Posted by: theoptimisticconservative | December 6, 2011

Getting some of that ObamaCare

A San Fernando Valley woman has posted an apology to President Obama in the Los Angeles Times.  At one time, she had criticized Obama:

I was pretty mad at Obama … I had changed my registration from Democrat to Independent, and I had blacked out the top of the “h” on my Obama bumper sticker, so that it read, “Got nope” instead of “got hope.” I felt like he had let down the struggling middle class. My son and I had campaigned for him, but since he took office, we felt he had let us down.

But then she learned about the Pre-existing Condition Insurance Plan (PCIP) created by ObamaCare, which is tailor-made for her needs as an uninsured Californian with breast cancer.

I have tremendous sympathy for this woman, who was facing breast cancer at a time when her husband’s COBRA had long since run out, and the family had been unable to afford insurance for several years.  Health insurance is very expensive in California, as a result of the state’s penchant for overregulation, public subsidies, and rent-seeking.  All insured health-care transactions in the Golden State contribute in one way or another to the gigantic state health-care apparatus, which endlessly drives up the cost of everything in the “private” sector.  (This squeeze has produced a mushrooming medical-services industry across the border in Mexico, as well as causing a growing number of practitioners in the state to operate on a cash-only basis – no insurance accepted.)

But PCIP is a superb example of how ObamaCare was frontloaded with goodies to attract constituencies.  Because if the Valley Gal were to read the fine print on PCIP, she’d discover that the program ends on 31 December 2013.

California administers the PCIP using ObamaCare funds.  Here is the information from the California PCIP website (emphasis added):

As a result of the federal Affordable Care Act of 2010, California has a contract with the federal Department of Health and Human Services to establish a federally-funded high risk pool program to provide health coverage for eligible individuals. The program will last until December 31, 2013 when the national health reform is set to begin. After that date, there will no longer be a need for high risk pools because federal rules will not allow insurers to reject persons with pre-existing conditions or charge them higher rates than those without such conditions.

The federally-funded program is called the California Pre-Existing Condition Insurance Plan (PCIP). The PCIP offers health coverage to medically-uninsurable individuals who live in California. The program is available for individuals who have not had health coverage in the last 6 months. The California PCIP is run by the Managed Risk Medical Insurance Board (MRMIB).

California actually already had a high-risk insurance program, before ObamaCare was passed.  The Major Risk Medical Insurance Program (MRMIP) became operational in 1991, and at one time served over 27,000 Californians.  Spiraling costs (partly due to legislative increases in plan benefits) meant the plan had to increase premiums and cap the number of participants at around 14,000.  In 2002, a 36-month limit was imposed on participation in MRMIP, with the proviso that MRMIP insurance providers would guarantee the offer of insurance to termed-out “MRMIP graduates” at 110% of the cost of their MRMIP premiums.

Loosely tethered to some semblance of fiscal accounting, MRMIP is definitely more expensive than PCIP in terms of monthly premiums.  Through 31 December 2011, for example, the woman in the San Fernando Valley can get PCIP coverage for herself for $306 a month, compared to the $480 she would have to pay Kaiser Permanente under MRMIP, or the $797 for a PPO plan with Anthem or Blue Cross under MRMIP.  And in January 2012, the MRMIP premiums are scheduled to increase.  The PPO plan premiums will go up to $865, and the Kaiser Permanente premiums to $516.

But that’s just something states and private companies have to do, because they face bad consequences if they don’t exert some control, however slight, over the gap between their revenues and their expenditures.  ObamaCare is subject to no such pressures.  Hence, it was able to lower PCIP premiums for Californians by an average of 18% in August 2011, because, as explained by the California administrators,“We want to make sure that everyone who qualifies for this program has access to its benefits and is not deterred by price.”

Presumably, ObamaCare, like Obama Money, comes from Obama’s Stash. It has certainly bought an apology from a Democrat who was previously angry enough at the president to switch to Independent; it may well buy her vote next year.  But the joke on her will not be a funny one.  PCIP ends on 31 December 2013, and what will happen after that is that premiums will go up – for everyone.  But services will also be restricted, for everyone who contracts for medical care using “insurance.”  And those are just the direct, first-order consequences.

The Valley Gal will find herself increasingly subject to state bureaucrats who get to decide how much she has to pay for her health “insurance” – which will actually be a state-run health plan over which she has no discretion – based on her income and assets.  Up to now, even in the wildly overregulated health care environment we have today, middle-class householders have been able to make choices of their own by maintaining private insurance at their discretion.  But it is “insurance” itself that is being subverted:  under ObamaCare, “insurance” is not a ticket to independence but a means for the government to exert control over the middle class.

