The Insurance Company-Government Partnership Is Wrong For Consumers
Working with is not the same as partners, and that is the root of Obamacare's failure as law for consumers and also the main reason that the then President Obama lied, outright or by omission when he was selling Obamacare. Uh-oh, "lie" and "President Obama" in the same sentence must be addressed, because after all, in today's political environment unless we have "sainted" and President Obama in the same sentence we are destined to oblivion.
But let's remember in 2013, President Obama delivered what Politifact dubbed "the lie of the year," with his repetitive assertion, "If you like your health care plan, you can keep it."
Let's also remember that campaigning and selling Obamacare President Obama did not advocate the individual mandate forcing Americans to purchase the consumer financial product of health insurance, (see The Atlantic, 6/29/2012, Andrew Cline's article, "How Obama Broke His Promise on Individual Mandates") but argued that lower prices for policies (whoops, another lie) would get the buy-in of American consumers.
Naturally, we were fans, oblivious to the deal that was already created by the health insurance lobby, AHIP, in 2008 that outlined the deal that addressed the cornerstone promise of covering pre-existing conditions made by candidates when the lobby produced its, "Health Plans Propose Guaranteed Coverage for Pre-Existing Conditions and Individual Coverage Mandate."
With the Republicans advocating repeal of that deal, the insurance lobby was eager to perpetuate its new status as government partner and came up with a new deal to pacify Republican candidates by speaking to their campaign promises to repeal Obamacare and create more competition among health insurers for consumer business in their new deal, "Making Health Care Work for Every American, Solutions to Deliver More Competition, Market Stability and Affordable Coverage."
I go into this document in detail and with cites in my December 8, 2016 post, "Trump and Consumers are Being Threatened by Insurance Company Demands: AHIP." Coincidentally, you'll see what we've been hearing from the Republicans mimicking the demands of the insurance lobby which threatens: Repeal can "either begin a stable transition to a better approach, or they can bring about even more uncertainty and instability."
Though insurance companies got their demands met from the Obama Administration, Obamacare still didn't work and created "uncertainty and instability," after all, you can't have MORE uncertainty and instability unless you already have it.
This is why it's good news that the Republican "plan" didn't go through with Paul Ryan as the Republican counterpart to the Democrat Obama as mouthpiece in chief for insurance company partners. It creates a consumer opportunity to focus attention on dissolving the partnership between government and insurance companies.
Naturally, they must work together but the use of our government to promote insurance company interests at the expense of consumer interests is the major challenge of such a partnership with the business of insurance.
The reason the government-insurance company partnership is anti-consumer is easily identified.
FIRST, GROUP insurance, the notion of an employer, a union or other GROUP of people offering their group membership in exchange for a group rate, much as group rates offer discounts in other consumer products offered for sale, was WEAKENED by Obamacare's creation of a FORCED purchase. You don't have to negotiate for customers if you're guaranteed by law that ALL people will purchase your product.
Further, in establishing the LEGAL MINIMUM of insurance coverage, Obamacare incentivized insurance companies to lower the quality of all insurance plans to merely meet these requirements while charging MORE for the now lower-quality plans.
This is not merely a language issue, and President Obama's attempt to characterize Obamacare as group health insurance was completely wrong for that reason, there was no incentive for insurance companies to negotiate rates in order to obtain groups of individuals as their members, every working American has to buy their product.
SECOND, a government-insurance company partnership that gave its partner special privileges is part and parcel of any partnership. So we got the Democrats able to impose Obamacare on us while exempting themselves from having to use the consumer product they deemed "good enough" for the rest of America.
THIRD, as part of the partnership's deal that fostered Obamacare, the real leader of Obamacare, insurance companies demanded additional business opportunities for themselves in the form of PROTECTIONS against loss by their partner, the government, as a tradeoff. These were the TEMPORARY provisions of Reinsurance, Risk Corridors and Risk Adjustment (only Risk adjustment surviving post 2017), were designed to protect insurance company profits so that they'd be willing to participate on exchanges.
