Obamacare and Religion
I am getting a bit tired of hearing all the rhetoric around
the recent mandate by HHS that all health plans provide contraception etc.
under the Obamacare law.
First did no one read this monster when it was passed? I
have been talking with faith based organizations about this segment of the law
since 2010. Did folks just think that this segment of the law was going to
miraculously go away? Just like so many other sections of Obamacare this is
another example of government over reaching in its regulations.
Here are the basics. The law says that all health plans have
to provide coverage for contraception and abortion services by 2014. Faith
based companies and other employers are clearly upset by this. The outrage
seems clearly focused on the federal government trying to mandate that plans
offer contraception even if they don’t wish to base it on religious beliefs.
While I too am outraged at such presumption and hubris on the part of the Obama
administration, we have much bigger problems.
The most serious of them is that the federal government is
trying to circumvent existing legislation and regulation of certain health plans
and force them to provide specific coverage. Specifically the feds are trying
(and might be succeeding) in circumventing ERISA. A self-funded employer today
has the choice of what benefits they want to offer in their health plans – as
they should. This right is provided for under the terms of the ERISA
regulations. Since 60% of all insured Americans are in self-funded plans this
represents a massive shift in the private health insurance industry. It also
sounds the alarm that our current administration has decided it is going to
override ERISA and remove some of the founding principles without public or
congressional approval. This is huge.
Let me be more specific. If Obamacare can decide at will
what benefits will be federally mandated and can force those benefits into self-funded
and insured plans then defacto we have a federal health plan or certainly the
infancy of socialized healthcare. This is nothing short of outrageous.
So while I empathize with the religious groups and
understand their indignation, the problem is actually bigger and much more
devastating than just a difference in beliefs. We can’t run a competitive
society if our largest industry is about to become a federal bureaucracy. Look
at the condition of the Social Security and Medicare programs. Do we really
think in our current economic condition nationalizing healthcare is a prudent
fiscal strategy?
Some may argue that now is the perfect time as we can cut
costs and thus be more competitive on the world stage. Sadly this reasoning is
fraught with several fallacies. First is that we can cut costs. When has a
government run program of any kind been lower cost than a private sector
venture? How long of a transition will this process be – 5 – 10 years? What
happens to our economic results in the interim? How competitive will be during
this transition? What will the national plan do that we can’t do privately?
Sadly it will eventually implement all the reforms I have been advocating for
more than a decade and maybe even more. Here are a few – they will quickly
eliminate all PPO networks and opt for Medicare based pricing; they will ration
healthcare over time; they will establish parity in drug pricing globally; they
will decrease if not eliminate broker compensation; and they will eliminate
state mandates in favor of a new set of federal mandates.
All of these reforms could be done in the private sector
with the result being a rampant decrease in healthcare costs and a significant
decrease in annual healthcare inflation. More on this is a subsequent blog.
So as the debate rages on Obamacare versus the religious
organizations remember that this is the beginning of a very serious paradigm
shift in healthcare reimbursement in the US and the impact on our economy will
be devastating and long lasting.