The
big news is the terrible rollout of Obamacare. I am going to try and
make some sense of what is going on. The big picture for me,
however, remains the same and is verified by the current chaos. This
law is flawed and will separate more now than in the past the
healthcare for the richer and the poorer.
The
poor will have no alternative except to enter into the world of
government healthcare, and the wealthy will get their care from
outside the government's help.
This
article will address various issues on the current healthcare scene.
First,
let’s talk about Medicare. Some people point to Medicare as
the perfect model that we should be following for everyone. It is
good that we have a system to help our elderly with medical costs at
the end of life. But there is a cost to this system.
The
reimbursement that Medicare (the government) gives to medical
providers for many procedures do not cover the costs. For medical
providers to survive, they pass some of that cost to other people
using their services. That would be anyone under the age of 65.
This
has worked in the past because there were fewer people over 65 and
many people under. With the baby boomers starting to turn 65, this
is going to be a problem. Already when I go into doctors' offices I
see signs saying they are not taking any more Medicare patients.
Now
on top of the people over 65, you add tens of millions of people that
go through the government to get their insurance. What is this going
to do to the providers? Will they survive? Will those insured by
the government be able to find providers? No answers for this one.
The
current fiasco for the website developed by the government to allow
people to get health insurance is at least problematic and may turn
into a tragedy. The healthcare law was interpreted by the leader of
Health and Human Services specifically to cause people who buy
individual insurance policies to lose their coverage.
To
date, five million people will lose their coverage starting January
1. If the website does not work properly, these people may be
without insurance for an extended period of time.
The
government needed the individual coverage cancelled to get healthy
people into the government exchanges. An insurance company sets
their premiums based on the amount of risk they believe is in the
group of people they are going to be covering (a risk pool).
Without
these healthy people paying premiums into the government exchanges,
then the exchange would only have sick people in the risk pool, which
is not how the premiums have been set. The insurance companies would
lose money and the next year raise the premiums to cover their costs.
These increased premiums would be too high and the remaining healthy
or less sick would cancel their insurance. This would again mean the
risk pool is not aligned with the premiums and the insurance company
would again lose money.
The
cycle would repeat over and over. When you hear about the spiraling
death cycle, this is what they mean. If the government does not get
the healthy young people in the government exchanges, the whole
structure falls apart.
We
can currently see the impact of Obamacare on those people that
purchase their own health insurance. What we don’t see is its
impact on employer insurance. At least not yet.
The
employer mandate was delayed for a year and states that any employer
that has more than 50 full-time employees must provide health
insurance for the employees or face a fine for each employee. I
am going to ignore the law's obvious impact on employment.
The
amount of the fine does not come anywhere near the cost of providing
health insurance for an employee. Employers will have every
incentive to not offer health insurance anymore and pay the fine.
This will force the employees onto the government exchanges.
Can
you see now why President Obama delayed the employer mandate?
Can
you even begin to imagine that beside all the current commotion that
there were additionally millions and millions of other people that
were losing their insurance from their employer and being forced into
the exchanges?
The
law may not have survived. And make no mistake, this law is going to
survive in some form. So where do we go from here?
The
law will survive. What we currently see as chaos will eventually
become normal. Imagine if the government just passed a law to set up
the DMV. You would hear people howling about the time you spend
standing in line. Now, of course, we just expect it.
Or
what about public education? We send our kids to school and many
leave without learning to read and most leave without being able to
apply critical thinking. Yet we accept this mediocrity.
Running
a school system is so much easier than running a healthcare system.
Why does anyone think the results of government run healthcare will
be better than our public schools? Yet just like the public schools,
the masses will just accept it as normal.
Adam Smith is obviously not the actual name of the author of this column. The real author has
worked for two Fortune 500 companies, one privately held company, and a public accounting
firm. His undergraduate degree was in accounting, and he earned an MBA for his graduate
degree. He also has completed coursework for a PhD. in finance. He continues to be employed
by one of the Fortune 500 companies.
The author grew up in the Washington D.C. area but also lived for several years in Arizona. He
currently resides with his family on the East Coast.
The author has held various callings in The Church of Jesus Christ of Latter-day Saints.