In my June 9th post, “Michael Hiltzik V. Michael Cannon: FIGHT!” (http://conoutofconsumer.blogspot.com/2014/06/michael-hiltzik-v-michael-cannon-fight.html) I chose a series of articles by two “experts” to illustrate part of why we, consumers face an enormous challenge in achieving meaningful modification to Obamacare that will support its purported attempt to get people insured as its chief aim in meeting its title, The Patient Protection and Affordable Care Act.
While this blog extensively covers why and what provisions indicate that the flaws far outweigh the benefits of this Act, it remains frustrating to watch political partisans and “experts” like the two named above behave deliberately dense and unable in explaining the law in order to self-promote and promote their political opinions.
At the end of the June 9th post I promised to try to find where these two agree.
The referenced articles remain the same as follow: M. Cannon, 4/22/14, “ACA exchanges at risk,” http://www.losangelesregister.com/articles/obamacare-598142-coverage-people.html. M. Hiltzik, 4/28/14, “Found: The lamest anti-Obamacare column of all (thus far),” http://www.latimes.com/business/hiltzik/la-fi-mh-lamest-antiobamacare-column-20140428-column.html. M. Cannon, 4/30/14, “Obamacare makes it easier than ever to free-ride, http://www.ocregister.com/articles/obamacare-612134-coverage-people.html. M. Hiltzik, 5/2/14, “Cato’s healthcare expert: Still clueless about health insurance, http://www.latimes.com/business/hiltzik/la-fi-mh-still-clueless-20140502-column.html. M. Cannon, 5/6/2014, “ObamacaCare Makes it Safer Than Ever Not To Purchase Health Insurance—And That’s a Bad Thing (A Response to Michael Hiltzik),” http://www.forbes.com/sites/michaelcannon/2014/05/06/obamacare-makes-it-safer-than-ever-not-to-purchase-health-insurance-and-thats-a-bad-thing-a-response-to-michael-hiltzik/.
Interestingly, the two agree on the provisions of the Act in so far as what they address. There is no claim by either that one of them or the other is misstating the provisions of Obamacare.
While it’s nice they agree on the surface, it’s almost creepy that there also seems some silent agreement between the two to allow gross overstatements of what the Act’s provisions cover or don’t cover in order to promote their own views. It’s this tacit tolerance of inaccuracy that prevents consumers from advocating effectively for meaningful change to the PPACA that I will address here.
The bee in Mr. Cannon’s bonnet appears to be the provision of Obamacare that does not ALLOW an individual with a pre-existing condition to be denied health insurance coverage by an insurance company or to be charged more in premiums for that health insurance coverage than individuals without such pre-existing condition.
But, facts aren’t good enough for Mr. Cannon and he determines that this provision “…creates a perverse incentive for people to drop their coverage and wait until they get sick to re-enroll,” (M. Cannon, 5/6/2014). Mr. Cannon then tries to exert his expertise by adding, “I expected most Americans would not know about this feature of ObamaCare, and that many of the law’s supporters would not appreciate my drawing attention to it,” (M. Cannon, 5/6/2014).
If you believe the law creates a “perverse incentive for people to drop their coverage and wait until they get sick to re-enroll,” you’re kidding yourself as is Mr. Cannon is who seemingly is desperate to find something to write about. While Medicaid is slightly different, perverse incentive, no.
Anyone who has purchased ANY insurance knows that it is purchased IN CASE a specific thing occurs. If you purchase health insurance it’s to cover your medical expenses IF you get sick. In its intended form, nobody NEEDS health insurance (prior to Obamacare) if they’re willing to gamble on being healthy.
The problem Obamacare addressed was that once you were diagnosed with a “condition” that health insurers were price gouging individuals for health insurance coverage or denying coverage all together so that PEOPLE WHO WANTED TO BUY INSURANCE WERE UNABLE TO AFFORD IT OR BEING DROPPED BASED ON THEIR CONDITION.
Just like in the case of other insurance, making claims was used as an excuse by insurance companies to charge you exorbitant prices or to deny you coverage. Obamacare said, “No.”
This is a GOOD thing for consumers except the way it was done in the law was to single out two other groups of people, regardless of their claim history and legislate it was OK to charge them more in premiums, the old and smokers, so essentially Obamacare switched out who insurance companies could pick on.
There is NO incentive to put off BUYING health insurance until you get sick under Obamacare. Actually the law makes it less attractive to put off buying health insurance by penalizing individuals with a tax if they don’t have health insurance. This tax, whether Mr. Cannon deems it meaningful or not did not exist prior to Obamacare.
What IS incentivized is under-insuring yourself or your family UNTIL you get sick because of the expense of health insurance and the increase in co-payments, co-insurance and deductibles under Obamacare making it largely true that it will cost you more for the same or even worse coverage under our new health law.
A second reason under-insuring yourself is incentivized, in addition to the increased cost of the same or worse coverage is the fact that after you are diagnosed, you can purchase silver instead of bronze, gold instead of silver health insurance to cover the increased medical treatments you require because of your condition. This absolutely is incentivized under Obamacare.
While Michael Hiltzik, our other expert doesn’t argue the facts stated by Mr. Cannon, he goes off on his own asserting, “…some people with serious injuries or diagnoses of dire diseases could well die within that time frame. Even for patients who survive, ‘a few months of medical bills,’ uncovered by insurance could render many families bankrupt. That’s if they take Cannon’s –yes--advice.”
Mr. Hiltzik, representing the blind-pro-Obamacare side is equally wrong, ignoring the FACT that BECAUSE Obamacare codifies into law insurance that under-insures Americans, leaving the risk of bankruptcy in the event of obtaining needed medical care a real risk to consumers because of any or all of its provisions that increase costs to consumers in the form of reduced coverage for illness, increased co-payments, deductibles and co-insurance rates that not only is bankruptcy a real risk but because of the INADEQUACY OF INSURANCE COVERAGE consumers are likely in some instances to choose to obtain needed medical care LESS OFTEN (see utilization rates) AND/OR be counseled that certain care is not worth it for them (see things like value-based cancer care).
Mr. Hiltzik comes across as hopelessly old-fashioned equating “health insurance” with the ability to afford health care without specifying the quality of that health insurance, waving the over-generalized term around like a talisman against bankruptcy in the case of illness.
Mr. Cannon comes across as hopelessly hostile ignoring the fact that it WAS insurance companies that prompted the pre-existing condition provision of Obamacare because in their greed which is optimized in charging premiums and paying out nothing for claims, they started dropping people or declining to cover people who actually needed the assistance of their product.
The happy medium for these two would be a heavy dose of reality and rather than talking about their incorrect conclusions about the law, and discussing provisions that might be put in place to protect people from being counseled against obtaining care, choosing not to have care or going broke obtaining care because health insurance policies inadequately meet the expenses of treating illness.
As consumers, we can help them out here. Consumer costs for health care under their health insurance policies are limited by out-of-pocket maximums. The maximum amount we are obliged to lay out before maximizing our insurance coverage went UP in 2013, costing us more(see IRS raises out-of-pocket amounts 5/2/2013).
On the other hand, household INCOME went down for US citizens in 2013 (http://www.deptofnumbers.com/income/us/).
If these two really believed that having insurance is a good thing so that people can AFFORD healthcare, then LOWERING the out-of-pocket maximum that individuals must pay should be the goal, ESPECIALLY in years when household income nationwide declines.
As for the rest of it, a little more work a little less drawing false conclusions from a few basic facts to self-promote, not only for these two but for all the big mouths sputtering about Obamacare.
