Stanley Feld M.D., FACP, MACE Menu


What President Obama Forgot To Tell US

 Stanley Feld M.D.,FACP, MACE

Nancy Pelosi was correct. The only way we are going to know what is in the Affordable Care Act is to pass the bill.

The weeks before January 1st when the web site was going so poorly we heard a lot about the healthcare insurance companies taking a bath on Obamacare because of the skewed enrollment.

Only the sick and elderly were buying healthcare insurance from the health insurance exchanges. Young people were needed to buy insurance in order to keep Obamacare from the “death spiral.”

The sick and elderly were more likely to be hospitalized and run up a big hospital bill. The high bills would eat into the insurance companies profits. Young people were needed to stabilize the risk pool or insurance premiums would sky rocket because insurance company profits would fall. Insurance companies could go bankrupt.

The government’s expressed fear is the healthcare insurance industry would not participate in the health insurance exchanges.

President Obama offered to bail out the healthcare insurance companies if this was to occur.

This was another of President Obama’s deception.

It is similar to the deception “If you like your insurance you can keep it. If you like you doctor you can keep him/her.”

Last week we learned that the insurance company bailout was built into the original bill passed in 2010. The President knew about this bailout before Obamacare was passed.

Did the congressional members who passed the bill know about the built in bailout?

If they did they should all be voted out of office. If the Democrats needed to pass Obamacare did not know about the bailout they should have and they should all be voted out.

It should be recalled that this was a Democrat controlled House and Senate. There was not a single Republican vote included in the passage of Obamacare.

The American people did not know about the built in bailout at taxpayers’ expense.

Obamacare contains a "Reinsurance Program that caps big claim costs for insurers (individual plans only)." Robert Laszewski, a prominent consultant to health insurance companies, writes that in 2014, 80% of individual costs between $45,000 and $250,000 are paid by the government [read: by taxpayers], for example." 

Private insurance plans bought through the health insurance exchanges are not private health insurance plans. They are plans that are subsidized by the government if the insurance bill goes over $45,000.

Who pays this government subsidy?

The taxpayers, by having their taxes increased.

 Who makes the profit from this subsidy?

 The healthcare insurance industry makes the profit because the insurance policies have been priced at high risk (Increased deductibles, and increased premiums for consumers not eligible for government subsidies).

 "The reinsurance program has done and will continue to do what it was intended to do; help attract and keep more carriers in Obamacare than might have otherwise come."  Thus, Obamacare is being aided by having taxpayers subsidize big insurance companies' business expenses.”

Obamacare also provides the healthcare industry a greater subsidy. It is called the Risk Corridor Program”. The “Risk Corridor Program” limits the overall losses of the healthcare insurance industry to 2.4%.

This is the way the “Risk Corridor Program” works. The healthcare insurance company submits its expected costs to the government for a particular year.

If the expected costs of the insurance exceed 102%, the government will pay the healthcare insurance company 80% of the difference above 102% at taxpayers’ expense.

 Taxpayers' are unwitting generosity toward these "participating health plans" (plans sold through Obamacare's government-run exchanges):

 "[I]f the health plan has costs at 110% of the medical cost target [the costs that the insurer expects to accrue], it will be responsible for only 102.4% of the target (a 2.4% shortfall)-only about a quarter of its losses.”

There is little risk to the healthcare insurance company for being involved in the healthcare insurance exchanges.

The key point is President Obama had this written into Obamacare without telling taxpayers about it. I wonder if the CBO knew about it and calculated it into the original cost estimates of Obamacare.

“In this way, and so many others, Obamacare takes a major step toward the government monopoly over American medicine ("single payer") that liberals drool about in their sleep.”

The problems with a government controlled single party payer system are multiple. I have enumerated them in the passed.

I will summarize the problems:

1.Consumers are dependent on the government to make their healthcare and medical care decisions.

 2. A single party payer system does not encourage consumers to be responsible for their health, healthcare dollars or medical care.

3. The inevitable cost overruns will result from government bureaucracy, regulations and inefficiencies.

4. The occurrence of fraud and abuse is inevitable. We have seen some fraud and abuse already.

Navigators are paid $48 an hour to help the poor enroll in Obamacare. One reader told me about a case were the navigator had to apply four times before the application was accepted without any errors.

This is only the first step in obtaining healthcare eligibility and then healthcare insurance.

4.  Government will be forced to limit access to care and ration care in order to keep the direct medical care costs down.

 5. All the secondary stakeholder costs are escalating as physician reimbursement is decreasing.

 6. Most importantly freedoms to choose your physician, your insurance and your treatment are being compromised at the expense of all taxpayers.

Something is very wrong with this plan.

This is all going to be done slowly so we do not notice.

America has been deceived. We are already feeling the effects of the deceptions.

There is more to come.

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

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  • Ryan

    You describe this thing very well . Now elections are coming on . Hope new govt do something in this case.

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