Tuesday, April 27, 2010

Now they tell us

The New York Times continues its fearless coverage of the consequences of ObamaCare in a series of articles that could be called, "That would've been nice to know back then" with the "then" being prior to the March 20th vote on ObamaCare in the Senate.

New York’s insurance system has been a working laboratory for the core provision of the new federal health care law — insurance even for those who are already sick and facing huge medical bills — and an expensive lesson in unplanned consequences. Premiums for individual and small group policies have risen so high that state officials and patients’ advocates say that New York’s extensive insurance safety net for people like Ms. Welles is falling apart.

The problem stems in part from the state’s high medical costs and in part from its stringent requirements for insurance companies in the individual and small group market. In 1993, motivated by stories of suffering AIDS patients, the state became one of the first to require insurers to extend individual or small group coverage to anyone with pre-existing illnesses.

New York also became one of the few states that require insurers within each region of the state to charge the same rates for the same benefits, regardless of whether people are old or young, male or female, smokers or nonsmokers, high risk or low risk.

The Ms. Welles in question here was paying over $17,000/year for individual coverage which includes that for her cancer and MS.

The Times article goes on to explain "risk pools" and the concept of needing healthy people to subsidize the health care expenses of those who need more health care. They also explain how in this model for ObamaCare in New York, the healthy customers decided that paying the high premiums weren't worth it and got out of the plan which, of course, resulted in sky-rocketing premiums for those who stayed in the plan.

Skyrocketing premiums to the point known in the healthcare industry as "adverse selection death spiral". We are not sure what bemuses us more: that the NYT would dare use the word "death" in describing a potential phenomena of ObamaCare (so, if you are not going to admit to "death panels" will you at least cop to "death spirals"?) or that the "adverse selection death spiral" is most commonly used when talking about universal/government-managed healthcare? Call it a toss-up.

Dig this:

“You have a mandate that’s accessible in theory, but not in practice, because it’s too expensive,” said Mark P. Scherzer, a consumer lawyer and counsel to New Yorkers for Accessible Health Coverage, an advocacy group. “What you get left clinging to the life raft is the population that tends to have pretty high health needs.”

Now we're clinging to life rafts?

Article goes on to explain that unless the government employs vigorous enforcement methods (hello, IRS) to ensure mandatory participation, it will be tough to avoid that whole death spiral thing. And don't we know it - we've been saying the same damn thing for months so it's good to hear the Times finally get into the act.

“In this new marketplace that we envision, this requirement that everybody be covered, that should draw better, healthier people into the insurance pool, which should bring down rates,” said Mark Hall, a professor of law and public health at Wake Forest University. But he added, “You have to sort of take a leap of faith that that’s going to happen.”

If you are scoring at home, we now have "death spirals", "clinging to the life raft", and "take a leap of faith", all used to describe what we can expect in the future from the HEALTHcare industry.

Go ahead and read the article. It's chockful of facts on just how royally screwed the healthcare industry in New York state really is. Again, this would've been really, really handy information for the "paper of record" to be so forthcoming with before the healthcare vote.

Not that it would've made a difference in the end, however, it'd be comforting to know that there was still some shred of decency and honesty remaining in the 4th estate of this country.


burro said...

I going to go ahead and predict the emergence of a cruise ship/medical industry where doctors can lease spaces on cruise ships in the legislative havens of international waters. If this is the case then the "poor people" on the State's sinking life raft would be an apt metaphor.

Dean said...

So, what you are saying is we can get that knee replacement in the afternoon and hit the blackjack table that same evening.

Smashing idea!