Screw the Supreme Court and screw Obama's health care plan says this self-employed citizen

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

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Michael Collins

DC area

9 CommentsLeave a comment

  • For my family, our premiums for an HSA plan was $350/mo. at inception 3 years ago. Today? $700/mo, on top of the first $5500 that we always pay out of pocket every year.

    The bottom line: $8,400 – $13,900 a year for single family insurance. Really, there is no way to get all the co-pays, monthly dues, and deductibles below $10,000 a year.

    But my taxes are 3% lower than they used to be a decade ago. Yippee!

  • Our self-employed premiums are now $24,000 a year. We have to eat into our savings to cover this and out of pocket costs of $6,000 or more. A couple we know are an opthamologist and psychiatrist – their self-employed premiums are $32,000. This has nothing to do with their malpractice insurance, an altogether other cost. They have to watch every penny. The people who have retired early and who are not yet 65 on Medicare are pretty much dipping into their savings to stay insured. People wonder why the retail investor has been fleeing the stock market for years now, and this is one main reason – people need their investment money to survive.

    Our daughter and her husband are in their 20s and run a retail store together. They don’t make enough money on the store to cover the ridiculously high premiums they are quoted, so they go without. Their only chance is to go to Mexico if one of them gets seriously ill, and babies will just have to wait until they can afford insurance.

    The health insurance system in the US is an absolute catastrophe. The country is going to have to make a decision at some point: does it want guns or decent and affordable health care. It can’t have both.

  • I disagree. All the universal systems pay a lot less per person than we do. Therefore, if we went that route I think we could save money so the guns vs healthcare is not a necessary choice. In fact, we could have more guns if we wanted.

    I think that this could be the key sales pitch for Duhmerika: universal coverage for less money. Same outcomes, more freedom, lower costs. What’s not to like about that? Oh, yeah, I forgot that Canadians have to wait 3 years to have a broken leg set.

  • This is so unreal, it helps to hear other people describe it My friends in the corporate/government world nearly fall over when they hear my annual figure (somewhere between you and the MD couple you mentioned).

    Here’s the scam talking points. If you look at premiums only, then it looks like the big states, more regulated, have highter rates. But when you combine the high deductibles in the low premium states, places like Utah actually have higher health costs for we, thek pariahs of health insurance, than Massachusetts.

    Blue line from right wing NCPA analysis (premiums only). Pink line (premiums plus deductibles) from Insure.Com (“Get Quotes”) for the state capitols of each state. Quotes here

    From Screwing the Self-Employed Out of Health Insurance

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  • …we can’t have much of anything with the ‘guns’ squeezing everything out of the budget. Stieglitz now has the total cost of Iraq and Afghanistan at $3 tril. I’ve followed his calculations of cost since he started a few years back. We’re all tapped out on guns. There’s no way to undo the $3 tril but plenty of ways to cut the future wars, which will ruin everything domestically and do the expected spectacular damage overseas. I remember Wesley Clark saying that Iraq is the ‘most disastrous’ foreign policy mistake i the nation’s history.

    I do hope there is a way to sell a decent universal health care package.

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  • All that money going to help the profiteers profit on the last exploitable segment of the health insurance market. My eyes roll in a serious way when I hear any of these pols talk about entrepreneurs etc. To be one today, you have to literally risk your life since what garage start up can afford health insurance.

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  • my kids will be out of the house and the wife and I will be 10 years from SS. I wouldn’t be surprised to just dump the “insurance” and chance it that decade. It really makes you sick (especially when like us, you almost never get sick.)

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