Friday, October 8, 2010

"Unintended" Consequences

I have a problem... But I guess in light of my lack of blogging consistency lately, I should probably go back a few steps first.

Here's the brief, but important, background you need to know: At the end of July, I moved across the country from Los Angeles to Connecticut. I did so to be with a woman who I intended to be my partner in love, in life, and in business... Unfortunately, and without going into the sordid details, despite my best possible efforts; my dreams of partnership were... let's say....... not adequately shared.

This was a chapter in my life that I can truly say, I went into expecting a completely different ending. Yet as these  kinds of painful experiences often remind me, life laughs in the face of the plans of men. I can't even begin to describe what's happened, and it would be pretty inconsiderate of me to get into much of it publicly anyway, but for me at least - it was devastating... So much so that staying in Hartford was just no longer a viable option. That city was a place I moved to out of love for someone incredibly special to me, and now it is synonymous with pain, betrayal, loss and loneliness. It was never a city I was moving to because of the city, and once my reason for being there was stripped away and my heart broken, it really had nothing more to offer.

Where I am... Ish.
A couple weeks ago, I went to visit a good friend in Catskill, New York and at my friend's invitation and based on the much more comfortable, homey and inviting environment of the little villages up & down the Hudson River Valley, I decided it best to leave Hartford and move 2 hours away to this lovely part of New York.

And so far, the move has taken me away from drama and problems that have been making me miserable for weeks and being happier makes me more productive and a better person to be around in general... It's all been a big win so far....

However... Personal anguish aside, this move has presented me with a number of other significant and somewhat unanticipated roadblocks. For instance, I have had to get a new cellphone on an individual plan to replace the shared, "family" plan I was on before, and I've had a lot of other standard moving expenses, a few business hassles and of course a ton of personal trials...
Good bye, lovely office :(
But boy was I unprepared for the problem that is the subject of this blog today!

Apparently, after just getting health insurance in the State of Connecticut, I need to (or at least, probably should) cancel that subscription and find a new plan in New York.

Yes... I know how absurd it is for people like me who have only changed geographical location by 70-80 miles to have to rearrange big expenses like health insurance - much less anything else - but thanks to decades of ridiculous anti-competitive policies, the minute I crossed that arbitrary boundary into New York state, I'm no longer legally supposed to have a Connecticut insurance policy - regardless of whether or not I'm pleased with the price or services as compared with my options in my new location.

So that is what it is... I've done it several times before, and each time I've been able to fairly quickly & easily find a basic (real) insurance plan that hedges against serious illnesses without costing me too much per month.

Until now...

When I began searching for a health plan again in the state of New York, I discovered that where I used to have dozens of options for individual plans, now I only had six... And none were remotely what I'd consider "affordable" (one was over $900 a month!). I was confused... and while poking around a bit, I found a possible explanation for this sudden change. From Connecticut's Blue Cross & Blue Shield's website, I was informed of the following:
‎"Please note effective 9/17/10, Anthem Blue Cross and Blue Shield will not sell Individual health insurance plans until we receive final approval from Connecticut Department of Insurance on our plans that include Health Care Reform mandated benefits"
I'm not entirely certain this is the cause of my problem finding insurance in New York, but this behavior isn't exactly uncommon among insurance providers and other health care professionals at the moment, is it?

I spent months writing thousands upon thousands of words on health care, and the misnomered plans to "reform" the system in the United States.

I'm not alone in this, but I can certainly say that I tried very hard to inform people in my immediate sphere of influence that the results of the bill that was passed would be uniformly bad as the already abysmal set of incentives created by the past 50 years of government intervention in to the health care market would be made catastrophically worse.

Thanks to an accident of fate, I am now going to wind up being a bit of a casualty in this problem purely because I have to change my insurance policy at the worst possible time.

In spite of the numerous times we were all told that if we like our current plans, we don't have to change them, that's obviously not the case. Granted, I'd have had to change my plan anyway thanks to the system already being set up as a cartel, but historically I'd have been able to find something comparable... And now I can't. Now as I can figure it, I have basically 3 options...
  1. Try to figure out a way to keep my CT plan and go across state lines any time I need to visit a doctor, or pretend I'm "traveling" to NY when I need care.
  2. Go broke trying to afford one of the limited options for NY health insurance that are available to me... or...
  3. Drop my health insurance coverage entirely and if/when I find myself in need some kind of serious medical care, and assume that in the 2,000-plus pages of mandates there really are those vaunted provisions forcing insurers to cover people with "pre-existing" conditions.
The funny thing about option three is that it's clearly the one that the new incentives most promote for someone in my position. I cannot afford the insurance options currently available, I don't really want the hassle or problems associated with trying to keep insurance in a state I'm not living in, and I know that my risk as a healthy, 27-year-old man with no history of serious illness and no chronic medical needs... So why keep the expense?

