Strict//EN" ""> EAGLES' REST: August 2016

Tuesday, August 16, 2016

Something the Whizzes in Washington Probably Didn't Think (THINK?) Of

I blogged about this in 2013. What with the recent announcements of insurers pulling our of "Obamacare" markets, I thought I'd re-post this now, as a testament to just how stupid the Affordable Care Act really is.

Anybody who'd spent much time in the insurance business could see this coming three years away....

So our fedd'l gummint is starting some new insurance plans. Well, having been with a company which was in that business, there's something I am sure they have not thought of. And somebody had to at least think about something, like maybe stock in Paper Companies, before they cobbled together that umpteen-thousand page monstrosity commonly known as Obamacare.

I'll try to simplify a complicated process.

Let's say you want to start an insurance plan. So you print the paper, prepare the website, and open for business. Who's going to sign up first?

  • People with pre-existing conditions. Hey, you've been bragging about that, so when you build it, they'll come.
  • People whose health has been generally poor, and they didn't want to pay the market price under those conditions, for coverage they COULD HAVE purchased on their own.
  • People who just would not buy coverage on their own.
  • People who worked for an employer who didn't provide coverage, and chose not to buy coverage themselves. Who would rather have a car payment than health coverage.
On the whole, you might guess that such a mix of people might produce a huge exposure to claims. And you'd be right ... certainly more than the average of all Americans.

Second unanticipated, but nonetheless real, snag: The first year this plan is up and running, they're only going to receive and pay 9 or 10 months of claims. When you buy this thing, you then get sick, and finally go to a doctor or a hospital, stay a while, after which a claim is sent to the company. There it is processed and eventually paid. By the time it's open 3 to 6 months, say, the process is churning along and claims are being steadily paid.

So after the first year, losses look pretty good. They should ... you got a year's premium but only 9 months of claims to pay. So rates stay the same.

Everybody else's rates go up a little, owing to inflation, but yours stay put, in light of the prior paragraph here.

NOW ... at the start of the third year, the plan has paid a whole year's claims, and finds the premium wasn't enough to cover it all. So ... BOOM ... a big rate increase. Then, those who can get coverage elsewhere cheaper, do so, and they were the healthier folks in the group! And that's when the plan goes sour.

There have been some of these sorts of plans that were backed by an insurance company. So, shortfall comes out of their reserves, called "surplus".

There have been some of these sorts of plans that were self-funded ... uninsured ... enabled by ERISA some years ago. They usually simply fold up, leaving kazillions of sick people uninsured.

Then there's the government......

And while we're on the subject of "pre-existing conditions" ... let's say you're in charge of a big checking account. Guys who own cars put some money in every month, and then when one of them bends a fender somewhere, he brings you the repair bill and you pay it out of the checking account. You could call it sort of an "insurance exchange". In fact, there are some of those, all over the country.

Then one day a guy comes in with a car that's already smashed up. Says he wants to join the plan, pay the first month, and you pay to fix his car. If you were in charge, would YOU do that?

I didn't think so. But that's what health plans that agree to insure pre-existing conditions do. (Note there are some exceptions to this, in very large groups and particularly where you're leaving one insurance plan that covered the illness, and joining another one that would cover it. That's called "no loss - no gain".)

Insurance companies have to hold what's called "statutory reserves" as a hedge against unexpectedly high claims payouts. Then it has to have surplus .. undesignated money over and above their capital. Since our government is broke, what do THEY do when year #3, say, of the health plan turns sour?

Can you say "Higher Taxes"?

There you have it, folks. The whole mess is JUST THAT STUPID!


Had a bit of an epiphany this morning. Big enough, in fact, that I knew I had to write about it.

That's really a big deal, seeing that I have not been inspired to write in something over a month.

It all hinged around Proverbs 3:5 - 6......

"Trust in the Lord with all your heart, and do not lean on your own understanding. In all your ways, acknowledge Him, and He will make your paths straight."

This is, incidentally, what I share with Deacons being ordained at FBC Pelham, and it's one of my favorite passages.

Anyway ... I  studied the verse long ago, digging into the original. I wanted to know how we could acknowledge Him in all our ways. What I found was ... according to this untrained guy in a pew ... the word "acknowledge" was "yada", meaning to perceive and see, to discern. And "ways" means our journey, the course of our life.

That's exactly what happened this morning when Kami ... our granddaughter-in-law ... dropped Mac off at our house so we could do a little baby-sitting. It struck me, as it always does, how much love she shows for Mac, in everything she does when she's around him. Peg and I have talked about that many times, in fact, what a good Mommy she really is.

What occurred to me this morning was that I have never heard Kami say that she loved Mac! But it is as obvious as anything can be that she does.

You can tell it by how she treats him! And how she goes out of her way to be prepared to treat him out of love. Always being prepared, always ready to feed, nurture, interact with him. To see to all his needs.

What really screamed at me this morning was I could see her love in all her ways, and this is the heart of Proverbs 3:6, for me ... that our love for God would show in everything we do in our relationship with Him, just as Kami's love for Mac shows in everything she does in relationship with Mac.

So the big question for me is: How do I discern Him ... perceive, see, discern ... Him in all my ways? That's certainly what I desire, as it's part of the abundant life which cause Jesus to come down here and live & die for us. Fortunately, He left us some clues as to how we can do that.

For instance: "If you love me, keep My commands". That's John 14:15.

Or maybe "Anyone who loves me will obey my teaching".  John 14:23.

Commands and teachings. I see them as a bit different ... one instructs us what to do or not do, while the other goes to who we are and how we're to act. And to do the things we're instructed to do.

That seems pretty comprehensive. And the interesting part is He's not telling us to say how much we love Him. 

We get the lingo down pretty good. But it seems to me the mouth isn't the first place our love for Jesus shows up. Just as everyone, regardless of their faith, could easily see Kami's love for Mac, so anyone, regardless of the setting, should be able to see ours for the God Who has done indescribably precious things for us.

I want to "yada" His presence in all my ways.

May it be so in my life....