Audits and investigations into the effects of ObamaCare from congressional committees, government auditors, advocacy groups, and others.

“If you like your doctor, you can keep her — unless you’re poor or disabled.
The latest installment of ObamaCare is a scheme that’s uprooting the elderly poor and disabled who get care under Medicare and herding many into state-run Medicaid plans.”

“As part of the Affordable Care Act (ACA), Congress directed the Centers for Medicare and Medicaid Services (CMS) to penalize hospitals with ‘worse than expected’ 30-day readmission rates. This part of the law has stimulated hospitals, professional societies, and independent organizations to invest substantial resources in finding and implementing solutions for the ‘readmissions problem.’ Although a focus on readmissions may have good face validity, we believe that policymakers’ emphasis on 30-day readmissions is misguided, for three reasons.”

“A majority of young doctors feel pessimistic about the future of the U.S. healthcare system, with the new healthcare law cited as the main reason, according to a survey released to Reuters on Wednesday.
Nearly half of the 500 doctors surveyed think the Affordable Care Act, President Barack Obama’s signature domestic policy achievement, will have a negative effect on their practices, compared with 23 percent who think it will be positive.”

“The biggest flaw in the Obama approach to bundling is that the administration is lumping the doctors’ services along with the cost of the technology that physicians use to treat patients and paying for both in the same ‘bundled’ payment. That means that if a physician chooses to use newer but pricier drugs to treat a cancer, for example, then the cost of the medicines will come out of the doctors’ bottom line.”

“One element of the Patient Protection and Affordable Care Act (PPACA) is the advancement of ‘comparative effectiveness research’ (CER). Intended to compare available treatment options, CER can benefit patients if used for informational purposes only, but it could also be harmful in practice. The expansion of the Medicare bureaucracy under the PPACA will allow the use of CER for more government micromanagement of personal medical decision making—hurting patients, doctors, and the practice of medicine.”

“In time, high taxes, large subsidies, and extensive mandatory contractual terms in tandem could well drive most private plans out of business… Where and when the tipping point comes, no one can say in advance, and perhaps some tenacious and well-run private plans may ultimately survive. But in the end, our gloomy prediction is that in the absence of a major change in course, a regulatory cascade will first force some plans to fail, after which other private plans will topple like tenpins.”

“As many as 20 million Americans could lose their employer-provided coverage because of President Obama’s healthcare reform law, the nonpartisan Congressional Budget Office said in a new report Thursday.
The figure represents the worst-case scenario, CBO says, and the law could just as well increase the number of people with employer-based coverage by 3 million in 2019.”

“The American public doesn’t support Obamacare, and a new survey shows that doctors have an even worse opinion. No one has a better grasp on the state of the health care system than physicians, and according to the Doctors Company survey, 60 percent of them believe that Obamacare will have a negative impact on overall patient care. This survey is consistent with the findings of another doctor survey taken in October 2010, which also showed doctors’ lack of confidence in Obamacare.”

“The IPAB was created by an act of the last Congress and is supposed to meet an arbitrary spending target that is not feasible without structural changes in Medicare and the health care delivery system. The IPAB has one tool—price controls—to hit the same kind of fiscal target that the SGR has. If the board requires politically unacceptable payment cuts, a future Congress will neutralize IPAB just as it has neutralized the SGR.”

“The article examined colonoscopy, something which many politicians believe in so fervently as preventive care that they included in ObamaCare a provision that waived the Medicare co-pay for the procedure. That will likely result in an increased use of colonoscopy. The article in the NEJM is particularly useful in shedding some light on whether that policy change will be worth it from a dollars-and-cents perspective. The article examined 2,602 patients who had advanced adenomas (large polyps, usually close to 10 millimeters in size) removed via colonoscopy. In the end, the authors estimated that it saved about 13 people from dying of colon cancer.”