Nontransparent Healthcare Reform Act Waivers

Stanley Feld M.D.,FACP,MACE The health care system is broken. President Obama’s healthcare bill should be repealed. Congress should start over again using common sense. The healthcare system is a complete nightmare for all stakeholders. It consists of a series of patches to fix a dysfunctional healthcare system. President Obama’s healthcare reform act is creating a bigger nightmare. President Obama should construct a consumer driven healthcare system with federal and state government oversight rather than a federal government driven system. President Obama’s healthcare reform act transfers congressional control of the federal healthcare system to the executive branch of government. Nonelected officials can make rules without congressional oversight. Checks and balances are lost. The loss of checks and balances is dangerous. Political decisions can be made by the executive branch of government without congressional input. The McDonalds’ healthcare insurance waiver became a political embarrassment to President Obama. The healthcare insurance waiver occurred just before the midterm elections. It was clear President Obama did not want to increase the number of uninsured before the midterm election. McDonalds said it could not afford to insure its employees under the new healthcare reform act’s regulations. The administration created a new rule to provide McDonalds and 32 other companies with a waiver from healthcare regulations that would go into effect January 1,2011. The government’s press release about the waivers created a big stir in the blogging world. It also caused a reaction in the traditional media. The President gave in to influence by lobbying groups. Cries of favoritism resulted. At the beginning of November the government issued 111 waivers without informing the press. The waiver was interpreted as an admission of just how job-killing and business-crushing the new health care law really is. These new waivers were buried in the Department of Health and Human Services web site without publicity. Below is a list of companies granted waivers so far.   Applicant Application Received Plan Effective Date Number of Enrollees Application Completed by Applicant Waiver Approved 1 Protocol Marketing Group 10/4/2010 1/1/2011 454 10/25/2010 11/1/2010 2 Sasnak 9/29/2010 1/1/2011 813 9/29/2010 11/1/2010 3 Star Tek 10/1/2010 1/1/2011 1,423 10/26/2010 11/1/2010 4 Adventist Care Centers 10/1/2010 1/1/2011 725 10/26/2010 10/29/2010 5 B.E.S.T of NY 10/7/2010 1/1/2011 1,200 10/27/2010 10/29/2010 6 Boskovich Farms, Inc 10/8/2010 1/1/2011 165 10/28/2010 10/29/2010 7 Gallegos Corp 9/29/2010 1/1/2011 86 10/28/2010 10/29/2010 8 Jeffords Steel and Engineering 10/4/2010 1/1/2011 112 10/28/2010 10/29/2010 9 O.K. Industries 10/4/2010 1/1/2011 1,238 10/28/2010 10/29/2010 10 Service Employees Benefit Fund 10/12/2010 11/1/2010 1,297 10/29/2010 10/29/2010 11 Sun Pacific Farming Coop 10/6/2010 12/1/2010 1,109 10/6/2010 10/29/2010 12 UFCW Allied Trade Health & Welfare Trust 10/5/2010 1-Dec 68 10/25/2010 10/29/2010 13 HCR Manor Care 10/5/2010 1/1/2011 2,666 10/26/2010 10/28/2010 14 IBEW No.915 9/28/2010 1/1/2011 930 10/15/2010 10/28/2010 15 Integra BMS for Culp, Inc. 10/4/2010 1/1/2011 34 10/25/2010 10/28/2010 16 New England Health Care Employees Welfare Fund 9/27/2010 1/1/2011 7,454 10/26/2010 10/28/2010 17 Aegis Security Insurance Company 10/6/2010 11/1/2010 67 10/25/2010 10/26/2010 18 Alliance One Tobacco 9/30/2010 1/1/2011 138 10/21/2010 10/26/2010 19 Asbestos Workers Local 53 Welfare Fund 9/29/2010 1/1/2011 2 10/21/2010 10/26/2010 20 Assurant Health (2nd Application) 9/29/2010 1/1/2011 19,024 10/21/2010 10/26/2010 21 Captain Elliot's Party Boats 10/12/2010 11/1/2010 10 10/25/2010 10/26/2010 22 Carlson