Some are More Equal than Others
According to the White House, a new Patient Bill of Rights includes:
- Barring insurance plans, with some exceptions, from denying coverage to children under 19 with preexisting medical conditions.
- Prohibiting insurers from rescinding coverage except in clear cases of fraud.
- Prohibiting insurance companies from imposing lifetime limits on what they will pay for care.
- Banning insurers from imposing annual limits of less than $750,000 on coverage of essential benefits including maternity care, emergency services and pharmaceuticals. (The minimum annual limit would rise to $2 million by 2014.)
- Prohibiting insurers from requiring that their customers get prior approval before getting emergency care outside the provider network.
Now exactly how many people do you suppose are going to be affected by these rights? Answer below the fold.
The official Office of Management and Budget (OMB) estimate puts the number at under 200,000 (even in the best case scenario), or less than 1/10 of 1% of the population.
And yes, it will cause everyone’s premiums to rise.
By way of contrast, remember that last week the administration announced that more than half of employees in employer-based health plans are going to lose the right (promised to them over and over again) to remain in the plan they currently have. They will instead have to enroll in more expensive, more highly-regulated insurance.
What a complete sham. The only rights that are protected are the ones that affect alomost no one. To hell with the 100 million plus workers who are going to lose the plan they are in and that they like.
I think this is truly bizarre. Hard to say what this White House thinks it is doing.
To paraphrase an old saying, “for every complex problem there is at least one simple solution. Unfortunately, it won’t work”.
ObamaCare is but one example. Unfortunately, it will also an become a case study of the law of unintended consequences.
I think we need to re-frame this “bill of rights”. While it might have positive effects for 1/10 of 1% of the population, it will have negative effects on 99.9% of the population. And the negative consequences will go beyond higher premiums.
Take for example, prohibiting insurers from requiring prior approval for out-of-network ER care. The real issue here is whether ER doctors can balance bill if they are out of network. I wrote a short entry about this a couple of years ago (http://tinyurl.com/23kp5lw). Obviously, the proposed “bill of rights” motivates all ER providers to quit insurers’ networks. Because patients in emergent situations often cannot “decide” where to go to the ER, the fees will obviously have no limit.
Indeed, the regulation might lead to even more ER overcrowding, because patients can go to any ER instead of having to go to an in-network primary-care doctor or specialist if they want treatment without prior authorization. Expect more services to be delivered in the ER, even when inappropriate.
I proposed that the physicians, hospitals, and health plans collaborate on a system of binding arbitration, but they all prefer to get what they want through politics rather than negotiation and collaborative problem-solving. Expect the federal government to fix ER physicians’ fees in short order, in response to health plans’ complaints about rampant costs.
The Act and Obamacare impose new constraints on core practices of insurance companies. This loss of freedom is not justified in any significant way especially to those companies who are being coerced. This violates one of the core principles of democracy, in its liberal form, which is that people coerced by the government are entitled to a justification that they can understand and perhaps even understand. The administration has failed in this respect.
John Graham: Maybe we should call it a Bill of Lost Rights.
This reminds me to Philip Howard’s books. Once we get away from defining the most basic rights, we end up creating all sorts of other problems. It’s like this whole airline bill of rights stuff. Too much complexity and too many crazy incentives result.
None of this is being covered by the mainstream media. That is a shame because people need to know these facts.