Democrats opposing and criticizing ObamaCare

A few recent articles about Democrats opposing or criticizing ObamaCare:

Are Democrats Starting to Regret Obamacare?: “Retiring Sen. Tom Harkin, the Iowa Democrat and chair of the Senate Health, Education, Labor and Pensions Committee, which did much of the heavy lifting on early drafts of Obamacare, now thinks that passing the law in its current form was a mistake.”

Democratic Sen. Chuck Schumer: Democrats Made a Mistake Putting Health Care Reform Before the Economy

Barney Frank on the White House Rollout ofhttps://patientpowernow.wordpress.com/wp-admin/themes.php Obamacare: “They just lied to people.”

(I should add more if I see any.)

 

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Balance billing: a partial remedy for low Medicare physician access, and high costs

David R. Henderson writes:

The problem: Doctors cannot legally charge more for a service than the amount that Medicare pays, and Medicare often pays a low amount. That’s a classic recipe for a shortage of doctors.

The problem starts with the Center for Medicare and Medicaid Services (CMS), the federal agency that sets prices for the medical services of Medicare patients. CMS is really a giant central-planning agency. It sets hundreds of thousands of prices. What are the odds that it sets all the right prices? Zero. In fact, with central planning, an organization like CMS cannot ever know what the right price is.

An obvious solution to this problem is to have a free market in healthcare—with no Medicare. But since that is unlikely to happen soon, incremental changes can be made to move closer to a free market. Despite the socialized system of CMS, it’s possible to approximate free-market prices with “balance billing.” In its purest form, doctors would be able to charge whatever they want for their services, and patients would pay the difference between that price and the amount Medicare pays. Today, doctors who accept Medicare reimbursement are not allowed to charge anything more.

With balance billing, many fees would certainly increase—at least for those seniors who are willing and able to pay them. But it would also stem, and even reverse, the exit of doctors from Medicare. And that’s not all. As any health economist can tell you, one of the biggest problems with our healthcare system, one that existed even before ObamaCare, is that the majority of what people spend on healthcare is “other people’s money.” One reason we know so little about prices is that few of us actually pay the price of medical care. Instead, we pay nothing, a small co-payment, or a small percent of the price. The main thing I learned in my two years as the senior economist for health care policy with President Reagan’s Council of Economic Advisers is that health care costs so darn much because we pay so darn little for it. Why hesitate to say yes to a $500 test your doctor wants to order if you know that you will pay only $50 for it?

Read more: Medicare and the Free Market | Hoover Institution.

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Seven Myths about King v. Burwell (ObamaCare & Supreme Court)

The Supreme Court has granted cert. in King v. Burwell, one of four cases challenging the IRS’s ongoing expansion of the Patient Protection and Affordable Care Act’s main taxing and spending provisions beyond the clear and unambiguous limits imposed by Congress. Here I will attempt to dispel common myths surrounding these “Obamacare” cases.

Read the whole article by Michael Cannon: Seven Myths about King v. Burwell | Cato Institute.

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Jonathan Gruber’s connection with ObamaCare

At Reason, Peter Suderman writes:

In the week since video surfaced of Obamacare architect Jonathan Gruber saying that “lack of transparency” and “the stupidity of the American voter” were critical to passing the health law, two more videos of Gruber making statements with similar themes or tones have received attention.

Both clips reveal a gleefully dismissive attitude toward public concerns about the law, and offer a telling reminder of the attitude that played a crucial role in shaping and selling the law to the public.  …

This is the person whom the White House relied on to help craft the bill; he was paid handsomely to model its effects (a fact he did not disclose, even when asked), and he was in the room when important decisions were made about how it would work. He claims to have helped write specific portions of the law himself. Gruber was not the sole architect of the law, but he was one of its biggest single influences on both its design and on how the media, which quoted him repeatedly, reported and understood the law.

