Sunday, December 4, 2011

Must read: The path to single-payer

A post today by karoli on Crooks & Liars nails down why we should all be more hopeful about the Affordable Care Act than the pundits have allowed. It's a pretty rosy view, but hard to dismiss when a writer for Forbes magazine says, "If you thought that the Obama Administration chickened out on pushing the nation in the direction of universal health care for everyone, today is the day you begin to understand that the reality is quite the contrary."

Like the arrest of Al Capone, it's about the money.

This is wonky and it requires a tiny bit of math to understand, but what's going on is the issuance of final rules on a vitally important but underappreciated part of the ACA package, the mandate to reduce the Medical Loss Ratio, meaning the percentage of income that insurers don't apply to health care. The new law requires that this ratio come down from 40-45% to 15-20%.

When it let the ACA through the legislative process in response to public outcry, the industry expected that the Department of Health and Human Services would ultimately provide enough loopholes to protect its gargantuan profits. Now it's quietly screaming. Good for us all.