Stop eating like a bloody hippo.
The Affordable Care Act — or ObamaCare, as I prefer to call it, giving credit where credit is due — is a wonderful panoply of the entertaining, the frustrating and annoying to me.
Of course, none of these things were going to happen, since they all result in a cost to the Government, the Health Insurance companies, or the Doctors.
And we can’t have that now, can we?
I got this message from the good folks at Anthem yesterday:
Let’s take that apart, shall we?
“Anthem was the target of a very sophisticated external cyber attack.”
I love the wording here – has anyone ever admitted to being the target of a simple external cyber attack?
“These attackers gained unauthorized access to Anthem’s IT system and have obtained personal information from our current and former members such as their names, birthdays, medical IDs/social security numbers, street addresses, email addresses and employment information, including income data.”
Translation: “We just released the identity thief’s treasure chest. Everything you need to open bank accounts, take out loans and generally pretend to be someone else, just ad a fake ID.”
“Based on what we know now, there is no evidence that credit card or medical information, such as claims, test results or diagnostic codes were targeted or compromised.”
It is obvious to me that they were struggling to find some comforting news to tell us, but the fact is that most of Anthem’s customers have Health Insurance through their employers. Since they do not pay Anthem directly, Anthem does not have their credit card details.
As for medical information, most people don’t really care about others knowing what ailments they are suffering from. Indeed, most will happily tell you if you stand still long enough. It is my understanding that HIPAA, the medical confidentiality law of the land, was originally created to prevent Celebrities’ medical secrets from falling into the hands of the press. It obviously works; I didn’t find out that Michael Jackson was bald until after his death.
So… the identity thieves’ wildest dreams have come true, but stuff you don’t really care about is totally secure. It really gives you the warm fuzzies, doesn’t it?
So… what are Anthem going to do?
Moral: If you run a big website, it’s not a matter of if you get hacked, it’s a matter of when.
The Healthcare Disaster in a nutshell
Her Ladyship recently had some routine blood-work done. Here is a rather disturbing excerpt from the bill.
This is mute testimony to the game that Health Insurance has become: the providers send massively overinflated bills to the Insurance companies, who then cut them down to size using specially-negotiated “sweetheart” deals – while those who have no insurance pay full price.
This is simply not right.
Once upon a time, a sick person would go to the local quack, and said quack would prescribe a course of leeches. This went on for quite a while. Many people died as a result of quackery.
Over time, “Leechcraft” became known as “The Healing Arts”, quacks became known as “Doctors”, and hospitals were invented by the church. The process of training Doctors became formalized, and moved from the hospitals to the universities.
And Healthcare got expensive.
Since a stay in the hospital was expensive, the first Health Insurance — “Major Medical”, which insured against the huge expense of an extended stay in hospital — was invented.
And Healthcare got more expensive.
“The Healing Arts” became “The Healthcare Industry”. HMOs were invented, ostensibly “to control the spiraling costs of healthcare” (did it work? You decide). The cost control in HMOs was achieved by giving your Doctor the power to decided whether further treatment was necessary and punishing them for making too many referrals. For those patients who did not want such restrictions, they invented the more flexible (and expensive) PPOs, in which the patient decided what treatment was needed, were invented. Those who could afford it got PPOs, those who couldn’t — also known variously as “The Plebeian Classes” or “The Great Unwashed” — got the leavings.
And Healthcare got more expensive.
We hit hard economic times, and one of the government’s well-meaning but inept responses was to freeze wages. Enterprising employers, looking for ways to incentivize employees without paying them more, introduced Employer-provided Health Insurance, where the employer footed part or all of the cost of health insurance. It soon became so popular that employers who did not offer “Health Benefits” found it difficult to attract staff. Within ten years, Health Benefits were such an integral part of the landscape that it was difficult to imagine a world without it, and it was only a matter of time before otherwise-intelligent people started to believe that Health Insurance was a basic human right.
Even for the uninsured, the vision of employer-provided health insurance was a compelling one; folks with jobs got insurance that paid their healthcare bills, while those without jobs — or those who could not afford insurance — would get free care with the money that was left on the table. A worthy and excellent vision.#And Healthcare got more expensive.
And then came merger-mania. The health Insurance industry was composed of hundreds of companies, some for-profit, some non-profit. As inevitably happens when these two types of businesses compete, the non-profit health insurance firms got acquired by the publicly-owned for-profit ones that were flush with shareholder cash. Over time, the playing field shrunk until there were only a handful of major players left standing.
At the same time, the Health Insurance companies looked at the the money left on the table and decided to grab it for themselves. And so they designed a system where all roads lead to Health Insurance. They introduced a system of Co-pays, Co-insurance and deductibles that passed on the costs to their customers, and created “Networks” of health professionals who were contractually obliged to accept lower payments than they would have liked. As a result, the healers, now doing more work for less money, no longer had the time or resources to give free treatment to the indigent.
And Healthcare got more expensive.#As is often the case when a significant proportion of the population are dispossessed, disenfranchised and disenchanted, the uninsured started looking around for someone with deep pockets to pay their part of the bill. Naturally they turned to the Government, who, having done such a stand-up job with Social Security, Welfare, and the Post Office, could clearly be trusted to look after the Nation’s health.
