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A Point Of View Is Not Reality

Stanley Feld M.D.,FACP,MACE

I find it harder and harder to believe the administration’s press releases. Every press release and press conference seem to be a lie.

How can President Obama’s press secretary live with himself?

America’s government is supposed to be a government by the people, for the people. The three branches of government are supposed to balance each other’s power.

The executive branch under the Obama administration has usurped much of the power of the legislative and judicial branches of government.

I have pointed out that things are not going well for Obamacare.

Consumers cannot keep their doctors.

Consumer cannot keep their insurance.

Obamacare’s hidden taxes have raise taxes at least 10%. Many increases are passed on to all consumers in every tax bracket.

Healthcare premiums have increased for everyone.

The only real increase in Obamacare enrollment has been in Medicaid enrollment. The central government currently pays for 100% of the insurance cost for Medicaid patients.

The Obama administration pays for the yearly increases for Medicaid premiums billed to it by the healthcare insurance industry.

Eighty-five percent (85%) of Obamacare enrollees receive subsidies. The average taxpayer does not know these facts.   I suspect most congressmen do not know these facts.

Meanwhile, during President Obama’s term in office, the budget deficit has increased from 12 trillion dollars to 19 trillion dollars.

Marilyn Tavenner was the former head of the Centers for Medicare and Medicaid Services. She helped construct policy, publicize, sell, and administer Obamacare and its expansion of Medicaid.

Ms. Taverner had one point of view as head of CMS. She helped create greater dysfunction in the healthcare system.

Now, she has a completely opposite point of view. She is presently president and CEO of America’s Health Insurance Plans, the healthcare insurance industry’s premier lobbying group.

She continuously defended Obamacare after each mishap such as the enrollment web site, the enrollment errors in counting enrollees, the insurance premium increases, the poor enrollment and the decrease in service. Each disaster increased the dysfunction of the healthcare system.

Now that her point of view has changed she has become extremely critical of Obamacare.

Her criticisms of Obamacare have gotten her closer to reality. Now, her point of view is that of the healthcare insurance industry.

However, it is not a point of view that supports the needs of consumers.

Someone ought to look at the consumers’ and physicians’ point of view.

Marilyn Tavenner has harsh criticism of the program she once helped get off the ground.

The Obama administration’s continuous praise of Obamacare’s success has marginalized Ms. Taverner’s recent criticism of Obamacare.

Unfortunately, the Obama administration’s praise of Obamacare’s success is a lie.

The news that UnitedHealth Group, the country’s largest health insurer, announced last month that it would pull out of many ACA markets next year is a very big deal.

UnitedHealth, which actually operates in nearly two-thirds of all U.S. markets, has predicted it could lose $500 million on its individual Obamacare plans in 2016.

The Obama administration’s response was a classic misdirection response.

“The news is not all that shocking, and it is not a sign that the law is failing.”

 United is not a dominant player in the marketplaces that the ACA “Obamacare” set up for individual insurance buyers. It covers only about 6 percent of 12.7 million marketplace participants. United does not appear to have been very effective at competing to attract customers.

 UnitedHealth CEO Stephen Hemsley has blamed higher medical utilization rates for Obamacare members, as well as the ease of switching plans, for his company’s Obamacare woes.

The higher utilization rates are because the government subsidizes 85% of the people in Obamacare. Medical care is essentially free. People do not join Obamacare or pay premiums unless they are sick.

A huge study released by the Blue Cross Blue Shield Association recently analyzed the medical claims of millions of Obamacare and employer-based members and found that Obamacare members are 22% costlier than employer-based members. Obamacare enrollees also tend to be sicker, coming with a host of chronic or expensive-to-treat conditions.” 

United plans offer the largest network of doctors, hospitals and other providers to choose from.

All this is expensive. Unsurprisingly, marketplace insurance buyers tend to pick lower-cost options. All this causes their premiums to be higher.

Most people believe free is best. Many are being conditioned by the administration to love free healthcare insurance.

The quality and availability of care is ignored in the administration’s boasting of Obamacare’s success.

The Obama administration wanted insurance companies with large networks to join. Only companies with restricted networks are joining. These companies are not providing the infrastructure for the access to quality care.

Obamacare ignores individual responsibility for healthcare and emphasizes individual dependence on the federal government.

The Obama administration’s misdirection continues;

“United’s selective exit from ACA marketplaces appears to reflect two positive features of the law. “

First, Obamacare was meant to spur competition among insurance companies, thus constraining premiums; in many markets, this dynamic appears to be at work, to the detriment of United.”

How is Obamacare promoting competition when UnitedHealth Group is leaving and Aetna is threatening to leave?

“Second, the law has curtailed many of the ways that insurers used to contain their costs, such as refusing to cover certain people or certain treatments, or jacking up premiums for older customers.”

This “positive feature” has caused premium prices and deductibles to increase and the affordable care act (ACA) to become the unaffordable care act (UAC).

“Many insurers on the ACA marketplaces have responded by offering plans that keep costs down by narrowing their networks of providers. This is a better way to contain costs than those the law forbids”.

Does anyone think this will make access to quality care more available?

 

Marilyn Tavenner is now implying the worst is yet to come. She made this prediction when she rolled out Obamacare and is declaring the same now as she runs the healthcare insurance lobbying group.

“I’ve been asked, what are the premiums going to look like [in 2017]? I think the overall trend is going to be higher than we saw in previous years. That’s my big prediction.”

 Marilyn Tavenner was formally a big fan of Obamacare. Her point of view has now changed.

She doesn’t see just one problem pushing premium prices substantially higher next year. She sees a confluence of many factors. This would suggest that overcoming these obstacles isn’t going to be easy.

I will discuss the factors Ms.Taverner is referring to my next blog.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.

All Rights Reserved © 2006 – 2015 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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