Obamacare’s 2013 Disastrous Rollout Foreshadows Potentially Worse 2014 as Its Rationing Becomes Ever More Clear
By Jennifer Popik, JD, Robert Powell Center for Medical Ethics
A year-end article from The Hill, a newspaper which covers DC politics, might have said it best — “The healthcare law faced a very tough year in 2013, but that could pale in comparison to what happens in 2014.”
In her piece, “Top 5 O-Care stories to watch”, Elise Viebeck went on to write,
“Between new exchange plans taking effect in January, the first enrollment period concluding in March and the midterm elections in November, the administration will have its hands full managing the rollout and mitigating negative stories for vulnerable Democrats.”
2013, by all accounts, has been a tough year for Obamacare. When one of the law’s major components, the health care “exchanges,” came online October 1, the problems were immediate and major. Not only were the exchanges difficult or impossible to enroll in, thanks to problems with the Federal website, but the replacement policies that people are finding in the state and federal exchanges are typically severely restricting the doctors and health care facilities in their plan networks.
Moreover, hundreds of thousands lost their coverage in what Politifact dubbed as the 2013 “Lie of the Year” – Obama’s now debunked promise that if you liked your plan you would be allowed to keep it.
Amid this controversy, public support for the law has dropped to a record low. According to a recent CNN/ORC national poll, support for Obamacare has declined over the past few months to only 35%, with 62% now opposing the law.
The polling is confirming a new and growing reality–American’s current insurance plans are gradually disappearing, while the new Obamacare exchange plans are going to be more restrictive, with less access to doctors and healthcare centers with specialized expertise and high reputations for providing effective life-saving medical treatment. More on this can be found here.
Problems are certain to get worse, not better. Viebeck explains:
“The political firestorm over insurance cancellation notices may not be over for the White House given the likelihood that some employers will drop their coverage next year. By 2016, the Congressional Budget Office has projected that 6 million fewer people will receive employer-based health insurance compared with 2013.”
While the president attempts to appease certain groups by offering temporary delays or the short-term ability to hang on to old insurance plans, the larger problems of eroding coverage for most Americans looms on the horizon.
Dr. Marc Siegel, a professor of medicine and medical director of Doctor Radio at New York University’s Langone Medical Center offered a sobering perspective from the medical community in his piece, “The Death of the Bedside Manner Obamacare is speeding the decline in the quality of medical practice” published on December 26, 2013 in the Wall Street Journal. He wrote
For me and many of my colleagues, the real practice of medicine is supposed to involve an intimate encounter with each patient and a diagnosis of illness leading to a potential cure. In the future, however, a diagnosis of Lyme disease or the severity of a patient’s depression may be missed because showing the photo or taking an extensive mental-health history doesn’t fit squarely into the 10-minute visit authorized by insurance, along with mandatory computer documentation, insurance verifications and appointment scheduling.
These problems predate Obamacare, but the new law brings more regulations and low-quality insurance at a time when we are already struggling to comply with the electronic health-record mandate.
Supporters of health reform will say that the Affordable Care Act didn’t cause all these problems, that President Obama shouldn’t be blamed for wanting to make sure that everyone has health insurance.
Unfortunately, the kind of insurance that is growing under ObamaCare’s fertilizer is the exact kind that was jeopardizing the quality of health care in the first place: the kind that pays for seeing a doctor when you are well, but where guidelines and regulations predominate and choice is restricted when you are seriously ill.
How can quality of care not be affected if the antibiotic or statin drug or MRI scan I feel you need isn’t covered under your plan? How can Obamacare be labeled a success when it adds layers of bureaucracy to an already overburdened system?
Since insurers are being compelled to cover more folks with pre-existing conditions, with no lifetime limits, and to cover everyone in a family plan at least up to the age of 26—all popular provisions of the ACA—they reduce costs by cutting fees to vulnerable doctors while restricting the tests they can order. This makes the practice of quality medicine almost impossible, but it helps preserve an insurance company’s bottom line while complying with a government mandate.
That copay that you no longer have to pay for colonoscopies or mammograms may have been the one bit of steady cash keeping in business many physicians and providers who perform them but work on very thin profit margins.
While many are quick to blame insurers, the real culprit is the Obamacare requirement that exchange bureaucrats are excluding insurers who offer policies deemed to allow “excessive or unjustified” health care spending.
Under the Federal health law, state insurance commissioners are to recommend to their state exchanges the exclusion of “particular health insurance issuers … based on a pattern or practice of excessive or unjustified premium increases.” The exchanges must not only not offer policies in an exchange when government authorities do not agree with their premiums, but the exchanges must even exclude insurers whose plans outside the exchange offer consumers the ability to reduce the danger of treatment denial by paying what those government authorities consider an “excessive or unjustified” amount. (See documentation at www.nrlc.org/medethics/healthcarerationing.)
This evidently is creating a “chilling effect,” deterring insurers who hope to be able to compete within the exchanges from offering adequately funded plans that do not drastically limit access to care.
When the government limits what can be charged for health insurance, it restricts what people are allowed to pay for medical treatment. While everyone would prefer to pay less–or nothing–for health care (or anything else), government price controls prevent access to lifesaving medical treatment that costs more to supply than the prices set by the government.
While Obamacare continues to roll out in 2014, it is important to continue to educate friends and neighbors about the dangers the law governing them poses in restricting what Americans can spend to save their own lives and the lives of their families.
Note: the abortion-related provisions dealing with the state exchanges are described here:www.nrlc.org/AHC/index.html