Yes, I can call it that now. President Obama embraced the name today - good for him.
(Edit: after writing this, I realized that the most excellent "citizen K" had already done a diary of it, kind of, but as his (hers?) was just a quick summary of a couple of articles, including Ungar's, I decided to post this anyway...heck, every time there's bad news, we get 500 diaries screaming about it, so a little repetition and (hopefully) a slightly differnet perspective on some good news can't hurt, right? Here's citizen K's diary, for anyone interested: http://www.dailykos.com/...)
The other day, December 2, 2011, Obamacare exploded in the face of insurers, at least according to this column.
Bomb Buried in Obamacare Explodes - Hallelujah!
Curious, then that President Obama picked today to start embracing "Obamacare" full bore. Coincidence? Hmm, don't think so. Let's look together over the fold.
Even if this:
At the end of the day, the law (PPACA) is - in the main - little more than a successful effort to put an end to some of the more egregious health insurer abuses while creating an environment that should bring more Americans into programs that will give them at least some of the health care coverage they need.
was the case, I would shout that Obamacare did a lot of good. I know people who have suffered at those "egregious health insurer abuses," after all.
But wait, there's a lot more, apparently:
There is, however, one notable exception - and it's one that should have a long lasting and powerful impact on the future of health care in our country.
That would be the provision of the law, called the medical loss ratio, that requires health insurance companies to spend 80% of the consumers' premium dollars they collect - 85% for large group insurers - on actual medical care rather than overhead, marketing expenses and profit. Failure on the part of insurers to meet this requirement will result in the insurers having to send their customers a rebate check representing the amount in which they underspend on actual medical care.
This is the true ‘bomb' contained in Obamacare and the one item that will have more impact on the future of how medical care is paid for in this country than anything we've seen in quite some time.
I think there's a couple of other bombs embedded in the law, too, but I'll get to them later...first, back to Mr. Ungar:
Indeed, it is this aspect of the law that represents the true ‘death panel' found in Obamacare - but not one that is going to lead to the death of American consumers. Rather, the medical loss ratio will, ultimately, lead to the death of large parts of the private, for-profit health insurance industry.
Why? Because there is absolutely no way for-profit health insurers are going to be able to learn how to get by and still make a profit while being forced to spend at least 80 percent of their receipts providing their customers with the coverage for which they paid.
Well, we had heard that this would happen, but will it really lead to the deaths outlined above?
As it turns out, HHS isn't screwing around. They actually mean to see to it that the insurance companies spend what they should taking care of their customers.
Here's an example: For months, health insurance brokers and salespeople have been lobbying to have the commissions they earn for selling an insurer's program to consumers be included as a ‘medical expense' for purposes of the rules. HHS has, today, given them the official thumbs down...
This is why the Republicans are so desperate to be rid of this President, more than anything else. Who controls HHS, after all (same with CFPB, but that's another story)?
With Obama's HHS making the rules, and implementing them, well, uh-oh...
So, can private health insurance companies manage to make a profit when they actually have to spend premium receipts taking care of their customers' health needs as promised?
Not a chance - and they know it.
Now that's a pretty bold proclamation - haven't seen that anywhere before, but according to Ungar, the parent companies are investing elsewhere.
Unngar goes on to state:
They know what we should all know - we are now on an inescapable path to a single-payer system for most Americans and thank goodness for it.
...and honestly, I think he's speaking to many of the people right here when he adds:
If you thought that the Obama Administration chickened out on pushing the nation in the direction of universal health care for everyone, today is the day you begin to understand that the reality is quite the contrary.
There were a couple of other bombs in Obamacare that most people don't seem to know. The first is quite straightforward: embedded in Obamacare was a de facto take-back of the Bush tax cuts, but only on the wealthy.
Under Obamacare, incomes over 200k (individual) and 250k (couple) are taxed an additional .9% on the Medicare portion of the payroll tax, and there is no upper limit on that Medicare portion.
Even more powerful, under Obamacare, investment income, including dividends, is no longer exempt from the (now) 3.8% Medicare tax. Now, I might be reading that wrong,
but given that the bulk of income for the very rich is investment income, that sounds like a left-hook hay-maker to me.
And finally, as I've argued before, the real beauty of the law lies in the subsidies. Those subsidies, for people making up to 400% of poverty level, are based on % of income and not absolute dollars. In other words, the Feds aren't going to give X dollars base don the cost of a policy, but rather, they're going to make sure that people up to 400% of poverty level can't pay more than X% of their income for health care.
What this means is that, after full implementation, increases in health care costs fall on the government for the huge number of people in this group, and not on the individuals and families. This change is dramatic for many reasons, not the least of which is the fact that health costs for everyone, not just Medicaid, Medicare, VA and SCHIP, but for ALL POLICIES, becomes a matter of the budget and can, in the future, be amended by reconciliation. It also means that the backbreaking cost of health care falls right on the shoulders of any Congress that fears runaway deficits and the like.