Health Care: Arbitrage Obama And The Dems
The Market Ticker ® - Commentary on The Capital Markets
Posted 2010-03-22 13:23
by Karl Denninger
in Health Reform
Ignore this thread
Health Care: Arbitrage Obama And The Dems
 

Yes, I mean it.

And yes, I've read the Health Bill.  Both the 2,000+ page original and The House changes as voted upon.

Here's the bottom line:

  • If you refuse to buy health insurance, you will be fined on a sliding scale that amounts to 2% of your AGI.  So if you make $100,000 a year, you could be fined $2,000 for "refusing" to buy insurance.

  • You cannot buy a catastrophic policy any more.  The "cheapest" acceptable policy will cost somewhere around $15,000 for a single person, and over $20,000 for a family.  This is, for most people, more than five times the maximum possible fine - each and every year.  The law makes it effectively impossible to maintain an existing catastrophic policy as they "renew" every year, and should any change be made you are then forced to buy something "acceptable" in the law (or pay the fine.)

  • When the "pre-existing condition" bar comes down you cannot be charged more or denied coverage due to pre-existing conditions.

  • I fully expect 20-50% premium increases immediately, and for the next three years sequentially, in all existing policies.  This is precisely what the banks did in front of the CARD act becoming effective, and it will happen here as well.  That is the cause of the short-term rocket shot in the health-related stocks this morning.

  • In addition the capital gains tax changes will do severe damage to capital formation immediately, and these changes will become especially severe starting in 2014.  The market will anticipate these changes and react accordingly, although you certainly wouldn't know it today.

Ok, this one's easy.

When the fines and pre-existing coverage "stop-out" go into effect (now for kids, in a couple of years for the rest) drop all coverage for those affected.

Why?

Because:

  • The fine is 1/5th or less the cost of the "insurance."

  • For routine care, you now can negotiate for your care before it is provided.  It will be cheaper to do so than to buy the insurance - for routine events.  Don't try to tell me it's not either - I've been carrying a catastrophic-only policy now for more than a decade, and as a consequence I've negotiated these fees and costs for routine things and saved tens of thousands compared to simply "buying a full-boat policy."  The only reason for me to carry the "catastrophe" policy - the possibility of being screwed if I developed a serious condition and thus got excluded - has just been erased by this law, effective in a couple of years.

  • If you have a catastrophe of any form, buy the insurance at that point in time.  You cannot be turned down or charged more.

Screw the government.  They are the ones who set the standards - we simply have to live with them, and this is the only logical action to take given what they have just done.

Is there a risk in this strategy?  Sure.  You could have a "zero notice" catastrophe before you (or someone with a power of attorney) could buy a policy.  So you have to be able to survive that sort of "short-term" event - but remember, you're going to be banking $10-20k per person during the time you're running "naked."  So do exactly that - bank it for a year or two - so you have the ability to cover the instant expense from one of those "aw crap!" catastrophic circumstances.  Fact is, they don't happen often and in a year or so you can have a very nice cushion against them.

Businesses will be dropping people like flies from business-covered "insurance"; there will be no reason for anyone as an employer to be providing this "benefit" into an environment where insurance prices will double - and probably double twice - in the next four years.  If you think not, look at what was done to credit-card holders in front of the provisions of the CARD act going into effect.

This, by the way, will bankrupt the insurance companies in the end.  Nobody will buy until they have HIV, Cancer or some other serious illness - then they will buy, and the companies will have to pay - with no lifetime caps or exclusions for pre-existing conditions.

The health care companies that are getting a rocket shot today in the stock market are being bought by fools

If you have any belief whatsoever in the efficient market hypothesis this is exactly what people will do as the effective dates for these provisions approach, as it will save them ten thousand dollars a year or more - each.  The insurance companies will instantaneously lose the "pool" of healthy people who buy against risk - rather, they will have a pool of all sick people who buy against known costs.

Forget it folks - this is the end of the health industry in America, and I will be looking for the recognition in the market (as expressed by technical analysis on the stocks in this sector) that the efficient market will come to the fore. 

