Obama’s Assholecare and the 80% payout requirement



The scumbag of the month award goes to Rick Ungar, contributor at Forbes news.  His article titled “The Bomb Buried in Obamacare explodes today” offers a few points why this guy is worth less than a spittoon in a church.

Ungar’s emotional tirade about what he considers a glorious part of Obamacare leaves me realizing that this law isn’t about healthcare reform, it’s just assholecare, plain and simple.  As Ungar says, “the provision of the law, called the medical loss ratio, that requires health insurance companies to spend 80% of the consumers’ premium dollars they collect—85% for large group insurers—on actual medical care rather than overhead, marketing expenses and profit. Failure on the part of insurers to meet this requirement will result in the insurers having to send their customers a rebate check representing the amount in which they underspend on actual medical care.”

So if your health insurance provider doesn’t spend 80% of all their money on actual patient care, they have to give their customers a refund based on the percentage they didn’t spend.  It sounds good to most, I’m sure, which is why most people are assholes, and why this law is strictly about taking care of the assholes.

Let’s look at what insurance is for, before I explain why those of you who support Obama’s Assholecare can be labeled this way.

When you purchase homeowner’s insurance, you do so to cover you in case of severe damage or loss to your home.  Homeowner’s insurance doesn’t cover light bulbs that burn out, air filters that get dirty, bed linens that get soiled or garage floors that get oiled.  When you purchase car insurance, the insurance company doesn’t pay for oil changes, brake jobs or car washes.  Insurance isn’t about maintenance, nor is it about prevention.  If you don’t change your car brake pads in a timely fashion, your car won’t stop.  That’s your responsibility to be aware that replacing those pads is a common maintenance item in all motor vehicles.

Health insurance has historically been needed for people who live healthy lives, put money into savings to take care of regular health maintenance and needs, but are wanting to protect themselves against the unlikely event of a health problem.  You don’t insure your car for windscreen wiper replacements, you don’t insure your house for floor waxing, you don’t insure your health for an annual physical or a headache — things that occur regularly and you should be prepared for covering yourself through savings.

That’s not the case in the modern world, though.  Instead of being responsible for ourselves, we’re asking everyone else to pay for our own irresponsible behavior and lack of foresight in socking away a measly 5% of our income towards basic health maintenance.  Many supporters of Obama’s Assholecare will say that medical care is too expensive for the average American, but no one wants to broach the taboo subject of why people need so much regular medical care and prescription drug coverage.  The simple fact is, we know what ails us, and we refuse to stop.

Chugging down soda with high fructose corn syrup, consuming hundreds of pounds of fructose and wheat a year per person, drinking down a 30 pack of cheap beer weekly, sitting on our asses while we stare at the TV or computer screen, sticking diseased holes without protection (or getting our holes stuck by a diseased appendage) — these are all symptoms of the lazy and irresponsible.  Combine lazy and irresponsible and you get the definition of an asshole: someone who doesn’t care about taking care of themselves, forcing others to pay for their own individual irresponsibility.

Here’s the great news about health care for the healthy: you don’t have to be an asshole, and you can cover yourself with a relatively small financial cost.  First, don’t get health maintenance insurance, stick to a high deductible health plan (HDHP).  Unfortunately, the bastards in government have put a cap on HDHP deductibles: currently you can only have a deductible as high as $5950 per year.  If you’re 25 years old, saving $6000 to cover emergency health care needs over the deductible is no problem.  7 years of work socking away $2.40 a day isn’t that hard.  It’s one beer at a bar a night you skip, one latte at the morning brewer.  It can be done.  For someone my age, I’d love a $25,000 deductible, but that’s illegal for insurers to provide.

For your annual health care needs, the focus needs to be on not being an asshole.  Lose weight, pound some heavy iron a few days a week, watch what you eat and drink, and cover any appendages before they’re stuck in any holes.  Pretty simple.  Almost all doctors and medical clinics will provide you with a negotiated “cash-on-the-barrel” rate for your annual physical and any non-emergency health care needs.  I once paid under $600 for a broken wrist just by calling around.  I needed a skin mole removed, called 6 different clinics, and was quoted between $200 and $1600.  Guess who I went with?

