Saturday, September 20, 2014

Market efficiencies

The ACA, by design, keeps the insurers involved in determining the cost of your health care.  This happened because we didn't want a "Big Gubmint takeover of healthcare."  The argument there was business people are good at finding "efficiencies" which Gubmint people are not. Insurers, being all business-minded and whatnot, are going to find the most efficient way to succeed at their business. 

Which is fine, except for the fact that the insurance business is not actually about providing you with health care. Instead it's about taking bets on when you're going to get sick or die and profiting from those bets.
The editorial comes several months after two advocacy groups filed a complaint with the Office of Civil Rights of the United States Department of Health and Human Services claiming that several Florida health plans sold in the Affordable Care Act marketplace discriminated against HIV patients by charging them more for drugs.

Specifically, the complaint contended that the plans placed all of their HIV medications, including generics, in their highest of five cost tiers, meaning that patients had to pay 40 percent of the cost after paying a deductible. The complaint is pending.

“It seems that the plans are trying to find this wiggle room to design their benefits to prevent people who have high health needs from enrolling,” said Wayne Turner, a staff lawyer at the National Health Law Program, which filed the complaint alongside the AIDS Institute of Tampa, Florida.

Turner said he feared a “race to the bottom,” in which plans don’t want to be seen as the most attractive for sick patients. “Plans do not want that reputation.”
I'll say this for them. They are very good at what they do.  Not sure why we want them to keep letting them do it, though. 

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