Curmudgeon's Corner

cur-mud-geon: anyone who hates hypocrisy and pretense and has the temerity to say so; anyone with the habit of pointing out unpleasant facts in an engaging and humorous manner

Trojan Horse?

U.S., Healthcare, Quality of Life

Thomas Jefferson is credited with the following quotation:

A government big enough to give you everything you want, is strong enough to take everything you have.

Jefferson died in 1782.  Obviously his concern hadn’t materialized at the time of his death and has yet to materialize in our era.  But, the fact that the government has yet to take everything we have does not necessarily mean that this thought is invalid.  Maybe he was thinking on a smaller scale; maybe he was thinking about incremental losses.

As we move further down the road of ObamaCare’s full roll-out, we will, in my opinion, get to a point where the current health care system and, more to the point, the health care financing system (which many of us know as ‘health insurance’ or one of the forms of government-run health care financing mechanisms such as Medicare or Medicaid) could be in jeopardy.

One change that is going to hit many of us very hard is the thing that we in the health insurance industry call rate compression.  The new law requires that there be no more than a 3 to 1 ratio between the lowest cost band and the highest cost band.  That contrasts with bands today of as much as a 10 to 1 ratio.  Older people tend to use more health services and therefore cost more money to insure.  Therefore, the younger people will help pay for more of the costs of older people.

This one aspect of ObamaCare will cause the younger person’s rate to skyrocket while it will be seen as a big advantage for the older people who will see a smaller level of increase if any increase at all.  This will cause younger people to try to avoid paying those prices.  One easy way to avoid paying the price is simply to remain without health care protection while healthy knowing that you can always get health coverage even after being diagnosed with a condition because there is no longer medical underwriting permitted.  No matter your health, you will be covered.

Couple that with the fact that an employer with less than thirty employees could simply drop health insurance coverage as a benefit and avoid the fines that larger employers will face for making the same decision.  This is where state exchanges are supposed to enter the picture.  If your employer does not provide you with at least the ‘minimum essential benefit’ coverage, and if that coverage would cost you more than 9.5% of your adjusted gross income, you would likely qualify for coverage through the exchange and receive a federal subsidy to help pay for that coverage so that you wouldn’t have to spend more than that 9.5% amount.

There is no assurance of which health care insurers will decide to participate in an exchange or of what those that do participate will have as their network of providers.  Having coverage and being able to see a provider is not the same thing.  That is where the conversations now being had by physicians at and beyond 55 years of age comes into play.  More than half of those doctors advise that they are going to have to consider whether or not they will stay in the active practice of medicine or if they’ll simply leave that arena.  And there is already a shortage of primary care doctors.

These are but a few of the things that have changed or will soon change in the world of health care and health care insurance.  There are additional changes that will occur and those will change the dynamics to the degree that reversing the changes made under ObamaCare will prove to be impossible even if we decided that was what we wanted and elected people who wanted the same thing.

We may find that we have given up our ability to make choices in healthcare by having been given everything we thought we wanted that brought about the realization of ObamaCare.  There is the real possibility that this march will prove to have been about nothing more than the way to move our country to a ‘single payer’ health care system.

Some of those who were proponents of ObamaCare have long wanted to move us to a single payer form of health care.

Is ObamaCare simply the Trojan horse that brings us to single payer health care?

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