Insurance corporations set to reap profits from health reform without solving crisis

By Richard A. Damon, M.D.
The Missoulian, Letters, Nov. 4, 2013

The greatest scam ever was allowing health insurance corporations to write the federal health law (Affordable Care Act). After enhancing their profits, the government and non-profit groups are marketing their shoddy products. Billions of public dollars have been expended to create new health insurance markets, advertise and solicit buyers. Strange that we would permit this since for 40 years our market-based health care system has not worked effectively or efficiently. Insurers compete by selling policies to those who are the healthiest, and deny or restrict coverage for those in need. The impression that insurers will change tactics is false, because they have cleverly worked around intended regulations. The law is designed by and for the health industries that profit from the current health system. Regulations can be circumvented or waived. Insurers can continue to find innovative ways to avoid the sick and paying for care.

ACA fails to solve the health care crisis.

It leaves tens of millions without coverage. It lowers the bar on what is acceptable insurance coverage. It continues the problem of financial barriers to care. It circumvents the requirement to cover pre-existing conditions. Insurers are restricting their marketing networks by avoiding areas of large medical centers and public hospitals where sick people accumulate, and limiting the number of providers. It has given insurers thousands of waivers from Health and Human Services to exempt them from requirements. One is the cap on consumer out-of-pocket spending; insurers claim “their computers are not ready to handle the caps.” We can expect higher premiums, lower coverage, and change of minimum benefit levels. It shifts funding from small hospitals to subsidize private insurance. It allows consolidation of health facilities by for-profit entities. It boosted payment to Medicare Advantage plans paying insurers exorbitantly.

Space doesn’t permit more.

The real solution is HR 676, Medicare for All.

Dr. Richard A. Damon lives in Bozeman.