Right Thinking From The Left Coast
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Thursday, March 10, 2011

The Latest Obamacare Wrinkles

Two new stories today.

First, the HHS is granting another one of their healthcare waivers.  This time, they are granting it to ... the entire fucking state of Maine:

The federal government Tuesday granted Maine a waiver of a key provision in President Barack Obama’s health care overhaul, citing the likelihood that enforcement could destabilize the state’s market for individual health insurance.

The U.S. Health and Human Services department said in a letter it would waive the requirement that insurers spend 80 cents to 85 cents of every premium dollar on medical care and quality improvement. Instead, the letter said, the state could maintain its 65 percent standard for three years, with the caveat that HHS intends to review the figures after two years.

The decision makes Maine the first state to receive a waiver of the requirement. Similar requests are pending from Kentucky, Nevada and New Hampshire.

The 80-85% figure was one that Congress pulled mostly out of their ass.  It has nothing to do with any realistic evaluation of the health insurance industry (or of federal programs, which falsely claim absurdly low administrative costs).

But it gets better.  Several friends in medicine have been complaining about people getting doctor’s appointments to get prescriptions for OTC medicine like Tylenol.  Why?  Because some congressional staffer slipped in a provision that eliminated reimbursements from flexible spending accounts for OTC medicine.  So people who use lots of OTC meds—e.g., any household with more than zero children or adults over the age of 30—is going to the doctor and spending more healthcare money to get pointless prescriptions.  Correction: they’re spending more of their insurer’s money—to them it’s only a $10 copay.


1. This is the sort of thing that happens when you have a massive bill, which nobody has a chance to read and evaluate front to back before it is passed. Instead, you get small groups working on little pieces and if they miss something you get screwed. This is precisely why major legislation needs to be posted on the internet several days before the vote.

2. I’ve always believed that health care reform requires consumers to make choices about how they spend their money. The flexible-spending accounts have the potential to do just that. But the rules of the game ought to be designed to encourage people to make decisions that lower health care costs, not to impose new ones.

3. It’s sort of appalling that this huge change came because one Senate staffer told an anecdote about how he would buy Prilosec instead of a prescription alternative.

It’s increasingly clear that the Democrats did not do anything approaching due diligence in passing one of the most massive bills in American history.  The 1099 provision (still not removed), the waivers, the underused coverage pools, almost canceling their own insurance—these are not things that happen to people who legislate carefully.  The Democrats were so desperate to pass something, anything that they just shoved this unholy, clinking, clanking, clattering collection of colligenous junk through.

It can’t be repealed with Obama in office, and probably not without 60 Republicans in the Senate, which is unlikely to ever happen.  What the GOP needs to do is start from scratch, design their own bill and start working it through.  Paragraph 1 section 1 should read: “Take the PPACA behind a barn and hit it with an axe.”

(Or maybe “lock it up in Harley’s farmhouse”.)

Posted by Hal_10000 on 03/10/11 at 10:35 PM in Health Care  • (0) TrackbacksPermalink
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