Try to think of the health insurance “exchanges” mandated by the Unaffordable Care Act as shopping malls.  Shopping malls without competitors, that is.  All of the “insurance” vendors would be required to display their products/services in these “malls,” and nowhere else.  Certain qualifications must be satisfied before they would be allowed to “sell” in these “malls.”  

The federal government, of course, is in charge of what these qualifications are at any given time, and if an insurance company displeases the political overlords for any reason, these qualifications can be modified such that company “A” is simply evicted from the “mall.”  Imagine a large insurance company’s lobbyist in the office of a Senator or federal regulator discussing new regulations and requirements that would put several of his competitors out of business, and how much he would need to “contribute” to the bureaucrat for these new competition-destroying regulations to come into play.  Think this is far-fetched?  How do you think we got the Unaffordable Care Act in the first place?

Those who meet certain low income criteria can shop at these “malls” with other people’s money.  The purchasing subsidy for these folks can only pass to those insurance companies selling at these “mall” locations.  The primary payer of the premiums for health insurance will no longer be the person insured, but rather the federal government, which having first collected massive new taxes from the dwindling number of taxpayers, subsequently doles the dough out to the favored (politically active!) insurance companies.  

I think we need a new word.  ”Mallpractice.”  You say, “I don’t want a policy with a $250 deductible.  I want to take more risk to keep my premiums low.”  Sorry.  This lowering of premiums by maintaining higher deductibles defeats the true purpose of the Unaffordable Care Act:  diverting giant wealth to corporate health care, the insurance companies, in particular.

“I don’t need a policy that covers pregnancy.  I’m a single male.”  Sorry.  No policies without this coverage are allowed to be sold in the “mall.”  “Why do I have to pay for drug addiction and rehabilitation?  I’ll just make sure on my end that this never happens.”  What?  Seriously?  Personal responsibility?  You don’t think it’s fair to pay for “insurance” that you don’t need?

The “exchanges” have their own overhead, as well.  The disgruntled folks from the post office and the TSA running these exchanges will need to be paid, and paid well they will be for their “hard work.”  They will come in handy when the crowds lined up at the exchange start to become unruly. 

Oh and then there’s this.  Twila Brase of the Citizen’s Council for Health Freedom has written about the unprecedented “tracking system” embedded within the exchanges, one which will funnel private data into the “Federal Data Services Hub” to at least five federal agencies and myriad state databases.  See Twila’s excellent rundown on the exchanges here.

Just as the post office has a monopoly on first class mail delivery, courtesy of Uncle Sam, these exchanges will have a monopoly on the delivery of what will be called “health insurance.”  Quality will plummet and prices will soar.  Duh.

G. Keith Smith, M.D.