And they were not alone: Women pushed for free birth control (presumably so they could slut around at somebody else’s expense) and free abortions (presumably to deal with the “unintended consequences” of said slutting around), and they called it “Reproductive Freedom”.
And there was much rejoicing.
With so many votes on the table, the politicians looked around for a solution. And after several abortive attempts over three decades, they finally came up with a compromise, which one wag described as follows:
…a healthcare plan we are forced to purchase and fined if we don’t, which reportedly covers at least ten million more people without adding a single new doctor, but provides for sixteen thousand new IRS agents, written by a committee whose chairman says he doesn’t understand it, passed by a Congress that didn’t read it but exempted themselves from it, and signed by a president who smokes, with funding administered by a treasury chief who didn’t pay his taxes, for which we will be taxed for four years before any benefits take effect, by a government which has already bankrupted Social Security and Medicare, all to be overseen by a surgeon general who is obese – and financed by a country that’s broke.”
This great compromise, had the following effects and unintended consequences:
In the end, everyone got what they wanted — Health Insurance, Pharmaceutical and Medical Industries got the profits they wanted, women got the free birth control and abortion pills they wanted, and large portions of the Great Unwashed got the free stuff they wanted.
And they all lived happily ever after. Except for the working insured and future generations of taxpayers, who will be presented with the bill.
Fairytale or History lesson? You decide.
Some preach “All things in moderation”, but the fact is that you can survive without “empty calorie” sugars and starches that we were not designed to consume in large quantities. As for me, my weight is down, my belly fat is GONE and my waistline is back to where it was a quarter of a century ago.
I just completed yearly Health Insurance enrollment through my employer. Last year we had three options: HMO, PPO and a High-Deductible Healthcare Plan (HDHP) with a Health Savings Account (HSA). At the time, I went with PPO. This year, they dropped the first two options and left us with the third. They say that this was due to overall cost increases of the other two plans, and had nothing to do with Obamacare. I find this hard to believe, mostly because none of us saw this coming.
|Premium (PPO vs HDHP)||$ 4,130||$ 2,694|
|FSA vs HAS||$ 2,500||$ 6,000|
|Total||$ 6,630||$ 8,694|
So assuming that next year will be the same as this, healthcare will cost me about 31% more. Gee, thanks Mister President.
This leads to my principal objections to this piece of legislation – the fact that it makes nothing affordable. I am far from alone in this. Everyone I have spoken to, without exception, will be paying significantly more in 2014 than they did in 2013. I have yet to meet anyone who is better off under the ACA.
This is hardly surprising: After all, the ACA mandates that Insurance companies provide more services than they did before. Many of these “features” are hard to dislike, such as:
There are other “improvements”, such as Free* Abortifactants (“morning after” pills) – that are contentious issues (no Dorothy, recreational sex without the fear of pregnancy is *not* a basic human right, however strongly you may “feel” about it). But whatever way you slice it, the cumulative effect of all of these changes will be to raise the overall cost of healthcare, which begs the question “How is this affordable?“
“But Wait, There’s more!” Says ObamaCare. “You will have more choices!” And there are savings, to be had! Not so fast… since I have a good job, I get *nothing* from the government; No help, no discount, nothing. And the options available on the exchanges are very expensive ($680/month and up).
It’s beginning to look a lot like “You on you own, foo!”
But the ACA story does not end there. The worst part is the arrogance and hubris of assuming that the free market can be bound by legislation like this without any adverse consequences. They seem to have forgotten some basic principles:
Most of us know people who have had their working hours cut to the point where their employers no longer have to offer Health Insurance. Some have lost their jobs entirely. Before blaming the “Eeeevil capitalistic employers”, ask yourself why they are doing this. To put it bluntly, this legislation made Health Insurance too expensive for them — and unlike the Federal Government, they can’t just print money and spend their way out of trouble.
Just as The Internet and Osama Bin Laden are President Clinton’s legacies, and the War On Terror is George Bush’s, ObamaCare will be the enduring legacy of this president. His fortunes, and that of the Democrats who rammed it through over the repeated objections of the Republicans, will be indelibly tied to this initiative. If it works, it will be their greatest shining moment since the New Deal. If it fails, it sill be a millstone around their collective necks for years to come – if not decades.
I believe it will fail. Here’s why: Healthcare is not a human right, and it is not a Governmental duty (one possible exception: chronic disease and serious disability). I know whereof I speak – I know *exactly*what Socialized Healthcare looks like; Britain’s National Health Service is inefficient, top-heavy, strained to breaking point, dangerously incompetent, and expensive enough to bankrupt the national economy of a first-world nation.
The only reason that it works at all is that the Government trains and employs the doctors – and we are trying to do it with doctors who trained themselves at their own considerable investment in time and money. It takes fifteen years and about a million dollars to train a doc. Force them to do business at a loss and they will walk – and then we will complain that there is a “Doctor shortage” and try to fix it by passing new laws.
Good luck with that.
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