Reality Check wrote:
> Obama will be taking a number of victory laps over the next three
> years regarding Obamacare and the Media will be leading the
> cheers.
> The Metrics will prove Obama was right.
> More people will be covered by health insurance using the
> traditional metrics everyone has used for measuring coverage
> before Obamacare.
> Medical costs will be down using the traditional metrics everyone
> used before Obamacare.
> Even the insurance premium costs for the second and third year of
> Obamacare will decrease from the first year of Obamacare.
> Contrary to the predictions of John and others.
> The individual mandate and the employer mandate were redundant,
> and the employer mandate unnecessary to achieve the political
> goals Obama wants to achieve.
> Obama-care compliant insurance policies truly does reduce per
> capita health care costs for all third party payers. Third party
> payers include Employers, Insurance companies, state governments (
> Medicaid), the Federal government ( Medicaid and Obamacare market
> place subsidies ) and insurance companies.
> Only the costs of such third party payers have been tracked in the
> past, so these will be the metrics that will be used to prove how
> well Obama-care has preformed.
> The only people who will see increased health care costs are
> people who become sick or injured while covered by an Obamacare
> compliant health insurance policy.
> These metrics have not been tracked in the past and Obama will not
> start tracking them now. So they will remain anecdotal opinions,
> not statistics.
> Without an employer mandate the incentive to terminate company
> sponsored health insurance plans and dump employees on the
> Obamacare exchanges - or Medicaid - will be huge. That will help
> all the metrics. Higher exchange enrollment and the higher costs
> for subsidies will be trumpeted as proof of how popular Obamacare
> is.
> Individuals who sign up for health insurance and pay one premium
> will be counted as enrolled in health care for the year. Those who
> only have health care for one month will be treated the same in
> the metrics as those who pay for each and every month, for 12
> months.
> The mentally ill on the streets and prisoners in state and federal
> prisons will be enrolled in expanded Medicaid plans, pushing up
> the metrics of those with insurance.
> For companies that want to continue providing health care to
> employees, even without employer mandates, there will be both
> mandatory and voluntary reasons for converting from traditional
> employer insurance policies to Obamacare compliant policies. As
> with individual market plans, any employer plan that changes
> anything is required to be replaced with an Obamacare compliant
> policies. Employers also save tons of money by converting to
> Obamacare policies with government set standards for deductibles,
> co-pays, coinsurance, maximum annual out of pocket, and strict
> limits on which services are preventive and which are subject to
> high co-pays and and high co-insurance. When employees become sick
> or injured the employer will be paying a small fraction of what
> they paid under the old traditional plans.
> The metric for transitioning to Obamacare plans, from traditional
> plans, will be much greater than originally
> projected. Traditional, non-Obamacare compliant employer plans (
> grandfathered plans ) will disappear from the market place much
> faster than projected.
> The insurance companies who wrote the regulations that shifted the
> costs from third party payers to sick or injured patients, also
> greatly jacked up the premiums for the first year of Obamacare
> anticipating the worse possible case. Exactly the opposite has
> happened. Patients have signed up and paid for Obamacare policies
> and then had months worth of services denied, cancer drugs not
> covered at all because they were not Obamacare approved drugs, and
> all the other things related to "working the kinks out" that will
> make the premiums high, claims paid small, and the net profits of
> Obamacare insurance plans huge the first year.
> Federal government revenue from Obamacare related taxes will sky
> rocket above projections. Due to far more Obama-care compliant
> policies ( from employers voluntarily switching their employees to
> Obama-care compliant policies ) and the per policy taxes/fees
> generating far more revenue than projected.
> Employees, and employees dependents, voluntarily dumped on to the
> exchanges by employers will sit Obama's political purposes, and
> make the Obama-Care private insurance market appear vastly more
> popular than expected.
> Excess profit taxes on insurance companies will spike revenue.
> Obama-care will do huge damage to the economy, but the metrics
> will not measure that.
I can't agree with any of this.
This is like saying that Nixon's wage-price controls would have been
OK as long as General Motors made a lot or money or, failing that, the
government bailed out General Motors. Nixon's controls failed because
the underlying damage to the economy caused shortages and skyrocketing
prices, resulting enormous outcry from the public.
Obama has already been forced to change many things as a result of
outcry from the public, and he'll have to do more as other problems
arise.
Reality Check wrote:
> More people will be covered by health insurance using the
> traditional metrics everyone has used for measuring coverage
> before Obamacare.
The whole point of my article is that this is irrelevant. I made
the comparison to Nixon announcing that anyone signing up could
buy Coca-Cola for a penny a bottle.
