“Four Horsemen of the Apocalypse (1887), by Viktor Vasnetsov.

Bryan Rotella, founder and managing shareholder of Rotella Legal Group, writes in The Hill of four areas that might suggest a healthcare system economic meltdown. He also notes that  health-insurance expert Joe Cortelli said that “we have done nothing to improve the outcomes of the 10 percent of the population that drives 80 percent of our claims costs.”

Mr. Rotella’s list of dangers:

• Members with health plans from the ACA exchanges tend to be sicker and more expensive, as detailed in a study from the Blue Cross Blue Shield Association.
• Insurance premiums are surging even before two of the ACA’s three premium-stabilization programs expire in 2017.
• Recalling scenes in The Big Short, very few people have gone around asking physicians how they  respond when high-risk patients are ”shuttled” to exchange plans.
• Big health systems and insurers  are seen as too big to fail. To prevent a death spiral, the ”public option” may be deployed to boost competition on exchanges. ”What irony, as the ‘public option’ looks an awful lot like the government bailout of the mortgage banks,” Mr. Rotella observed.

To read his op-ed in The Hill, please hit this link.