The real bottom line on Reid's health reform

[Revmitchell]

The Congressional Budget Office had more bad news on Sen. Majority Leader Harry Reid's health-care bill this week -- even if some media outlets missed it.

CBO not only found that Reid's "reform" would hike premiums for millions of Americans who buy insurance in the non-group market, it noted other significant changes Reid would impose on the policies now held by millions more.

CBO predicts that 6.4 million people who now get insurance through their employer will lose that coverage and buy insurance on the non-group market: The bill would push many employers who have older or sicker workers to simply end their existing insurance plan, forcing these workers into the non-group market. Other older workers might be enticed into the non-group market because the rates will initially seem cheaper.

The New York Times and others hyped the CBO finding that Reid's plan wouldn't cause premium increases for large-group plans. But a chief reason CBO cited for that finding is that, as Reid forces older and sicker workers into the non-group market, many younger workers will be buying into that group coverage. Since this insurance "pool" will thus be covering people who need less care, its rates could actually drop -- except that other portions of Reid's plan would be likely to push the prices right back up.

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[windcatcher]

One thing this is not pointing out....
mainly because the CBO is focusing on health insurance cost and premiums according to their own models and statistics is, whether they are correct or not in their projections, they are not disclosing another important piece of information and that is the employers behavior.

When an employer has a relatively modest work force of ....say 100 employees and 10-20% of them are in their mid-40s and 50's....that same employer often has access to medical records or at least the data of charges and billing for services from which they can draw their conclusions, if the company participates in the filing or review of their insurance costs and expenses.... courtesy of accounting and the human resource or benefits department. Also if the company requires regularly occurring physicals... data on each employee is available regarding changes in weight, recent medical complaints, changes in values like blood pressure or presence of conditions such as diabetes, AND family history for health conditions.

From this data a company can cherry-pick and choose who to terminate or increase hostilities to force out... and if done carefully......... it can be difficult to uncover and prove that people were forced out of work because of issues related to increases in health insurance due to presence of health conditions or projected risks or age itself. A superficial charge against a company suspected of doing this is not likely to raise the hair on a lawyers back to persue if.... because one employee its age, another has a chronic condition but is younger, and another has bad health habits revealed in their physical such as obesity and smoking ..... and the reasons given on file for termination or firing don't tie together with the common thread of economics and holding down insurance overhead.... to force a complaint of discrimination. As for productivity..... it can be so subjective and manipulated that remarks made can be both difficult to prove or disprove, as reasons for firing or getting the employee to terminate.

BUT, and additional expense, not stated by the CBO or the GAO, is the cost of these unemployed workers drawing unemployment and seeking employment at a time in life where their skills might have become highly specialize for one employer but considered unneeded, obsolete, or over trained by another potential employer.

What tendancies I see in this.... is a way to 'out' older workers in larger companies.... hire the younger workers to fill those positions who have less insurance risk/cost..... and because they are removed from the potential pool of temporary labor which is the backbone of construction, and labor.... these pools will either be filled by the under trained or undereducated youth OR by illegal aliens willing to take the occupational risks which are inherrent to many of these jobs.

Maybe others have some thoughts on this....
But I think I've presented at least one potential senario which has the effect of a snowball breaking many areas of economic stability, not just for health care. The other part, still denied, is that when government finds that it can't afford the services for those who can't provide insurance for themselves.... there will be a rationing.... and there are ways of doing this without calling it rationing such as saying there's a shortage of nursing homes, therapist, other specialist...... and people must wait their turn in line for weeks or months.