered the most obvious and decades old predatory health insurance complaint, "We're paying more for less." These results were and are part and parcel of Obamacare, from the beginning, not surprises nor are they unexpected consequences.
Even more stunning, the article quotes another "It's Working" fanboy who happens to be the Executive Director of Covered California who resorted to the scam/myth of "a very competitive marketplace."
The authors also talk about Hillary Clinton's rescue plans, choosing to mix apples and oranges by focusing on her idea of "allowing" people to buy into Medicare. It's unclear why the authors chose to ignore Hillary Clinton's published goals for Obamacare with the intention of further kowtowing to insurance companies.
Clinton proposed to not only increase the handout entitlement for exchange enrollees (who at BEST represent 11 million Americans) by allowing for a $5,000 government credit for Obamacare exchange users leaving out the MAJORITY of Americans who are not on exchanges from her planned handout, but she also plans to defy the provisions of the law in order to create a new pool of customers by allowing anyone REGARDLESS OF IMMIGRATION STATUS to join. See: "Hillary Clinton: Middle Class Employees will be Gutted to Pay for Obamacare," http://conoutofconsumer.blogspot.com/2016/03/hillary-clinton-middle-class-employees.html, and https://www.hillaryclinton.com/issues/health-care/.
Not Improved Care: The authors also resort to the Obama lie that any insurance improves health care thereby coming up with the phony claim that health insurance and health care are equivalents. This lie was seemingly based on a study of Medicaid, which is a program of virtually FREE health insurance and virtually FREE health care, a far cry from what anyone gets under the Affordable Care Act exchanges, even if they maximize the handouts of premium assistance and cost-sharing, because they're still subject to out-of-pocket maximums, they're still often subject to paying something of their bills for health services.
That study of free health insurance and free health care, Medicaid can be found at 2012 research, “Mortality and Access to Care Among Adults After State Medicaid Expansions,” by Benjamin D. Sommers, Katherine Baicker, Arnold M. Epstein, New England Journal of Medicine, online July 25, print September 13, 2012, that found that “…expanding Medicaid to low-income adults leads to widespread gains in coverage, access to care, and—most importantly—improved health and reduced mortality.”
Yet this article is about a 13% increase in premiums for exchange plans, different from the free health insurance/free health care model of Medicaid. The article also ignores some developments in our health CARE stats, the death rate in US rose for the first time in a decade (search exactly that), medical error is the third leading cause of death in the US (search exactly that), the US ranks 43rd in life expectancy (http://www.infoplease.com/world/statistics/life-expectancy-country.html).
But the article, in spite of its weaknesses is progress, especially for the LA TIMES and the authors at least give a nod to some of the realities of Obamacare including its failure to contain "few controls on overall costs," which should have been clarified as costs to consumers since we've already learned how the government and insurance companies ARE saving money per capita (that means on actual people rather than spending on themselves) which is by REDUCING COVERAGE and REQUIRING MORE OUT OF POCKET SPENDING by consumers.
0 Response to "Six Years In and Starting to "Get" Obamacare, the LA Times"
Posting Komentar