ObamaCare’s Hidden Trigger Paves The Way For Single Payer

When ObamaCare was passed conservatives slammed it as a government takeover of the health insurance industry and progressives complained the law didn’t offer at the least a public option, but it seems as though that the law had a hidden trigger that may very well pave the road to single payer health insurance system or Medicare for all. That trigger is the medical loss ratio. This is the part of the law that makes the health insurance industry use at least 85% of your premiums to cover medical expenses. This is something the for profit health insurance industry detests, because it limits the amount of dollars you pay into the system to go toward CEO pay, bonuses, lobbying and advertisements.

Listen here to my interview with Rick Unger,

Well, it turns out that the MLR (Medical Loss Ratio) is working rather quickly. In Rick’s latest article

“Among the many companies that are dropping out of the business —rather than comply with the MLR requirements that would force them to actually spend an appropriate share of the premium monies received from customers on real health care— are some of the nation’s largest carriers.

Principal Financial Group had already announced late last year that they were leaving the health insurance business, impacting on some 840,000 insured.

Another key player in the business, Cigna, has decided to quit the small business market in states like California, Connecticut, Florida, Georgia, Hawaii, Illinois, Kansas, Missouri, New Hampshire, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Texas and Virginia. In Colorado and Michigan, insurance giant Aetna is bailing on both the small business and individual markets.”

In fact, even further into the MLR requirements is the fact that Aetna is estimating they will have to pay out $100 million dollars to their subscribers in 2012 for failing to meet the 85% threshold.

As more and more health insurance companies refuse to use 85% of their billions of dollars in premiums to pay for your medical care, they will drop off the face of the earth and will ultimately pave the way for the American government to expand Medicare for everyone.

33 Replies to “ObamaCare’s Hidden Trigger Paves The Way For Single Payer”

  1. Yes, but the time period between now and the expansion of Medicare to all could be pretty rough as insurers drop out of the market and you have genuine scarcity of available medical insurance. When Aetna leaves Michigan, are we certain that their insureds will be picked up by the existing HMOs, disability insurers or Blue Cross Blue Shield of Michigan? Do we really think that the anti-Medicare / anti-Social Security crowd will take positive steps for something as trivial as suffering among the citizenry? Crises are unpredictable catalysts for change.

  2. that sounds like a plan to me. There is absolutely no excuse why we are this many years behind the rest of the world.

  3. Take a look at the exchanges that have been implemented so far (with more to come) at http://www.healthcare.gov/

    These will help those who lose their health insurance during the transitional phases, and have been helping people with pre-existing conditions and other insurance issues.

  4. The logical expansion is the High Risk Pool now for those over 133% of the Federal Poverty Level. Already rules are changing – you do not necessarily have to wait 6 months if you get dumped, and the premiums are pretty affordable (around $300-400 per month depending on where you live and your age) compared to private insurance that can be 3-4 times that high. MANY people are gravitating into it, especially those on COBRA that costs the earth. The gap is in the subsidy – with a maximum of 9% up to 400% FPL, that is not yet due to kick in until 2014 which makes FAMILY coverage very difficult. If we retake Congress with a family-friendly rather than corporate friendly body, perhaps those rules will also change? Maybe we can have this kick in a year earlier. It’s worth pumping for – this administration has been VERY supportive of what is best for people. Also – remember that Obama and HHS have promised that when Vermont finalizes its proposed single payer plan, it will become the state option. CA needs to get on board, too – there is a bill pending, and it needs to move forward. We can secure that waiver IF we get our act together here. As it becomes clear that this is the best choice, more states will follow, but in the meantime, the High Risk Pool – which IS a public option – offers hope for millions including those in Michigan.

  5. Thank you for posting the link – I forgot to add that. This is a great site for getting the best information on what is available in your own state.

  6. We’re this far behind the rest of the world because we haven’t spent ourselves into default…that’s coming (as well as poor healthcare) when obamacare comes fully into effect.

  7. The critics of this man need to learn patience. He really is doing what he said he would do, and right under the noses of the GOP.

  8. Wrong. Affordable Care Act will lower our deficit and the amount we are now paying for those without insurance(read billions here) Countrys with universal health care are far better off than we are during this financial crisis

    Thats an argument you will lose every time

    BTW fingers, the countrys with universal healthcare are consistently voted as having the best healthcare. See the Netherlands, France and other countrys.Get off the talking points

  9. I’m 100% behind Sally. I am VERY satisfied with this President.

    I believe with all my heart he’s for the People of the United States- and he’s made some tough choices that I don’t always agree with, but I also understand he has many more factors to work through than I could even dream exist.

    We gotta fight to get him back in there to finish the work.

  10. Your statement has so many errors that it’s rather hard to decide where to begin.

    I think the main point you need to understand is that the problem with the other countries is not that they spent themselves into default by helping the ordinary people, but because they have a much worse gap between the rich and the rest than this country. Even as that’s one of the main causes of the problems in this country, the gap between the rich and poor has already brought other countries to default.

    Their 1%, from what I’ve read, get even more from their government than the 1% in this country, and return far less. THAT is what really caused the default.

    (That’s a warning for you if you support the Republicans.)

    Regarding health care, the other countries spend far less than ours does and their healthcare system is vastly superior to this one (especially for the ordinary people). The working environment for both doctors and nurses is much better (they only have a fraction of the turnover problems found in this country, and caregiver burnout is by report not much of an issue, totally unlike American medicine).

  11. damnfingers
    another faux snooZe viewer navigates to the wrong blog and thinks he can spew his BS talking points here….ummm NO!

