The socialist editorialist Clarence Page has called the GOP out, Mitch McConnell, in particular, for not having a replacement plan for Obamacare if they can manage to repeal it.  This very short-lived interlude, void of any more health care ideas from Washington, is kind of nice.  I’m sure the GOP will spoil the silence, though.  Seriously, what on earth would lead someone to believe that any answer coming from Washington wouldn’t be designed to line the pockets of the special interests at the table writing the bill? 

I’m all about repeal.  But let’s not stop with Obamacare.  Let’s move on to many disastrous legislative interventions brought to us from the other side of the aisle.  How about Medicare Part D, brought to us by a GOP-led executive?  Why didn’t the GOP change the tax code to end the discrimination against individual purchases of health insurance during the time they had all the power?  Hint:  see paragraph one of this blog.  This tax reform isn’t likely as the shift away from employer-purchased plans will gut the scam of PPO repricing, a devastating blow to the big insurance companies. 

Remember how “repricing” works.  My apologies to loyal followers of this blog for repeating this, but it is important…I’ll have something new at the end.  Insurance companies are perversely rewarded by seeking out the most expensive “providers” they can find.  They subsequently “reprice” a bill of $100,000 to perhaps $28,000 and charge the employer plan a fee percentage to the extent that they have “saved” them this $72,000.  Hospitals gladly produce these bills for their pals, as they can write the fictitious loss off as “uncompensated care” and bill Uncle Sam for a percentage of this number.  Insurance companies agree to lock out certain competitors to garner the hospitals’ participation in this little scam. 

Insurance companies make more money doing this than they do from premium collection!  This money isn’t included in the calculation of the new MLR (medical loss ratio) requirements of the UCA (Unaffordable Care Act).  This MLR only applies to premiums collected.  Beginning to see why the big insurance companies wrote the bill this way?  Administrative fees and PPO access fees are also not included in the MLR calculations. 

Changing the tax code ends this scam.  Individual policies (as opposed to group or employer-sponsored policies) are not subjected to “repricing” fees.  You will know that the GOP is furious with the insurance companies when this tax reform passes.  If the GOP threatens to pass it, then doesn’t, you will know that they did this to raise money from the insurance companies as extortion. 

What would the reaction of the average working person be to the following from the GOP:   “We aren’t advocating a replacement plan because this government is so completely compromised, corrupt and incompetent that something as important as health care can’t be trusted to it.  We are going to fade back and punt this to the states and let them unwind the insanity we have thrust on everyone in the country.  Our gift to you is to remove ourselves from this issue entirely, rather than continue to sell our influence at your expense.” 

I know.  It will never happen.  Fun to think about, though.

G. Keith Smith, M.D.