Insurance 101

ObamaCare and Insurance 101. It may be a bit dry, but this is the problem with it and why the claims of lower premiums was such a lie and why this whole thing was either a scam or more pie-in-the-sky feel good liberalism taking a piss on reality.

So the Democrats have started working on what if it’s struck down:

Under the law, insurers would still have to accept all applicants regardless of health problems, and they would be limited in what they can charge older, sicker customers.

As a result, premiums for people who directly buy their own coverage would jump by 15 percent to 20 percent, the Congressional Budget Office estimates. Older, sicker people would flock to get health insurance but younger, healthier ones would hold back.

To forestall such a problem, the administration asked the court – if it declares the mandate unconstitutional – to also strike down certain consumer protections, including the requirement on insurers to cover people with pre-existing health problems. That would mitigate a damaging spike in premiums. (AP)

So the administration wants the parts that they say “the people love” to be struck down to mitigate the damage. Fascinating… 🙂

Kind of like the Mandate was going to be great for everyone, then 1700+ waivers, mostly to unions, were granted because it was going to hurt these people.

And of course, it wouldn’t be there fault when grandma gets thrown off a cliff and run over by the bus! 🙂

Mind you, as I have said since this whole thing started that ObamaCare was designed to destroy the private insurance industry and replace it with nothing but government controlled insurance anyhow.

Adverse Selection: It describes a situation where an individual’s demand for insurance (either the propensity to buy insurance, or the quantity purchased, or both) is positively correlated with the individual’s risk of loss (e.g. higher risks buy more insurance), and the insurer is unable to allow for this correlation in the price of insurance. This may be because of private information known only to the individual (information asymmetry), or because of regulations or social norms which prevent the insurer from using certain categories of known information to set prices (e.g. the insurer may be prohibited from using information such as gender, ethnic origin, genetic test results, or preexisting medical conditions, the last of which amount to a 100% risk of the losses associated with the treatment of that condition). The latter scenario is sometimes referred to as ‘regulatory adverse selection’.

The insurance company is unable to screen out “pre-existing conditions” so premiums will be higher simply because people with conditions that will cost more than the premium can charge will rush to the door and flood the system thus causing a financial hardship on the company. Thus premiums will inflate to cover this.

This has always been one of the factors in ObamaCare that made me laugh when they said premiums would go down.

That is simply NOT POSSIBLE with “pre-existing conditions” mandated.

But does that mean that people like this are just left out in the cold by mean old, greedy insurance companies?

No.

There are risk pools for that. Pools usually subsidized for their high risk, much like Flood is or that idiot driver that you can’t refuse auto insurance to even though they’ve had 5 DUI’s in the year (yes, that does really happen- rare, but it does happen).

2010: Last year, Charles Baker, former CEO of Harvard Pilgrim Health Care, one of Massachusetts’s largest health plans, noticed some health insurance brokers posting comments on his widely read blog. They were suspicious that people were applying for health coverage after a medical condition developed, got the care they needed, and then dropped the coverage.

From April 2008 to March 2009, 40% of the individuals who applied to Harvard Pilgrim stayed covered for less than five months. Yet claims were averaging about $2,400 a month, about six times what one would expect.

Blue Cross and Blue Shield of Massachusetts has now confirmed it is experiencing similar problems. The company says that in 2009, 936 people signed up for three months or less and ran up claims of more than $1,000.

And that’s just Two Examples. Just Two. From 2010. Imagine the Future.

Furthermore, if there is a range of increasing risk categories in the population, the increase in the insurance price due to adverse selection may lead the lowest remaining risks to cancel or not renew their insurance. This leads to a further increase in price, and hence the lowest remaining risks cancel their insurance, leading to a further increase in price, and so on. Eventually this ‘adverse selection spiral’ might in theory lead to the collapse of the insurance market.

And ObamaCare does this in spades, but with the Mandate in place these lowest risk individuals are not allowed to cancel and assume their own risks. Not without a penalty and a visit from an IRS agent that is. But if the penalty is less than the premium then you just keep gaming the system.

To counter the effects of adverse selection, insurers (to the extent that laws permit) ask a range of questions and may request medical or other reports on individuals who apply to buy insurance, so that the price quoted can be varied accordingly, and any unreasonably high or unpredictable risks rejected. This risk selection process is known as underwriting. 

That’s why now a policy can be cancelled by Underwriting if it is found you made fundamentally false statements because it has to be assumed at the time of the contract that both parties are acting in good faith.

Mandates increase a moral hazard is a situation where there is a tendency to take undue risks because the costs are not borne by the party taking the risk.

Uber Liberal Economist Paul Krugman described moral hazard as “any situation in which one person makes the decision about how much risk to take, while someone else bears the cost if things go badly.”

Aka, you and higher premiums.

Also you get high premiums from what could be called REGFARE (aka Regulatory Warfare) and boy does the Obama Administration love using this with HHS, The EPA, The FCC, the IRS, Justice Dept., ad nauseum.

In insurance markets, moral hazard occurs when the behavior of the insured party changes in a way that raises costs for the insurer, since the insured party no longer bears the full costs of that behavior. Because individuals no longer bear the cost of medical services, they have an added incentive to ask for pricier and more elaborate medical service—which would otherwise not be necessary. In these instances, individuals have an incentive to over consume, simply because they no longer bear the full cost of medical services.

And does this not sound like ObamaCare to you?? :)

Example: if you know you have terminal cancer and you buy insurance to cover your last 6 months but don’t disclose this to the insurance company (“pre-existing condition”) the company will be paying 10’s of thousands of dollars in claims potentially with virtually no premium to cover that.

Now multiply that by millions of people. The 30 million uninsured. They may not all have this intent, but the scale is still relevant and the effect is too.

Are you starting to see the problem here and how ObamaCare was meant to subvert it?

And if it’s struck down, the Democrats will just come back with another pig and new lipstick.

Being able to decide who lives and who dies and to control every facet of your life “to cut your costs” (Food Police anyone?) is the Holy Grail of Liberalism so they won’t give up if even if it’s unconstitutional. They’ll just re-brand it and call the pig by another name but the effects will still be the same though.

LAWFARE. Waging a war by lawsuits and REGFARE, waging war by regulation and subversion of Adverse Selection and Moral Hazard.

That’s the Insufferably Morally Superior Left in a nutshell.

So endeth the lesson.

Political Cartoon by Chuck Asay
Political Cartoons by Lisa Benson

Political Cartoons by Glenn Foden

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s