The next time you’re at the grocery store, buy $100 worth of groceries. Tell them you will pay them $25 and for them to send the receipt to your bank for the remaining $75. How many of you think there is any chance of getting out of that store without being arrested for shoplifting?
Now, consider this scenario. Call a doctor’s office to schedule a visit and tell them you have no health insurance. You might not even get an appointment. There was a time when this was how we all received health care service… we paid for it! For the few patients who had insurance, it was their responsibility for filing claim forms to receive reimbursement. The provider was paid by the patient.
Over the years, rules have changed dramatically and soon, despite the new federal law mandating insurance coverage for everyone, finding insurance at an affordable premium will be difficult if not impossible. This is the hidden agenda of what many call “ObamaCare” aka The Patient Protection and Affordable Care Act (PPACA).
Marketed as universal access, the key problem is that limited capacity leads to rationing of care. Ultimately, the government will decide who gets care and who does not. Welcome to President Obama’s “Signature Legislation”
The new Patient Protection and Affordable Care Act is worse than a solution. No matter how well-marketed, this legislation has geometrically compounded the problem of delivering affordable health care to all. If not immediately defunded and ultimately repealed, it will irreparably harm the health of our nation.
This legislation was never about health care, rather it was about taking control of every American citizen’s personal life. The path that led to its passage is directly tied to many years of apathy by Americans. When it came to Healthcare…Who Cares?
Now, with eyes and minds open, it is time to examine a better solution. Make no mistake about it – we desperately need healthcare cost-delivery reform.
Readers would do well to review the potential damage almost caused by a “reform” called “Section 89” over 20 years ago. I said almost because it was immediately repealed. What’s the big deal about Section 89? It was a lighter version of the PPACA mandate component, recently – and fortunately – ruled unconstitutional by a federal appeals judge (this dispute will now go to the U.S. Supreme Court). Section 89 was repealed because it was so laden with red tape and discrimination-testing requirements for employers that it would have made doing business impossible.
So, how bad is the PPACA? As of the date of this article, The Department of Health and Human Services (HHS) has already granted 222 known waivers exempting some very large national companies and unions from new mandates that are far worse than the old Section 89 compliance rules. If small businesses are the backbone of America and large employers receive waivers for compliance mandates on the grounds it would destroy their ability to do business, what will The PPACA do to America’s backbone? This is why I believe that the current healthcare legislation is the most malicious and malevolent act ever passed by the United States Congress.
A sales phrase called “Post-Purchase Cognitive Dissonance” (PPCD) means that after a purchase, the buyer may get the feeling that something is not right. In some cases it results in cancellation of the sale; the item is returned or other action taken. Once the transaction is reversed, the buyer feels better.
What we citizens have been demanding is reform to the economic relationship between healthcare providers and cost protection mechanisms.
Candidate, now President, Obama won election to The White House with that promise. Senator Harry Reid abused long-standing rules of the Senate to pass PPACA; in the House, Speaker Pelosi used an emotional appeal laced with arrogance, urging passage so the country could find out what was in the bill. In early 2009 in a video I posted on YouTube, I warned then that Congress would use “Reconciliation” to pass this because it could not stand up to public scrutiny and that is exactly what happened.
What we have now discovered is that we do not like its contents. What we got was rationing and, as people understood what was done to them, a groundswell of anger grew. The result was visible last November. Now we want our money back!
Unfortunately, the health care industry has become part of everyday life for Americans. Worse, it is too complex for the majority of people to understand. The natural tendency, therefore, is to become frustrated, angry, then walk away – muttering about blaming someone else for this mess.
The only question now is whether or not the American people will stay focused and continue to hold Congress’ feet to the fire. By their actions in the lame duck session, it is obvious that Democrats don’t think so. The Republicans also fear any potential public resolve because they would have to actually develop a backbone of constitutional principles.
However, there is hope to fix this looming man-made disaster. It starts with every single American each learning about this subject. There is currently ample motivation because this is a different situation than the early 1990’s healthcare cost-delivery crisis. This time the problem is compounded because of the longevity of the parents of baby boomers who need more care and the baby boomers themselves simultaneously now drawing down on the system for care.
Our education continues by understanding that our healthcare delivery system is a monopoly. You and I cannot hang a shingle outside our office and say we are practicing medicine. From one perspective this is a good thing. It protects the quality of care. It also means a healthcare provider (private physician/ hospital, etc.) can charge any amount that the market will bear. The provider does not have to contract with any insurer nor accept Medicare or payment from any governmental agency for that matter.
There are providers in America not contracted with major insurance companies and government agencies, who reimburse for health care services. They still accept cash. They are also a small minority. When the majority of local providers want more money for their services, they do not go on strike. They simply “renegotiate” their contract by quietly raising their fees above the existing contractual allowances in their insurance reimbursement contracts. This ultimately leads to an increase of contractual allowances in various geographical areas as new reimbursement contracts for providers are written. That in turn leads to higher premiums and a perfect monopoly… except for one small problem.
