by Madeleine KandoAetna, one of the major insurance companies in the country, is pulling out of the Obamacare exchanges in 11 of the 15 states where it currently offers plans.
The reason the company gives, is that it is losing money selling insurance to individuals who are in need of more care than was anticipated. But some experts (including economist Paul Krugman) say that it is vindictiveness after antitrust authorities turned down a proposed merger between Aetna and Humana.
Now, why they are losing money is confusing. They say that there are not enough healthy people to financially offset those with major health problems who require high-cost care.
So, what happened to the ‘Individual Mandate’? Isn’t there a requirement that everybody gets health insurance or pay up to $2000 in penalty? (in 2017). Does it not get enforced? Are there too many exemptions? Wasn’t the whole point of the ACA to make health insurance cheaper and available to more Americans?
Whatever the reason, that means that over 800,000 people on the exchanges will have to look for alternatives and in some areas of the country, there isn’t much to choose from. You wonder how that can possibly be legal, that health insurance companies are allowed to stop providing coverage in the name of profit.
The U.S. is the only industrialized nation to rely heavily on for-profit insurers for basic health care, although profit on supplemental coverage is not uncommon in other countries. The sensible thing to do is to subsidize high-risk pools, so that companies can remain competitive. But none of that seems to be happening. It’s possible that Aetna’s notion of ‘profit’ is just too high.
But the most obvious solution for this dilemma is to bring back the ‘public option’. Back in 2009, the Democrats needed Joe Lieberman’s vote to get reform passed, and insurers knew it. Shortly before the Senate was set to vote on the bill, Lieberman said he would vote for the bill only if the public option was stripped out. They justifiably called him an ‘Insurance Puppet’, but the insurance industry got its way. “A public option plan is unnecessary,” he told Fox News. “It has been put forward, I’m convinced, by people who really want the government to take over all of health insurance.”
Opponents of Obamacare always exclaim that it will stifle competition. But what competition are we exactly talking about? Our country has about 35 health care companies that need to service a population of 320 million. Compare that to a tiny country like Holland with a population of 17 million, where there are 9 health insurance companies. That averages out to 9 million versus 1.8 million per company. Some competition…
If it turns out that Aetna isn’t actually interested in providing insurance to those 800,000 people, why not let the government step in (as Hillary Clinton is in fact proposing)?
Although my family is covered under an employer based health plan, if I wanted to, I could enroll in Medicare because of my age. That’s what the public option is. If it was available, those 800, 000 people would have a cheap, efficient and life-long alternative.
In other words, the insurance companies have us by the balls. If they pull out of the exchanges, there is no alternative. Putting in the Public Option would fill that gap. leave comment here
4 comments:
I don't have a problem with the public option (Medicare) as long as there can be a two tier system where people with private insurance or personal wealth can buy better treatment and not have to wait. Having been in Kaiser Permanente waiting rooms, I'm particularly in favor of separate waiting rooms for Fanon's "wretched of the earth" versus middle and upper classes (much like veterinarians have separate dog and cat waiting rooms).
Meant to say Medicaid above, Medicare would be too expensive.
I hope you are joking about the waiting rooms part. For your information, the public option is not the same as Mediare OR Medicaid. It would be a government sponsored insurance program the would get funded by premiums and compete with private insurance. The advantage is that it would keep prices down because of its bargaining power and it wouldn't have to make a profit.It's a no-brainer and it would break the stranglehold that the likes of Aetna has over all of us.
...preaching to the choir! Let's see what, if anything, Hillary or Barack does to address Aetna's graft.
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