We've had universal health care for years. Anyone can visit an
emergency room and get care, with or without insurance. An emergency
room uses waiting lines to ration healthcare. Signing up millions of
people for free medicaid or subsidized insurance won't change
anything. Rationing will still be required, in one form or another.
The major political difference is that Obamacare will be blamed.
Theoretically (i.e., according to far left theory), Nixon's wage-price
controls should have worked. They failed because you can't control
everything. As in Whack-a-Mole, if you whack one problem, then
a bigger one pops up elsewhere.
Or if you don't like that analogy, then let's use the balloon
analogy. If you squeeze the balloon in one place, then it will
bulge in another place.
In other words, Obamacare can't control everything, and millions
of clever people will find ways to take advantage of the rules
to make money, pushing up costs for everyone else, and using
up other people's resources.
Reality Check wrote:
> Medical costs will be down using the traditional metrics everyone
> used before Obamacare.
> Even the insurance premium costs for the second and third year of
> Obamacare will decrease from the first year of Obamacare.
> Contrary to the predictions of John and others.
I don't know where you get this from. Nixon's wage-price controls
went through several phases, and each phase was accompanied by a
prediction that inflation would end next year, and it never did.
Reality Check wrote:
> The individual mandate and the employer mandate were redundant,
> and the employer mandate unnecessary to achieve the political
> goals Obama wants to achieve.
They're not redundant. They're complementary, and they're both
necessary to get everyone into Obamacare. With the employer mandate
gone and the individual mandate all but gone, all that's left is a
free marketplace with fewer options and higher prices.
How's a single person going to feel when he has to pay $300 per month
for Obamacare, and then discovers that he has a $5,000 deductible,
before the insurance pays anything.
Reality Check wrote:
> Obama-care compliant insurance policies truly does reduce per
> capita health care costs for all third party payers. Third party
> payers include Employers, Insurance companies, state governments (
> Medicaid), the Federal government ( Medicaid and Obamacare market
> place subsidies ) and insurance companies.
Well, there you go. You're making the Whack-a-Mole argument.
Reality Check wrote:
> Employers also save tons of money by converting to Obamacare
> policies with government set standards for deductibles, co-pays,
> coinsurance, maximum annual out of pocket, and strict limits on
> which services are preventive and which are subject to high
> co-pays and and high co-insurance. When employees become sick or
> injured the employer will be paying a small fraction of what they
> paid under the old traditional plans.
I've worked for professional firms my whole life, and I can tell
you with certainty that any professional firm that did what you're
suggesting would face a huge employee revolt. If it were even
attempted by one firm, they'd lose their employees to another
firm that didn't do it.
Reality Check wrote:
> Only the costs of such third party payers have been tracked in the
> past, so these will be the metrics that will be used to prove how
> well Obama-care has preformed.
> The only people who will see increased health care costs are
> people who become sick or injured while covered by an Obamacare
> compliant health insurance policy.
AND the people who don't become sick, but have to pay higher insurance
premiums. The only ones who WON'T see increased costs are the ones
who don't buy insurance and don't become seriously ill.
The stuff about metrics isn't true. There are plenty of new
metrics being discussed and measured with regard to the web site,
such as ratio of sick to healthy signups. Nobody paid any attention
to how many chickens were being killed until Nixon's price
controls, and then they became national news.
The way it will work is this: The administration, the NY Times,
NBC News, etc., will all try to emphasize the number of signups.
But one day there'll be a "chicken-killing" story of some kind
that will gain national attention.
Obamacare has faced one problem after another, and had to rush to fix
it -- replace the web site, delay the employer mandate, delay the
individual mandate, expand the "grandfather" clause, add new
"substandard" policies, and so forth. That litany of problem is not
going to end, just because the enrollment period has ended,
and we're in the middle of a breather.
The administration has repeatedly lied or stonewalled about
figures it doesn't want to admit. There are many figures it's
refusing to release now, and you can be sure that's because
they're embarrassing. The administration would never stonewall
about a number that serves their political purposes.
And at some point, the Supreme Court is going to speak on all
these unilateral changes to the law.
In the end, Obama will preserve his legacy with something called
"Obamacare," which will be a market solution with no significant
mandates, restoration of the "substandard" policies, but with much
higher prices and a lot of rationed services, and maybe a few more
people enrolled than in the past, and Obama will continue to declare
victory at every chance he gets. But it won't be anything like
Obama's original universal health care proposal, and it will be worse
than the old system of "universal health care" provided by emergency
rooms.
John