The intention of The Democrats (and liberals generally) in this legislation is clear and impossible to hide - they intend to completely destroy private health care in favor of a fully-government-run single-payer system.   The efficient market guarantees this outcome given the law they passed, and they know it. 

I cannot stop this idiocy but I can sure attempt to profit from it.

I am looking to establish the largest targeted short positions of my investing career if and when the technicals confirm that this obvious arbitrage is about to, or is, taking place.

This is one place where a fistful of PUTs can easily turn thousands into hundreds of thousands, and is an extremely-high probability play.

Disclosure: No positions in the sector yet, but as discussed I will have some extremely large ones in the coming months and years!

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User Info Health Care: Arbitrage Obama And The Dems in forum [Market-Ticker]
Otiswild
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Wouldn't LEAPs be premature, at least prior to Nov or Jan 2011? If enough folks put down the hamburgers and get up from American Idol...

(yeah yeah, I'm filled with hopenchange :p)
Snowmizuh
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The liberals that engineered this know this as well. They're evil, but not stupid. The end game is destruction of private health insurance companies in order to attain the final goal: a single-payer system.
Pooslinger
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Karl are you referring to just the health insurer stocks and not the drugmakers?
Fidgit
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Snowmizuh, yup, that's the Holy Grail we're all slogging toward...
Snowmizuh
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By the way, thanks for posting this Karl. This idea was something we were just discussing over lunch.

Here's a niggling detail we thought about: what if you go to the emergency room without insurance. You apply for insurance, and the insurance company can't turn you down, but it takes them 10 days to 'turn on' the coverage (they drag their feet about it). Does that mean you are still on the hook for day 1 to day 10 in the hospital?
Genesis
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Poo, both.

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I don't care if it makes sense -- only if it makes money. -- Me
Bank (n): See scam, fraud and theft. Eat a bankster -- they're low-carb.
What part of "shall not be infringed" was unclear?
Dmm219
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"Here's a niggling detail we thought about: what if you go to the emergency room without insurance. You apply for insurance, and the insurance company can't turn you down, but it takes them 10 days to 'turn on' the coverage (they drag their feet about it). Does that mean you are still on the hook for day 1 to day 10 in the hospital?"

My bet is there is serious wiggle room in the legislation for insurers on this one. KD's idea works for slow moving conditions such as cancer, Heart Disease, Alzheimer's'...however, it will leave you with your pants down in the case of a true catastrophic emergency.

Best bet if you do this: Save up enough in a HSA to cover at least 2 weeks in the hospital with some high level tests (at least $10k or so).
Genesis
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Yep. Or just save up the money. You're going to be banking $10k+ a YEAR telling the insurers to go pound sand - your risk exposure window on that "true zero-notice catastrophe" is less than one year in duration.

I'll roll the dice on that.

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I don't care if it makes sense -- only if it makes money. -- Me
Bank (n): See scam, fraud and theft. Eat a bankster -- they're low-carb.
What part of "shall not be infringed" was unclear?
Snowmizuh
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I agree on the strategy of self-insuring via HSA. I am definitely going to pull the trigger depending on when this goes into effect (I'm still a little confused about what provisions in the legislation start when). I'll check with BCBS/Alabama for my small business this week to see if we can drop immediately or if we have to wait for open enrollment (Nov-Dec).
3250fps
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Or the insurance industry will figure out how to fill that gap with a rider to life insurance or something.
Daveincsa
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In the South
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I can't wait for my employer to give me the big raise Obama promised since this will be saving them money!
Micronin127
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I fully expect some people to pay the fines instead of purchasing insurance, but the cost of a single catastrophic event can be quite severe and beyond the means of most people to have saved up.

The worst possibility is heart attack requiring immediate triple bypass surgery to avoid death as the outcome. This surgery will set you back a cool half million. And there won't be much negotiating going on.

It will be interesting to watch as the core problem of isolated markets with monopolistic pricing power wasn't addressed.

