Doctor on Insurance Rates Soaring: ‘It’s Sticker Shock’

Typical Virginian nonsmoker would see rate triple under new law, analysis shows

Pediatric urologist Dr. Hal Scherz told Fox News host Neil Cavuto Monday the implementation of Obamacare will bring a lot of unwelcome surprises to healthy Americans, calling it "sticker shock."

Wall Street Journal analysis stated that health insurance costs were set to double and triple in some cases for healthier Americans, with the new exchanges likely to offer fewer or none of the the lower-price policies offered now to people with healthy habits. Then a presidential candidate in 2008, Obama repeatedly pledged his plan would reduce premiums for the average family by $2,500.

Scherz also said the Affordable Care Act has the effect of the government monopolizing health care through hospitals, thus limiting competition from personal physicians and other specialists like himself and leading to increased costs:

SCHERZ: I think that what we're going to see is the beginning of a lot of surprises. It's sticker shock, and they're going to be a lot of surprises that people are going to be in store for. The first are going to be the increased costs that everybody are going to be facing, and instead of seeing a reduction in our health healthcare premiums, which we were promised by President Barack Obama, we're going to be witnessing increases. There's going to be, according to the IRS, this year, an average premium for family of four of $20,000, so this is just the beginning of many surprises that I think we're facing.

CAVUTO: From your vantage point and your specialty going for you, the idea is those who are specialists and those, by the way, who have the extra education and expertise behind that, there's really no upside to that in this law. Is that true?

SCHERZ: Absolutely correct. Everybody is going to feel this. We're feeling this already in health care in medicine, and one of the problems that we're seeing right now is a consolidation in the health care industry. One of the provisions of the health care law is consolidating power in the hands of hospitals. The accountable care organizations are going to be a way that the government feels that they can control costs. So, they're allowing hospitals to come together and become monopolistic in some communities in this country and at the same time limit competition from physicians and other entities that could actually help lower health care costs. Where that's been implemented, we've seen health care costs plummet, but in places where there's been consolidation under the guise of better coordinated care –

CAVUTO: They're not seeing that.

In essence, participants in First Lady Michelle Obama's "Let's Move" campaign to combat American obesity will be soundly punished by the new law. Cavuto pointed out sardonically that this law would be "pay dirt" for people who engage in risky lifestyles like smoking, eating a poor diet and not exercising.

"This law, Neil, never had anything to do with true health care," Scherz said. "It was about controlling people, it was controlling the health care of individuals."

The Wall Street Journal's analysis of the coverage to be sold on the law's new exchanges discovered healthy consumers could see insurance rates explode when they look for individual coverage under the federal health law later this year, while the premiums paid by sicker people are set to become more affordable:

The exchanges, the centerpiece of President Barack Obama's health-care law, look likely to offer few if any of the cut-rate policies that healthy people can now buy, according to the Journal's analysis. At the same time, the top prices look to be within reach for many people who previously faced sky-high premiums because of chronic illnesses or who couldn't buy insurance at all.

Several big provisions in the law taking effect in six months affect rates for the estimated 20% of Americans who don't have coverage through an employer, Medicare or Medicaid. Plans must be available to consumers regardless of their health and must cover certain items such as hospitalization, maternity care and prescription drugs. The exchanges are set to open Oct. 1 selling plans effective Jan. 1.

A review of rates proposed by carriers in eight states shows the likely boundaries for the least-expensive and most costly plans on the exchanges. The lower boundary is particularly important because the government wants to attract healthy people to the exchanges, and they may choose to pay a penalty and take the risk of going without coverage if they believe they can't get an acceptable deal.

Virginia was one of eight states that was investigated, where a middle-aged nonsmoker's health care costs would more than triple:

In Richmond, a 40-year-old male nonsmoker logging on to the eHealthInsurance comparison-shopping website today would see a plan that costs $63 a month from Anthem, a unit of WellPoint Inc. That plan has a $5,000 deductible and covers half of medical costs.

By comparison, the least-expensive plan on the exchange for a 40-year-old nonsmoker in Richmond, also from Anthem, will likely cost $193 a month, according to filings submitted by carriers.

In June, a California report showed Obamacare would increase individual individual-market premiums by as much as 146 percent, leading to concern there about rate shock when the law's main provisions take effect Jan. 1, 2014.