Soar Like My Healthcare Costs

“The Supreme Court announced [December 19^th] that it will use an unprecedented week’s worth of argument time in late March to decide the constitutionality of President Barack Obama’s historic health care overhaul before the 2012 presidential elections.” Washington Post, December 19^th. A full week of arguments never happens. With massive unemployment (where health insurance benefits, where they existed, end), half the workforce at a Census Bureau “low income or less” level, and average premiums rising 9% in the last year, you’d think that this denigration in finding affordable health insurance would be more in everyone’s focus. Instead, the deficit (yes, it’s related) and tax policy seem to dominate the headlines, even as the Supreme Court is set to take on the pejoratively-labeled Obamacare legislation, which the GOP is planning to repeal (if the Supreme Court allows it to exist) “when we get elected.”

The “pre-existing conditions” and “lifetime cap” provisions don’t go into effect until 2014, and the mandate for states to create healthcare “exchanges” by January 1^st of that year – where insurance coverage is pooled and information about rates and other options is made available to the public – is being ignored by most states, either because they lack the funding or because they oppose the mandate (and believe the Supreme Court will toss out the legislation anyway). There is an undercurrent that if the states fail to provide this massive organizational benefit (with a huge computer database that has to be generated), the federal government may opt to step in and substitute its version of an exchange instead of suing and trying to force the states to live up to their mandate… assuming that the law survives the legal challenge.

Since state exchanges would be electronically linked to a national system anyway, this alternative structure is not so far from what would effectively happen anyway. The difference is that by allowing the feds to step in and create this bigger exchange, states that are opposed to national healthcare would effectively be helping move that policy into existence by ceding any power they might be able to exercise with a state-sized exchange that they would control.

What’s going on in the real world? “Matt Salo, executive director of the National Association of State Medicaid Directors, said computer systems in some states are old and may need substantial upgrading. There is some doubt, he said, about whether there is enough “physical capacity in the IT systems world” to get it all done in time.‘Our members have been having conversations with the vendors since the law was passed, and they are coming to the gradual conclusions that no, they don’t have the capacity to do this everywhere in the time frame,’ Salo said.

“Political threats also abound. No one knows whether the Supreme Court will invalidate part or all of the law next year; it is not clear how much funding will be available to launch and operate the federal exchange; and the outcome of the presidential and congressional elections could delay or derail the entire process… Although federal officials are saying very little about their progress, they have signed contracts worth more than $150 million with several private contractors who are working on creating the federal exchange. Last month, Oregon’s top insurance regulator, Teresa Miller, was hired by [the Department of Health and Human Services] to oversee development of health-insurance exchanges.” Washington Post, December 16^th. By opposing the legislation and not preparing for its implementation, we may be one giant step closer to true national healthcare. Clearly, the biggest failure of all attempts at healthcare has been the rather complete inability to contain costs.

I’m Peter Dekom, and in these perilous economic times, too many Americans are falling by the wayside and being ignored by the terrified remaining folks who remain in the middle class.