Of course, some people are born with terrible diseases or health issues.  For these people, a group plan provided by an employer makes sense.  What is the percentage of people who are born with health issues versus those who bring it on themselves, though?  Even if it was as high as 50/50 (which I doubt it is), health care costs would fall in half if the 50% born healthy would stay healthy.  Those are the assholes screwing it up for the rest of us.

Back to the matter at hand: forcing insurance providers to pay 80% of their income annually to patients.  This is a curious mandate, one that doesn’t make any economic sense in a market where the payouts are for emergencies.

You can theoretically self-insure your house or car.  If you had the ability to save enough money to cover 99% of emergency contingencies, you could have a nice bank account set aside just to pay for emergencies.  That’s the point of saving for a rainy day: you don’t expect to pay out of that set-aside money, and you can grow that nest egg over time.  Insurers are just groups of people who are saving for a rainy day.  Why should an insurer be forced to find ways to spend that money annually?  If a group of people all throw $50 into a hat each year and decide it’s going to be used to help any member of the group who gets their wallet stolen, does it make sense to force that group to pay out $40 each year even if no one was robbed?

It’s ridiculous.  Health insurers take risks: they’re assuming that fewer people will get sick than who pay in.  You don’t pay for insurance to get a payout, you pay for insurance to hedge against the risk of something bad happening that you don’t have enough in savings to cover.  If a health insurer in a competitive market happens to get lucky and have a year where they don’t pay out as much as they take in, that’s not specifically a profit, but money that can be used towards future years where they might have to pay out more than they take in.

The 80% mandate is just there for one reason: assholes who buy insurance also immediately want to put it to use.  They think that the money they pay every month should cover health care that is costlier than $300 a month.  They want to “tax” those of us who live a healthy lifestyle and never expect to get any health care needs covered because we work hard not to need it, only expecting it in an actual emergency.

Sadly, Obama and the cronies in Congress don’t care about us.  They care about the assholes, who are also the same ones who go to the polls.  That’s an unacceptable use of political power — and an unacceptable limitation on those of us who want to be healthy but protect against a rainy day (or worse).  I have no ability to find an insurer who can make the decision to NOT cover the fat, lazy and addicted: the same laws that force insurers to pay out 80% to actual health care costs also prevent insurers from having  prejudice that other members of the insurance pool may want to not cover.

I don’t want to pay for assholes.  I’m happy to pay for those who were born with problems, who who actually have problems that are no fault of their own.  I want that option.  In a free market, I would have the option, but the assholes certainly don’t want to give me that opportunity.

They can’t understand why I’d want it.  That’s because they’re assholes.

Related posts to peruse:

  1. Assholes, A Theory; by Aaron James
  2. Blame the Shysters
  3. Spirit Airlines cancels my return flight, offers no reimbursement
  4. R.I.P. Steve Jobs: and the ketogenic diet versus pancreatic cancer?
About A.B. Dada

A.B. Dada resides in Chicago, Illinois and manages a multitude of businesses involved across a wide range of industries.

Comments

  1. Firepower says:

    You of course know,
    that as the Asshole Cohort
    begins far outbreeding the rest
    the hospitals will FILL with spawn

  2. Blah Blah says:

    Crap article. The 80% clause is to control spiraling costs, which, if you’ve been paying attention, you’ll know has doubled in the last decade or so while the number of per capita insured has decreased. There is no rational reason for the existence of the health care industry anyway, since the government is much more efficient at providing health care (see private care vs medicare for evidence). Rather than scrap it and go to single payer a la medicare, Obama threw the private industry a lifeline to ensure their existence many decades from now rather than the otherwise eventual collapse where 50% or more of Americans wouldn’t be able to afford private insurance. Sometimes, loving the free market means actually checking it so that it doesn’t collapse under it’s own weight. All things are like this. Even the economy. Growth at 3% is more stable and continuous than growth at 6-8%. Same kind of thing with HCR.