Restaurants 9/22/2010 1/1/2011 3,381 10/21/2010 10/26/2010 23 CH Guenther & Son 9/24/2010 1/1/2011 300 10/21/2010 10/26/2010 24 CKM Industries dba Miller Environmental 10/5/2010 11/1/2010 34 10/25/2010 10/26/2010 25 Caribbean Workers' Voluntary Employees' Health and Welfare Plan 10/14/2010 10/1/2010 4,500 10/18/2010 10/26/2010 26 Darden Restaurants 9/30/2010 1/1/2011 34,000 10/21/2010 10/26/2010 27 Duarte Nursery 9/23/2010 1/1/2011 283 10/19/2010 10/26/2010 28 Employees Security Fund 9/29/2010 1/1/2011 22 9/29/2010 10/26/2010 29 Florida Trowel Trades 9/27/2010 1/1/2011 297 10/21/2010 10/26/2010 30 Ingles Markets 9/30/2010 1/1/2011 917 10/25/2010 10/26/2010 31 Meijer 10/1/2010 1/1/2011 4,873 10/1/2010 10/26/2010 32 O'Reilly Auto Parts 9/23/2010 1/1/2011 9,722 9/23/2010 10/26/2010 33 Plumbers & Pipefitters Local 123 Welfare Fund 9/30/2010 1/1/2011 534 10/21/2010 10/26/2010 34 Sun Belt 9/28/2010 10/1/2010 114 10/20/2010 10/26/2010 35 UFCW Local 227 10/12/2010 11/1/2010 1,125 10/12/2010 10/26/2010 36 Uncle Julio's 9/30/2010 11/1/2010 115 10/25/2010 10/26/2010 37 United Group 9/24/2010 1/1/2011 177 10/19/2010 10/26/2010 38 US Imaging 10/11/2010 11/1/2010 148 10/25/2010 10/26/2010 39 Vino Farms 10/8/2010 11/1/2010 152 10/21/2010 10/26/2010 40 Advanta Staff, Inc. 9/20/2010 9/1/2011 52 9/20/2010 10/21/2010 41 Agricare 9/23/2010 11/1/2010 437 9/23/2010 10/21/2010 42 Alaska Seafood 9/23/2010 1/1/2010 262 10/15/2010 10/21/2010 43 American Fidelity 9/22/2010 10/23/2010 9,358 10/14/2010 10/21/2010 44 Convergys 9/20/2010 1/1/2011 1,400 9/20/2010 10/21/2010 45 Darensberries 9/28/2010 10/1/2010 1,450 9/28/2010 10/21/2010 46 Gowan Company 9/23/2010 1/1/2011 225 9/27/2010 10/21/2010 47 Greystar 9/23/2010 1/1/2011 1,747 10/13/2010 10/21/2010 48 Macayo Restaurants 9/22/2010 12/1/2010 46 10/18/2010 10/21/2010 49 Periodical Services 9/27/2010 1/1/2011 464 9/27/2010 10/21/2010 50 UniFirst 9/23/2010 9/1/2011 2,659 10/14/2010 10/21/2010 51 Universal Forest Products 9/23/2011 5/1/2010 1,738 10/19/2010 10/21/2010 52 UFCW Maximus Local 455 10/4/2010 1/1/2011 59 10/18/2010 10/18/2010 53 American Habilitation Services, Inc. 9/22/2010 1/1/2011 400 10/12/2010 10/14/2010 54 GuideStone Financial Resources 9/21/2010 1/1/2011 354 9/21/2010 10/14/2010 55 Local 25 SEIU 9/29/2010 10/1/2010 31,000 10/7/2010 10/14/2010 56 MAUSER Corp. 9/21/2010 1/1/2011 47 9/24/2010 10/14/2010 57 Preferred Care, Inc. 9/15/2010 1/1/2011 918 9/15/2010 10/14/2010 58 Ruby Tuesday 10/8/2010 1/1/2011 3,219 10/8/2010 10/14/2010 59 The Dixie Group, Inc. 8/27/2010 6/19/2010 269 10/12/2010 10/14/2010 60 UFCW Local 1262 9/20/2010 10/1/2010 5,390 9/20/2010 10/14/2010 61 Whelan Security Company 9/23/2010 1/1/2011 287 10/12/2010 10/14/2010 62 AMF Bowling Worldwide 9/14/2010 1/1/2011 295 10/7/2010 10/12/2010 63 Assisted Living Concepts 9/17/2010 1/1/2011 1,174 9/17/2010 10/12/2010 64 Case & Associates 9/17/2010 1/1/2011 87 9/17/2010 10/12/2010 65 GPM Investments 9/17/2010 1/1/2011 275 9/17/2010 10/12/2010 66 Grace Living Centers 9/14/2010 10/1/2010 534 9/14/2010 10/12/2010 67 Mountaire Corporation 9/17/2010 1/1/2011 2,074 9/17/2010 10/12/2010 68 Swift Spinning 9/16/2010 1/1/2011 240 9/16/2010 10/12/2010 69 Belmont Village 9/10/2010 1/1/2011 785 10/4/2010 10/8/2010 70 Caliber Services 9/13/2010 1/1/2011 606 9/13/2010 10/8/2010 71 Cracker Barrel 9/9/2010 1/1/2011 16,823 9/17/2010 10/8/2010 72 DISH Network 9/13/2010 3/1/2011 3,597 9/23/2010 10/8/2010 73 Groendyke Transport,  Inc 9/2/2010 1/1/2011 1,322 9/2/2010 10/8/2010 74 Pocono Medical Center 9/24/2010 1/1/2011 3,298 9/24/2010 10/8/2010 75 Regis Corporation 9/10/2010 3/1/2011 3,617 10/1/2010 10/8/2010 76 The Pictsweet Co. 9/13/2010 1/1/2010 694 9/13/2010 10/8/2010 77 Diversified Interiors 9/28/2010 10/1/2010 300 9/28/2010 10/1/2010 78 Local 