Election issues for adjusters: Part 2
The entire medical insurance issue is one for Congress, not the presidential candidates.
From the Democratic debates, it is quite evident that health insurance will be a major point in the 2020 election. The “moderates” want to retain what is left of the old Patient Protection and Affordable Care Act (“Obamacare”) and make improvements to it, while the “progressives” want to throw it out and have “single-payer” or “Medicaid for all.” We’ve addressed this before.
Being on Medicare, I’m aware of how wonderful it is. One goes to the doctor, shows his Medicare card, and the doctor pokes and probes, no billing. Well, not quite. There’s also a Medicare Supplement Policy at $4000 to $7000 a year, and at least one bill a month from the doctor for what those two programs don’t cover, usually a “co-pay” or “deductible.” Plus, there’s another few thousand for a prescription coverage premium called “Medicare Part D,” and that comes with deductibles, co-pays, and what is delightfully called “the donut hole.” (Some donut … insureds provide the dough!) None of these cover dental bills, eyeglasses, or the cost of hearing aids. That’s all extra. And if you are wise, you’ll also have an “excess medical policy,” in case expenses exceed what Medicare and the supplement will pay.
The costs candidates never mention
So, who does this “Medicare for all” really benefit? The first group that comes to mind are the fraudsters who rip off Medicare, Medicaid, the health insurance industry and casualty insurance industry for well over $100 billion annually. The proponents of these programs suggest the savings will come from reducing the administrative costs incurred every time you go to a doctor, who has to hire five clerks to handle your insurance claims, and the insurer that has to hire five more to process your claim. But nobody at the Medicare office or the health insurer ever checks to see if you actually went to that doctor with a case of terminal halitosis.
Of course not! In the 21st century, we simply run the billing with artificial intelligence, and it handles the payment all by itself. That’s a lot of unemployment. Is that why these “Medicare for all” opponents are saying it will cost $30 trillion over 10 years?
What was so bad about the Affordable Care Act? It has all sorts of options, and, had it not been jinxed by Congress and the Courts, would have worked well. Those using it would pay a premium rather than a tax (although the Supreme Court deemed it a “tax”). The hullabaloo was about the “mandate.” You had to get insurance or pay a penalty! Why don’t we bellyache about having to buy uninsured motorist coverage? Or mandatory auto liability insurance? Or workers’ compensation for employers?
The closest America currently has to “single-payer” health coverage is the Veterans Administration. Like Sarah Palin, the 2008 Vice Presidential candidate from Alaska, might have asked about the VA medical program, “How’s that workin’ for yah?”
The first principle of insurance is spreading the risk among many homogeneous exposure units. The entire medical insurance issue is one for Congress, not the presidential candidates. It’s a red herring, like flag burning, abortion or some other nonsense that directs our attention away from the real issues of foreign policy, global warming and other topics.
Ken Brownlee, CPCU, ARM, (kenbrownlee@msn.com) is a former adjuster and risk manager based in Atlanta, Ga. He now authors and edits claims adjusting textbooks. Opinions expressed are the author’s own.
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