  3. MakeThemEatCake says:

    the 80% payout of premium payments, is to keep in check what an insurance carrier DENIES. You know, when a doctor states you need, say an MRI to see inside you to aid him/her to diagnose, treat and possibly cure you. the insurance carrier, with an incentive to make as much money, in as short a period of time as possible (capitalism), often elects to turn down, or at best delay, such requests. Not due any medical option but simply to say no. Right now, my premium has gone up, yet my out of pocket expense for coverage, called a co-pay, keeps going up as well. And my premium payment is well above the $300 a month this clown is using as his example. So even of you live a healthy lifestyle, this drive to deny coverage often, is based solely on THEIR monetary goals. so the one time you may need aggressive medical treatment, your insurance carrier decides what medical treatment you can receive. And believe me, that 80% is going to be a line in the sand that will never be crossed.

    • A.B. Dada says:

      I belong to a boutique care medical group, so I don’t have co-pays or insurance submissions. I pay annually for the privilege of seeing doctors who are not busy or scatter brained. They focus on providing me with insights on how I can live free of medicines or ridiculous medical tests.

      I have zero copays. I have an annual deductible of somewhere around $7000 or so (Congress mandated maximum, I would make it $20,000) before my insurance kicks in. So far, my insurance has never kicked in.

      I save money, tax free, in an HSA. If I don’t use it, it rolls over for future years. My HSA is somewhere around 5x my deductible now. As long as I don’t have a real emergency (accident, cancer, etc), I won’t use it until I’m old.

      I take no prescriptions. My doctors refuse to prescribe any as I’m healthy at 38, healthier than most 21 year olds.

      Insurance is a scam. High Deductible Health Plans are what healthy individuals should use. My premium monthly is under $100.

      • MakeThemEatCake says:

        I’m genuinely happy for you, really, but who is this boutique care medical group of which you speak? Who, outside of you of course, has access to it? I would love to pay $7000 a year and get the coverage you do. Do you have a family? Any children? What is your line of work? Because, trust me, YOUR contribution to this plan is $7000 but the remainder of the cost is being picked up by your employer. And if insurance is a “scam” as you describe it, why do you have an HSA at all? Why are you paying about $100 a month for insurance? Do you go to private, for profit, doctors and medical facilities? who are they charging their real fees so you can be provided the great coverage at next to nothing that you are talking about? Again, trust me, their drive for profit is there, they just aren’t getting it from you. This plan allows the majority of this country to get at least better medical care. Now don’t complain about how you now are being expected to pay for people you don’t know or care about because, based on your response, you are paying next to nothing anyway.

        • A.B. Dada says:

          I don’t pay $7000 a year to the boutique care coverage, I have a deductible of $7000 per annum. I pay well under $1500 a year for the boutique care coverage, which includes most tests and exams and doctor’s housecalls even (I do pay a $35 gas surcharge for a housecall). Most insurance providers can’t give housecalls because then they’d have to give it for Medicare patients to, so doctors havae removed housecalls from their program, but not in boutique care.

          Also, my clinic only works with healthy living adults. Since they have the freedom to choose who is in the program, they pick people who cherish their lives and bodies and minds, not people who are addicted to foul “foods” and chemicals. I don’t want to work with doctors who happily work with people gorging their bodies with disgusting fantasy foods.

          My main doctor receives the bulk of my annual boutique payment. He only has about 150 patients total, so he can see each of us for 16 hours per year if he needed to. He only sees me for 2-4 hours per year, maximum. Because he’s got 150 patients each paying him say $1000 a year (or more!), he’s making a solid income. He also works at a local hospital one day a week but for pretty meager payments.

          Why pay $100 a month for insurance? In case of cancer or a dire emergency. That’s where the $7000 annual deductible kicks in, but since I have more than that in my HSA, I am covered for up to 5 years of full deductible needs. Since I’ve NEVER met my deductible in 15 years of boutique HSA coverage, it just builds and builds. My payments to my boutique care coverage come out of the HSA tax free, as do any minor lab workups that may be an extra cost outside of my coverage I pay cash for those.

          MOST doctors and clinics even offer a “cash on the barrel” rate — call your clinic today and ask. I went to a clinic in Los Angeles last year that charged insurers $350 for a visit ($25 copay typical). I called and asked how much it would be if I paid before service, and they said $75. I paid it out of my HSA, tax free, and saw a doctor immediately. All labs and tests were included in that $75, since they were paid upfront, before service.