This wasn't some unknown, it was in the original Affordable Care Act and explained by CMS, CMS defines REINSURANCE as Federal dollars that “Provides funding to issuers that incur high claims costs for enrollees,” (which prevents the issuer insurance company from bearing those losses). RISK CORRIDORS “Limits issuer losses (and gains),” and RISK ADJUSTMENT “Transfers funds from lower risk plans to higher risk plans.” (See "Fool us Once…Risk Corridors and Elections," 9/26/2014).
Once their partner government's payoffs stopped, we saw mass exodus of insurance companies from the exchanges. The same pitfalls of stopping payments to any group apply to insurance companies too, they don't want to give up those dollars.
FOURTH, having partnered with insurers, Obamacare actually incorporated some of the worst insurance practices in terms of gouging consumers instead of advocating on behalf of citizens. Coverage of cheap finite costs of preventive care replacing meaningful coverage for needed medical services as we saw that the "free" preventive care was used as an excuse for insurers to charge more overall on their plans and more in copay, coinsurance and deductible expenses for consumers to "cover" their expense of covering checkups. Narrow networks, meaning few provider choices have and remain insurer means of saving money. According to the Obama Administration, this was a basic part of Obamacare: The CBO, the government publication 49973 of March 2015 stating: “CBO and JCT anticipate that many plans will not be able to sustain such low provider payment rates or such narrow networks over the next few years, placing upward pressure on exchange premiums.” Special interest insurance coverages were balanced out with enormous promises of rate increases from the beginning, “Some insurers have said rates could rise by double-digit percentages in certain markets,” (emphasis added) Tami Luhby, “Most people pay Obamacare premiums,” http://money.cnn.com/2014/05/07/news/economy/obamacare-premiums/.
The takeaways for consumers are based on the problems above, first and foremost, individuals must NOT be penalized for rejecting a consumer financial product that doesn't work for them. This is basic marketplace of anything 101. Such FORCED purchase discourages innovation in response to consumer concerns and leaves consumers in the same position as they were when many opted out of purchasing health insurance because they were dissatisfied with the product regarding cost as related to the coverage they were offered.
Second, public employees must be bound by the laws imposed on the rest of us. President Obama was a bureaucracy guy and therefore addressed problems as if he were the head of the bureaucracy not of the country establishing privileges of pay, benefits and protections to public employees even as the rest of the country suffered on all three fronts resulting in a replacement of the middle class with a public employee middle class. That DEMOCRATS allowed this is appalling, that Obama created an additional subsidy pool in connection with Obamacare in case public employees had to participate was a betrayal, that people like Harry Reid stood up and defended the public employee exemption from Obamacare was an abomination.
Third, preventive care coverage was offered by the smartest insurance plans before Obamacare for the simple reasons that first, insurance companies used it to possibly prevent the greater costs of illness as it progressed by catching it early, though that's debatable, and second, and more likely, because they compiled this information about their members in order to come up with their insurance plans to make sure they didn't lose money, and third, because they used this finite cheaper "coverage" to justify higher rates. Consumers require a more meaningful, in terms of reimbursement and extensive coverage of NEEDED medical services rather than the finite costs of checkups.
Similarly, the provision of covering grown kids until they're 26 was already in places in many states where insurers realized that they could get those young-healthies by making it possible for their parents to purchase insurance coverage for them which was not the basic, bronze or catastrophic health insurance but was the same plan the parent employee was offered. This was a benefit to insurers, the law didn't need to include this provision.
Fourth, and most significantly, government, representative of the VOTERS cannot dilute its loyalty or in some instances replace its loyalty to voters with its loyalty to an industry. That's what Obamacare does. We did not elect representatives to defend insurance companies. Working with insurance companies with skilled negotiation, and using the force of law to protect consumers is not possible if you're partners with the very entity that's negatively impacting consumers, which is obvious and proven by Obamacare.
