Universal Health Care… It Starts Today?
When I was sixteen to when I was about twenty-two, I worked in a retail pharmacy to help pay for college. One of the biggest atrocities that I saw being forced upon people was that simple, SIMPLE, things like generic drugs being overcharged to people through the pharmacy. For example, our cost for a powder amoxicillin (ya know, the bubblegum flavored mess you’d give to your kids as a liquid?) the pharmacy bought for $2.30/bottle and sold for about $20. Insurance companies take the brunt of that cost (your co-pay is what it is, SIR), or most non-insured folks wouldn’t mind paying. This is oh so common and happens often with medications, especially when they are generic. Don’t get me started on extended release meds. Anyway, this increases the cost of insurance… if we simply decreased the cost of drugs at the retail level, we could decrease the cost insurance.
But I digress. The healthcare insurance industry is about to be rocked to its core. Insurance companies will have to change how they use their current income and cash on-hand. Interesting, no? This is what Forbes has to say:
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. 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. If they could, we likely would never have seen the extraordinary efforts made by these companies to avoid paying benefits to their customers at the very moment they need it the most.
Today, that bomb goes off.
Today, the Department of Health & Human Services issues the rules of what insurer expenditures will—and will not—qualify as a medical expense for purposes of meeting the requirement.
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, as well they should have. Selling me a health insurance policy is simply not the same as providing me with the medical care I am entitled to under the policy. Sales is clearly an overhead cost in any business and had HHS included this as a medical cost, it would have signaled that they are not at all serious about enforcing the concept of the medical loss ratio.
So, does that mean that I will no longer see advertisements in the DC metro for UnitedHealth? Or, I will, but I’ll also get a check from them? Or maybe the system is just not able to be that solvent, where the need for a single payer will come into play and we’ll need to simply wipe them all out. Maybe that was the intention all along. That’s what this columnist asserts, anyway.