Sunday, December 29, 2013
Fiddler On The Roof
In the opening number of the movie Fiddler on the Roof the town Rabbi is asked if there is a prayer for the Tsar:
Lebisch: Rabbi! May I ask you a question?
Rabbi: Certainly, Lebisch!
Lebisch: Is there a proper blessing... for the Tsar?
Rabbi: A blessing for the Tsar? Of course! May God bless and keep the Tsar... far away from us!
With the disastrous rollout, rules and regulations being created on the fly and the President’s penchant for modifying deadlines, many of us in the insurance business have decided that we are happiest when Mr. Obama puts all of his time and efforts into immigration reform.
2013 was the year of the missing hero. There never seemed to be anyone in charge, anyone willing to be responsible, anyone who actually gave a damn about the American people and was prepared to work on our behalf. The year started with a last minute deal to fund the government and keep the lights on. But in an effort to cement the impression that ultimately we are all alone, the U.S. House of Representatives adjourned BEFORE addressing the need for emergency relief for the victims of Hurricane Sandy. That behavior would repeat itself throughout 2013. Only bills repealing Obamacare were guaranteed to reach the floor of the House.
And then the Republicans shut down the government. This, in of itself, isn’t the end of the world. Both parties have used this tactic with varying degrees of success over the years. What was particularly disheartening about this year’s government shutdown was that it was about Obamacare. The leaders of this fight exhibited as much forethought and preparation for this battle as the White House, the Department of Health and Human Services (HHS), and the Centers for Medicare and Medicaid (CMS) had in preparing to implement the law. This breath taking incompetence, this failure to lead responsibly, on either side, this idea that there will always be someone to clean up the mess has already impacted us in untold ways.
Insurance agents have a unique perspective on The Patient Protection and Affordable Care Act (PPACA or Obamacare). Regardless of political affiliation, our first priority is to get our clients insured. Nothing, not which insurer, not how we are paid, is more important than getting everyone covered. So we all have PPACA success stories. I have been able to get the very sick and the working poor health insurance that they would not have had. Eliminating health questions will allow Americans, some who are without insurance through no fault of their own, to purchase coverage. Completing the paperwork with someone contemplating surgery or in need of care is life affirming.
But this comes at a cost. And those same agents who are celebrating these client victories have also been sounding the alarm about those costs.
Picture a teeter-totter. For every cancer patient who will now enjoy a health insurance rate decrease there has to be at least one healthy person seeing a corresponding rate increase. One of my clients is rabidly anti-Obama. He actually came to my office in the summer of 2012 to campaign for Mitt Romney. Before I showed him his new, 2014 rates, I joked that if he saved over $1,000 per month he had to complete the last form in the packet and register as a Democrat. His savings was closer to $1,100 per month. Of course he accepted the new policy and the huge savings, but he realizes that his savings is at the expense of others. And no, he did not change his registration.
It is equally wrong to deny the gains or losses of the PPACA. Neither side has exhibited the least bit of intellectual honesty.
But honesty has been in short supply. People who can help you have also been scarce.
The agents knew that we were alone when we encountered the new federal registration system in August. Part was under one cabinet official with one computer system, while another part was under an entirely different division of the federal government with a different computer system. We got a full tour of government inefficiency and redundancy. It was a preview of the issues we would all encounter during the open enrollment.
The American public faced their own set of challenges. The PPACA gave us something new. Not an agent, but with more authority than our better trained secretaries, the PPACA begat the Navigator. I’ve talked to a couple of navigators. They knew next to nothing about insurance, networks, or the different policies. The Navigators aren’t prepared to help the mouse get through the maze to find the cheese. No, Navigators know just enough to drop the mouse into the maze and wish the mouse (YOU) “Good Luck”.
But the navigators weren’t the only folks complicating our lives this year. My friend Greg, who now lives in Florida, sent me an email about his difficulty in finding new coverage. As NPR reported, there were plenty of people willing to exploit the weakness of this law.
As Tevya might ask, “A health insurance agent in 2014”? Between the government that wants to replace us and the insurers that hate to pay us and a public that only appreciates us when they really need us, it sounds a little crazy. But here in the U.S. we all have our part to play. Much like a fiddler on the roof, each of us is trying to scratch out a pleasant, simple tune without breaking our necks. It isn’t easy. You might ask “Why do we stay up there if it is so dangerous”? Well, we stay because it is what we do.
And as our health care system changes, our lives, yours and mine, have become as shaky as… as… as a fiddler on the roof!