It's time to dissolve the Obamacare insurance company-government partnership and remind our representatives that our interests have been utterly defeated by Obamacare, we have fewer choices for more money and more hoops to jump through to get the services we pay for…Three strikes you're out.
But let's remember in 2013, President Obama delivered what Politifact dubbed "the lie of the year," with his repetitive assertion, "If you like your health care plan, you can keep it."
Let's also remember that campaigning and selling Obamacare President Obama did not advocate the individual mandate forcing Americans to purchase the consumer financial product of health insurance, (see The Atlantic, 6/29/2012, Andrew Cline's article, "How Obama Broke His Promise on Individual Mandates") but argued that lower prices for policies (whoops, another lie) would get the buy-in of American consumers.
Naturally, we were fans, oblivious to the deal that was already created by the health insurance lobby, AHIP, in 2008 that outlined the deal that addressed the cornerstone promise of covering pre-existing conditions made by candidates when the lobby produced its, "Health Plans Propose Guaranteed Coverage for Pre-Existing Conditions and Individual Coverage Mandate."
With the Republicans advocating repeal of that deal, the insurance lobby was eager to perpetuate its new status as government partner and came up with a new deal to pacify Republican candidates by speaking to their campaign promises to repeal Obamacare and create more competition among health insurers for consumer business in their new deal, "Making Health Care Work for Every American, Solutions to Deliver More Competition, Market Stability and Affordable Coverage."
I go into this document in detail and with cites in my December 8, 2016 post, "Trump and Consumers are Being Threatened by Insurance Company Demands: AHIP." Coincidentally, you'll see what we've been hearing from the Republicans mimicking the demands of the insurance lobby which threatens: Repeal can "either begin a stable transition to a better approach, or they can bring about even more uncertainty and instability."
Though insurance companies got their demands met from the Obama Administration, Obamacare still didn't work and created "uncertainty and instability," after all, you can't have MORE uncertainty and instability unless you already have it.
This is why it's good news that the Republican "plan" didn't go through with Paul Ryan as the Republican counterpart to the Democrat Obama as mouthpiece in chief for insurance company partners. It creates a consumer opportunity to focus attention on dissolving the partnership between government and insurance companies.
Naturally, they must work together but the use of our government to promote insurance company interests at the expense of consumer interests is the major challenge of such a partnership with the business of insurance.
The reason the government-insurance company partnership is anti-consumer is easily identified.
FIRST, GROUP insurance, the notion of an employer, a union or other GROUP of people offering their group membership in exchange for a group rate, much as group rates offer discounts in other consumer products offered for sale, was WEAKENED by Obamacare's creation of a FORCED purchase. You don't have to negotiate for customers if you're guaranteed by law that ALL people will purchase your product.
Further, in establishing the LEGAL MINIMUM of insurance coverage, Obamacare incentivized insurance companies to lower the quality of all insurance plans to merely meet these requirements while charging MORE for the now lower-quality plans.
This is not merely a language issue, and President Obama's attempt to characterize Obamacare as group health insurance was completely wrong for that reason, there was no incentive for insurance companies to negotiate rates in order to obtain groups of individuals as their members, every working American has to buy their product.
SECOND, a government-insurance company partnership that gave its partner special privileges is part and parcel of any partnership. So we got the Democrats able to impose Obamacare on us while exempting themselves from having to use the consumer product they deemed "good enough" for the rest of America.
THIRD, as part of the partnership's deal that fostered Obamacare, the real leader of Obamacare, insurance companies demanded additional business opportunities for themselves in the form of PROTECTIONS against loss by their partner, the government, as a tradeoff. These were the TEMPORARY provisions of Reinsurance, Risk Corridors and Risk Adjustment (only Risk adjustment surviving post 2017), were designed to protect insurance company profits so that they'd be willing to participate on exchanges.
