'RINOCare' Would Not Work
When the government can force you to buy insurance, the insurance companies can force you to accept whatever they’ll give you. And make you pay whatever they feel like charging you.
This inevitably means you pay more -- and get less -- because there's no longer any market discipline to keep costs down and services high.
This is the nut of the problem with ObamaCare, which forces people to pay top dollar for coverage they may not need or want, while denying coverage for the things they do need.
For example, some of the “bundled” ObamaCare plans require single, middle-aged men without kids to pay for maternity coverage -- but won’t cover an emergency room visit that wasn’t “pre-approved or care provided by an “out of network” doctor.
Most of the time, these surprise medical bills can be avoided, but only if you’re not in a hurry. You can research which hospitals are in your network when you're arranging ahead of time for a physical or routine screening.
But what if you’re in a hurry? What if it's an emergency?
When you're on a gurney, taking an unexpected ride to a hospital, probably the last thing on your mind is whether the doctors who are going to treat you when you get there are "in network."
But it'll be on your mind later -- when you get the bill.
This business of surprise medical bills, which President Trump has been railing against, is a predictable consequence of government mismanaged (and mandated) health care. Which is both arbitrary -- and expensive.
Insurance that was market-based, which people could tailor to meet their specific circumstances -- would address the problem in a market-based way.
They could, for example, buy coverage for emergency room/specialist care -- and skip coverage for maternity care or substance-abuse counseling.
By paying nothing for the latter, they'd pay less for the former.
But ObamaCare has instituted a one-size-fits-all model that's made insurance more expensive for practically everyone -- and much more profitable for the insurance industry -- while reducing access to medical care (which is a very different thing than having insurance).
The LHCC, which is sponsored by Sen. Lamar Alexander of Tennessee, naively proposes to one-size-fits-all prices charged for medical care -- especially for emergency services -- along the Medicare model.
A “median in-network rate” would be imposed, which would enable insurance companies to pay less to doctors and hospitals -- while charging policyholders more -- for premiums, to offset the “lower” costs paid to doctors and hospitals, in order for the insurance companies to make more money.
Because policyholders can’t say no to premium increases -- or arbitrary changes made to their coverage -- when insurance coverage is mandatory. As it has been since the not-so-Affordable Care Act (ObamaCare) was passed into law.
But doctors can still say no to less pay by declining to offer their services at "median in-network" rates -- the euphemistic language used to soft-sell the price control regime that would be established under the LHCC.
Unless doctors are to be literally enslaved and made to work exclusively for the government -- and for the benefit of the insurance companies -- at whatever (low) rate the tag-team decrees, they’ll do what anyone else in the same position would do:
Go somewhere else, where the pay’s better. Or do something else entirely.
Thus, the LHCC would impose doctor rationing (and scarcity) as well as price-increasing.
And it would inevitably get worse -- and cost even more -- as time goes by because the insurance companies would flex every muscle they've got to continuously lower the "in network" prices they are obliged to pay under the terms of the LHCC, while at the same time jacking up policy premiums.
As Charlie Sheen used to say -- winning!
Only we’re the ones losing.
The fact that the insurance industry supports the LHCC ought to raise everyone's eyebrows -- including Sen. Alexander's.
Keep in mind that these are the same insurance companies which are already infamous for dodging claims whenever they can get away with it.
With government backing them up -- under the LHCC -- they'd be able to get away with it even more.
In their defense, part of the broader problem with health insurance today is that it no longer is insurance -- which is supposed to be a shared-risk pool that pays occasionally for unlikely and unexpected things, not for everything.
Imagine what your car insurance would cost if you filed a claim for every tire rotation and tune-up. Such things are still affordable because you can shop around and negotiate prices. And say no, if the price isn’t right.
The LHCC -- however well-intended -- would fix the prices. Which will break an already broken system even more.
Bryan Crabtree, is author of the book, "The Trump In You: Acting Like Trump Is Actually A Good Thing." He is host of The Bryan Crabtree Show in Atlanta Georgia on WGKA, AM 920 and WAFS, biz1190 as well as the publisher of Talk40.com