Peering Through The Smoke

As the Affordable Care Act continues to progress, in a somewhat lumbering yet steady manner, the individual mandate included in the bill continues to come under attack. While insurance companies and some candidates are busy claiming that this mandate would be burdensome, and increase the cost of coverage, in reality they are using that as a smokescreen for their real objection and agenda. You see, most people don’t know this, but the ACA mandates that insurance companies MUST spend money on care, not pretty buildings.

•In 2011, insurance companies will be required to spend at least 80% of your premium

dollars on health care and quality improvements instead of overhead, salaries, or

administrative expenses – or provide rebates to consumers.

That very small provision is going to really get in the way of for-profit medical care, and hamper many hospitals and clinics that were charging as much for their settings as they did for the care they gave.

Another small but truly big impact provision is that next year, hospitals and doctors will start receiving payment on “Out-Come Based Care”, basically linking payments to hospitals based on the quality of care. Hospitals would publicly report their outcomes with infections, pneumonia and such, and the patient would report their satisfaction with care. Hospitals could garner extra grants this way. Imagine, if you can, the patient being the one to say what the quality of care would be!

Finally, we have the quality and efficiency laws that will impact our Seniors and our Children.

Improving Health Care Quality and Efficiency

Effective no later than January 1, 2011

The law establishes a new Center for Medicare & Medicaid Innovation that will begin testing new ways of delivering care to patients. These new methods are expected to improve the quality of care and reduce the rate of growth in costs for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP).

These provisions are small, but they are going to cost the insurance companies in big ways. Not happy, those companies are lobbying daily to “Repeal ObamaCare”, and such things. One needs to look past the individual mandate and see what the ACA really does for the patients and their families.

It is time that we look to the insurance companies to do what they are intended to do, insure against a catastrophic illness. They should not be the cause of bankruptcies and such. Keep this in mind, when they object to new people to insure, you have to ask yourself why? The answer is simple, they won’t be able to make “record profits” after all. Insurance companies are trying to divert your attention, don’t be fooled.