Saturday, March 29, 2014

Architect Ezekial Emanuel Finally Pulls PPACA Curtain

"Step right up, Ladies and Gentlemen.  Witness the blue-chip employer Great Health Insurance shedding.  Watch Captains of Industry slither from past promises.  Dare to look as they gnash on retirees' pocketbooks!"

NYT's You're the Boss:  The Agenda shared a prediction by Ezekial Emanuel, M.D., a paid advisor to the Obama White House on health reform (PPACA):

By 2025, “fewer than 20 percent of workers in the private sector will receive traditional employer-sponsored health insurance.” The source of this claim? Dr. Ezekiel J. Emanuel, in his just-published book, “Reinventing American Health Care.” 

Dr. Emanuel is an accomplished oncologist, medical ethicist and academic (and contributing opinion writer to The New York Times). And, of course, he’s no stranger to politics: He helped craft the Affordable Care Act as a health policy adviser to the Obama administration

Mr. Emanuel argues that in the next two or three years, “a few big, blue-chip companies will announce their intention to stop providing health insurance. Instead, they will raise salaries substantially or offer large, defined contributions to their workers. Then the floodgates will open.” He says that few small businesses will join the SHOP exchanges set up for them and that most of those that offer coverage are even more likely than big companies to drop it, since those who employ fewer than 50 workers face no mandate to offer it in the first place, which Mr. Emanuel thinks is fine.
How kind of Dr. Emanuel to reveal the end game for PPACA.  It is five years after my prediction.

I believe reform sets the table for employers to shed that pesky health insurance benefit.
Many big, blue chip employers recently jettisoned retirees from their health plan, foisting them into individual exchanges with a defined contribution.  PPACA provided $5 billion to employers to encourage maintaining early retiree health coverage.  Over $2 million went to the owner of Newport News Shipbuilding, which later dumped their over 65 retirees onto an exchange.   Other companies jettisoning retirees include:

IBM, TimeWarner, Energizer, DuPont, GM, Ford, Honeywell, 3M and Caterpillar 
These are big, blue chip companies who already did to retirees what Emanual states they'll do to their employees.

Presidents Obama and Clinton got together to push PPACA last year.  I wrote:

PPACA set up the acceleration of the great employer health insurance shedding, already well underway.  It also rejiggered the health care table for private equity underwriters (PEU's) to make billions buying and selling health care companies.  Think KKR and HCA, Cerberus and Caritas Christi Health System, Gentiva and Capstar's Harden Healthcare, CCMP Capital Partner's sale of CareMore to WellPoint. 
Obama's White House Health Reformer had PEU origins and returned to her PEU roots after her public service.  Look for Nancy-Ann DeParle's Consonance Capital to lever PPACA to great profit. 
Oddly, Nancy-Ann continued to receive private equity distributions from previously undeclared investments while serving in the Obama White House.  No conflicts here.  As P.T. Barnum would say "Move on the to Great Egress."

The Great Egress is where employer sponsored health insurance is going.  President Obama's advisors finally told us so, five years after implementing the game plan.

Catch Ezekial Emanuel on CNBC Sunday to hear it from the barker's mouth.

Update 11-16-14:   CNBC reported PPACA's future could include "Employees may experience up to a $6,150 reduction in their health-care benefits and little or no increase in their pay."

Update 12-8-14:  Ezekial laid the groundwork for the government to stop paying for medicines and treatments for people 75 and older.  Pretty easy for a 57 year old to say.

Update 6-18-17:  Ex-President Obama accepted $400,000 to speak for one hour at Cantor Fitzgerald's healthcare conference this September.  The man who turned health care further into a for-profit wasteland is getting his payback.

Update 3-15-18:   Skyhigh healthcare costs differentiate the U.S. from the rest of the globe.  PPACA's cost curve bent in the wrong direction, acceleration.

Update 7-4-19:   Health equity declined since 1993 despite PPACA's promises.

Update 9-25-19:  Employers shifted costs to employees via higher deductibles and increased co-pays.   PPACA has not helped make healthcare more affordable.  It has made a lot of money for the PEU boys.

Update 4-16-20:  A coronavirus pandemic revealed America's broken healthcare system and PPACA's many shortcomings. How many  22 million newly unemployed  can afford the premiums?  How many of these will get COVID-19 and die at home without proper care?