Big-profit insurers sure like to whine (just look at Aetna CEO Mark Bertolini's recent whining over CT's plan for a public option, SustiNet.)
Their whining, though, really enrages me. They don't have to take care of our poor and sick (Medicaid), they don't have to take care of our elderly (without Medicare, of course, no big-profit insurance company in this country could stay in business paying for end-of-life care for seniors), and they don't have to take care of our not-poor-but-sick (high-risk pools). This is exactly why I'm so incredulous about the heroic effort that PPACA makes to preserve this -- as Wendell Potter describes it -- "evil industry."
Physicians for a National Health Program, citing a report by Kaiser Health News, reminds us exactly why the PPACA -- while better than nothing and something I support -- will translate into an expensive, bureaucratic nightmare for our government and its citizens. But, oh right, Mark "I'm an Arrogant Jerk" Bertolini will still get to keep his hot tub on Avon Mountain. More below the fold.
Originally, when the health overhaul was signed into law, the amount the government could recover was capped at $400 for families with incomes below 400 percent of poverty. The amendment adopted in December increases the amount families will owe on a sliding-scale basis. Under the December amendment families with incomes at 200 percent of poverty will have to pay back as much as $1,000; families with incomes at 400 percent will have to pay back up to up to $2,500.
Basically, before now, if you got a subsidy and you ended up earning enough money in the year to "unqualify" for the subsidy, you only had to pay back a small amount (no more than $400) -- Democrats realized that it would suck to be a person so close to the poverty line already, make a few dollars extra in December, and then learn you owe many thousands of extra dollars in taxes for the subsidy the government now says you don't deserve. Is your head freaking spinning yet?! Oh, right, anything, though, to preserve what I like to refer to as a boutique role for big-profit insurance companies.
Did I tell you the Aetna CEO also likes to sip fine Italian wine in his Avon Mansion hot tub? (Avon is one of the state's glitziest towns.)
Anyway, back to the bigger point of this diary, which is that it is going to be a HUGE, EPIC, GINORMOUS expense for the IRS -- and expense in time for American families -- to deal with such a convoluted system. The result according to PNHP? More people will stay uninsured:
Fear of potential end-of-year liability could be a substantial deterrent to participation in the advance premium tax credit program. It was estimated that the December amendment increased the likely number of uninsured after 2014 by about 200,000 people, who would rather be uninsured than face substantial repayments. Millions more consumers will face unanticipated financial burdens
Why are we torturing ourselves to preserve a role for a big-profit insurance industry that only serves less than half of the American population? This is insanity!
And, PNHP doesn't even begin to discuss how the big-profit insurance companies will handle people who fall in and out of Medicaid eligibility as a result of the PPACA expansion of Medicaid.
What happens if someone with recently diagnosed cancer on one of Mark "I like My Bubbly Italian Wine Served in a Bubbly Hot Tub" Bertolini's Aetna plans loses his or her job in July of 2015 and then becomes eligible for Medicaid? Don't you think for a second that Aetna -- and all of the other big-profit insurers -- are not thinking of a way to screw over consumers or the government in situations like this hypothetical one. "Oh, we're sorry, you should have been on Medicaid when you had that mastectomy, you're going to have to figure out how to get the government to reimburse you for that care now -- we're taking our payments back."
Call it "Retroactive Rescission 2.0."
Of course, there's a way around this insanity: single-payer, Medicare-for-all coverage equitably financed by a mix of general taxation and payroll taxes. As the PNHP so artfully concludes:
This is not only unfair, it is so unnecessary. We can fix this by funding a single national risk pool that covers everyone, using equitable progressive tax policies.
No longer would we have to link individuals and families to premiums in the private insurance market. We don't need the private insurers at all (and we certainly wouldn't need to give them 15 to 20 percent of the premiums for their own intrinsic purposes). The system will have already been paid for through taxes, and people would simply receive the care that they need, when they need it.
Simpler. Cheaper. And better. Taking care of us all. Why don't they get it?
Why don't they get it, indeed?! Maybe we need to go all Cheesehead on Washington...