Saturday, June 11, 2016

AMERICAN HEALTH CARE CRISIS


Do you recall President Obama’s proclamation on September 20, 2012, when he informed us that his signature health law, the Affordable Care Act, aka Obamacare, would reduce annual insurance premiums by $2,500 for the typical family”?  If you’d care to know how things are working out, you should note the following recent report by the Associated Press.


The nation’s major health insurers, citing financial losses, are requesting massive premium increases for 2017, this to account for a variety of unanticipated circumstances.  North Carolina’s largest insurer will seek an 18.8% increase; the requested hike in Vermont is 44%; Texas’ major health firm wants to raise its rates by nearly 60%.  And what sort of circumstance is triggering these financial losses?  It’s that under Obamacare, millions of health care recipients who fit into carefully contrived politically favored classes are shielded from price hikes by government subsidies.  It will be those consumers not eligible for the government grants who must pick up the tab.  And remember, under the law most Americans are required to have health insurance or risk being fined.


In connection with the delivery of medical services in America, a number of things deserve to be said.  Over the past couple of decades an unmistakable trend developed, and it may well be that none of us will escape the inevitable.  The problem is remarkably simple.  While medical technology becomes increasingly complex and costly, a substantial and growing portion of the population, with little or no financial resources, is guaranteed limitless access to the services.  The solution to the problem is far more complex, involving the political quandary of requiring massive transfers of wealth among various groups of the society.  As difficult as this might seem, there are three factors that will make it all the more unresolvable.


The first is that the retirees eligible for Medicare number in the tens of millions and continue to grow steadily.  The second is that an increasing number of employers, many for pure survival, are ridding themselves of employees and transferring their assets outside our borders to be beyond the reach of the regulators and tax collectors.  The third, and perhaps most crucial of all, is that the effective tax rate on a middle class working American is approaching 50 percent.  Not only is there little slack, but the rate is reaching historical revolt conditions.  Although The Affordable Care Act was enacted ostensibly to address these problems, it’s clear that it cannot do so.  Instead, it’s pitting class against class . . . income group against income group . . . American against American.


A dozen or so years ago, under a prior administration, the country was responding in a different fashion in the search of ways to reduce services and the attendant costs.  The main vehicle for this change was the health maintenance organization (HMO), ideally set up to ration health care.  The fact the federal government aggressively promoted this concept for Medicare and Medicaid recipients was understandable.  Of course, this was not happening without severe upheaval, as the HMOs were squeezed between the medical recipients demanding ever more benefits, and the payers seeking to reduce expenses.  What developed, as a logical response, was the capitation arrangement by which medical providers agreed to accept a set fee per patient per month.


The effect on the entire medical establishment became strained as physicians, pharmacies, therapists, and the like, saw their fees reduced to unacceptable levels.  In the meanwhile, the financial position of many HMOs deteriorated, with mergers and bankruptcies increasingly common, and the attempt by many to shed themselves of unprofitable Medicare patients were opposed by the government in a variety of ways.  It became obvious that the nation would eventually decline to extract money from $9.50 per hour service station attendant Billy Rae Campo so that the bunions from both feet of Myrtle Fellers, a ninety-four-year-old penniless widow, could be removed at a cost of $9,700 to the Medicare system.  In the meantime, however, it was business as usual.  With such expenditures, of course, there would be corresponding economies such as Billy Rae's wife, Sue Ann, not having her cervical cancer diagnosed in time to save her life.


There’s no point in relating the many tales of medical malpractice; you’ve heard the horror stories told and retold.  As members of a prestigious California HMO for fifteen years, my wife and I discovered how the system could¾in fact, was designed to¾break down.  The only thing that need be said is that for us things turned out satisfactorily: In 1981 we escaped with our lives.


This brings us to the point where we must ask: What will be the ultimate resolution of our health care crisis?  I believe I see where it’s going.  I’m convinced the Obamacare advocates knew from the beginning that their program would be unworkable.  The actual aim was a single-payer system providing universal coverage to all Americans, operated by the federal government.  What we are witnessing is the piece-by-piece dismantling of Medicare, Medicaid, private hospitals and pharmacies, health insurance companies and all individual medical practitioners.  In its stead will be a single entity, operated and funded by Uncle Sam.  Welcome to your health care organization of the future:  the U. S. Government HMO.


                                       

If you enjoy this weekly Straight Talk by Al Jacobs, you’re invited to check out my monthly Financial Newsletter, as well as my new book, The Road to Prosperity


                                       

 

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