Health insurance

Health insurance reform proposals, legislation

Who do we blame for soaring health insurance premiums?

You can blame AARP, health insurers, doctors and hospitals and the politicians that they paid with campaign contributions to distort the health insurance and health care markets.

And you can blame uninformed, unorganized and powerless voters for letting the Henry Waxmans of Congress and every president since JFK for making it all go wrong.

Health care is big money and big government.

Big government spends big money.

Big money in the hands of Big Government corrupts. 

Big government corrupts politicians, campaign contributors, drug companies, hospital administrators, physicians and regulators who have anything to do with distorting our health insurance and health care markets.

That's why America's huge government is and looks so corrupt. We're a third world country now.

The backlash against ObamaCare (Affordable Care Act, which is an oxymoron) is soaring among small businesses and their workers who are losing jobs and having their hours and take home pay cut while health insurance premiums are set to soar in 2014.

Premiums will soar as community rating, the best thing in ObamaCare, and expensive new mandated benefit plans kick in in 2014. The impact of community rating will be mostly a one-time event. Community rating protects the sick and most people over 40 from being discrimated against by employers because of their health status and age as I've written here. Please see the links at the bottom of that November 2009 blog for more information about community rating.

Expensive new mandated benefits designed to enrich providers and alternative care providers will keep premiums soaring until they're repealed and revised.

I've tweeted this morning at RealDonJohnson:

#ObamaCare backlash builds. #Community rating not problem. Benefit plans are.  http://on.wsj.com/11Rzaur 

Why #community rating 1 of best things in #ObamaCare. http://tiny.cc/erwcww

LINKS:

How to reform health insurance markets. The Business Word.

U.S. needs community rates for health risks. By Donald E. L. Johnson

Risk rating leaves people without health insurance; shows need for community rating. The Business Word.

Mark Hillman bill rigs market for Anthem Blue Cross. The Business Word.

Mandated health benefits in Colorado increase the cost of health insurance up to 50%. The Business Word.

Divider-in-Chief Obama is sending America over the fiscal cliff he created and is trying to use to turn America into a one-party, Chicago style corrupt and bankrupt country. Sec. of Treasury Geithner, a leading liar for Obama, says the country will reach the debt ceiling on Dec. 31, 2012, Previously he had warned the ceiling would be reached in February.  All House GOP Members should sign a letter to Obama that says the debt ceiling will be raised for one year when: 

The Wall Street Journal reports that some health care systems are getting into the health insurance business.

Gosh, how history repeats itself. Back in the 80s and 90s, several so-called "integrated" health systems got burned in the health insurance business. They didn't have insurance expertise, financial resources, market clout or credibility with individuals, employers or regulators. So most failed.

Hospitals and docs created Blue Cross and Blue Shield back in the 30s to make sure that they got paid the way they wanted to be paid, patients and payers be damned. That scam worked for decades until Medicare/Medicaid and smarter employers came along and forced the Blues to work for the payers instead of the providers.

If hospital systems try to compete with national health insurers, they'll lose the price wars even if they are the providers. This is because the national insurers have the financial and political resources and the market share that will allow them to crush the providers' plans whenever they decide to do that.

Over the last 35 to 40 years, too many hospital administrators have gotten their institutions into businesses that they knew little about, and they cost those institutions millions. Or, I should say, they ran up huge losses that they recovered by over-charging insurers and self-insured patients.

Most health care administrators are too smart to get into the insurance business. But their medical staffs get frustrated with insurers and demand that the hospital systems go into the health insurance, medical supply, group purchasing or whatever business the docs think will help them become richer.

Any board of directors that lets its CEO take it into what will be a money-losing, over-regulated business such as health insurance strikes me as being either incompetent, manipulated, self serving and/or all of the above.

State and federal legislators and regulators should not only outlaw health care providers from getting into the health insurance business, they also should enact anti-trust laws that break up the big regional and national health care chains and insurers.

Democrats and Republicans are deeply divided within each party as well as between parties on how to avert putting the country over the "fiscal cliff," which really is a slope, not a cliff. As a Small Government Republican Medicare beneficiary who's benefited from the free gift of Part D, cheap Medicare premiums, tax credits on home mortgages and coverage of primary care services that I should be paying for out of pocket, here's the deal I would like to see:

1. Make Medicare and Medicaid catastrophic programs only. Drop all the wellness and primary care nonsense that enriches providers and often hurts patients with false positives and harmful procedures.

2. Take all Congressionally imposed mandated benefits out of M/M.

3. Take all payments for teaching and medical research out of M/M. Fund them in separate bills and programs.

4. Breakup regional and metro hospital systems, medical groups and national health insurers.

5. Free seniors to buy non Medicare health insurance plans that cover primary care, wellness care and alternative care services without any Medicare subsidies for those premiums.

6. Raise premiums on all parts of Medicare. They're ridiculously low. 

7. Raise co-pays for all primary/preventive care and lower co/pays on catastrophically expensive cases.

8. Make Medicare Advantage enrollees pay the full premiums for the expanded coverage. 

9. Use money saved by eliminating coverage of provider-enriching preventive and wellness services to cover long-term care expenses that become catastrophically expensive as a percentage of the beneficiary's wealth, including the value of a a home or other investments. If someone is worth, say, $5 million, and long-term care costs, say, $80,000 to $100,000 a year, let that person pay for that care. If the person is worth $500,000 or less, Medicare could pay. That's the Moocher Nation way, of course.

