Unintended consequences. They ripple out from every law our elected leaders pass, like the waves from the proverbial pebble (or in this case boulder) in the pond.
Sometimes it still takes us by surprise — even when we see it coming. Not unlike this latest story, where we see carriers trimming down provider networks — in particular specialist hospitals — in a bid to keep premiums competitive. As Bloomberg reported Thursday morning:
“The law puts pressure on premiums by requiring insurers to ‘broaden health benefits, restricting how much premiums can vary with age and adding a new health-insurance tax,’ said Robert Zirkelbach, a spokesman for America’s Health Insurance Plans, or AHIP, a Washington-based trade group. Narrowing networks to those that accept lower payments in exchange for higher patient volume ‘is one way to help mitigate cost increase for consumers,’ he said.”
Once again we find this law struggling to serve two immutable masters — consumer choice — and low premiums. So we dart frantically between the two like Jack Tripper fumbling between a pair of dates at the Regal Beagle in one of those old Three’s Company episodes. Jack falls down and no one leaves happy.
The pundits might call this an unintended consequence, but those of us in the business saw this a long time ago — just the first step down the road to rationing.
Other times, it just takes a little while longer for those ripples to reach us. At least that’s the case in Chicago, where we find Cook County officials shuffling their state prisoners into the federal exchange. The county saves money, those poor prisoners still get “free” health care — and the rest of us get stuck with the bill. Why am I not surprised Chicago’s out in front on this one. Think someone tipped them off?
In the meantime, we’re all still bickering over the latest report from the Congressional Budget Office. While I respect that last remaining bastion of Beltway nonpartisanship, their reports are little more than Magic 8 Ball predictions. “Ask again later,” might as well be their slogan.
Jokes aside, their reports have a shorter shelf life than Sochi Olympians. Next year, these numbers will all be different.
Meanwhile, these other stories — dozens of which creep out unnoticed for every one big story that dominates the evening news (or social media) are the ones that are quietly shifting the ground beneath our feet. Before we know it, we’ll be the ones flailing in the pond, way over our heads.