There Was an Old Lady Who Swallowed an Insurance Law by Michael Gorback MD


I recently decided that I despised my health insurance company to the point where I would look for a new policy. Of course, this is the triumph of hope over experience. After all, I am a physician and have witnessed the ravages of health insurers on a daily basis, at the hands of just about every company. I’m a realist; I’m shooting for “less horrible”.

I contacted an insurance salesperson, who informed me that due to the ACA I can’t change policies whenever I want to. I must wait until the enrollment period, which begins on November 15. I am stuck paying premiums to a company I have come to despise until November. If I cancel the policy it will be impossible to get insurance for months.

I will also be breaking the law, should the law ever be enforced.

That’s because under the ACA an insurer can’t refuse you coverage. The myopic meddling morons authors of the ACA erased much of the part of insurance underwriting that estimated risk and charged an appropriate premium to the insured, or flat out refused coverage. It’s really not insurance any more in the traditional sense. Maybe now we should call them “insurance providers” and if you have two policies, e.g. Medicare plus supplemental insurance, Medicare would be called your “Primary Insurance Provider” or PIP. The PIP pays your PCP (Primary Care Provider, because “family doctor” is so 20th Century). But I digress.

As a result there was concern that people would game the system by jumping on and off plans or ratcheting up and down between cheaper and more expensive coverage levels pro re nata (as we say in the medical biz).

In response to that legislature-induced conundrum they created the enrollment period. You can only enroll in a health insurance plan during the enrollment period. There are certain exemptions – such as changing jobs, marriage, divorce, having a baby, etc – but for the most part entering into or severing health insurance contracts between two private parties is now forbidden by the government except during one annual temporal window.

To recap: The authors of the ACA did not want insurance companies to be insurance companies, which begat mandated coverage, which begat gaming the system, which begat enrollment periods, which begat yet another government-generated distortion of free markets by the great farce that is ObamaCare.

It reminds me of the old nursery song,

There was an old lady who swallowed a dog.
My what a hog to swallow a dog
She swallowed the dog to catch the cat…
She swallowed the cat to catch the bird …
She swallowed the bird to catch the spider
That wiggled and wiggled and tickled inside her.
She swallowed the spider to catch the fly.
I dunno why she swallowed the fly.

You apply patch after patch after patch in escalating amounts, twisting and turning until you end up with monstrosities like ObamaCare, a road to Hell paved with good intentions. Sometimes I get so distracted dealing with the problems ObamaCare has created it’s hard to remember what problems ObamaCare was intended to solve.

In the song the old lady swallows a horse and dies. The American public also ingested something big in 2010, although arguably it was more of a forced-feeding. Let’s hope we fare a little better than she did.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  2 comments for “There Was an Old Lady Who Swallowed an Insurance Law by Michael Gorback MD

  1. Pat
    July 12, 2014 at 7:56 am

    We won’t, Michael, but an enjoyable column all the same.

    • Michael Gorback
      July 15, 2014 at 3:07 pm

      I just saw another victim of the enrollment period. She had a baby, couldn’t keep up the insurance premiums and her policy was canceled. Now she can’t get back on until November 15.

      How do you distinguish someone like that from someone who deliberately games the system?

      This must be how the turtles feel when they get caught in the tuna net.

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