When "Salon," talks Obamacare you'd better be ready for some crazy. This week, Gary Legum wrote, "Paul Ryan has an idea for replacing Obamacare, and once you stop laughing I’ll tell you what it is," http://www.salon.com/2016/04/29/paul_ryan_has_an_idea_for_replacing_obamacare_and_once_you_stop_laughing_ill_tell_you_what_it_is/.
I'm no fan of Paul Ryan and it is sort of sadly funny that he keeps getting wheeled out as the "modern" hope of today's out of touch Republicans. From his budget (rejected) to his candidacy (rejected) to his extremist views (rejected), for many of us he's what's worst about today's Republicans, so when Mr. Legum ripped into Mr. Ryan and his promise for a new REPLACE plan for Obamacare, I was hoping for the laugh promised.
But the only laugh was the uncomfortable one that comes from seeing someone make an unintentional fool of himself while trying to make fun of someone else.
Mr. Legum focused in on preexisting conditions and Republicans' dusting off the concept of high-risk pools (an old-time insurance idea that charges more to some people based on their health and risk factors) supposedly in stark contrast to Obamacare. Here come those uncomfortable chuckles.
Mr. Legum seems to forget that the solution to covering those with preexisting conditions was Obamacare's concession to the insurance lobby that the government would partner with insurance companies and FORCE people to purchase a consumer financial product--health insurance. Before Obamacare, the individual mandate was the insurance lobby's idea (AHIP, 2008).
Mr. Legum also seems to forget that in selling Obamacare to the American public the number of individuals actually DENIED health insurance because of preexisting conditions was inflated as revealed when the question was posed as to whether it was true that "129 million Americans with a pre-existing condition could be denied coverage without new health reform law?" Answer: "No." http://www.factcheck.org/2011/02/millions-with-preexisting-conditions/.
Mr. Legum also ignores that we're ALL paying more for needed medical services and products because Obamacare bought into the insurance company model of paying for the cheap finite costs of checkups and overcharging for well, you know, needed medical care and services in the form of HIGHER copayments, coinsurance and deductibles.
It gets "funnier." Mr. Legum identifies the high risk pool model as a no-go and seems to imply that Obamacare's alleged single risk pool is just so much better. You'll notice first how Mr. Legum redefines the issue originally framed about those with preexisting conditions--DENIAL of coverage. It was not about premium charges. Naturally, Mr. Legum changes the issue because as it turns out the denial of coverage problem was overstated by Obama--(see FactCheck described above).
Then Mr. Legum tries to sell how neat-o it is that those with preexisting conditions can't be charged more in insurance premiums based on the statistical likelihood that individuals with preexisting conditions will cost insurers more ignoring WHO OBAMACARE DOES SAY IT'S OK TO CHARGE MORE TO: Older people (and younger people) and those who use tobacco, singling out NEW government-identified groups who insurers CAN charge more to, creating a new "coverage ghetto" as he calls it.
The persistent failure of the young to realize that Obamacare drastically raised the price of their health insurance by linking it to what is charged to older people which formerly was a 5 to 1 ratio and then changed that ratio to 3 to 1 IN ADDITION TO SPECIFICALLY PERMITTING HIGHER RATES TO BE CHARGED TO OLDER PEOPLE, thereby necessarily again raising how much young people pay is a sad knowledge gap that leaves young people defending a law that works against them in terms of what was and what is in health insurance.
Obamacare SINGLES OUT GROUPS FOR HIGHER PREMIUMS, just not those with preexisting conditions. Obamacare instead singles out tobacco users, older and younger people for higher premiums while permitting others who are statistically higher-cost centers for insurance companies such as those who choose to become pregnant, those who are obese, drug users of all kinds, alcoholics legally protected from being charged more in premiums. This is the "single risk pool" fantasy Obamacare created.
Then there's the biggest stupidity of all--making fun of insurance company risk pools while IGNORING that while Mr. Legum is sitting on his uninformed laurels insurers and government are using among other things forced exams, forced wellness and technology to gather information for upcoming rate increases, using those "free" checkups under Obamacare as a means of gathering information to establish RISK POOLS, though under Obamacare EVERYONE will be charged more based on this gathered information (the single risk pool fantasy).
Hierarchical Condition Categories-HCCs are used to help HEALTH INSURERS ADJUST THEIR MODELS BASED ON THE HEALTH EXPENDITURE RISK OF THEIR ENROLLEES. As stated by the government itself, "We have attempted to address the range between enrollees without HCCs and those with HCCs by finalizing the incorporation of preventive services into our simulation of plan liability…resulting in more accurate payments for enrollees without HCCs," Federal Register, https://s3.amazonaws.com/public-inspection.federalregister.gov/2016-04439.pdf.
Insurers haven't given up on risk pools, they've simply partnered with government to create a faux SINGLE risk pool so that everyone's premiums reflect increases.
Insurers are still using HCCs and now with the government's support have access through the info gathered by Obamacare's "free" checkups and the new turn to forced "checkups," even when the efficacy, wear and tear and even accuracy of such tests should leave room for individual choice NOT to take such tests. Further Obamacare encourages even more defensive medicine, since now providers figure if it's paid for then the physical and emotional wear and tear of endless testing is justified since it helps providers protect themselves. All that info gathered from consumers is used as it always was, to calculate rate increases based on RISK so, we're seeing rate increases for EVERYONE based on that info.
What Mr. Legum also fails to notice as he snickers at Paul Ryan is that Obamacare is an insurance company-government partnership that is used against consumers that has provided government entitlement money in the form of premium assistance and cost-sharing to WORKING Americans, (and labor participation is at a 38 year low--see stats on labor participation) AND as a non-assets eligibility allows even millionaires who can make their incomes fall within Obamacare bounds get that government payout that leaves MILLIONS of those too poor to obtain health insurance OUT.
Obamacare simply promises not to FINE the often poorest and most desperate who cannot get health insurance as revealed on "HealthCare.gov hardship exemptions from individual mandate," including the homeless, those facing eviction or foreclosure, shut-off notice from utility company, bankruptcy, medical expenses you couldn't pay.
Mr. Legum is at least over two years behind in the bunk he's peddling since the neatly timed 2014 reveal when some of the draconian measures of Obamacare hit the proverbial fan. In his article, Mr. Legum is snarking like it's 2010 instead of 2016.