The White House and its allies are desperately trying to distance themselves from Gruber right now by downplaying his role in the law’s creation. But the record of his involvement is clear enough: At The Washington Post, Ezra Klein has variously described Gruber as “one of the key architects behind the structure of the Affordable Care Act” and “the most aggressive academic economist supporting the reform effort.” The New York Times in 2012 described his role as helping to design the overall structure as well as being “dispatched” by the White House to Congress to write the legislative text. Gruber’s work was cited repeatedly by the White House, Democratic leadership, and the media.

So when he describes the thinking about how the law was crafted and sold to the public, it’s worth taking note. This is the posture of one of the law’s authors and chief backers. It’s part of the spirit in which the law was created and passed. Gruber’s ideas were embedded in the law’s structure and language, and so was his attitude.

Read the whole article: Jonathan Gruber Embraced Misleading the Public About Obamacare Even While It Was Still Being Debated – Hit & Run : Reason.com.

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Government Buries Evidence of Poor Access to Care under Obamacare

From John R. Graham:

Thank providence for USA Today, which has given us yet another story describing how poor access to health care is under Obamacare.

People who fell for navigators’ sales pitches and signed up for Obamacare are discovering that it is junk insurance:

“The exchanges have become very much like Medicaid,” says Andrew Kleinman, a plastic surgeon and president of the Medical Society of the State of New York. “Physicians who are in solo practices have to be careful to not take too many patients reimbursed at lower rates or they’re not going to be in business very long.”

Kleinman says his members complain rates can be 50% lower than commercial plans.

“I definitely feel like a bad person who is leeching off the system when I call the doctors’ offices,” she says. Shawn Smith of Seymour, Ind., spent about five months trying to find a primary care doctor on the network who would take her with a new, subsidized silver-level ACA insurance plan.

Note: This person had a silver plan, not a bargain basement bronze plan.

More: Government Buries Evidence of Poor Access to Care under Obamacare | Health Policy Blog | NCPA.org.

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Despite ObamaCare Supporters’ Claims, Health Insurance Plans Prior to ObamaCare Exchanges Were Neither ‘Crappy’ Nor ‘Substandard’

From David Hogberg at the National Center for Public Policy Research:

When millions of people in the individual health insurance market lost their health plans in late 2013, ObamaCare supporters claimed those lost plans were “substandard” or “crappy.” However, they failed to support that contention.

This study examines the claim that the policies on the individual market were inferior in quality to those on the ObamaCare exchanges. First, it compares the premiums and the size of the deductibles as well as maximum out-of-pocket costs of policies on the individual market prior to the exchanges to those of current polices on the exchanges. Second, it examines the quality of provider networks by comparing the number of plans that are HMOs versus those that are PPOs in the individual market prior to the exchanges and those now on the exchanges.

The study finds that there were many policies on the individual market that had lower premiums and lower or equal deductibles and out-of-pocket maximums than the cheapest plans now available on the exchanges. It also finds that the individual market prior to the exchanges offered a greater choice of hospitals and physicians since it contained far more PPO policies than HMO policies, whereas the exchanges offer more HMO policies.

Read the whole study: Despite ObamaCare Supporters’ Claims, Health Insurance Plans Prior to ObamaCare Exchanges Were Neither ‘Crappy’ Nor ‘Substandard’.

Via the National Center for Policy Analysis.

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Medicaid Expansion: Wisconsin got it right by liberating people from Medicaid ghetto

As Devon M. Herrick concludes his policy brief :

On paper, Medicaid coverage appears far better than what most Americans enjoy — with lower cost-sharing and unlimited benefits. But by almost all measures, Medicaid enrollees fare worse than similar patients with private insurance and often experience worse health issues than patients with no insurance. Wisconsin made a wise choice when it decided to forgo a full Medicaid expansion in favor of a smaller program that would maximize the availability of private coverage for Wisconsin’s low-income residents

Read more: Medicaid Expansion: Wisconsin Got It Right | NCPA.

More on the Medicaid ghetto here and here.

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