This wasn't some unknown, it was in the original Affordable Care Act and explained by CMS, CMS defines REINSURANCE as Federal dollars that “Provides funding to issuers that incur high claims costs for enrollees,” (which prevents the issuer insurance company from bearing those losses). RISK CORRIDORS “Limits issuer losses (and gains),” and RISK ADJUSTMENT “Transfers funds from lower risk plans to higher risk plans.” (See "Fool us Once…Risk Corridors and Elections," 9/26/2014).
Once their partner government's payoffs stopped, we saw mass exodus of insurance companies from the exchanges. The same pitfalls of stopping payments to any group apply to insurance companies too, they don't want to give up those dollars.
FOURTH, having partnered with insurers, Obamacare actually incorporated some of the worst insurance practices in terms of gouging consumers instead of advocating on behalf of citizens. Coverage of cheap finite costs of preventive care replacing meaningful coverage for needed medical services as we saw that the "free" preventive care was used as an excuse for insurers to charge more overall on their plans and more in copay, coinsurance and deductible expenses for consumers to "cover" their expense of covering checkups. Narrow networks, meaning few provider choices have and remain insurer means of saving money. According to the Obama Administration, this was a basic part of Obamacare: The CBO, the government publication 49973 of March 2015 stating: “CBO and JCT anticipate that many plans will not be able to sustain such low provider payment rates or such narrow networks over the next few years, placing upward pressure on exchange premiums.” Special interest insurance coverages were balanced out with enormous promises of rate increases from the beginning, “Some insurers have said rates could rise by double-digit percentages in certain markets,” (emphasis added) Tami Luhby, “Most people pay Obamacare premiums,” http://money.cnn.com/2014/05/07/news/economy/obamacare-premiums/.
The takeaways for consumers are based on the problems above, first and foremost, individuals must NOT be penalized for rejecting a consumer financial product that doesn't work for them. This is basic marketplace of anything 101. Such FORCED purchase discourages innovation in response to consumer concerns and leaves consumers in the same position as they were when many opted out of purchasing health insurance because they were dissatisfied with the product regarding cost as related to the coverage they were offered.
Second, public employees must be bound by the laws imposed on the rest of us. President Obama was a bureaucracy guy and therefore addressed problems as if he were the head of the bureaucracy not of the country establishing privileges of pay, benefits and protections to public employees even as the rest of the country suffered on all three fronts resulting in a replacement of the middle class with a public employee middle class. That DEMOCRATS allowed this is appalling, that Obama created an additional subsidy pool in connection with Obamacare in case public employees had to participate was a betrayal, that people like Harry Reid stood up and defended the public employee exemption from Obamacare was an abomination.
Third, preventive care coverage was offered by the smartest insurance plans before Obamacare for the simple reasons that first, insurance companies used it to possibly prevent the greater costs of illness as it progressed by catching it early, though that's debatable, and second, and more likely, because they compiled this information about their members in order to come up with their insurance plans to make sure they didn't lose money, and third, because they used this finite cheaper "coverage" to justify higher rates. Consumers require a more meaningful, in terms of reimbursement and extensive coverage of NEEDED medical services rather than the finite costs of checkups.
Similarly, the provision of covering grown kids until they're 26 was already in places in many states where insurers realized that they could get those young-healthies by making it possible for their parents to purchase insurance coverage for them which was not the basic, bronze or catastrophic health insurance but was the same plan the parent employee was offered. This was a benefit to insurers, the law didn't need to include this provision.
Fourth, and most significantly, government, representative of the VOTERS cannot dilute its loyalty or in some instances replace its loyalty to voters with its loyalty to an industry. That's what Obamacare does. We did not elect representatives to defend insurance companies. Working with insurance companies with skilled negotiation, and using the force of law to protect consumers is not possible if you're partners with the very entity that's negatively impacting consumers, which is obvious and proven by Obamacare.
It's time to dissolve the Obamacare insurance company-government partnership and remind our representatives that our interests have been utterly defeated by Obamacare, we have fewer choices for more money and more hoops to jump through to get the services we pay for…Three strikes you're out.
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