Another Day, Another Fallacy?
There are all sorts of interesting things about this one that are out of the control of our neighbors, such as the
right-wing blog with odd linking policies (yeah, really, we know why you don't want to link out to the opposition argument, guys) but in the end, what's going on here is that people are jumping to political arguments and then hoping nobody calls it out. The idea, of course, being that nobody will tell a cancer patient she's wrong.
Right?
Wrong.
Sundby shouldn't blame reform — United Healthcare dropped her coverage because they've struggled to compete in California's individual health care market for years and didn't want to pay for sicker patients like Sundby.
The company, which only had 8,000 individual policy holders in California out of the two million who participate in the market, announced (along with a second insurer, Aetna) that it would be pulling out of the individual market in May. The company could not compete with Anthem Blue Cross, Blue Shield of California and Kaiser Permanente, who control more than 80 percent of the individual market. "Over the years, it has become more difficult to administer these plans in a cost-effective way for our members," UnitedHealth spokeswoman Cheryl Randolph explained. "We will continue to keep a major presence in California, focusing instead on large and small employers."
The two insurers were also operating at a tax disadvantage in the state. As California Insurance Commissioner Dave Jones explained, "One of the factors I believe contributed to this decision ....is the special tax break that California law gives to Anthem Blue Cross and Blue Shield, which has allowed and continues to allow those two companies to avoid paying $100 million in state taxes a year." "Aetna and United Healthcare don't get the special tax break provided to Anthem Blue Cross and Blue Shield, and so they faced a major competitive disadvantage in California."
And then there is the company's own justification for leaving. "The company's plans reflect its concern that the first wave of newly insured customers under the law may be the costliest," UHC Chief Executive Officer Stephen Helmsley told investors last October. "UnitedHealth will watch and see how the exchanges evolve and expects the first enrollees will have ‘a pent-up appetite' for medical care. We are approaching them with some degree of caution because of that."
Get that? The company packed its bags and dumped its beneficiaries because it wants its competitors to swallow the first wave of sicker enrollees only to re-enter the market later and profit from the healthy people who still haven't signed up for coverage.
Sundby is losing her coverage and her doctors because of a business decision her insurer made within the competitive dynamics of California's health care market.
(Volsky)
The funny thing about BizPac Review's attempt to sleight the counterpoint is that it still points us to the answer; they're just hoping people won't follow through if they can't simply one-click it. (No, really, when I blog, I do the same thing; since WordPress doesn't integrate well with the Twitter embed, you cap it, cut it, upload it, and serve it; the choice to not link the image is up to the writer and editor—being confident in my sources, I always link those images. There really is no excuse for such willful omissions, except, of course, that they're conservatives, so, you know, it's okay.)
In the end what we're dealing with comes back to a juxtaposition arising all too frequently in conservative politics; it is one thing to acknowledge human frailty, another to pin your success on the exploitation thereof.
This is the sort of thing that keeps happening. As
Jonathan Cohn noted, of Obamacare horror story victim Dianne Barchette, featured in a CBS News reprort:
I'm not the first person to examine her situation. Erik Wemple of the Washington Post called her shortly after the CBS article appeared. Nancy Metcalf of Consumer Reports examined her case and provided a detailed breakdown of what insurance she has today versus what she could buy for next year. What follows builds on their work—and that of other writers, like Tommy Christopher of Mediaite, Michael Hiltzik of the Los Angeles Times and Paul Waldman of the American Prospect, who have examined similar stories.
Barrette's story isn't a stand-in for everybody losing existing coverage—a group that represents a tiny proportion of the population, yet still numbers in the millions. Even so, Barrette's tale provides a good window into some of the primary changes taking place as a result of Obamacare. Those changes are way more complicated than the initial media coverage suggested.
The policy Barrette has today is called the Go Blue Plan 91. It is not what most people would consider real insurance. Its coverage of doctor visits and tests, such as MRI scans, consists of paying $50 and then letting Barrette pay the remaining balance. Drug coverage works more or less in the same way, only the plan pays $15 per prescription—which is enough to cover generics, but not many name-brands. And hospitalization? The plan pays nothing at all. As Wemple put it, "it's a pray-that-you-don't-really-get-sick 'plan.'" Barrette doesn't really disagree—but this plan, she says, was all she could afford. "Most everyone I talked to said they were paying thousands more to get hospital coverage," she told me, "so I took my chances with what I have now."
Right now, the problem Barrette faces is the Healthcare.gov site—
When I gave her a broad description of the plans available, she seemed interested. I noted that she'd be paying $100 or $150 extra a month for policies that still had high cost-sharing, so that she would still be a lot of money out of her own pocket. (I also made very clear that I'm not an insurance agent or broker—that, when she finally goes shopping for insurance, she should talk to a real expert for advice.) Here was her response: "I would jump at it," she said. "With my age, things can happen. I don't want to have bills that could make me bankrupt. I don't want to lose my house."