The process of subverting medical insurance began decades ago, as alert readers will no doubt point out.  But ObamaCare takes it across the finish line with the insurance mandate.  Under no circumstances is the premium-cutting, welcome-all-comers PCIP model sustainable – and without a mandate, its unsustainability will blow up all over the Obama Stash program very, very quickly.  There’s nothing behind the politically deceptive PCIP premium-cutting except the future earnings of millions of people who have other plans for their money – if they’ve even been born yet.

Will Obama get his mandate?  The Supreme Court will make one decision on that before the 2012 election.  Americans may or may not accept it, if it goes the wrong way.  But one thing is for sure: as provided by the “Affordable Care Act” itself, PCIP will cease providing access to medical care in exchange for unrealistically low premiums in a little over 24 months.  I’d strongly suggest no one build his or her life around it.

J.E. Dyer’s articles have appeared at Hot Air’s Green Room, Commentary’s “contentions,Patheos, and The Weekly Standard online.


  1. ” Health insurance is very expensive in California, as a result of the state’s penchant for overregulation, public subsidies, and rent-seeking. ”

    not according to this…..

    • Your link covers employment-sponsored health insurance programs, which are influenced by (among other things) the structure of health insurance in CA and the rent-seeking behaviors the author cites. Valley Gal was seeking individually-contracted insurance.

      • Welcome, John Kaufmann. My apologies for the delay on your comment — there’s a one-time “approval” to keep down the spam. Now that you’re “in,” your comments will appear automatically.

        Your point is, of course, correct.

    • Let me put my hip boots on before descending into the endless bureaucatic crap. The report you site is for companies with 50 to 99 employees. I don’t know what percentage of California Health premiums that represents. Obviously you don’t either.
      You should do marketing for California “The Low Cost Leader For Affordable Living” Move Today, Join The Fun”

      • This was directed at Fuster, of course. Looks like I ended up in the wrong pew.

  2. Wait a minute. I thought we were going to get FREE medical care, what’s with this monthly payment thing? So it’s just another kind of expensive insurance program. Do they send me a bill every month or six and then I send them a money order, or what? And what if I don’t pay? Do they just shovel me off the street into one of those ugly plastic bags? The government guys just don’t get it, everybody deserves free medical care, like they got everywhere else, period.

    • …and a pony that poops gold bars…..

      you don’t pay you get to be a liver donor…. assuming that the thing’s not cirrhotic.

  3. Obamacare might be the worst and most damaging piece of legislation that has ever become law in the history of this country. Not only will it accelerate our national bankruptcy, but more insidiously, makes just about every single one of us a dependent of the state. There’s no surer way to sap the spirit of a people than to strip them of their individual liberties and hand those liberties to the state. We’ll become sclerotic just like Europe.

    To me, there is no greater importance to the 2012 elections than to get people in office who will repeal Obamacare. I’m concerned that Obamacare hasn’t been at the forefront of the “defeat Obama” campaign. However, if the Supreme Court is going to make a ruling on the individual mandate, etc.. in June, that will hopefully bring Obamacare back to front and center, which hopefully will remind everyone how dreadful that piece of legislation is.

    • RE~~~~ look to SCOTUS to get rid of Obamacare,,,,,that’s about the only way it’s gonna happen.

      other than that, it’ll just get stretched one way and another without ever disappearing.

      • fuster, you may be right that SCOTUS is our only hope, but I’m a little more optimistic that Obamacare can be torpedoed through the political process. It’s still quite unpopular. Also, don’t forget that it was passed through the lowered bar “Reconciliation.” If it can pass through Reconcilation, it can be repealed through the lowered bar Reconciliation too. To start though, we need the Rs to hold the House, win the Senate and, especially, win the WH in November.

        • they’ve got a good shot at holding the House.

          damned if I can see how anyone currently running for the nomination not named Rpmney can beat Obama unless the economy gets even worse.

        • Well, I wouldn’t hold your breath then.

          Its either Obama or:

          1. Romneycare of the Democratic lite party, or
          2. Gingrich, the much married moral paragon and non-lobbist, who was paid millions for his “historical” advice to the Fannys (Not bad when the emmenent intellectual giant of our times couldn’t even get tenure in a third-rate university)
          3. Paul who is far too sensible for the nutters who nowdays control the Republican party.
          4. Ditto Huntsman.