          Insurance is a fraud because most people don’t need daily maintenance coverage, they need to live healthy lives free of medical advisors who are aiding and abetting in their slow deaths.

  4. MakeThemEatCake says:

    and more often than not, the “free market” argument used by butt wipes like the author of this article, is used when talking about necessities. Gas prices do not follow U.S market trends. Nor food prices. Nor energy costs. But those of the entire world. So, accepting your argument, prices here take into account foreign influences. THAT is the “free market” you have fallen in love with. Example, conserving, reducing, energy usage, (lowering the thermostat in the winter or raising it in the summer) is rewarded by utility requests to raise the price per kilowatt hour of electricity so their demand of a specific profit margin is met. Insurance companies behave the same way. A decided upon profit margin controls the treatment you receive. Doctors, nurses, hospitals, mechanics, et al (the service provides of the most common insurance types – auto and health) are being asked to curb THEIR costs yet what is paid out by insurance provides needs to mandated

    • A.B. Dada says:

      The vast majority of the medical industry is unnecessary. It exists solely to provide death care for the slow and agonizing deaths that most humans suffer because they follow government guidelines on proper diets, exercise and health maintenance.

      If you eat what society wants you to eat, of course you’ll be sick. Go running on a treadmill, increase your risk of heart attack.

      Health maintenance is a personal choice, and if you eat properly and work out properly, not like society says, you won’t need as much medical care as the fat bloated gasbags that are eating the so-called “heart healthy” diet.

      My doctors earn plenty of profit working for healthy and wealthy individuals, not bloated fat gasbags going through a 50 year slow death. They deserve their profit.

      • MakeThemEatCake says:

        Right, YOUR DOCTORS. These wealthy individuals do not even notice a 5%-7% increase in a premium or out of pocket costs. It is just a blip on their radar. You’re comparing your lifestyle and access to care to people that aren’t you. And will never be you. When last I checked a government is supposed to work for ALL of its people. And right now, it doesn’t. Yet any, and now all, attempts by that government TO work for all of its people is met with threats from those that, in reality, are not affected by scenarios this health plan will try to deal with.

  5. Eric Welch says:

    Interesting points. I have a couple of questions on how your boutique medical care system works.

    1. Once enrolled, can you be dropped by your plan if you should contract something like cancer or Parkinson’s or some inherited disease that you were not aware of when you were enrolled?

    2. Let’s say you are married and both of you are enrolled in your plan and then you have a child who is born with muscular dystrophy. Nothing in your life style who have prevented such an accident of fate yet you would be faced with 20+ years of very high medical bills. Would your plan pay for that.

    3. It seems the boutique plan survives only because it can cherry-pick who it wants to insure the young and healthy. Do they continue guarantee coverage into old age when traditionally medical bills begin to sky rocket? (I’m 65 and very healthy but my wife is 67 with Parkinson’s and a congenital heart condition. Would I be covered but not my wife?)

    4. Does your plan cover all hospitalization? For example if you were hit by a car which fled the scene and you required two months of hospitalization and rehab.

    The problem (well one problem at least) with our current system is that those who pay for health insurance (the regular kind) are subsidizing those who don’t. The law mandates that hospitals treat the ill regardless of their ability to pay. That’s why you were quoted different numbers in LA. It’s interesting that you could get the hospital to even quote a figure. When my university was looking into becoming self-insured, we couldn’t get ANY hospital or doctor to quote us a cost for ANY medical procedure, e.g. tonsillectomy.

    Love your site. Discovered via the Lendlink debacle.

  6. Barbara says:

    I view the healthcare insurance companies as greedy worthless parasites. Since Obamacare in 2008 my premiums have doubled and I now have a high deductible and it hasn’t even kicked in yet. The affordable care Act is a joke and will not be affordable to many people.

    The healthcare insurance love obamacare because when all those big corporations left this country they also decreased the large healthy workforce that never went to the doctors and this hurt healthcare’s profits so to make this up this is why they are doing mandated coverage.

    They could care less about the public health, only that the yincrease profits.

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