There is no additional money to continue this inverse supply and demand equation. In simple language we have addicted our healthcare providers to a steady stream of external revenue sources and that stream is drying up at the most inopportune time, at the highest demand.
The worse solution we could implement is to ration the money because that, in turn, will lead to rationing of healthcare. Yet that is exactly what PPACA did. We wanted healthcare cost-delivery reform and we not only got rationing of money, we got rationing of healthcare.
Another crucial component to the problem is the current cost-protection system. The insurance industry is one significant source of cost-protection and government, at all levels is another one. Of course it is understood that consumers are paying more and more as well.
Insurance companies raise premiums to cover increasing costs; the public screams about the evil insurers. What about the outcry when government is forced to raise taxes to pay for the healthcare cost protection that its many programs provide?
The only difference is that consumers generally dislike the concept of insurance and there are no regional or national spokespersons extolling its value. On the other hand, we elect politicians who promise to help us get affordable healthcare. I say to Congress no more help, please!
A better solution involves factoring in the predictability of human random actions This simple but complex-sounding component is the reason why the new law was mortally wounded on arrival. It seeks to control everyone by uniformly rationing care and federally mandating citizens to buy a product – insurance!
To craft a workable solution we must view the situation as a jigsaw puzzle. This means ridding America of The PPACA and crafting a new federal law that addresses true cost-delivery reform. Let’s call it The FEDERAL HEALTH Act. It will not ration care and there will be no federal mandates.
This unpredictability can now be factored into the solution. We all function differently – earning power and lifestyles. Each community across the country has its own identity because we are human beings who individually decide where we live, what we do, etc. Everything about each of us is unique.
Therefore, we are the key to true healthcare cost-delivery reform, not the politicians and bureaucrats in Washington! It is essential to weave our individuality into a system that allows people to freely move throughout the country and access care wherever they are.
This innovative solution is based on capitalism. It injects competition into the present monopolistic system of how health care services are currently delivered.
To develop this comprehensive approach, which will lead to a better, affordable delivery system, we do not need to reinvent the wheel. This is going to absolutely shock everyone reading this when I say what a crucial role the IRS needs to play.
However, that role is not as an enforcer. The reality is that although we fear and dislike the IRS, like every governmental agency, it is not going away. Therefore, we need to use the IRS to ensure that each local community/region gets its share of funds needed to provide care. I see this as a far better use of the IRS instead of how The PPACA creates and funds 16,000 new agents, then charges them with the task of seizing our money to fund an unaccountable, bloated federal government that offers false promises of free healthcare.
I have an even deeper question. Why would our federal government mandate the purchase of something we generally dislike -insurance? I unequivocally believe it was NOT done to force you to buy insurance. Instead, President Obama did this to eventually eliminate the insurance industry from the equation. The result is a single payor system. However, what few seem to know is how powerful the insurance industry really is; buildings named after carriers, etc., Like them or not, they move money through our society. Intentionally creating legislation designed to destroy the biggest mover of money through our economy is malicious and speaks to a hidden agenda in The PPACA.
Wouldn’t it make more sense to design a system that uses the insurers instead of economically strangling them and by extension, America? It is true that insurers pad every cost factor that goes in a rate under the global umbrella of actuarial science; you either pay the premium or go without coverage.
However, The PPACA creates more and more bureaucracies with more and more tax dollars and give us things like the new agency, The PCORI. It is under the direct control of The President. The Patient-Centered Outcome Research Institute ultimately will decide who lives or dies by regulating the care received. How is this better healthcare? Where is the reform?
True reform should NOT be implemented by passing a law allowing a group of unaccountable people in The White House under direct control of one person – The President- to implement rules that control your life. In other parts of the world we call this a dictatorship.
Having been a guest on radio shows all across our country and a newspaper columnist on healthcare I consistently state one request of all Americans. “Stay healthy. Stay tuned. Get involved. Learn what is being done. Your life now does indeed depend upon it.”
About the Author
Dennis began his insurance career in 1976 after graduating from San Jose State. Immediately Dennis began to specialize in group health insurance. His clients range from small companies to Fortune 500. One of his favorite achievements involves a huge multi-national law firm who in 1997 contacted him out of the clear blue. He walked in and they told him before he sat down that he was their new broker and they needed him to fix their benefit problem. His ground breaking work on this matter set precedent for how the national individually-franchised network of Blue Cross and Blue Shield companies today work across state lines.
In 1977 he won a national award for his work in creating what we all know today as Community Health Fairs. In 1986 he began a book (published in 1991) that forewarned of the coming health care cost-delivery crisis, while also offering an innovative solution that is now – almost twenty years later – gaining traction, especially now. Dennis can be reached at Dennis.Wolfe@comcast.net.