After reading a rabid rant against the Patient Protection and Affordable Care Act (PPACA), I thought to myself how unsurprised I was.
Having been active in many health agent chat groups, and having attended local National Association of Health Underwriters (NAHU) and National Association of Insurance and Financial Advisors (NAIFA) meetings, getting to know the politics and sociology of fellow agents over the past several years, it all makes sense.
Who are health agents? If you visit the chat boards and go to meetings and look around, you don't see many minorities or women. You don't see many liberals. This is a white-male industry. And for the most part these are the angry white males of the political right…often the far right. As the kids say, “It is what it is.”
At the macro level there are two broad mainsprings of dissent which feed rants expressing the total hatred of the PPACA and anyone connected to it.
The first is economic.
Who is going to be in favor of any plan that cuts their compensation from 50 percent to 70 percent? Agents make a lot of noise about “it's about the client” but at the end of the day, it's about the commission.
Disagree? Well, after four years of discussing PPACA with colleagues, I'm convinced of two things.
The first is that if the PPACA was the greatest plan in the world -- if it met every operational criteria of the health agent community but paid little or no commission, it would still be vilified.
Second, if PPACA was the absolutely worst system in the world, but where even an average agent could earn a sustainable living (which I believe is $50,000 a year) by working normal hours, it would be hailed as the greatest thing since sliced bread. I'll bet even at an “easy” $30,000 a year in commission, agents would be lining up to shake President Obama's hand and hug Kathleen Sebelius!
If you want to know why so many agents hate PPACA, it's not about following the clients, it's about following the money.
The other reason for the vitriol against the PPACA is historical.
Bottom line, health agents, most of whom are political conservatives, are on the wrong side of history, as conservatives always are.
Going back to their anti-union, anti-civil rights, anti-voting rights, pro-segregation, pro-Vietnam War positions of the past 50 years, it is no wonder that the sons are as anti-PPACA in 2013 as their fathers were anti-Medicare in 1963.
Insurance agents as a group, and health agents in particular, simply don't like change…because they are conservatives.
For some reason I've never understood, conservative agents believe that the rest of the country believes as they do.
But it is not so.
We had a national referendum on PPACA in the last election. The country could have voted for former Gov. Romney who vowed to end PPACA on his first day in office. He lost.
We've had court case after court case about PPACA in the past four years, yet conservatives have lost there too. It has been upheld as the law of the land.
The carriers that health agents represent have not joined agents in any meaningful opposition to PPACA…they see a viable business model under it, mainly because they wrote it!
Investors favor the PPACA. Those who follow the industry believe that the profits selling over the web without costly underwriting and agent comp are going to skyrocket. See the 52-week trading range for Wellpoint (NYSE: WP) and United Health (NYSE: UNH) and you will see how investors like the profit prospects of PPACA, despite anti-PPACA editorials in the conservative Wall Street Journal.
Even the health agent's 'own' organization, NAHU threw agents under the bus when they basically sided with the carriers over the medical loss ratio (MLR) rule that cut commissions by half or more.
Health agents are all alone in the end zone.
The insurance agents who fulminate against PPACA see the law in the same terms as they see any change…as a perceived loss of their “freedoms,” or as a “takeover” by an evil government, or as a subterfuge of and by liberals and minorities to undermine our social structures. To paraphrase Milo Minderbinder, “It's a conspiracy, and everyone has a share.”
No matter where you go or what you read, the tone and tenor of outrage on PPACA from the agent community is the same.
Health reform is what it is…reform. And that means change. And we know how conservatives view change. True to their name, they want to conserve the past…to roll back the progressive (they call it 'communist') social legislation passed since 1932.
No matter how often they are told, they have not yet realized that it's not going to happen.
It took liberals and moderates 60 years, starting from the Truman administration, to accomplish even a smidgen of reform to the health care financing system…and like all major reforms whose time has finally arrived, there is no retreat.
Conservative health agents can bay at the moon all night long, but the country is not going back to pre-ex declines, 100 percent rate increases on closed blocks of business and arbitrary dollar-limits on coverage.
People are required to buy auto insurance, and now health insurance…people get it; it's not rocket science.
And of highest concern to health agents, we're not going back to 20 percent first-year commissions and yearly 10 percent renewals on constantly-rising health insurance premiums. Health agents are going the way of travel agents, who went the way of buggy-whip makers. It's called progress…and progress is on the right side of history.
Just as conservative insurance agents would like to repeal the social legislation they vilify daily on the chat boards and in print, their opposition to PPACA is just another example of them being on the wrong side of history. The Borg said it better: “Resistance is futile.”
Take one example from history.
I remember being in high school in the 1960s when Medicare was being debated. Ronald Reagan released (under sponsorship of the AMA) an 11-minute spoken LP (i.e. the MP3 of its day) titled “Ronald Reagan Speaks Out Against Socialized Medicine.”
“One of the traditional methods of imposing statism or socialism on a people has been by way of medicine,” he [Reagan] said. “It's very easy to disguise a medical program as a humanitarian project.” No real American wants socialized medicine, Reagan said, but Congress is attempting to fool the nation into adopting just such a program.”
But what happened? Reagan as president “led the battle for a Social Security reform bill designed to ensure the long-term solvency of the system, and oversaw the passage of immigration reform legislation, as well as the expansion of the Medicare program to protect the elderly and disabled against "catastrophic" health costs.
I could go back and give examples of how conservatives at the time were against Social Security. The point is simply that health agents who rant and rail against PPACA, like their parents before them on Medicare and civil rights, are simply on the wrong side of history.
So where are the voices of the few liberals who are agents? The answer is in the word “few.” There are not many of us, and most of us do not speak up because it takes so much time to make a tin foil hat and to put on the asbestos underwear. The dialectic becomes so toxic that the effort to have a rational discussion is wasted.
There is not one conservative insurance agent reading this who is going to change their mind, but I'll bet there are a hundred who will happily beat the tar out of me for writing this op-ed.
You know how Kermit says “It's not easy being green?” In the insurance community, it's not easy being right (unless you are far right!).