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On the Third Hand: Questions

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Trying to blog about Patient Protection and Affordable Care Act (PPACA) rules and programs while covering PPACA news stories is a little awkward because, of course, PPACA is a really controversial, partisan subject.

On the one hand, if I, as a news reporter, write news stories about bunny rabbits being soft and fluffy, and also blog about bunny rabbits being soft and fluffy, that’s not really a problem, because, clearly, just about everyone knows that bunny rabbits are soft and fluffy. There’s not a lot of controversy about that point.

Similarly, I think it’s pretty obvious that someone writing for LifeHealthPro.com might have a bias toward the idea that private insurance can, under the right circumstances, be a good thing; that it’s great if insurance agents and brokers make a lot of money (by selling great products, under the right circumstances, to the right people); and that it’s wonderful if as many people as possible can get the right amount of appropriately priced health care.

Given that I’m a reporter, it seems as if it’s also obvious that I like transparency. I want government institutions, and government-like institutions, to be as open and honest as they can be, and to give me whatever information they do release in a clear, consistent, low-key, non-hyped-up way. 

I think it’s also reasonable for me to think that, in general, insurance agents and brokers may want to see any laws, regulations, regulatory bodies, products and markets that happen to exist work as well as possible, under the circumstances, while they exist. Many LifeHealthPro.com readers may hate PPACA with a passion and want it to be dead, dead, dead, but, given what they do for a living, even the vast majority of the PPACA loathers may want to see the PPACA-related insurance products they’re stuck selling to clients cover the clients’ medical bills in a decent way. 

But, on the other hand: Who wants to read news articles about PPACA by a reporter who’s clearly on one side or the other? It’s pretty easy to turn any PPACA-related story in an article that boils down to, “The Obama administration is evil and stupid,” or “The Obama administration is saintly and brilliant.” But why would anyone want to read articles like that? Why not pick up some more rewarding hobby, like collecting plastic soda bottle caps?

On the third hand, I’m a human being, and maybe the honest thing is to disclose the kinds of questions that do shape my coverage of the health insurers that started with PPACA Consumer Operated and Oriented Plan (CO-OP) loans, and of the PPACA risk corridors program.

So, here are some of the questions that affect how I see this story:

  • Should the government even consider making commitments to support private companies when those commitments lack strong bipartisan support?

  • If Party A makes one set of promises, and Party B gets control, what kind of obligation does Party B have to make good on the commitments made by Part A? If Party B changes course, does it have any obligation to provide transitional relief? How much transitional relief, and what kind?

  • What if Party B comes in and changes course, and some of what Party A promised turns out to (possibly) be nuts?

  • How reasonable was it for the CO-OP managers to depend on the risk corridors program to work, especially after state insurance regulators made it clear that the CO-OPs shouldn’t treat getting the risk corridors program receivables as a sure thing?

  • How much responsibility do consultants who developed elaborate health insurance pricing strategies based on the idea that the risk corridors program and other PPACA programs would work have for the current problems?

  • Could some CO-OPs be using the risk corridors program funding shortfall as an excuse to avoid having to talk about how poorly run their operations were?

  • Given that new insurance businesses often lose a lot of money during their first few years of existence, are the CO-OPs really doing all that badly? Is the problem that they’re doing so horribly, or just that PPACA CO-OP ownership rules cut them off from the kinds of support systems that would normally keep a new health insurance business going through the rocky early years?

  • Where does courageous commitment to sticking up for the interests of consumers end and an arrogant disregard for how the world works begin?

  • Were traditional health insurers or other CO-OP enemies engaged in anticompetitive skullduggery behind the scenes, and, if so, how did that work? 

  • Why do just about all of the CO-OP “winding down of operations” notices sound the same? Is the CO-OP failure public relations strategy evidence of how skilled federal and state regulators are at handling PPACA-related glitches, or an example of how creepy they are, or both?

  • If I had spent three years working around the clock for little money to get a CO-OP off the ground, what would I feel like when I read snippy LifeHealthPro.com articles about CO-OPs failing?