American Elephants

ObamaCare is Rolling-Out On a Bumpy and Potholed Road—That Wasn’t Shovel Ready. by The Elephant's Child


The Inspector General for the Department of Health and Human Services has not assessed whether ObamaCare will be ready to roll out on October 1, a spokesman for the Inspector General said today.

They have not done in-depth inspections of specific parts of the law, the spokesman said. “Whether the Affordable Care Act will be able to be up and fully functional on October 1, is not something that we have done assessments of,” said Donald White, a department spokesman.

That immense stack of paper is a printout of the Affordable Care Act. Nancy Pelosi thought she was being cute when she said “We have to pass it to find out what’s in it.” It wasn’t funny, but unbelievably crass. Passing a bill with not so much as a single word included from a  Republican, a bill ginned up in a back room, passed with the most corrupt form of bribes, and without a single Republican vote — is not the way things are supposed to work.That alone should be enough to fire every single Democrat congressman.

Democrats have long wanted single-payer health care, like the British have. Because it is paid for through taxes and a reduced standard of living, the Brits believe that their health care is free at the point of service. If it’s free, then you can run off to the doctor for every sniffle and cold, and over-use becomes a real problem.

But the British have long been glad to return to power whoever promises not to interfere with their “free” healthcare. Unfortunately, the service is terrible; waits for service long; hospitals are filthy; the aged are left without water, clean sheets, or care to die from neglect. The scandals are real, people die, because the incentives are all wrong. Doctors are servants of the system, the newest medicines or newest diagnostic tools are too expensive to buy. Patients are encouraged to over-use the system, hospitals and doctors offices are encouraged to treat more patients in less time so it will cost less. And Doctors and hospitals are desperate to be paid adequately for their services. Incentives are really important.  So, as was completely inevitable, Britain’s National Health Service is going broke.

Forbes magazine reports that ObamaCare will increase the average Individual-market insurance premiums by 99% for men, 62% for women.  The technology problems involved in the exchanges are huge, and it doesn’t look like they’ll be ready or functional at all. The U.S. has had to delay the deadline for finalizing the final agreements with  insurance plans. In some cases they say they’re ready, but nobody has checked.

The architects and supporters of ObamaCare had wonderful visions about the possibilities of information technology, the kind of visions held only by those who have never been more deeply involved with their computer than moving the mouse around. Megan McArdle said she worked in an IT consultancy, and she thought setting up this system would be something like an eight-year job. You should hear the doctors who have to switch from handwritten notes to entering data in a laptop. My doctor says the errors are going through the roof (how often do you have a typo? And it’s worse with numbers) and endangering patients.

A Price-Waterhouse study found that “insurers passed over major medical centers” in many states to keep premiums down. Those buying a Blue Cross plan in California’s exchange will have access to 47% fewer doctors and 22% fewer hospitals than subscribers can get today. The Blue Cross plan in New Hampshire excludes more than half of the state’s hospitals. That’s what the incentives direct insurers to do, and how the best intentions go astray. Having an insurance card does not guarantee access to specialists or other providers.

At the Clinton Global Initiative on Tuesday, President Obama did admit that  his health care law does raise taxes after all. ” So what we did— it’s paid for by a combination of things. We did raise taxes on some things.


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