The past several years I've kept the expense because it was moderate, affordable and in the off-chance that I have needed any kind of health problem taken care of, it made my unforeseen expenses a little bit lower. I visited the doctor for the first time in 5 years about 4 months ago, and my out-of-pocket expenses were perfectly reasonable... Nothing wrong with that.

But the game is changed now... And not just for me... Millions of Americans are about to experience some serious disruptions in their health insurance.

McDonald's and a host of other major corporations have already applied for (and received) waivers exempting them from the new health care bill, 3M and a few others have already started dropping and modifying their employee benefits and insurance companies across the United States are already significantly modifying the options they're offering to their customers, for instance by dropping child-only coverage plans... Oh, and prices for insurance coverage have already gone up significantly!

Out of some pretty astounding and sometimes hilarious naiveté, a number of my acquaintances are employing a few different tactics to deflect any criticism of the law and the new incentives it created by alternatively pretending that no one is really making any changes, or admitting that things are changing significantly but claiming that the changes are all going to be good in long-run.

This is right in line with the double-speak coming from the Obama administration about the law anyway, though, isn't it?

Obama repeatedly said things (exactly) like this:
"Let me be exactly clear about what health care reform means to you. First of all, if you’ve got health insurance, you like your doctors, you like your plan, you can keep your doctor, you can keep your plan.  Nobody is talking about taking that away from you."

Then why bother with changing things? 

OF COURSE the new health insurance legislation was designed to force changes to the system! That's the whole point... Why pretend otherwise? The answer to that question is easy enough: The vast majority of Americans were/are relatively happy with their coverage.

A few years ago, a Washington Post/ABC Poll found that:
"Among insured Americans, 82 percent rate their health coverage positively. Among insured people who've experienced a serious or chronic illness or injury in their family in the last year, an enormous 91 percent are satisfied with their care, and 86 percent are satisfied with their coverage."
Now, the same poll found that a majority of Americans were dissatisfied with the overall state of health care/insurance and they would prefer a single payer system... Of course, when it comes to single-payer ideas:
"support, however, is conditional: It falls to fewer than four in 10 if it means a limited choice of doctors, or waiting lists for non-emergency treatments."
All this really shows is how ignorant of economics Americans (and most people around the world for that matter) tend to be...

What it's really saying is that a lot of people want someone else to pay for all their health care bills and cover everyone, and they want more choices, and no waiting lines, no rationing and better quality of care, AND they don't want their taxes to go up.

I wanted a magic lamp with a musical, wish-granting Groucho Marx in it after seeing Aladdin when I was 9, too.

The real problem here is that people engage in a lot of fantastical thinking when they ponder this topic, in large part because they never bother to understand or learn the principles of economics involved. Obama can take advantage of people's poor understanding by talking out of both sides of his mouth. On the one hand, if you like what you've got, keep it - on the other, everything needs to change!


I really wish it were possible to live in a world where everything just magically works out and everyone gets everything they've ever wanted without working for it, paying for it, or even producing it. Such a world would be wonderful indeed... We could all laze about and eat grapes while having our every material need & want instantly provided for. Alas, we live here in the real world where resources are limited by what has actually been produced and is available for consumption.

In this case, we've created a situation where producing health care goods & services is severely limited and bottlenecked. There are government mandated limits to how many doctors & nurses can be licensed each year, limits to drugs & vaccines produced, limits to the number of clinics & hospitals built, limits to competition in insurance and limits on which treatments insurers must pay for and thus limits on how affordable insurance will ever be.

At the same time, we've subsidized buyers of health care and artificially ballooned demand for insurance to a massive degree, promising everyone basically anything they want at no cost to them.

Out here in the real world, what that does is cause supplies to diminish, and prices to rise... A lot.

To this day I cannot figure out why anyone thought this would be a good policy to pursue. And perhaps I overestimate people's logical reasoning abilities, but considering I spent the last year trying to warn people about the consequences of the new incentives - I cannot see how the consequences we're seeing today and the ones we're going to be saddled with for the foreseeable future (higher prices, poorer quality, lower access to actual health care - regardless of how many people are "insured") are "unintended".

That's always the problem with ignoring economic reality... In a few months, all the people I know who are still defending the health care bill will claim that all the new problems are just those greedy, evil insurance companies seeking "profit over the people".

Blah blah blah... They will never own up to the incentives that were already in the system, or the massively worse ones that are now propelling us towards a true health-care disaster. When that disaster comes, they will claim that "no one" saw it coming, and that all the "experts" were so sure that this would work, and if only those dirty businessmen hadn't changed their behavior in "unpredictable" ways everything would have worked perfectly just as the planners had designed it to.

And history repeats itself... The longer I live to see this cycle play out, the less credulous I am when people want me to believe that the bad results of their ideas are the result of good intentions. Politicians and their "advisers" who promise undeliverable miracles are either remarkably stupid, remarkably cynical (seeking power at any cost, regardless of how many lies they have to tell their constituents), or they are undeniably evil. 

I'm not a big fan of any of those selections... Are you?

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