Part Deux: Now You Get To Keep Your Plan?
Mike walker, Col. USMC (retired)
All,
First, let me say that getting health insurance for the 30 million uninsured Americans is a just and honest goal. Screwing with +300 million Americans to achieve that aim is disgusting hubris.
This is such a mess and what the President proposed yesterday is no solution whatsoever.
Simply put, each of the 50 states can decided if they want to permit the old policies to be reinstated… Or not.
That throws the whole system into chaos, as millions will avoid the exchanges making the exchange cost calculations worthless and perhaps rendering them financially unstable.
Even worse, none of the old policies exist and will have to be rebuilt.
What does that mean?
In simple terms, to offer the old plans, two components must be put in place: (1) the health care networks and (2) pictures of the "pool of souls" who will use each of the networks.
The agreements with doctors, clinics, and hospitals that formed the health insurance network for the old plans are GONE so they will have to be reassembled.
That means negotiating to put them back together again (if possible – think Humpty Dumpty) by getting agreements on what fees the doctors, clinics and hospitals will charge for 2014 – a tough and time consuming process that will likely never happen before 31 December.
Additionally, the pools of souls were disbanded, gone with the wind, wiping out all the historical data used to calculate health care usage rates and thus the cost of the plans.
How on earth are the insurance companies going to figure out what doctors, clinics and hospitals are out there, let alone what they are going charge in 2014, and how can they then gaze into their crystal balls to see what the new pools will look like in order to estimate the costs?
Health care providers rightfully pay expensive fees to get good actuaries to do this type of number crunching. Relying on their calculations (that may possibly begin in December), in a health care marketplace that has been ripped apart unlike anything ever seen in American history, is absolutely frightening.
Expecting something to be done for those who lost their insurance and need a fix by 31 December is insane.
Doctor Frankenstein and the lovers of Zombie movies may be thrilled (The Walking Dead Health Care Plan Lives Again!), but this is an unmitigated national disaster.
Where do I get my reasoning? I spent nine years on the board of directors for a non-profit health care provider in Southern California.
I am sick to my stomach.
Mike Walker
29 Palms CA
