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A “Healthy” exchange on the Health Care Legislation recently upheld by the Supreme Court

Those of you who know Euby, are aware, that if someone wants to talk about any topic…even the ones that we are told “should not be discussed…religion, politics, race, the sexes etc….. and they insist on my comments, I will always

be willing to share them….but always with the upfront understanding that I enjoy a good discussion, even an energetic debate, but that I do not understand, nor will I participate in any angry exchange…if it cannot be discussed professionally

and courteously …then simply move on to other topics.

There are many folks that I can have these discussions with…and I can listen to their opinions, and they mine….if we agree great…if not…we can exchange ideas…. they probably will not change my mind, nor I theirs….but we both might learn

something we didn’t know prior if we take time to discuss.

I am always amazed at the number of people who are willing to share their opinion on topics, and if I disagree, immediately label all people who “think that way” in a negative and derogatory way.  Ironically, most often it is them insisting

that everyone should feel the way they do …be tolerant and inclusive…..BUT…if you disagree…”they toss you and all who think that way” to the curb as intolerant trash!  So…the logic is… what?  If you do not agree with what they feel, you

are “intolerant”, however, they “label” and “castigate” you in the name OF tolerance????  Never knew that “tolerance Terrace” was a one way street!   You would think it would run both ways….wouldn’t you?

Oh well…I do not think anything I say or  write will change those minds …but at least it lays the groundwork for the exchange that follows….a very FRIENDLY exchange on the Health Care Legislation and it’s pro’s and / or con’s based on

where you might stand on the subject.   This is a discussion between two really wonderful folks in our industry…. and then some “Euby” comments tossed into the mix since they included me in the exchange…. There are some great pieces of

information in the exchange and I thought it might be of interest.  It is NOT intended as a commentary or opinion of Suncoast or Euby…. simply an informative exchange on a “political” football topic…that is having and will continue to have

a HUGE IMPACT on all of us.  I hope you enjoy reading…..( Names have been removed for privacy )

———————————————————————————————————————————————————————————————————————————————————————————

Clearly this legislation is a political land mine and I choose not to  weigh in on that point. At this point it’s the law of the land and as > such I do believe there are some significant changes that, on balance,  benefit association group members.

Specifically:

STATEMENT ONE

– It creates a purchasing pool that enables small businesses and  individuals to maximize purchasing power.  Presently, these  individuals are largely priced out of the insurance market place ( Small group  members can attest to this I’m sure).  Pooling the small group market  will incent insurance companies to compete for this business —  something they don’t do today.  This is, perhaps, the most significant benefit to group members.

I have heard many people ask their groups to create an insurance pool to  maximize purchasing power among members.  This is that concept on steroids.

RESPONSE

Several “States” had this type of pool available already…. and it  did work…..for the “Small Pools” …HOWEVER…it NEGATIVLY impacted  the larger groups increases as the Health Insurers ( as all businesses

do… ) had a bottom line goal and they simply put additional profit ( and Profit is NOT a dirty word )  dollars into the other areas to maintain their bottom lines.
STATEMENT  TWO

– It restricts insurers ability to over-charge by requiring that 80% > of premium dollars go toward payment of medical care.  Today private > insurance medical premium payments hover around 65% to 70% meaning

that 30% to 35% of premium dollars going to overhead (marketing, executive compensation, etc).   In contrast, Medicare has a 1.5 to 2% overhead load so 98% of premium  dollars go to pay for medical care. ( see later

comments regarding the “unfunded entitlements over the next 20 years )

RESPONSE # 2

This was done earlier in this current administration to the “greedy evil  banking industry”  by placing restrictions on late fees, and penalty “interest rates”  to poorly paying late clients….the Banks responded by raising the prices of

ancillary services TO EVERYONE to maintain their bottom lines, and continue to do so to this day.  The  same thing all companies “singled out” in the same way would do.  As soon as the Health Care penalty phase kicks in, the Health

Insurance companies will have to do the same, and as  soon as they get to the “Evil Gas and Oil Companies” and eliminate  their research tax credits…those increases will be passed along to all drivers in higher gas > prices….  ( this will

certainly happen if current admin stays in place, as they are already talking about it )  As a business owner,  I can tell you this…there are very FEW if ANY companies that could survive on a GP mandate not to exceed 20% !  Maybe that is the

end plan….

