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Monday, January 16, 2017

The Four Horsemen Of Individual Health Care

...riding, riding, riding, not merely for the Affordable Care Act, known commonly as ObamaCare.

Even I, who am not the brightest bulb on the Christmas tree, knows that businesses do not like uncertainties, and they really do not like uncertainty on the scale of the Death Star in Star Wars.
I mean, the whole premise of starting a small business is having a hearty meal of torturous work preceded by an tapas plate of uncertainty and worry. Who wants more?

 The lack of intelligence, the lack of ability, the lack of real interest in individual welfare and in individual health are the four horsemen of the Apocalypse for the ACA and for all Individual Health Care that meaningfully addresses the needs of the millions who were without health care before the ACA.

It does not matter when the Republican repeal the ACA, because they will never have an adequate replacement ready. It is fairly obvious that the best the Congress will do is toss the hot potato back to the States, who will then let the bloody thing drop... like a hot potato.
I mean, the track record of the US Congress for doing things intelligently over the past 20 years is not stellar, and if the names of the four horsemen are Death, Plague, Famine, and War, the US Congress has acted more like a group of stable boys prepping the grounds armageddon-wise at some apocalyptical, end-of-times,  Ride and Hunt Club.

When the people in power say they are going to destroy something, businesses take heed. When the people doing the destroying have demonstrated no skill in building, businesses take note.

A very good summation here:

J.B. Silvers, Professor of Health Finance, Case Western Reserve University

The Conversation
As Republicans ready to dismantle ACA, insurers likely to bolt
December 29, 2016 4.19pm EST
There’s a joke among insurers that there are two things that health insurance companies hate to do – take risks and pay claims. But, of course, these are the essence of their business!

Yet, if they do too much of either, they will go broke, and if they do too little, their customers will find a better policy. This balancing act isn’t too hard if they have a pool sufficient to average out the highs and lows. I speak with some experience as the former CEO of one of these firms.

Employer-sponsored insurance has fit this model fairly well, providing good stability and reasonable predictability. Unfortunately, the market for individuals has never worked well...

An extremely good accounting of what has happened and so logical that it functions as sort of a spoiler alert  for what is going to happen. The last sentence quoted above gives it away: the market for individuals never functioned very well, so the task is to better that market; to amend, to make better, not to destroy.

Ah, well. It must await a more enlightened age yet to come.


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