Monthly Archives: December 2016

Insurance Companies, Fearing Repeal Of The PPACA, Ask For Continued Government Support

I realize that I’m recycling the headline from earlier today, but I’m making a point about who has really benefited from the PPACA.  Actually, the insurance companies have not made out as well as the hospitals, because a lot of young, healthy people decided to pay a fine instead of paying health insurance premiums.  Unfortunately for many insurance companies, they did not see this coming, and they were counting on the profitable policies of the young and healthy to subsidize the money-losing policies on old codgers like myself (I was on a marketplace plan for a few months, and it turned into one of the worst deals MHS ever made).  Too few young’uns, too many codgers, and many of the insurance companies lost money on their marketplace policies.  They were already planning to retreat from a lot of their PPACA markets before the election, and now I cannot imagine a set of circumstances that would keep them in this business.  Insurance companies hate uncertainty above all else, and with a Trump administration vowing to repeal the PPACA without a backup plan, the whole healthcare industry is up to its neck in uncertainty.

One thing is certain: if you hire someone to help you out with your own money, he is accountable to you.  Direct primary care is you hiring your own doctor with your own money, and I would be very pleased to help you.

Hospitals, Fearing Repeal Of The PPACA, Ask For Continued Government Support

Another way of reading this plea by the hospital industry is that they have an unsustainable business model that has been made viable and even prosperous for many years by the government voting them money.  Whatever else the PPACA, DSH payments, and facility fees were, they were ways for the feds to favor hospitals over their competitors (private physician offices, outpatient surgery centers), with the justification that all these hospitals are necessary to provide medical care in their communities.  I reply, no, they’re not all necessary, and showering money on hospitals only delays the transition of health care toward innovative means of providing outpatient and in-home care.

I don’t think that all hospitals should close, of course, but we have more than we need in this country, and we will not be able to find out how few we need to meet our healthcare goals until the government quits propping them up.

Direct primary care is a threat to hospitals, because its goal is to give patients good, thoughtful, attentive care that prevents the need for many ER visits and hospitalizations.  DPC is bad for hospitals, but it’s good for patients, and if the government wants better health for its citizens it should find ways to be supportive of direct primary care instead of pouring more money into the hospital industry.