 

 

STATEMENT THREE

– It eliminates exclusions and adverse rating for people with  pre-existing conditions, rating women higher than men, and denying  coverage to poor-risk groups. Most personal bankruptcies exist due to  medical bills so this is also a significant change.

RESPONSE # 3

Again, the insurers are forced to transfer these expenses to the  “General Pool” increasing everyone’s overall bills… and not for  nothing, we all know people who “Choose” ( no not all, but a significant number )  to lead unhealthy life  styles….

( one reason diabetes related illness is our largest US medical expense ) and those of us who lead healthy lives with good  diets and exercise will be rewarded with covering ALL forms of bad  health…both those unfortunately enough to be ill

thru no fault of  their own…and those who “choose” lifestyles that create all types of  illnesses in their lives.

 

STATEMENT FOUR

– It eliminates the problem of uncompensated care – when an insured  person goes to a doctor or hospital and doesn’t pay their bills, the  hospital or doctor makes up for that by over-charging its paying  patients.  With most people covered, this uncompensated care subsidy will largely be eliminated.

RESPONSE # 4

It does not eliminate it….it takes it from the one pool and places  it into the “general pool” for all to pay for…. this is a HUGE win  for areas like NYC, San Fran, Chicago,  Philly,  and large entitlement  population areas…and will hammer

other areas with increased costs as  we “Spread the Pain” !  Most of these “costs” are associated with the Emergency Room visits… and the number of NON-EMERGENCIES treated in our ER’s far outweighs the number of “Emergencies”

that are treated in them.  This is a “care management issue” that well intended Government Intervention and legal issues have created.  If non emergency patients were simply forwarded to regular “Dr’s offices” “or clinics” where they should

have went in the first place, the costs would be greatly reduced.
STATEMENT FIVE

– It creates new reporting standards so that purchasers of insurance  can compare apples to apples when buying a health plan, something that  can’t be done today.

RESPONSE # 5

Actually, it can be done, we do it EVERY YEAR for our company staff… it does  take a little time… but we simply have our insurance agent do a spread  sheet with all coverage’s and co pays side by side…usually 6 to 8 pages…..and then based

on bang for the buck…make the decision. Just like any other purchase decision in life. It is really not that complicated.

CLOSING STATEMENT

These are highlights but the law is designed specifically to address  the needs of small businesses and individuals.  There is a lot to  complain about on both sides but to say it offers zero to Association members is I believe incorrect.

CLOSING RESPONSE

I would agree with this statement, there are some “benefits” to all  association members….and they are going to PAY big for those limited benefits…again, going back to the banking industry…. it has failed miserably there….but they will try

again and again,  but in the end…..you cannot “legislate business” and have  “free enterprise”…they are fiscal opponents.  Eventually you have to declare which team your playing for…. “Free Enterprise Economy” or a “Government

Administrative Economy” ….   You cannot do both….. The Government Admin Economies ( Communism and  other similar ism’s ) have all failed this century…if they even  survived they are locked into substandard living conditions ….. if

they “blended the two”  ( Socialism and Progressive ) they are so  upside down they cannot function….Europe has tried the “blend” and  has failed….  I really struggle with following their lead…. as my  “Grandma used to say”….”so

grandson…….your watching your friends run  off a cliff in front of you,  and you feel compelled for “what reason”? to follow them”???

She was a smart woman…wished she were in this current administration …. but I do  not think they allow “common sense” to cross the beltway into D.C. anymore.

P.S.   By the way, do you know our “unfunded entitlement projections” for  Medicare and Medicaid over the next two decades?  It is over 10 TIMES  the current national debt.  If no one is worried about the $15 trillion dollar debt…maybe that

$190 Trillion pending debt will get their  attn…..and just to end this on a “more negative note” we just added  another 40 million people to the “unfunded problem” …… it just  keeps getting better and better….

Sorry to be so negative…but the numbers simply do not add up.  I  love the “positive thoughts and spin….I live that way”….but  numerical facts are facts….only DC can possibly come up with  something like this and package it as a wonderful

decision……again…”No Common Sense” allowed in DC

That is it…Thought I would share….again…both sides presented….”Fair and Balanced”!  Where have I heard that before????     Comments and responses are encouraged…it is a very important topic!       Till next time…..  Euby

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