802 Musicians Health Fund 9/29/2010 10/1/2010 1,801 9/29/2010 10/1/2010 79 MCS Life Insurance Company 9/20/2010 10/1/2010 6,635 9/23/2010 10/1/2010 80 The Buccaneer 9/22/2010 10/1/2010 125 9/28/2010 10/1/2010 81 CIGNA 9/17/2010 9/26/2010 265,000 9/30/2010 9/30/2010 82 Greater Metropolitan Hotel 9/16/2010 10/1/2010 1,200 9/24/2010 9/30/2010 83 Local 17 Hospitality Benefit Fund 9/16/2010 10/1/2010 881 9/24/2010 9/30/2010 84 GS-ILA 9/15/2010 10/1/2010 298 9/15/2010 9/28/2010 85 Allied 9/13/2010 10/1/2010 127 9/13/2010 9/27/2010 86 Harden Healthcare 9/9/2010 1/1/2011 874 9/29/2010 9/27/2010 87 Health and Welfare Benefit System 9/16/2010 10/1/2010 41 9/16/2010 9/27/2010 88 Health Connector 9/20/2010 10/1/2010 3,544 9/24/2010 9/27/2010 89 I.U.P.A.T 9/16/2010 10/1/2010 875 9/23/2010 9/27/2010 90 Sanderson Plumbing Products, Inc. 9/22/2010 10/1/2010 326 9/22/2010 9/27/2010 91 Transport Workers 9/20/2010 10/1/2010 107 9/23/2010 9/27/2010 92 UFT Welfare Fund 9/16/2010 10/1/2010 351,000 9/27/2010 9/27/2010 93 Aegis 9/16/2010 10/1/2010 162 9/21/2010 9/24/2010 94 Aetna 9/16/2010 10/1/2010 209,423 9/16/2010 9/24/2010 95 Allflex 9/20/2010 10/1/2010 34 9/22/2010 9/24/2010 96 Baptist Retirement 9/10/2010 10/1/2010 127 9/17/2010 9/24/2010 97 BCS Insurance 9/13/2010 9/24/2010 115,000 9/22/2010 9/24/2010 98 Cryogenic 9/20/2010 10/1/2010 19 9/20/2010 9/24/2010 99 Fowler Packing Co. 9/8/2010 10/1/2010 39 9/17/2010 9/24/2010 100 Guy C. Lee Mfg. 9/15/2010 10/1/2010 312 9/15/2010 9/24/2010 101 HealthPort 9/17/2010 10/1/2010 608 9/17/2010 9/24/2010 102 Jack in the Box 9/17/2010 10/1/2010 1,130 9/21/2010 9/24/2010 103 Maritime Association 9/17/2010 10/1/2010 500 9/21/2010 9/24/2010 104 Maverick County 9/21/2010 10/1/2010 1 9/23/2010 9/24/2010 105 Metro Paving Fund 9/20/2010 10/1/2010 550 9/20/2010 9/24/2010 106 PMPS-ILA 9/19/2010 10/1/2010 15 9/23/2010 9/24/2010 107 PS-ILA 9/19/2010 10/1/2010 8 9/23/2010 9/24/2010 108 QK/DRD (Denny's) 9/16/2010 10/1/2010 65 9/22/2010 9/24/2010 109 Reliance Standard 9/14/2010 10/1/2010 varies 9/14/2010 9/24/2010 110 Tri-Pak 9/20/2010 10/1/2010 26 9/20/2010 9/24/2010 111 UABT 9/17/2010 10/1/2010 17,347 9/17/2010 9/24/2010   total     1,175,411     What does it say about an the administration’s healthcare reform act when it grants so many exemptions from a law? Didn’t President Obama tell us this healthcare reform act would be ultimate solution to our health care problems? Shouldn’t the waivers be automatically to companies and unions without application? Wouldn’t companies that are granted the waiver have a competitive advantage over other companies in the same industry that do not have an exemption? Last week the Department of Health & Human Services published a set of new guidelines for those seeking to apply for a waiver.  As news of these waivers starts to spread the Department of Health & Human Services will swamped with applications for waivers. The Office of Consumer Information and Insurance Oversight’s sub-regulatory guidance on the process for obtaining waivers of the annual limits requirements may be found at: http://www.hhs.gov/ociio/regulations/patient/ociio_2010-1_20100903_508.pdf The administration says it is responding to concerns of employers and others. Many workers would not have a healthcare insurance alternative. President Obama’s healthcare reform act is causing more problems than it is solving. Just think about the administrative bureaucracy, costs and inefficiency generated by this unintended consequence. Other unintended consequences will be generated by President Obama’s healthcare reform act. President Obama needs to start all over again and develop a consumer driven healthcare system that aligns all the stakeholders’ incentives. -The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.