Understanding The Anger Over Healthcare In One Picture

Authored by Mike Shedlock via MishTalk.com,

Healthcare costs have soared. Obamacare failed to live up to its promises. And my lead image dramatically understates the problems with costs…

Data from the BLS, chart by Mish

Changes Since 1983

• CPI: 208 percent
• Medical Care Services: 505 percent
• Hospital Services: 975 percent
• Medical Care Commodities: 308 Percent

Changes Since Obamacare Started

• CPI: 41.28 percent
• Medical Care Services: 77.98 percent
• Hospital Services: 77.98 percent
• Medical Care Commodities: 29.94 percent

Understanding BLS Calculations

The numbers look bad but they are much worse than they look because of the way the BLS calculates the CPI.

On all CPI calculations, the BLS only counts costs directly paid by consumers.

To the extent corporations and Medicare are obscuring more of the costs, the CPI numbers are understated.

Health Insurance Coverage 2023

• Employment-based insurance: 54.5% of the population
• Medicare and Medicaid: 18.8% of the population
• Direct-purchase coverage: 9.9% of the population
• TRICARE (Active Military Service): 2.4% of the population
• VA and CHAMPVA coverage: 1.0% of the population 

The above is an AI-generated response. It totals 86.6 percent.

Census. Gov says that in 2022, 92.1 percent of people, or 304.0 million, had health insurance at some point in the year.

Those in various Medicare plans have seen smaller increases than those buying insurance for themselves.

And the cost of direct pay is outrageous. Large corporations can get better deals than smaller ones.

The BLS averages this all in to arrive at the numbers posted in the chart. Heaven help anyone paying for their own insurance who gets cancer or other serious needs.

Rolling the Dice

Obamacare penalizes young and healthy for the benefit of those older and with conditions.

Young adults not working for a company that provides health care benefits frequently opt out. No one can blame them.

ObamaCare Con

The Wall Street Journal discusses the ObamaCare Con

Progressives are at last acknowledging that ObamaCare is a failure. They aren’t doing so explicitly, of course, but their social-media screeds against insurers, triggered by last week’s murder of UnitedHealthcare CEO Brian Thompson, suggest as much. “We’ve gotten to a point where healthcare is so inaccessible and unaffordable, people are justified in their frustrations,” CBS News medical contributor Céline Gounder said during a Friday segment on the roasting of health insurers.

Remember Barack Obama’s promise that if you like your health plan and doctor, you could keep them? Sorry. How about his claim that people with pre-existing conditions would be protected? Also not true. The biggest howler, however, was that healthcare would become more affordable.

Grant Democrats this: The law has advanced their political goal of expanding government control over insurers, in return for lavishing Americans with subsidies to buy overpriced, lousy products. (One might observe that Democrats are driving a similar Faustian bargain to induce automakers to produce more electric vehicles.)

One problem is that simply having insurance doesn’t change people’s behavior. It does, however, cause them to use more care. This is a particular problem in Medicaid, since beneficiaries often rush to the emergency room for nonemergencies because they don’t have deductibles or co-pays.

Another problem: The nearly 100 million Americans on Medicaid or tightly regulated and generously subsidized exchange plans struggle to find doctors to treat them. Physician access for Medicaid patients has long been limited owing to the program’s low reimbursement rates.

It has gotten worse since ObamaCare expanded eligibility, as states have tried to hold down Medicaid costs by reducing reimbursements. A 2019 study found that patients were only half as likely to get an appointment with a doctor compared with privately insured patients before the law passed. Post-ObamaCare, they were less than one-third as likely. Medicaid is insurance in name only.

Patients with exchange plans hardly fare better. Affordable Care Act plan networks include on average only 40% of local physicians and 21% of those employed by hospitals. Patients must pay significantly more out of pocket to see out-of-network doctors. If you find a doctor in network, there’s no guarantee he’ll continue to be. Insurers are narrowing coverage to keep down costs.

They are also hiking deductibles, which this year averaged $5,241 for a typical plan. That’s up from $2,425 in 2014. Although subsidies reduce how much people with ObamaCare plans pay toward their premiums, they are stuck paying out of pocket until they hit their deductible.

Most healthy young people never do. That means their insurance is worthless except in the event of a catastrophic emergency, which was the gist of recent rants against insurers. Perhaps they should take up their grievances with Mr. Obama, since his law’s mandates and regulations are to blame.

ObamaCare requires plans to cover myriad government-determined “essential benefits” regardless of whether people need them. It also prohibits insurers from charging higher premiums based on a patient’s health-risk factors and limits their ability to do so for older people. The young and healthy are thus required to subsidize their elders, while taxpayers are required to subsidize everyone on the exchanges.

The WSJ noted “states have tried to hold down Medicaid costs by reducing reimbursements.”

Everyone else pays more because if it. Wait times and the struggle to find a doctor who takes Medicaid are not factored into the CPI at all.

‘This Is A Warning’: Warren, Sanders Address Sympathy For UnitedHealthcare CEO Killing

The Huffington Post reports ‘This Is A Warning’: Warren, Sanders Address Sympathy For UnitedHealthcare CEO Killing

Two of the biggest critics of the U.S. health care system condemned the assassination of UnitedHealthcare’s CEO Brian Thompson while calling out “vile” insurance company practices aimed at maximizing profits.