  12. It is amazing how brilliant Obama is in outmaneuvering the Republicans…of course, he hardly has worthy opponents…

  13. I say good riddance to those bad companies who make excessive profits in healthcare. The Republicans, of course, will say that “Obamacare” is a “job-killer” when actually it is our dysfunctional healthcare delivery system that is the real killer, of people, not jobs.

  14. Serious question and let me first pose, until Obamacare is in full swing, I do not know how I feel about it. But as I read this, the first thought that did pop into my head was….there goes a lot of jobs, quickly. My second thought was bad companies are normally replaced by good companies or good companies can expand = jobs. Here is my question though, isn’t telling insurance companies that they are only allowed to spend 15% of the money we pay in on overhead the equivalent of us spending 85% on our home mortgage/rent? In other words, I am asking (because I may truly not understand)is that 85% to be used for everything other than payroll? And if not, you need to excuse me, but can you please give me an example of any other business where overhead is under 15%. I completely agree that everyone in this country should be entitled to health insurance, companies should not be able to reject people based on previous health care options, etc…I am just undecided on if a government take over is truly the best option and would like to be more informed.

  15. I live under single payer. It’s really rather good and vastly better than the lies you have been told about it. America could do far worse than adopt some form of single payer system.

  16. The overhead for the NHS (which is actually very good and a lot better than you’ve been told) is under 7%. There is nothing sacred about the free market and this is one area where government takeover would be vastly better.

  17. Here’s a copy of a letter from Alan Grayson, running to reclaim his House seat in Florida, about what the Flavor of the Minute Rick Santorum has to say about healthcare:

    Maybe I should leave it alone. Maybe I should just let Rick Santorum enjoy the 15 minutes of fame that comes with getting 30,000 Republicans to vote for you. (Less than one-hundredth of one percent of the U.S. population, by the way.)

    But there is something that Rick Santorum said last month that really bothers me. And I’m going to tell you what it is.

    On December 5, Santorum was talking to a group of about 100 students at Dordt College, a small Christian college in Iowa. A student referred to a 2009 Harvard study showing that 44,000 Americans die each year because they don’t have health coverage. The student then asked Santorum what that meant for the Christian responsibility of caring for the poor. Specifically, the student questioned whether “God appreciates the fact” that all those Americans die each year for lack of healthcare.

    Santorum’s response? Rick Santorum “rejects” the idea “that people die in America because of lack of health insurance.”

    Wake up, Rick.

    The student was referring to the same study that I publicized on the Floor of the House two weeks after it was published in the American Journal of Public Health. Here it is. It documents that 44,789 Americans die each year because they have no health insurance. In fact, if you take two Americans who are physically identical – same age, same gender, same race, same weight, same smoking history – and one of them has health insurance and one does not, then the one without health insurance is 40% more likely to die h year.

    Here is a link to my speech on this, entitled “I Apologize to the Dead and Their Families.”

    I remember the same response from right-wingers then as we hear from Santorum today – anyone can go to an emergency room. I ask them to show me an emergency room that will provide chemotherapy to a cancer victim. There isn’t one.

    But to answer that challenge, I started a website called http://www.NamesOfTheDead.com. I invited surviving family and friends to tell me about people whom they had loved and lost, because they had no health coverage. And they did – thousands of them. I read some of their stories on the House Floor.

    Then I gave a speech identifying how many people died each year for lack of health care in each district represented by a Republican healthcare opponent. The Republicans interrupted that speech for two hours, until the House Parliamentarian told them that they had to let me continue. A reporter who has covered Capitol Hill for more than 25 years told me that that kind of interruption had never happened before.

    But Rick Santorum apparently never got the memo. He thinks that no one in America ever dies because he has no health care.

    Why does Santorum think that? Because he has to. He has to engage in flat denial of the reality that 50 million Americans – one out of every six of us – face each day. Because to face that reality would mean that Santorum would have to face the brutality, the swinishness, the cruelty and the savagery of the policies that he so enthusiastically espouses.

    For God’s sake – every single other industrialized country in the entire world has universal health care. Why can’t we? How many more people have to die? How many more sacrifices on the altar of Almighty Greed?

    Any health care system that denies necessary care on the basis of wealth is evil. It doesn’t matter how you micromanage it, or tinker with it. It’s evil.

    When Justice Harry Blackmun began voting against death in every death penalty case, he gave this simple and eloquent explanation: “From this day forward, I no longer shall tinker with the machinery of death.”

    We need to reach the same kind of realization in health care. Forget about the tinkering. This is America, not Myanmar. People who are sick need to be able to see a doctor. Because we are human beings, not cattle. End of story.

    Are you listening, Rick Santorum?

    Alan Grayson

  18. Thank You Alan Grayson,

    I really appreciate your providing us with the truth that counters Republican lies. I will do all I can to support your election in Florida. I don’t have much money, since I live on my “entitlements for Social security and medicare, but you are one of the very few to whom I will send my small offerings. Please continue in your role of National Conscience.

  19. Sorry, but Spain has one of the best healthcare systems in existence and didn’t have to borrow anything to pay for it. In fact, it wasn’t the socialist government that got it into the HOT MESS it is currently in. It was the banks giving too much credit to the citizens of Spain. The government of Spain, up until the economic collapse caused by the BANKS of the world, had borrowed next to no money. Once the collapse started to happen, the government was forced to borrow to cover the banks bad debt. Now the people are blaming it on the socialist president instead of their own bad borrowing habits and the banks bad lending practices.

  20. What you are forgetting is the poor reach emergency rooms and guess what, the local communities – cities and counties have to pay for them. Thus, the GOP is trying to shift federal responsibility to local entities and most stupid people never understand they will pay more property taxes to support the uninsured in one way or other. So, try to understand the broad picture and ask yourself insightful questions. Don’t forget that your ancestors came as poor and look you now, how rich you are yet forget your past!

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