Back when ObamaCare was being contemplated, a lot of us took a look at the provisions (at least those Nancy Pelosi let us know about) and pointed out a lot of the flaws and loopholes that would be rife with abuse.
For example, the “no exceptions for pre-existing conditions” rule set up a very interesting scenario: suppose a person had a condition that wasn’t really critical, but still unpleasant (needing a hip transplant, for example). The person could weigh the costs of government-mandated health insurance, compare them with the fine for not having insurance, and simply go without. Then, when they wanted their hip replaced, they could sign up, get the coverage for their hip replacement, and then drop the coverage again. For a few premiums and the fines, they get their new hip — all paid for by everyone else who doesn’t game the system.
Ludicrous, right? Never happen, of course?
Any time you set up a system like this, a hugely complicated system, you’re going to have these kinds of loopholes, and you’re going to have people who will game the system. And they will play the rules to maximize their benefits and minimize their costs. Quite frankly, they’d be fools not to.
And it won’t just be individuals, either. Already companies are running the numbers on how much they will spend on providing health care for their employees versus the fines for not providing it, and making plans to dump their workers on the public plans. Others are looking at the rules for numbers of employees and rejiggering things to slip under the limits. I recall reading about one enterprising owner of a chain of restaurants in the Midwest who planned on splitting them into separate companies, with no one company having enough employees to meet the minimum.
Does our current system of health care coverage have issues? Oh, absolutely. But ObamaCare is not the answer to “how to make it better,” but “how could we possibly take it and make it far, far worse?”
And Massachusetts is, typically in such cases, leading the way.