A year ago, I boldly predicted there would be a lot of talk about change but not much done. For the most part, I was right as we have not finalized the latest health care bills yet. However, I was wrong about no changes to the Medicare Advantage program. A reduction of payments resulted in benefit reductions, 25% average increase in premiums, and approximately 20% of plans exiting the market. Scrutiny increased significantly signaling that future insurance marketing will become even more highly regulated. When reform is fully implemented, it's likely all health plans will have the same templates for all documents explaining benefit plans. That's not a bad thing except for the fact that Medicare considers 33 pages to be a reasonable length for a benefit "summary". If that's a summary, you can imagine what the full book looks like. Health care reform may result in deforestation.
For 2010 predictions, I will continue to shoot down the middle:
1. Seniors finally realize what is happening to Medicare Advantage but don't riot: There will likely be additional cuts to revenue that Medicare Advantage pays health plans which will result in an average increase of $30 per month for seniors. The Republicans repeatedly raised this point to try and foment a senior rebellion but the Democrats countered by claiming that the only cuts would be to health plans' profits.
As Medicare beneficiaries realize the true impact, they will rise up and announce that they are still happy with the Medicare program. They don't need gold plated health plans and understand they are not immune to the health care increases.
2. No one else riots over the passage of health care reform either: Although opinion polls on the health care bills place it on the same satisfaction level as the latest straight to DVD version of American Pie (Does Eugene Levy need the money that badly?), Democrats will not be punished in the mid-term 2010 elections. As the incumbent party, they will lose some seats.
However, the public will better understand the benefits that they got from the health care bill and forgive its shortcomings. I also realized that the Republicans won't get punished for spending most of the debate playing Sudoku. Republicans always oppose new social benefit programs just like they did with Medicare in 1965. I think that it's part of the oath that they take when they join the party.
3. Health Insurance Reform Passes! In other bold predictions, we still don't resolve the question of whether people to drink Miller Lite because it tastes great or is less filling. Congress will produce one bill that passes. It's major provisions will start earlier, in 2013, to realize benefits sooner. There will be no Public Option plan.
4. The Health Care Construction Boom is over: Architects bemoan the loss of one of their more lucrative lines of business. The restrictions on health insurance will reduce the amount of money in health care. There is now only enough to money to pay for the Boomers hospital stays in the existing supply of beds. The next boom will be in technology that keeps patients out of hospitals and doctor's offices since space and supply won't increase.
5. State start working on their own health care reform: We saw the federal government's best effort with health care reform. While admirable, it's kind of like the best effort of whoever is playing quarterback for the Chicago Bears. It fell short. The states will stop waiting for the federal government for solutions and start designing their own. This will make health care even more local and regional which will hurt national plans. However, it will represent the best chance for true heath. care. reform.
6. We finally learn how to pronounce 2010: People who call it Oh-10 will be viewed in the same light as those who think global warming is caused by polar bear farts. Aught 10 is too awkward. Ten will work just fine.
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