Most Americans believe that the United States has the greatest healthcare system in the world, rightfully so. As the country moves into a new decade, many questions remain unanswered as to how we create an affordable healthcare delivery system, while equitably compensating physicians for their services. The notion that Obamacare is a socialist program is laughable. The public has not been privy to all of the back door deals that were negotiated with Big Pharma and the Insurance Industry so a half-assed healthcare reform bill could be passed. The statistical fact that 50% of all personal bankruptcies are attributed to catastrophic healthcare should be cause for concern that there is something fundamentally wrong with the entire system. When patients, doctors, and hospitals are at the mercy of an unaccountable insurance industry, that can deny coverage, fix and manipulate pricing, deny claims, and intimidate and scare patients, it's time for the Federal Government to repeal the McCarron-Ferguson Act of 1945.
TSB can hear the moans and groans from the Spine Nation. WTF? How crazy is this person, asking us to rise up and start a campaign for the Federal Government to finally challenge this legislation in a court of law. In order for those of you that don't believe that this is an issue of life and death, one needs to understand how this Act effects our industry. The average person needs to understand the machinations of how McCarron-Ferguson works to keep the government off the backs of the insurance industry. Of course, the free-marketeers will react in typical knee-jerk style without looking at the view from thirty thousand feet. Historically, McCarron and Ferguson worked to invalidate the U.S. vs. South Eastern Underwriters Association Supreme Court decision and established ground rules for decades of highway robbery by our friendly insurance industry. Essentially, the bill is a heist perpetrated upon the American people by elected officials in concert with the insurance industry.
McCarron-Ferguson was originally written to maintain authority by the states over the insurance industry, but, it also included a provision that the Sherman Act would apply if and when state laws were inadequate. Basically, it was intended to be a temporary law set to expire in 1947. As with any bill, it can be rewritten. A new clause emerged from conference that stated that after January 1, 1948, the Sherman, Clayton, and FTC acts "shall be applicable to the business insurance to the extent that such business is not regulated by the State Law. Instead of being a temporary Act, allowing the Sherman Act to be applied when state laws proved inadequate, the law became permanent excluding the application of the Sherman and Clayton Acts. Therefore, the insurance industry was given a license to steal.
How absurd is it that physicians are not allow to collaborate and determine structural pricing, or they will be thrown into jail, yet, the big bad insurance industry colludes by sharing and setting reimbursements by manipulating the market? Ever hear of INGENIX? It gets crazier when in 1980 an amendment to the Federal Trade Act was passed making it illegal for the Federal government to investigate the insurance industry? A LEGAL CHALLENGE to ending the Anti-Trust Exemption for the Insurance Industry should be a mandate from all people. Isn't it absurd that Senator Ben Nelson has received over $1,259,000 in campaign contributions from the insurance industry and the Democratic Party caved in and gave Nelson's Nebraska $100 million and allowed Nebraska to have its Medicaid payments subsidized by other states? Isn't it time that an anti-competitve law passed over sixty years ago by mistake, be repealed?
Our industry loves to chase a wagging tail. How absurd is it for a physician to unequivocally blame sales people for driving up the cost of healthcare? How absurd is it for a CEO to pontificate at an Analysts' call about how insurance companies are denying coverage to patients, which in turn affect a companies ability to achieve its fiscal guidance? If anything, we have learned that by dividing, one can conquer, or at least keep everyone busy arguing with one another. A mandate to citizens that they must all be covered is not a solution to the problem. If anything, it is another empty promise, another stop gap measure. Of course, many bloggers will attack the point of this editorial, claiming that TSB is a socialist, that TSB desires to impede free-markets. But unless one truly exposes oneself to the realities of the system, how can one understand the issues at hand? How can we be competitive, if our own elected officials game the system? How will you make the correct choice in 2012 at the ballot box? The reason TSB infuses political issues into our posts is because everything we do in life is influenced and determined by politics.
So in closing, if NASS, AAOS, AANS, CNS, AMA, etc, etc, etc, really want to make a difference, don't spend your money on lobbying bullshit issues that just keep greasing the wheel, take a real position on an issue that is effecting not only your livelihood but your ability to deliver the best healthcare in the world. TSB wants to know, are you part of the problem, or do you want to be part of the solution?