Newtown, CT – July 31, 2015
For those who have taken the mantle of Beckett, Ionesco, Sartre and Camus, we've got today a nice example of the Theatre of the Absurd – A new group has popped up, seemingly after having popped a few too many pills, to defend the status quo of rich benefit designs. They call themselves The Alliance to Fight the 40. The 40 represents the 40% excise tax that will be levied on the excess of plan value above the threshold set by the ACA for "Cadillac" health plans. In simpler words, the Alliance is fighting to get the Cadillac Tax repealed. Apparently, this motley crew, mainly composed of the privileged few public employees whose rich benefits are fed by our taxes, want us to continue funding their lifestyle to the detriment of ours. Much like the characters in Ionesco's The Bald Cantor, or Beckett's Waiting For Godot, they stream out absurd statements seemingly completely oblivious of the insanity of their situation. Some of the 40's statements include the need to "protect health care" and to ensure that benefits stay "affordable". For those who are currently not in a parallel universe, let's observe some real facts. First, health care spending rates have started to increase again. Second, almost all economists agree that the tax subsidization of health benefits is an anachronism that should be stopped. Third, the same economists agree that rich benefit designs that insulate plan members from cost sensitivity warp market dynamics by creating artificially induced demand for services. These three facts impact all of us by increasing our premiums and continuing the impoverishment of middle class families – in other words, the opposite of the 40's stated goals.
What this means to you – The Fighters of the 40 would have all of us pay three times for their profligacy. Once by using our tax dollars to subsidize their rich benefits, another by inflating our premiums, and a third time by increasing the budget deficit and having us pay interest on additional debt. Not only do they want a free ride, they want to be paid to ride for free. It would actually be as funny as the Theatre of the Absurd if it weren't a serious threat to every American's financial and physical well-being. At a point in time when providers have finally embraced the inevitability of value-based payment, a group of purchasers is fighting to turn the clock back and to pit patients against physicians. The artificial demand created by rich benefit designs runs completely counter to the new payment incentives some of these very same purchasers are promoting. The fact they don't see this additional absurdity clearly places them on the stage of Waiting for Godot. The rest of us, however, cannot idly sit watching this play unfold, because the price we will pay at the end of it depends entirely on whether Congress becomes another witless actor or puts an end to it. So look carefully at this list, and if you see an organization of which you're a member, or with whom you have a business relationship, let them know that you're not willing to be a part of their Theatre of the Absurd.