By Michael Collins
I hadn’t paid much attention to the Supreme Court hearings on the Obama health care program until today. Someone told me Obama’s lawyer was tanking the case, which surprised me. Reflexively, I thought, Oh, that’s too bad. Then it all came back to me, my revulsion at what a lousy deal Obama’s health care program was and is.
The health care law does nothing about drug costs, a huge factor in affordability. It does nothing much about preexisting conditions, putting that off until 2014 (unless you are under 18 and how many of those folks buy their own plans?) It should target those medical conditions that create the greatest health care costs. It does not.
The most appalling feature of the program is what’s left out. Why on earth is Medicare banned from negotiating discounts with drug companies, the same type that the VA did? Are these people f’ing serious?
The law is utterly devastating to the self-employed. Premiums (in regulated states) or deductibles (in less regulated states) or both went up exponentially. I’m self-employed and my premiums literally doubled between the musings about the plan and its implementation. I could buy a house for the cost of my monthly premiums! I have a plan out of New York but live in the DC area. I could save a good deal by transferring it here. Unfortunately, I’m not under 18. That’s the tell.
The Obama folks had to get two powerhouse special interest groups to back off and let the legislation pass. They took care of the drug companies by keeping Medicare from negotiating 40% to 60% group discounts for medicine, as the Veterans Administration had done. How did they pay off the health insurance companies?
They didn’t go for single-payer system, it is argued, thus allowing health insurance companies to stay in the business of making good money for bad service. That’s true, in part. The health insurance companies are the centerpiece of the new program. But single-payer never had a chance anyway, not with this crew in the White House. So where was the payoff?
The self-employed and very small businesses are the last area of egregious profits for health insurance companies. They were left unprotected and served up as a profit feast for the insurance companies. That was one clear payoff to big insurance to leave the Obama plan alone.
The White House and Congress allowed health insurance companies to ravage the self-employed and very small businesses in the most dramatic fashion in the period before the plan was passed. These people purchase directly from and get claims paid by insurance companies. They account for around 20% of the health care market.
The profit margins on these plans had been fairly decent but became a gusher of pure profit during the rate gouging period. Self-employed people ended up with some combination premiums or deductibles in the range $25,000 a year – out of pocket!
A huge majority of workers, 60%, have company plans where the company/organization pays the bills and has insurance companies administer the benefits. These are not terribly profitable for insurance companies. They offer administrative services that are purchased by businesses that have choices and limit costs (and insurance company profits off of these services).
So when I hear the boo-hooing about those enablers of corporate greed, the big bad Supreme Court, taking away Obama’s health care plan, my response is a pox on both of their houses.
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N.B. I read the recent E.J. Dionne, Jr. column on the Supreme Court review of the Obama health plan. It was all liberals versus conservatives. There was no critical thinking on health care analysis and policy. There was no mention of how much of the reform could be done through ERISA. It was all about that meanie Scalia beating up on the administration’s lawyer. But when you’re getting gouged on a mission-critical line item in the family budget, it’s really of no interest, none at all.
The Money Party and the sickness unto death series:
Screwing the Self Employed out of Health Insurance Aug 22, 2009
What Obama Actually Said about Health Reform Sep 10, 2009
Fraud and Death Trump Citizen Health Oct 13, 2009
Failure by Design: The “Public” Option Nov 1, 2009
Healthcare Reform ”“ Abandoning the Self Employed Jan 10, 2011 Appendix