Tuesday, March 2, 2010

The magic of Obamacare

Movin’ Meat has up a post in which he cites the case of Anthem Blue Cross Blue Shield paying claims late and says:

Actually, that's pretty much SOP for most insurers: deny and delay at will, and dare providers/consumers/regulators to punish them. Fines (when there are any) just go back to the insureds as increased premiums, and any time the providers/consumers are fatigued out of demanding the insurers actually pay, that's pure profit for the insurance company.

Pass. The. Damn. Bill.

As I said in the comments there, I don’t see how any of the three (perhaps soon to be four) health care reform bills that might be passed would eliminate this issue. The bills don’t get rid of insurance companies so the business models for the companies won’t change and bad insurance companies won’t suddenly become good ones. I suppose supporters can argue that Federal law will be better at regulation than State law but in rebuttal I would simply mention the Great Financial Crisis of Twenty-Aught-Eight. Whoever was at fault in that Crisis, no one can argue that having the Federal government regulating the financial industry made companies behave in a saintly manner. Incentives are incentives even for the best companies in any industry and every industry has some bad apples. All the Federal law in the world won’t change that.

What intrigues me about this is that it’s representative of a firm belief in some quarters: passing Obamacare will make all the problems with our health care and our health insurance magically disappear. Movin’ Meat believes Obamacare will make insurance companies stop delaying claim payments. Yet Obamacare doesn’t get rid of health insurance companies. Similarly, at the health care summit, Representative Louise Slaughter said:

I have a constituent that you won’t believe and I know you won’t, but her sister died, this poor woman had no dentures. She wore her dead sister’s teeth which of course were uncomfortable and did not fit. Do you believe that in America that’s where we would be?

Yet according to The New Republic:

The Senate and House health reform bills are relatively silent about dentistry. (The word "dentist" appeared once in the 1,502-page Senate Finance committee draft bill.) Child coverage has been expanded. Provisions are included to strengthen the dental work force and to address other infrastructure concerns. Yet these bills do relatively little to ensure adult access or to apply a careful delivery reform lens to dental services. (The status of stand-alone dental plans within proposed insurance exchanges raises delicate concerns, for example.)

Based on that analysis, I don’t know why Slaughter would think Obamacare would magically produce dentures for her constituent.

A week ago, Movin’ Meat was claiming that we had to pass the health care bills in order to eliminate rescission. Yet the House health care bill still allows for rescission in the case of “clear and convincing evidence of fraud” subject to third-party review. The Senate bill is even more gentle, allowing for rescission in the case of fraud or intentional misrepresentation; this is not an improvement over most State regulations and existing Federal regulations. When the Exchanges are up and running in 2014, everyone will have to buy health insurance so there will presumably be no conditions under which rescission can happen. But until then passing Obamacare will not eliminate rescission.

If Obamacare passes, it will be interesting to see what happens to all the stories about people who suffer from denied claims, delayed claims, lack of dental care, and being dropped by their insurers because they left something off their applications. I don’t believe the problems will magically cease. I do believe those on the Left will magically stop talking about them.

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