Monday, October 14, 2013

Avik cuts to the chase

If you're not regularly reading Avik Roy's "The Apothecary" (and you should be - it's in the sidebar), you're missing out on some of the most accurate, cutting-edge analysis of health care policy and polity available. Here, Avik explains with cystal clarity exactly why the ObamaTax Exchanges are a colossal failure:

"Healthcare.gov forces you to create an account and enter detailed personal information before you can start shopping ... HHS bureaucrats knew this would make the website run more slowly. But they were more afraid that letting people see the underlying cost of Obamacare’s insurance plans would scare people away." [emphasis added]

The key concept here is "no wrong door." Simply put, the entire process begins (and, for most, ends) at the front gate. The "no wrong door" philosophy is that, once one gets through the initial portal (and some do), the very first thing that happens is that one is directed to a widget that determines what, if any, subsidy one may be entitled to, and then applies that subsidy when one begins "shopping" for plans.

And there's a very simple, elegant reason for this: the actual premiums would cause a normal person to seek immediate medical help, and we can't have that. Only after the subsidy (and whether one is truly eligible has become a matter of debate, as well) has been applied are the proles "customers" allowed to see the prices.

This is brilliant.

Evil, but brilliant:

The most important demographic, from the ObamaTax POV, is the "young invincibles;" those people, in their twenties and early thirties, who have very little in the way of health care costs (save for, perhaps, maternity) but who are counted on to provide outsized premiums to subsidize their healthcare-consuming elders. After all, someone has to pay the piper, neh?

And remember, the ObamaTax mandates that there can only be a threefold difference in prices between the young invincibles and seasoned citizens. If the former are scared off early - as they most assuredly would be if they knew the true price of their "free" health care insurance - then the system grinds to a halt.

If one were a cynic, one might consider that a feature, not a bug.

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