Bad by Design


This week’s health policy news roundup curated by Jane Orient, M.D.

As most Americans are finding out, Obamacare is a bad deal for them. This is not a flaw, but a feature. As Devon Herrick points out, Obama’s Robin Hood scheme is bad by design, a scheme to force the majority of Americans to pay for the minority of unhealthy people, say 4 million out of a total population of 320 million, who couldn’t get insurance coverage at a price they were willing or able to pay. It is at its core a wealth redistribution scheme. And the rhetoric about “health disparities” neglects to mention that most health disparities are due to behavior, not lack of health coverage.

What did the law accomplish? In essence, the law’s first 18 months of full implementation has increased the percentage of the population with health insurance coverage from a 17-year average of 85.7 percent to around 91 percent, an improvement of 5.3 percent, writes Doug Badger. It’s not clear how much was due to ACA, versus a decline in unemployment, more people turning 65 and eligible for Medicare, or more qualifying for Medicaid under pre-existing criteria. Calculating the cost of that progress is no simple matter—especially if one includes the disruptions and the suffocating regulatory regime.

Investigations of failures, such as bankruptcy of the co-ops, are shrouded in secrecy.

Then there are side effects. ObamaCare may be growing the number of unpaid medical bills, writes Scott Gottlieb. “The structure of the insurance products offered under ObamaCare was deliberately skewed toward hollowed-out health plans.” ACA mandates “essential health benefits.” Then, to “accommodate full coverage of these routine costs, the plans skimp on access to doctors and drugs, and saddle consumers with high out of pocket costs on mostly catastrophic medical bills.”

One of the worst and least known features of ACA “calls for federal government to pay physicians and hospitals bonuses if they deny health care to seniors and the disabled—and even encourages them to form local monopolies to make it harder for them to find alternative sources of care,” writes Robert Book. So much for Obama’s stated goal “to prevent patients from being denied health care so that others could increase their profits.”

It shouldn’t be surprising that ObamaCare’s approval rating has dropped to around 26%.

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