Barrette can't be sure until she sees the numbers for herself. And so far she hasn't been able to do so, thanks to the technological problems at healthcare.gov. But as she's become more aware of her options, she said, she's no longer aghast at losing her plan—and curious to see what alternatives are available. "Maybe," she told me, "it's a blessing in disguise."
—and, well,
that, at least, is on the government, both the administration responsible for the policy and the congressional opposition that has blocked attempts to fix known problems in the law.
But we are well into the wolf-cry phase of the chicken little apocalypse. At this point, the horror stories are the assertions requiring extraordinary support.
And
Brian Ross makes an interesting point that seems to get overlooked:
Shopping for plans took a couple of hours, but that was due to the the dozens of complex plans. Most came from Blue Cross of Florida, which seems to take the three-card-monte approach to selling health insurance by producing tons of plans with such subtle nuances that they could hang them up next to the Matisse paintings in a museum as works of bureaucratic art.
Freelance writers are definitely individual buyers. We have been victims of the very costly and very arbitrary system for those without employer umbrellas to protect them.
For my family of seven people, four currently in college, in senior citizen-laden Florida, my pre-ACA Blue Cross of Florida policy that we have held for the last three years has made lots of changes to our insurance:
• Our pre-ACA rates doubled since 2009
• Big Blue, without spelling out that they could make these radical changes to the plan that I bought, shifted us from a 2,000 per person per year deductible, where they would pay claims after each person crossed that $2,000 line, to whopping $14,000 AGGREGATE annual deductible.
• The out of pocket cost rose from a manageable $5,000 to a crushing $25,000 per year.
• They collect a 25 percent surcharge for allergies, even though they never pay a nickel for them, as the $1,800 cost of my medicine a year comes nowhere near their $14,000 deductible.
• Health insurers don't like keeping my four college students on a family plan. Single plans cost more, and make them more, so you pay for the privilege of keeping your kids on your plan.
• Over the last few years we've been forced off of plans with good deductibles and benefits because Blue Cross of Florida has changed the terms of those policies, usually on pharmacy benefits, to make staying on them untenable.
The "insurance" card became a discount card. We received "discounts" from Blue Cross that knocked down what I owed providers, with that $14,000 always a number that thankfully we did not cross.
The good news for individuals like us is that, effective January 1, the ACA will end the insurers' ability to impose lifetime caps, "surcharges" for pre-existing conditions, and end the loopholes that companies have used to radically change terms of existing insurance to force customers on to more expensive plans with fewer benefits. Deductibles and out of pocket costs have dropped too.
The bad news?
The private insurers' Byzantine websites are awful. The plans are complex, and the rates are still too high.
This is something I see a lot; people get upset at the idea of "government", but seem a lot more willing to bless the private sector for behaving just as "badly" or even "worse".
How much of what you paid for a product today went to the people who manufacture, deliver, and sell the product to you? How much of that goes to the executives? How much goes to advertising? How much goes to questionable "R&D" intended to keep money in the company and out of the tax loop? How much goes to lobbying? How many people who routinely whine about taxes actually care how much the private sector inflates prices for nonessential reasons?
Or in this case, if the government is so horrible because insurance plans deliberately crafted to be insufficient are being forced to change, why are these complainers so complacent with private-sector gouging?
All of these issues get swept aside with the deceptive calls to panic.
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Notes:
Dorstewitz, Michael. "WH shameful excuses why cancer victim lost plan; blame victim". Biz Pac Review. November 5, 2013. BizPacReview.com. November 5, 2013. http://www.bizpacreview.com/2013/11...hy-cancer-victim-lost-plan-blame-victim-86569
Volsky, Igor. "The Real Reason That The Cancer Patient Writing In Today’s Wall Street Journal Lost Her Insurance". ThinkProgress. November 4, 2013. ThinkProgress.com. November 5, 2013. http://thinkprogress.org/health/201...or-story-cancer-patient-losing-doctors-wrong/
Cohn, Jonathan. "'I Would Jump At It'". The New Republic. November 3, 2013. NewRepublic.com. November 5, 2013. http://www.newrepublic.com/article/115457/obamacare-victim-florida-happy-she-can-get-real-coverage
Ross, Brian. "Obamacare, the Game: The Exchange Isn't the Problem, It's the Insurance Companies". The Huffington Post. November 1, 2013. HuffingtonPost.com. November 1, 2013. http://www.huffingtonpost.com/brian-ross/obamacare-the-game_b_4177062.html