10. Eliminate the death tax. Keep taxes on capital gains and dividends at 15%. No tax increases on the rich unless everyone gets income tax increases. Shrink the number of people who don't pay income taxes, get food stamps and are fraudulently filing disability claims.

11. Keep SS/Medicare enrollments at current ages. Change CPI calculations to reflect real inflation, which is a lot higher than the CPI shows today.

Congress and the Obama administration are fighting over how to fix entitlements, especially Medicare and Medicaid. Even Democrats disagree among themselves, according to today's Wall Street Journal. Some Democrats want no cuts, others want cosmetic cuts. Republicans want real reforms, but good luck with that.

Here are some ideas for fixing Medicare and Medicaid that I've made over the years and are even more relevant today: 

1. Take free physician office visits out of ObamCare. They waste physicians' time and create tremendous wait times for sick Medicare/Medicaid beneficiaries, which increases costs.

2. Require patients with minor symptoms to see nurse practitioners and other allied providers before wasting the time of the shrinking number of primary care physicians.

3. Eliminate coverage of the most wasteful primary care and allied providers.

Mitt Romney may have a tough time raising enough money to be competitive in the general 2012 election. (Nov. 20, 2012 update: Romney wasn't able to raise enough money after the primaries to fight Obama's successful character assasination ads. He raised billions later in the campaign, but spent the money on lousy ads and a dumb campaign strategy. And he turned out to be a weak campaign strategiest and candidate. As predicted below, he turned off young women. And he turned off young men. The social issues libertarians and the Moocher Nation won.)

His potential contributors are

Mitt Romney introduced his economic reform plan today in USAToday. The 59 points follow:

Every Friday, Jennifer Rubin, the Right Turn blogger on the Washington Post web site, asks her readers a question. On Sundays, she picks one or two answers posted by commenters on her blog and comments on the thread that she started.

This week's question: "What does [Rick] Perry need to do to maintain his momentum and begin to minimize doubts about his electability?"

This morning she picked two answers. My post about my eight ideas for stimulating consumer spending and hiring was one of the two answers she picked out of a bunch of good comments that followed her question. That thread is here. My slightly edited and expanded version of my comment, which I posted on this blog, is here.

Rubin summarized the answers this way:

I was struck by two important assumptions running through the answers. First, unlike many in the right blogosphere, the readers did not dismiss criticisms of Perry out of hand or characterize them as creations of the liberal media. They want to put Perry through the paces, and they understand there are real concerns about his candidacy. Second, it is apparent that readers are sick of platitudes and one-liners; they want detailed proposals and an explanation as to how the candidate’s background equips him to deal with our current national challenges. If Right Turn readers are representative of the Republican primary electorate, the party is in very good hands. The primary process is a time for not only choosing, but probing and testing.

Over the last 35 years, there have been a lot of attempts to slow the growth in Medicare expenditures, which have continued to soar unabated because of poor policy making by both parties. 

Although the Budget Control Act of 2011 (S. 365) says the Joint Budget Committee that will try to agree on the next round of budget cuts won't be allowed to change Medicare's benefits, I think it should.

Here are some ideas for changing Medicare that would give consumers and providers strong financial incentives to increase access to care and higher quality care at lower costs per patient and per enrollee:

The Budget Control Act signed by President Obama today creates a Joint Committee of a dozen members of Congress. It's job is to cut the budget by Thanksgiving.

Everyone expects that the committee, which will be comprised of six members of the Senate and six members of the House with six from each party, will target Medicare, Medicaid and other health services for savings.

This is a slightly revised piece I'm posting on comments sections and on Facebook:

What I want GOP candidates to promise:

On Thursday, Mitt Romney, a yet-to-be-announced presidential candidate, will try to get the RomneyCare Massachusetts health insurance disaster off his back. 

Romney experimented with health insurance markets in Massachusetts, and his stab at increasing access to health services while containing costs has failed big time. Health insurance is more expensive and health care is harder to get in Massachusetts under Romney care. And 100,000 still are uninsured.

RomneyCare's costly failures will dog Mitt Romney until he explains how it has gone wrong and how he would fix the politically distorted health care and health insurance markets. So far, he's called for repeal of ObamaCare, but he seems incapable of showing that he's learned from RomneyCare's mistakes. Sally Pipes, a leading analyst of health insurance and health care markets in Canada and the U.S., spells out the cost of RomneyCare for Forbes. http://tiny.cc/zqwti . Impact graphs:

A Florida Federal District Judge who today ruled ObamaCare (PL 111-148) is unconstitutional because it mandates that all Americans must buy government-approved health insurance also ruled that the law's provisions that force states to spend more on Medicaid is constitutional according to case law. The only thing that will save the states on the Medicaid issue is the judge's ruling that the unconstitutionality of the mandates makes the whole law unconstitutional. Links:  Decision on Florida v. DHHS. Scholars, politicians discuss the ruling here.