ObamaCare State of Emergency. Will Single Payer Fix It?

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

“ObamaCare Keeps Our Health System In A State Of Emergency,” writes Sally Pipes (Investor’s Business Daily, Apr 1). Obama “promised that the Affordable Care Act would alleviate the pressure on ERs by expanding access to insurance—and thus diverting people who previously would’ve gone to the emergency room for routine care to the doctor’s office instead.” This hasn’t happened. Medicaid recipients are actually using ERs more, finding it difficult to find care elsewhere, and the system’s grade for quality, according to the American College of Emergency Physicians, dropped from a C- in 2009 to a D+ in 2014. http://www.investors.com/politics/viewpoint/obamacare-keeps-our-health-system-in-a-state-of-emergency/

On doing what it promised, ObamaCare gets a score of a miserable 57% in its sixth year, writes Chris Conover (Forbes, Mar 30). And the per-enrollee cost of coverage is 18% more than had been anticipated just a year ago. The wheels are quickly falling off the ObamaCare bus, he concludes. http://www.forbes.com/sites/theapothecary/2016/03/30/now-we-are-six-obamacares-disturbing-underperformance-in-a-nutshell

The increasing costs should not be surprising. After 10 years of “RomneyCare” in Massachusetts, overall health care spending is up 57 percent, from $38 billion, or $5,924 per person, in 2006 to a projected $60 billion, or $8,755 per person, in 2016. http://commonhealth.wbur.org/2016/04/massachusetts-health-law-numbers

Could we fix it by confiscating and redistributing large insurers’ profits to plan members? It would reduce monthly premiums by $4.25, writes Conover (Forbes Mar 31). http://www.forbes.com/sites/theapothecary/2016/03/31/what-if-we-confiscated-all-profits-for-large-health-insurers-and-redistributed-it-to-members

And what about those fat CEO salaries? In the same issue, Conover writes that the average total CEO compensation at Fortune 500 health insurers amounts to 42 cents per member. http://www.forbes.com/sites/theapothecary/2016/03/31/what-if-we-confiscated-the-compensation-for-large-health-insurers-and-redistributed-it-to-members

Will “single payer” fix it? The proposition on the ballot in Colorado in November would displace both Medicaid and private insurers. Revenues are projected to be $38 billion annually, compared to today’s total state budget of $25.7 billion. http://www.denverpost.com/news/ci_29742803/coloradocare-revenues-would-be-bigger-than-mcdonalds-report

Single-payer Cuba, much admired by Obama, may have the answer: slave labor. “Cuban medical personnel are coerced by a dictatorial state and inadequately rewarded from the profit they generate (Marx’s surplus value), which accrues primarily to the Castro dictatorship,” writes Paul Roderick Gregory (Forbes, Apr 5). He quotes a Cuban doctor who served overseas before defecting: “We are the highest qualified slave-labor force in the world.” http://www.forbes.com/sites/theapothecary/2016/04/05/barack-obama-extols-cubas-slave-labor-medical-care

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