          Cain (various things I don’t believe in), Bachperson and Palin who have imploded because even the GoP membership can only stomach so much hate, and Perry (who is not up to the job because he is stupid, shallow,……. and I’ve forgotten the third reason…..) are hors de combat as the cheese-eating surrender-monkeys say.

          • Paul sounds very sensible as long as you don’t think about the nonsense ideas and beliefs behind his words.

            He’s about half-crazy and who the hell names a son “Krugerrand”?

    • Hi Richie,

      The Europeans (particularly in the thriving economies of northern europe like Germany and Denmark with the most comprehensive health-care provision) pay a far smaller percentage of their national wealth on paying for health-care than we do. That doesn’t sound like sclerosis or serfdom to me (Unless you believe that belated and third-rate medical care for you and your family is liberating). What you call sclerosis sounds more like efficiency to me.
      In Europe the state has become less intrusive where it really counts – intrusion into the lives of the citizens by the agents of the security state. Sadly, we have gone in the other direction. Only Ron Paul and a few other courageous voices have stood up to the growing securitocratization of our nation, and the burgeoning empire-building army of securocrats who are consuming our taxes and eroding our civil liberties.

      • Denmarks GNP is on par with The 7-11 stores in NW OKC.

  4. “The American Republic will endure until the day Congress discovers that it can bribe the public with the public’s money. “ Alexis de Tocqueville

    • Geoffrey, that day came and went many decades ago, and we’re still standing. Limp a little, but still…

    • Hi G,

      You will be interested to note that Hayek the author of “The Road to Serfdom” who so influenced Margaret Thatcher (and subsequently, Reagan’s advisors) in her determination to scale down government and its intrusion into our lives specifically stated that health-care-provision was one of the few areas where government intervention was both justified and required. He listed the various reasons why, almost uniquely, the market could not operate effectively in the sector in a modern industrial economy.

  5. They are eliminating the incentives for two types of cancer screening, well we didn’t need those anyway, Not surprising since Ezekiel ‘I have qualms with the Hyppocratic Oath’ Emmanuel, was among the designers of the thing, next up, leeches from Theodoric of York.

  6. What really gets up my nose is the rampant hypocracy that underlies it.
    JED as a military vet has the best gold-plated socialized health care that the long-suffering US tax-payer can be shaken down to provide. Her socialized health-care is probably the best available outside of Denmark.

    Added to this is her glib intellectual carelessness. We actually have universal health-care in the US. Health-insurance is only one mechanism for paying for it. In the US we have a multi-layered “system” for paying for our health-care. Military veterans and some protected elites have gold-plated socialized health-insurance. The old have less generous socialized provision. Some of the poor have basic socialized provision. Immunization of the young is extensive and socialized. A diminishing percentage of the employed have employer-provided private health-insurance. A diminishing number of the self-employed can afford private health-insurance. The remainder, such as the California lady who can’t afford health insurance, eventually obtain treatment through the socialized default public system because in the end we are a civilized nation. Unfortunately, this lady will typically not get her treatment until her disease is at a stage when treatment is likely to be most expensive and will have a less favourable outcome. JED, with her socialized health-care has no such worries. For those who rely on private insurance, provision is increasingly rationed by insurance company bureaucrats who operate “death-committees” which use an ever percentage of their premium-income to devise ways of avoiding and escaping their obligation to pay out.

    Most of our fellow democracies also have universal health-care. Some of them have a system of universal insurance to pay for it. Interestingly, all of these countries need to spent far less of their national wealth on healthcare than we do to obtain better health-outcomes. Even more interestingly, their insurers seem to spend far less of their premia on administration and more paying for health-care. And most interestingly of all, it is the economically thriving countries of Northern Europe like Germany, Denmark, Sweden, and the Netherlands, rather than the economically troubled nations of southern europe that have the most comprehensive health-care provision through universal insurance. In Europe insurers have to apply “community rating”, and cannot dump their sick customers. If JED’s thesis had a grain of truth in it one would suppose health-insurance to be far more expensive in Europe – or healthcare much worse. The opposite is the fact.

    If our insurers are inefficient and mendacious, and the providers over-remunerated in comparison to their counterparts in competitor economies, US health care will be more expensive. That and not JED’s suppositions, is the reason why health-care is so much more expensive here.

    And as for having “tremendous sympathy” for the unfortunate woman who hasn’t socialized health-care like JED and cannot afford insurance, What hypocritical poppycock! The only bit of human sympathy JED has ever exhibited is reserved for herself and her fellow professional victims of the fringe right. The injustice of it is – this lady has probably been paying for JEDs socialized health-care through her taxes all her working life.


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s


%d bloggers like this: