Facts You Won’t See on the Nightly News – Part 2

Letter to the Editor, Submitted 10/5/10 – Des Moines Register declined to publish

In a recent editorial, the Des Moines Register criticized Iowa poll respondents who dislike the new health care reform bill for not understanding specific details in the law. Given that the legislation is over 2,000 pages long, one might forgive the public for not knowing every detail. As Nancy Pelosi famously said during the debate, “We have to pass the bill so we can find out what’s in it.” The reality is that the more people learn, the more frustrated they become.

For example, Iowa employers who have been receiving their annual health insurance renewals now understand that President Obama’s much publicized insistence that, “If you like your current plan, you can keep it” is a lie. Many of the reforms in the bill impact health plans and raise costs even if your plan can remain “grandfathered.” Still more changes will occur if your plan loses its grandfathered status, and the way the rules are set up, precious few plans will be able to avoid the costly mandates contained in the law.

The Register’s editorial chastises the public for believing that the new law would raise taxes in 2010. While it’s true the law does not create new taxes in 2010, the public is now learning that beginning in 2011, the law systematically raises taxes all over the board to the tune of $438 billion over the next ten years. Given the state of the economy, the public has a right to be concerned about almost a half trillion dollars in new taxes.
The Register editorial also points out that the law is intended to lower the deficit by $124 billion over the next ten years. But Iowans, by and large, are not suckers: they know when something sounds too good to be true, it probably isn’t. Lowering the deficit would require that we realize the almost $500 billion in savings the law projects from Medicare. However, Medicare already operates in the red, and the health care bill contains no meaningful reforms that will lower costs. Instead, Iowans understand that Congress will do what they have always done and continue to override scheduled cuts in payments to Medicare doctors and other providers. The net result? The law will not only raise taxes but also massively increase the deficit.

Iowans are also quickly learning other examples of the law’s destabilizing impact. One example – in Iowa, every carrier except Blue Cross and Blue Shield of Iowa has quit offering dependent-only coverage because they can no longer underwrite those policies. Here’s a guess: Blue Cross won’t allow itself to be the only carrier who must take on unknown risks without adequate premiums forever. And when that happens, there will be no carriers in Iowa who write dependent-only policies.

Last week, Iowans also learned that Principal is leaving the health insurance business, costing Des Moines 1,500 jobs. In addition, we learned that Iowa Insurance Commissioner Susan Voss recently asked Health and Human Services to delay the Medical Loss Ratio guidelines in Iowa until 2014. Why? Because without that extension still more carriers will exit the Iowa marketplace. Most Iowans understand the value of competition and that less and less competition in Iowa’s insurance market seems an odd recipe for lowering costs.

While the Register chastises the public for not seeing the health care reform bill through rose-colored glasses, I on the other hand give the public credit. As the public has learned more, they are starting to realize that the law will raise insurance premiums, raise taxes, increase the deficit, and leave us in worse shape than ever. Like most Iowans, I have always supported genuine reform that streamlines the delivery of health care, lowers costs, and creates a sensible, fair market. This law does none of those things and should be repealed.

Facts You Won’t See on the Nightly News – Part 1

Letter to the Editor, Submitted 5/28/10 – Des Moines Register declined to publish

Two recent events leave me wondering if there is any accountability left in government. However, those same events leave me with no doubt about how a monstrosity of a health care bill that does more harm than good has become law.

Event one: In March, Governor Culver delayed the Wellmark Blue Cross and Blue Shield rate increase to allow an outside actuarial firm can review those rates (This, after his own insurance commissioner had already completed such a review). When the outside actuarial firm confirmed the rate increases were necessary, Governor Culver announced he was “disappointed” that Wellmark’s rate increases were justified.

Hmm.

I’d like to ask the Governor just what disappointed him the most? That Wellmark wasn’t trying to cheat customers and actually knows how to price health insurance? Or the fact that Wellmark needing an 18 percent increase runs counter to the only narrative he and other politicians subscribe to – that the health care problems in this country are due to greedy insurance companies, not to rising costs of health care itself.

Governor Culver took the easy way out by creating a scapegoat out of an insurance carrier. But by focusing only on the insurance industry – instead of the primary drivers of health care costs – he has contributed to the illogical political environment that resulted in 2,500 pages of national insurance reform, which will do virtually nothing to lower health care costs.

It is absolutely true that some health insurance reform was needed. But what was needed could have been written in two pages instead of 2,500 (e.g., no more underwriting, pre-existing conditions, or insurance rescissions). The remaining 2,498 pages could have been devoted to reforms that would actually lower costs – things like tort reform, real wellness subsidies (50 percent of health care costs are attributable to preventable behaviors), and outcome-based reimbursement strategies.

Event two occurred Wednesday morning (May 26) when Senator Harkin sent an email to those who have contacted him regarding health reform. The email extolled the virtues of the new health care reform law and included one important quote:

The PPACA also establishes a process to annually review premium increases before they go into effect, as well as to require public disclosure of how the premium rates were determined. Just recently we saw the benefits of rate review in Iowa, when Wellmark Blue Cross Blue Shield attempted to raise premium rates by 30 percent. A review of these rates by the Iowa Insurance Commissioner found the hike unreasonable; as a result, the proposed increase was cut by one third, and implementation of the increase was delayed by 30 days, the longest delay available under state law.

Perhaps Senator Harkin’s staff wrote this email on “opposite day.” What the Senator sent to thousands of Iowans was an intentional deception and a thinly-veiled attempt to curry favor for a disastrous piece of federal legislation that will place extraordinary burdens on individuals and small businesses. Most important, it was a fabrication that ignores the real cost drivers behind health care.

It is unfortunate that Wellmark needed an 18 percent increase on their individual business in Iowa. And today’s high health insurance premiums create real hardships for individuals and businesses alike. No one understands that better than I do. But if we are ever going to find real solutions – solutions that would lower costs and improve quality – we need to focus on the real issues and stop with the political nonsense.