The Annoyed Man wrote:What most of the dummies who supported this bill either don't realize, or do realize and don't care (which makes them evil, not just dummies), is that insurance company participation in the exchanges is not mandatory. They can join and stay in the exchanges so long as it is profitable for them, and if it is NOT profitable, they can either not join, or they can quit. Government sets the prices they can charge in the exchanges. Government has no mandate to keep insurance companies profitable, but the law does give government a mandate to control prices within the exchanges, and insurance companies don't vote. The people who are forced into the exchanges DO vote. The result is utterly predictable.TexasGal wrote:Aetna is leaving the individual health coverage market in California for the same reason--ObamaCare:
http://wallstcheatsheet.com/stocks/aetn ... ml/?ref=YF
I think I hear the sound of an avalanche starting
Within a year—two years at most—there will be no more major insurance providers participating in the exchanges. Since the AHCA does not require the insurance companies to even join the exchanges, let alone stay in the exchanges, when government sets prices below a certain level of profitability, those that joined in the first place will leave the exchanges, and the others will not join. The exchange system will collapse.
Some might say, "well that's good, isn't it?" Let's unpack that.....
Within a week to 10 days of the passage of the AHCA, my very healthy (now 55 year old) wife's insurance premium went up 10%. It has gone up even more since then, and yet she has never given them a reason to raise prices from the standpoint of their cost of insuring her. (Personally, I'm a lost cause. I haven't been insured since February 15, 2008, when my former employer's coverage of me expired. The price of a regular private insurance policy for me is more than I earn in some months, being about the equivalent of my last mortgage payment. There's simply no way I can afford it, and I refuse to become part of the problem and go become a JPS patient on the public dole, not to mention that seeing my doctor turns into a 23 mile drive instead of a 4-5 mile drive.)
What's happening with my wife's insurance is that passage of AHCA has caused insurance providers to hedge their bets. They were already priced too high for most people to afford out of pocket for a number factors—the three primary ones being, in no particular order: A) the buy-in costs of new technologies; B) the practice of doctors ordering unnecessary tests to protect themselves from attorneys; and C) the fact that health insurance became a staple of most employee benefits packages and the fact that group buying allowed them to keep the cost per covered person (for some of the group members) down by spreading the risk over a larger number of people. As insurance providers withdraw from the exchanges in order to remain profitable, they will face having to compete for a a dwindling pool of customers who can afford their service. They will do what they can to remain competitive in that diminished pool of potential customers, but the vast majority of currently insured Americans will no longer be able to afford their product, and as the situation snowballs, that pool of customers who can afford it will dwindle to the point where privately purchased insurance becomes a thing only for the very wealthy........as it already is in countries with already established communist healthcare systems. The other facet of that is that more and more Americans will become uninsured. As more and more people become uninsured because the evil of liberalism broke the system, the greater the outcry will be in favor of simply nationalizing healthcare.......and rich canadians and brits who currently flee to the U.S. to escape the inertia of inefficiencies and delays and death panels to obtain the healthcare they need now will no longer have a place to flee to.Every time you see a tear-jerker story in the news about some poor child from Pokkistan or Africa who has a facial deformity or heart defect and charities fly them here to the U.S. for treatment they can't get at home? Those will stop, because American taxpayers are not going to feel particularly charitable when they themselves are facing exactly the same situation that child is facing back home.
Here is just ONE of the major fallouts from the passage of the AHCA: an increasing shortage of "primary care" physicians in this country—http://www.breitbart.com/system/wire/up ... 35806-4920. What happens when there is a shortage of primary care physicians? People stop going to doctors and the state of their health decreases. So the AHCA actually makes us LESS healthy, rather than making us MORE healthy.
Here is another: more and more doctors—primarily "primary care" doctors—are cutting ties with insurance companies altogether and are switching to a cash-basis fee for service practice......and guess what....reducing their fees!!!!: http://www.breitbart.com/system/wire/up ... 32724-6523. By the way, I have been paying for my healthcare exactly this way since February of 2008. My doctor thinks that the AHCA is a disaster, and he expects that he may have to stop accepting health insurance covered patients at some point down the road because it makes staying in practice too difficult. Look for this to be an increasing trend.
So when the exchange system collapses.......and it WILL collapse because it was designed to collapse.......what will happen?
Americans will have to make a stark choice between two fundamentally different systems:
I predict (C), but both (A) and (C) have a problem: a severely diminished number of people who choose to become doctors. With (A), the "why" is obvious. Who wants to go through 4 years of college, 4 years of medical school, a year of internship, and 3-4 years of residency (not to mention any specialty fellowships), in order to take a government job for low wages (compared to what they might have earned in private practice) and practice "assembly line" medicine? With (C), fewer and fewer doctors are going to be willing to compete with government when government sets the rules of competition. Fewer and fewer patients will be able to afford their care. They will have to raise their prices in order to keep earning a living. Fewer people will be able to afford their prices. They will have to raise their prices again to compensate for the loss of patients......leading to fewer patients.....leading to higher prices......leading to fewer patients.....leading to higher prices.....etc., etc., etc., until the only doctors still left in practice cave in and go to work in the government system.
- FULLY socialized medicine—the democrat option;
- A cash-basis fee-for-service system;
or- Some combination of the two—the republican option.
More and more of the decision making and care on the part of healthcare professionals will be done by physicians assistants and nurse practitioners. Eventually, general practitioners, and then internists, will go the way of the dodo bird as their type of medicine gets transferred to PAs and NPs. The only MDs still remaining in practice will be specialists.
There once was another country that had a medical system just like that—the USSR.
The only choice that can save the quality of American healthcare is (B)—the cash-basis fee-for-service option—which also happens to be the libertarian choice.....
....and by the way, this was how medicine was practiced for generations before "progressives" came along and screwed it all up.....and somehow, people still saw doctors and got the care they needed—at least within the state of the existing medical arts at the time.
Medical tourism to India???
We're headed for a pay as you go system might not be such a bad way after all see a doc pay with cash I like it.
