Prod a Democrat Party loyalist on the shortcomings of ObamaCare and you are likely to get two retorts: come 2014 at least everyone will be covered; and from the moment when Obama signed the law pre-existing conditions can no longer be used by the insurers to deny coverage. It turns out, however, that neither of these claims is true.
Let’s take universal coverage first. It turns out that in 2016, two years into full implementation of ObamaCare, there may be 30-40 million Americans sans coverage. From whence and whom comes such a number? No less than Dr. Robert Kocher, former special assistant to Obama on health care who directed the simulations to get these numbers in his new post at McKinsey and Co., an international consulting company. The simulations involved a detailed county by county analysis across the country.
Asked who would remain uninsured, Kocher replied: “There will always be a residual pool of uninsured that includes the following populations: undocumented [foreigners], people between jobs, those who may lose coverage from either changes in income [or from] rolling off of Medicaid. Also, the [people whose employer-based coverage] was dropped but who haven’t yet purchased insurance; those eligible and not enrolled in Medicaid; and those [who have not enrolled in insurance] by choice.”
OK then, our Obama loyalist might say, at least as of the moment the president put pen to paper to pass ObamaCare, the insurance robbers were themselves robbed of the ability to deny coverage based on pre-existing conditions. Perhaps in theory, but that does not turn out to be the case either. It turns out that although 6 million Americans are eligible for the “Pre-Existing Condition Insurance Plan” provided in ObamaCare, only 8011 are enrolled. Why the shockingly low number? Two reasons emerge. First most people and physicians do not know who is eligible or how to enroll, a recurrent problem in a health care system designed for the insurers not the insured. And second the cost, the monthly premiums for the plan ranging from $320 to $570 a month.
So even these minimal benefits turn out to be an illusion. And as we in Massachusetts are learning from RomneyCare, the model for ObamaCare, costs are not controlled by such programs. Premiums continue to rise here and now the insurers are beginning to provide physicians with global budgets for their patients with financial incentives for the docs to withhold care. We can expect more of that under ObamaCare.
But at its core the worst thing about ObamaCare is that it does not provide egalitarian care. That is, health care is not a right. We must pay bribes (aka premiums) to the insurers for our health care and better care comes to those who can pay the bigger bribe. And for those who can’t who are too poor to pay any bribes there is Medicaid whose coverage in some states is no different from having no coverage at all, based on the outcomes.
One wonders whether it would not be better if ObamaCare failed in the courts leaving us with the reasonable two choices: Medicare for all, as in Canada and France, or a National Health Service, as in the UK. Progressives might well want to ponder joining the suits against ObamaCare.
JOHN V. WALSH can be reached at John.Endwar@gmail.com. He recommends following the sorry twists and turns of ObamaCare on Dr. Don McCanne’s superb column, “Quote of the Day,” from which some of the info above is drawn, on the web site of Physicians for a National Health Program, www.phnhp.org