Health Law's Flaws Will Spur Drive for Single-Payer Reform

[eridani]

by David Himmelstein and Steffie Woolhandler
http://www.commondreams.org/view/2012/07/20-4



It’s good the Supreme Court decided to follow the Constitution rather than play politics. But, from a medical point of view, there’s little to celebrate in its upholding of the Affordable Care Act.

The health reform will leave 26 million uninsured even when it’s fully implemented, and force tens of millions to buy lousy coverage from private insurers. Instead of cutting out the insurance middlemen who caused the health care crisis, Obamacare hands them a trillion-dollar windfall from federal subsidies, mandated premiums and Medicaid managed-care contracts.

Because of this sweetheart deal with the insurance industry, the ACA offers no relief from spiraling health care costs.

The results are predictable. Twenty-six million uninsured means 26,000 deaths each year from lack of coverage. Soaring health costs and ever-skimpier insurance mean financial ruin for more and more Americans; already 800,000 middle-class families are driven into medical bankruptcy each year.

In Massachusetts (where Mitt Romney enacted the model for the ACA in 2006) the number of uninsured has fallen by half to 5.6 percent, but costs have skyrocketed. The premium for the cheapest mandated coverage for a 55-year-old is $5,000, and the policy has a $2,000 deductible – that’s $7,000 out of pocket before insurance kicks in.

Little wonder that medical bankruptcies haven’t fallen in Massachusetts, and surveys have found little improvement in how easy it is to get or afford care.

The unrelenting health crisis in Massachusetts has led doctors there to support more radical reform – single-payer national health insurance – by more than 2 to 1 over Romney/Obamacare; even fewer want to go back to the pre-2006 system.

[dkf]

1. +1000

[Fumesucker]

2. Health Care Law's flaws were deliberately built in..

And those flaws will be changed over the shrieking last ditch efforts of Big Medicine, Big Pharma and Big Insurance.

This _is_ the hill that they will choose to die on and they'll have no problem taking the rest of us with them if they think they are going to lose.

[kestrel91316]

3. I have been saying this since ACA passed.

Highly flawed, but better than nothing. Its flaws will drive people to demand Single Payer.

[mzmolly]

4. So Obama did fight for single

payer...

[eridani]

5. He fought to postpone it as long as possible n/t

[mzmolly]

9. Either the legislation wil lead to single

payer, or it will not.

[Edweird]

6. If by 'for' you mean 'against', then sure.

[mzmolly]

10. The article must be wrong,

then.

[Edweird]

12. "Because of this sweetheart deal with the insurance industry, the ACA offers no relief

from spiraling health care costs."

Let's see:
Sweetheart deal for insurance companies: check
Doesn't help citizens: check

I'd say the article is dead on. You, however, are wrong. Do we really need to have the candidate Obama was against the individual mandate show and tell again?

[mzmolly]

13. The authors are aware that rebate

checks are in the mail, correct?

http://insurancenewsnet.com/article.aspx?id=350196

Snip:

The week before the U.S. Supreme Court upheld most of the Affordable Care Act, the federal government announced that 12.8 million Americans would receive rebates on their health insurance premiums at an average of $151 per household.

Those checks are now in the mail or in the hands of those who paid the premiums, who, in most cases, are the employees of companies that have health insurance through a commercial plan. In Missouri, some $65 million in rebates due by Aug. 1 will be shared among 588,000 private health insurance customers.

The rebates were triggered by the "medical loss ratio" provision of the 2010 health care reform law that essentially caps insurance companies' administrative costs at 20 percent of premiums.

[Honeycombe8]

7. The ACA has one thing that Massachusetts' law doesn't have: the 85% rule.

The ACA requires ins. cos. to use at least 85% of premiums collected in the payment of claims. If they don't, they must reimburse to policyholders the amount necessary to bring the ratio in line to 85%.

So this MAY hold down the cost of premiums. The rise of ins. premiums has already slowed markedly in the two years since the ACA passed in 2009, according to Bill Clinton.

[eridani]

8. All increases this year average 9.9%

By sheerest coincidence, I'm sure, 10% is the threshold over which ACA requires explanations. ARe you fine with your premiums going up by 9.9% every year for the forseeable future?

BTW, the data to calculate MLR comes from insurance companies. Draw your own conclusions.

When we had a "health care crisis" in the early 90s, MLR averaged 93%. 85%? Big whoop.

[Honeycombe8]

11. No, I'm not fine with a 10% increase. But it's better than the 29% increases before 2009. nt

[eridani]

15. It is no more sustainable than a 29% increase, which was allowed because

--the bill postponed almost all benefits until 2014. Another unnecessary compromise--it is perfectly obvious that this was on purpost, so that the evil monsters who run insurance companies could start off thein 9.9% a year grand theft robbery from the highest baseline possible.

[Honeycombe8]

17. Why do you refuse to admit an advancement, a good thing, an improvement?

Are you that ingrained in a "my way or the highway" mentality that anything other than what YOU regard as 100% successful is a total failure, in total disregard of the millions of people that are being and will be helped?

How utterly selfish of you. To work for further improvement, yes. To disregard the improvements being made along the way, foolish and destructive to success.

The ACA is a success and is in fact helping with insurance costs. That is a fact. You cannot deny it with any credibility. Let's see if that success continues, or if it falters.

I say this without asking for a link from you proving a 10% increase in premiums in 2011. (You can't mean 2012 since the year isn't over yet.) I will look this up on my to confirm. BTW, insurance at my employer did not increase at all. 0% increase this year. Minimal increase last year, 2011.

[eridani]

19. When did I say there were no improvements? What I said was that--

--those improvements are NOT sustainable. How long can your budget tolerate 9.9% annual premium increases?

http://www.buckconsultants.com/portals/0/publications/press-releases/PR-2012-NHCTS.pdf

Buck?s National Health Care Trend - 24th Survey

9.9% - Preferred Provider Organization (PPO)
9.9% - Point-of-service (POS)
9.9% - Health Maintenance Organization (HMO)
9.9% - High Deductible Health Plan (HDHP

Discussed in more detail here-- http://www.democraticunderground.com/1002559959

[LiberalFighter]

14. What happens when all of the states that refuse to implement state exchanges

have federal exchanges created? There might be 20 or more states with exchanges that are run by the federal government. I would think it would be likely that single payer would be fast approaching once it happens.

[eridani]

16. Single payer will happen because the plan that exchanges become self-sustaining--

--surviving mainly on premiums, is not possible.

[LiberalFighter]

18. Seems to me that we likely will end up with what many want.

[eridani]

20. Only if we fight for it

The forces that eliminated drug price bargaining and the public option are still with us.

[LiberalFighter]

21. On that level

but other levels will speed up the process especially when federal exchanges are the norm for the states.