This legislation is going to cost a fortune and all the predictions of savings are about as trustworthy as any other government statistic.
Genesis
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Immediate, no-notice triple-bypass surgeries? C'mon - what's the odds on that one? Near zero.

Now if you ignore the fact that you can't climb a flight of stairs for five years, ok, sure. That's not exactly "no notice" is it?

Look, the point of this is that you PAY OUT OF POCKET for the routine things you need to buy to be reasonably insured (by your own knowledge of your health!) against such a "lightning strike" event. Yes, there are things that can **** you HARD like this - a CVA being one of them - but those are extremely rare in someone with NO risk factors (that is, truly "out of the blue") just as is that triple-bypass coronary.

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I don't care if it makes sense -- only if it makes money. -- Me
Bank (n): See scam, fraud and theft. Eat a bankster -- they're low-carb.
What part of "shall not be infringed" was unclear?
Tdaly
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Hey Karl- We have a HSA account that of course is pre tax. When this goes in effect are people going to pay for their health insurance and pay a tax at the same time depending on their tax bracket? So in essence people will be paying double? Its a little confusing.

Thank you.
Gator
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I like this idea. But is there a risk that once private insurers fail and and we have government paid health care, that it will be illegal to pay cash for health services and drugs.

I could see this happening. Get ready for a big underground economy. I think they're going to need more than 16000 IRS agents, and need more shotguns. smiley
Abn0rmal
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What percentage of health care expenditures goes towards conditions that are the result of lifestyle choices?
Effinre
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Hey KD,

How would it affect women and pregnancy. Can we drop my wife's coverage and purchase coverage after we find out she's pregnant too? Boy will that save us a lot of money.
Gator
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Holy crap Effinre. That is the only reason I wouldn't do this myself. My insurance (at it's current cost of course) is a very good deal as long as we're planning more children.
Genesis
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Effinre, looks that way. No pre-existing condition exclusions!

----------
I don't care if it makes sense -- only if it makes money. -- Me
Bank (n): See scam, fraud and theft. Eat a bankster -- they're low-carb.
What part of "shall not be infringed" was unclear?
Steelhead23
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Brilliant Karl, There's just one glitch in your plan. In effect, you would be banking on the American Public wising up, putting pencil to paper and figuring stuff out. Today, most Americans consider doing without health insurance as unthinkable, a similar kind of thinking that made folks believe that overpriced houses were still a bargain a mere 4 years ago. More likely, the insurance companies******them for years until their squawking causes Congress to change the law - perhaps to a single payer, perhaps to simply drop the mandatory aspect of the bill. If they did that, then those puts would be so much fodder for the shredder. So, this is not a risk-free opportunity. I have never seen the government more involved in the markets, making it hard as hell to determine when a play makes sense. Be cautious.

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"Give me control of a nation's money and I care not who makes it's laws" —Mayer Amschel Bauer Rothschild Benjamin Bernanke
For-profit commercial banks are a menace and should be eradicated
Genesis
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I'm not putting the position on until the market confirms (technically) the efficient market. But when it does, oh boy...

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I don't care if it makes sense -- only if it makes money. -- Me
Bank (n): See scam, fraud and theft. Eat a bankster -- they're low-carb.
What part of "shall not be infringed" was unclear?
Ssg263
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KD- Won't companies be violating the HMO Act of 1973 if they stop providing plans to their employees?
Widgeon
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What if you pursue KD's proposition and say, have a serious traffic accident where a whole lot of "care" is given quickly ... well before you are cogent & able to "buy" into a policy. Seems like "pre-existing" or not, the date of the "care" would precede the effective date of the policy, thereby exposing you to the entire bill.

Also, what would prevent the insurers (or gov) from invoking a 30, 60, 90 day or longer delay into the "start" date of new policies in an effort to prevent exactly what is being proposed? I can easily see that happening.

Jubber
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Could someone list the likely shorting candidates, as a Limey I don't know who is involved, so I can watch them, Thanks in advance

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“The problem with socialism is that, sooner or later, you run out of other people’s money.” Thatcher
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