Don johnson – The Health Care Blog

Watch Insurance Premiums Soar

Apr 8, 2010• 22

By DONALD JOHNSON

Enactment of ObamaCare will open the floodgates for new federal mandates that insurers cover expensive wellness and alternative care services and send health insurance premiums soaring. While the New England Journal of Medicine says 50% of physicians will leave medicine because of ObamaCare, it’s more likely that the number of practicing physicians will shrink by 10% to 15% over the next five years. This will force Congress to boost payments to physicians to keep them in Medicine and to get them to accept more Medicaid and Medicare benefiaries. So taxes and Medicare premiums will rise even faster. ObamaCare encourages more people and employers to drop health insurance and game the system. Therefore, we’ll see as many uninsured Americans citizens who aren’t covered by various government programs as we see now. But they may be the higher-income folks who are smart enough to game the system.

Meanwhile, the hospitals who think that they will be the biggest winners because there will be fewer uninsured and few patients whose bills won’t be covered by the government will wind up the big losers. State and federal legislators will tax the not-for-profits and cut margins for the investor-owned hospitals to the bone. Long-run, they’ll lose physicians and money. Same for drug companies. Now that politicians control health insurance companies and markets more than ever, they’ll use the insurers and various forms of price and utilization controls to make the pharmas unprofitable.

Democrats who lose their seats in November will become rich lobbyists until Republicans take power and put them out of business.

People Who Are Smart About Money Won’t Buy Health Insurance Until They Get Sick

ObamaCare will give working Americans who are smart about money strong financial incentives to become and stay uninsured until they need catastrophically expensive health care. If they recover and no longer need insurance, they’ll drop it until the next time. The number of people who can afford to buy health insurance today but don’t is about 15 million. In five years, it could be several multiples of that.

Economists are just figuring it out here and here. Even liberal bloggers are getting it.

Don Johnson blogs at The Business Word Inc. Between 1976 and 1986 he was editor of Modern Healthcare magazine. As its top editor, Don helped build Modern Healthcare, a Crain Communications Inc. publication, into the hospital industry’s leading business magazine and one of the top magazines in the country.

Why buy insurers stocks, When the Obama health bill would bankrupt them?

Dec 23, 2009• 30

By DONALD JOHNSON

Don Johnson

On Monday, liberals sneered when insurers’ stocks rose, indicating that speculators thought ObamaCare (HR 3590) would be good for the big regional companies. But today several of the stocks are sinking, probably in response to University of Chicago Professor Richard A. Epstein’s op-ed piece in The Wall Street Journal, “Harry Reid turns insurance into a public utility; the health bill creates a massive cash crunch and then bankruptcies for many insurers.”

Here are charts for AET, CI, CVH, HS, HUM, UNH and WLP. Click on a chart for more information. The stocks that are sinking serve the individual and small group markets. Those that are rising are less invested in those markets, I think.

Now, the big companies might benefit from having smaller insurers that serve individuals and small employers bankrupted. But they would be crushed by new regulations and price controls that would not allow them to make profits. Nothing in the bill says insurers should be allowed to earn market returns. That means they’re as likely to go bankrupt as the smaller insurers.

Epstein’s impact graph:

The perils of the Reid bill are made evident in a recent Congressional Budget Office (CBO) report that focused on the bill’s rebate program, which holds that once an insurance company spends more than 10% of its revenues on administrative expenses, its customers are entitled to an indefinite statutory rebate determined by state regulatory authorities subject to oversight by the Secretary of Health and Human Services. Defining these administrative costs is a royal headache, but everyone agrees that they are heaviest in the small group and individual markets, where they typically range between 25% and 30%, without the new regulatory hassles.

Equally important, Epstein writes, the bill would turn insurers into heavily regulated utilities without giving them the right to make market rate returns on investments, which is unconstitutional.

That the bill appears unconstitutional may be good news for insurers, but think of the uncertainty that investors in insurers will face for years as the courts take their time deciding the case.