Thursday, August 5, 2010

Show Me ObamaCare - Despite a voter rebuke, how an obscure mandate will reshape health care.

From The Wall Street Journal

… Wait until the public discovers the government is now literally determining what qualifies as "health care" in America.

That isn't a typo. ObamaCare mandates that insurers spend a certain percentage of premium dollars on benefits, but Democrats never got around to writing the fine print of what counts as a benefit. So a handful of regulators are now choosing among the tens of thousands of services that doctors, hospitals and insurers offer. Few other government decisions will do more to shape tomorrow's health market, or what's left of it.

This command-and-control mechanism is the bill's mandate for insurance "medical loss ratios" (MLR) of 85% for large employers and 80% for small businesses and individuals. The MLR is an accounting statistic that measures the share of premiums paid out in patient claims ("losses"). In the individual market, MLRs typically run between 65% and 75%, and Democrats like Jay Rockefeller and Al Franken think this is evidence of excessive profits, executive pay, marketing and other supposedly wasteful overhead.

The same mentality prevails in the Administration, so it may well adopt a narrow definition of medical expenses when it issues final regulations by early fall. The insurance industry is lobbying for a less rigid standard: It will be easier to run a business and turn a profit if more of the costs are considered truly medical in nature.

Read more… 

[ How much clearer can this be? In essence, the government decides profit ratios which really puts them in total control! Statism, socialism – pick your “ism”. And then decide how you are going to resist and repeal ObamaCare. – JS ]

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