American Elephants


“Free Medicine” or Free Market Medicine? Hype or Hope? by The Elephant's Child

The case of ObamaCare will be argued before the Supreme Court next week. The Court has given it an unusual five hours for arguments over three days, then the decision is expected to come down some time in June.

The administration plans a coordinated campaign to force an unwilling public to accept ObamaCare. As usual, they will not present evidence, but instead focus on ” better messaging.” Focusing attention of their target audience on dramatic stories of the wonderfulness of the Affordable Care Act and Patient Protection ( I can never remember what comes next). Hopefully not the false story of Obama’s mother’s insurance again. The White House has a lot of persuading to do. Americans don’t like it.

Now events have put it back on the front page: the case brought by 26 states reaching the Supreme Court, the  issuance of a compulsory contraception mandate, and a new cost estimate from the Congressional Budget Office. The bill came with all sorts of budget gimmicks so President Obama could trumpet 10-year costs of $938 billion. Now the CBO is estimating costs for 2013 through 2022 at $1.76 trillion, nearly double the phony original number, and even that is probably understated.  Annual gross costs after 2021 are more than a quarter of $1 trillion forever, every year.  Added to our $16 trillion in debt, of course.

Aside from lying to us about the costs, they lied to us about the need for reform. The cost of health care was NOT spiraling out of control, it had been declining for ten years back towards the normal rate of inflation — caused by advances in medicine, treatments, medicines and management. The part about evil insurance companies was hooey too, as was Obama’s claim that his mother’s insurance denied payment. He got several Pinocchios for that.  The big problem is simply that it won’t work.

Liberals get all excited when they want to accomplish single provider insurance. They want to cover everything to prove how nice they are. After all, their aim is to make you completely dependent on them. But things are not free. Somebody has to pay for them, and the only somebody around is taxpayers. When they generously offer to pay for your contraception, the cost goes up.

The Medicare Drug program was designed to cost less than was estimated because of the “donut-hole” provision that gave seniors an incentive to keep their own costs down by using generics and avoiding unnecessary drugs. When a senior’s cost for drugs reached a certain level, they had to pay for their own (incentive) unless they could not afford it, in which case the plan picked it up. Liberals were horrified, and eliminated the provision that kept costs down, which is insane.

President Obama claimed that his health-care plan would lower annual family health insurance premiums by $2,500 before the end of this term. The Kaiser Family Foundation reported that the average family premium has increased by $2,200. The promised long-term care program, called the CLASS Act has been eliminated because it was financially unworkable, but the loss of the premiums that would have been collected wiped out $70 billion of supposed deficit reduction.

Around 50% of employers plan to stop offering health insurance to their employees once the law is implemented. Their choice is to pay $20,000 per family for care or a $2,000 fine. The incentive is to drop coverage. The plan was devise to become single payer.

But nevermind, there won’t be enough doctors anyway. The nation could face a shortage of as many as 150,000 doctors in the next 15 years, according to the Association of American Medical Colleges. The U.S. now has 352,000 primary-care physicians now. Four new medical schools have opened and have enrolled about 190 students. Some 18,000 students entered U.S. medical schools in the fall of 2009. The big blockage is the three-year residency period; there are about 110,000 resident positions, and teaching hospitals rely on Medicare funding, which Congress capped.  It will probably take 10 years the AAMS’s chief advocacy officer says, to even make a dent in the number of doctors needed.

Add to that the fact that most doctors would now advise their own kids not to go into medicine. And more than 43% of doctors say they are considering retiring within 5 years. Used to be that many families had lots of doctors, but the profession, under ObamaCare, is no longer so rewarding.

Under a program like ObamaCare, the #1 problem becomes cost. When the government has promised all things, they have to find ways to cut those costs. The first choice is to cut the cost of senior citizens, for the highest costs come in a person’s final years. It would be much more convenient if they would not demand (or get) expensive procedures, and expensive care. Obama already took $500 billion out of Medicare payments to providers. The consequence: fewer doctors will accept Medicare patients, more emergency room use. The focus of the entire enterprise becomes eliminating cost.

Under the American health care system, before Obama got his hands on it, the focus was on getting people well, making them healthier, or more comfortable. That’s what all those new treatments, new procedures and innovation was all about. Doctors and hospitals were rewarded for excellence.

I think that’s what they called “the free market.”




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