“The visceral response from people across this country who feel cheated, ripped off, and threatened by the vile practices of their insurance companies should be a warning to everyone in the health care system,” Sen. Elizabeth Warren (D-Mass.) told HuffPost in an interview on Tuesday when asked about the cold response to Thompson’s death, which included celebratory posts on social media.

“Violence is never the answer, but people can be pushed only so far,” Warren added. “This is a warning that if you push people hard enough, they lose faith in the ability of their government to make change, lose faith in the ability of the people who are providing the health care to make change, and start to take matters into their own hands in ways that will ultimately be a threat to everyone.”

After drawing some criticism for her remarks, Warren clarified her comments in a statement provided to HuffPost on Wednesday.

“Violence is never the answer. Period,” the senator said. “I should have been much clearer that there is never a justification for murder.”

Sen. Bernie Sanders (I-Vt.) called Thompson’s killing “outrageous” and “unacceptable” before similarly criticizing insurance company practices.

“I think what the outpouring of anger at the health care industry tells us is that millions of people understand that health care is a human right and that you cannot have people in the insurance industry rejecting needed health care for people while they make billions of dollars in profit,” Sanders said.

Sen. John Fetterman (D-Pa.) also criticized “vile” social media posts for celebrating an “assh*le that’s going to die in prison.”

“If you gun someone down that you don’t happen to agree with their views or the business that they’re in, hey, you know, I’m next, they’re next,” he added. “And people want to celebrate it. It’s twisted.”

It’s Twisted

Government meddling is one of the reasons healthcare is so expensive.

Obamacare failed across the board. And it did so by creating big pools of those who overpay and underpay.

Let’s not mince words. People who smoke ought to pay more for healthcare because they are a higher risk. Those who are grossly overweight ought to pay more as well.

Medicaid encourages emergency visits by paying primary care doctors so little that the doctors refuse new patients.

To avoid lawsuits, doctors perform more tests than necessary. Fraud is rampant. Paperwork is excessive.

“Medicare for All” would enhance problems in all of the above.

No Skin in the Game

Customers who have already reached their max out of pocket deductibles have no skin in the game. And that’s a huge problem.

According to Medicare.Gov “No Medicare drug plan may have a deductible more than $505 in 2023. Some Medicare drug plans don’t have a deductible. In some plans that do have a deductible, drugs on some tiers are covered before the deductible.”

Once deductibles are reached, sometimes in one month, consumers have no incentive to shop around.

Other customers, unaware of cost differentials, fill prescriptions on the basis of convenience, that being the nearest pharmacy.

Denver Health at “Critical Point” as 8,000 Migrants Make 20,000 Emergency Visits

January 24, 2024: Denver Health at “Critical Point” as 8,000 Migrants Make 20,000 Emergency Visits

The Denver hospital system is turning away local residents because it is flooded with migrant visits.

Medicaid Expansion Was Supposed to Pay for Itself, Instead Hospitals Are Closing

March 9, 2024: Medicaid Expansion Was Supposed to Pay for Itself, Instead Hospitals Are Closing

10 states did not fall for the Medicaid expansion trap under Obamacare. The rest are suffering. Private payers (you, one way or another) make up the loss.

Medicaid does not pay enough to cover hospitals’ costs, meaning hospitals need to make up for the shortfall by charging private payers more.

This was one of the easiest “I Told You So” advance predictions in history.

Best of all, we have a decade of data to prove it thanks to ten states that resisted the trap.

Hospitals Turn to Pay In Advance, In Full

May 9, 2024: Hospitals Turn to Pay In Advance, In Full

If you are in the hospital emergency room, and that’s where most people without insurance go, then you get treated. Otherwise, many hospitals are turning to pay in advance for services.

Nonpayment a Huge Problem

It’s interesting to note that hospitals want payment in advance for births. Most illegals just walk in and never pay for anything.

Nonpayment is one of the reasons costs are soaring for everyone who does pay.

Obama claimed Medicaid expansion would pay for itself.

Whenever you hear that claim please run. Free government handouts are never free and most often backfire completely.

As long as we are going to have Medicare, and no politician will ever get rid of it, It would behoove Medicare and insurers to require the cheapest cost alternative on all drugs. That would force competition and eliminate fraudulent collusion.

US consumers are subsidizing the rest of the world. I would put an end to that by allowing drug imports.

The Right to Die

It’s an uncomfortable topic, where demagoguery about “death squads” abounds, but we need to have a talk about the right to die and how much money we spend prolonging a terminal patient’s life, in massive pain, for a few weeks or months.

I have made my wishes known. I do not want to be kept alive by heroic means if the quality of my life is expected to be grim. That’s a personal decision.

At the national level, we must face this very uncomfortable question: Should we spend hundreds of thousands of dollars keeping someone alive whose life expectancy is 3 months? 6 months? a year?

I say no to all for those without insurance, and no for me personally, regardless.

Also, hospitals should be free to turn away those without insurance. We need tort reform to cut down legal expenses.

When consumers have no skin in the game or not enough skin in the game, no one other than the insurers are interested in reducing costs.

That is the fundamental problem with US healthcare. Senators Warren and Sanders proposals would make everything worse.