Sunday, July 7, 2013

Obamanatin's Path to Single Payer Healthcare

The latest news from this 4th of July week is that the Obama administration is delaying the mandatory employer reporting requirements under Obamacare for one year.  Along with this was also the announcement of a delay in the requirement to verify eligibility in the state exchanges.  So employers don't have to report what insurance they offer, and exchanges don't have to verify that an applicant meets eligibility requirements (as in that their employer offers affordable insurance).  What does this mean in the end?

Now I'm no Obamacare fan at all, and don't want to see this implemented at all, but everyone on the 'right' is looking at this all wrong.  Most are crowing about with 'I told you so's'. "See?  It's so screwed up they can't implement it!  Hah!  It's broken before it starts!  We win!"  No, I don't think so.  Here's how I see it.

Folks realize they can get subsidized health insurance through the exchanges and don't have to worry about eligibility (because of the lack of employer reporting and the lack of enforcement of said eligibility because of the lack of said reporting).  So they get insurance from the exchanges for less out of pocket.  The exchanges grow and the Obama administration starts hawking how successful these are, how many 'more' people have insurance now (ignoring the fact that a lot of these folks had insurance before and are simply seeking the subsidy).  Congress gets squirmy (or more accurately, the Republicans in Congress get squirmy) and see no other route except to increase funding for the exchanges/subsidy because all these people 'need' this insurance.  Then in a year or two, the bill is getting HUGE, and some folks start talking about trimming the subsidy, or trying to reduce the number using it. What happens then?  Well, of course, now anyone trying to control that subsidy is 'trying to take health insurance away from people'!  Never mind where all this started, with no eligibility verification, so no idea how many people are 'actually' supposed to be eligible for the exchanges.  Evil Republicans are trying to take healthcare away from the poor!  So of course that will never happen.  Now, between Medicare/Medicaid and the Exchanges, the government is providing or subsidizing an even larger percentage of the population (over half?).  Tipping Point!  No way folks support congressmen that want to rein this in.  No one will vote to cut their own subsidy.  More money required, less and less provided by the private sector (employer provided insurance: why would an employer provide this and have a cost share when they can push everyone to the exchanges?)  Insurance companies are squeezed as they can't operate on the low rates (see Medicare) and start closing up or getting out of the healthcare business.  What then?  Nothing else but for Uncle Sam to step in and take over the whole shebang.

We're doomed if something doesn't change soon.

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