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

“Obamacare is already exacerbating some of the current trends in American medicine that work against the interests of patients. Paramount among them is an erosion in the quality of the nation’s doctors. If unaddressed, America’s heyday as the world leader in the practice of medicine could draw to a close.”

“In 2009, using a PPACA-adjusted MLR
definition, we estimated that 29% of insurer-state
observations in the individual market would have
MLRs below the 80% minimum, corresponding to
32% of total enrollment. Nine states would have
at least one-half of their health insurers below the
threshold. If insurers below the MLR threshold
exit the market, major coverage disruption could
occur for those in poor health; we estimated
the range to be between 104,624 and 158,736
member-years.”

“Every year, thousands of people make a deal with their doctor: I’ll pay you a fixed annual fee, whether or not I need your services, and in return you’ll see me the day I call, remember who I am and what ails me, and give me your undivided attention. But this arrangement potentially poses a big threat to Medicare and to the new world of medical care envisioned under President Barack Obama’s health overhaul.”

“The problem is common here and across the country, especially as states, scrambling to balance their budgets, look for cuts in Medicaid, which is one of their biggest expenditures. And it presents the Obama administration with a major challenge, since the new federal health care law relies heavily on Medicaid to cover many people who now lack health insurance.”

“In other words, the new rules constitute a detailed attempt by the federal government to tell primary care doctors, specialists, and other providers exactly how they should work together. Rather than encourage private, market-driven experimentation, ObamaCare’s ACOs create yet another model of care built around satisfying government rules and regulations.”

“Access, cost, and quality have long been known as the three-legged stool of health reform. It is hard to improve one without worsening the others. So trade-offs must be made.
But not this time. Congress decided it no longer had to make trade-offs. It could have its cake and eat it, too, by creating (drum roll)…tah daaaaah!…ACCOUNTABLE CARE ORGANIZATIONS (ACOs)!!!!”

“A new article in Health Affairs brings attention to the problem of ‘churning’ in the eligibility requirements for subsidized ObamaCare. The study by Benjamin Sommers and Sara Rosenbaum looks at how often people will fall in and out of eligibility for, on one hand, Medicaid for people up to 133% of the poverty level, and on the other hand, subsidized coverage for those up to 400% of poverty in the Exchange.”

“The absolute worst feature of Obama Care (and it truly is inexplicable) is that close to 310 million Americans are going to get more primary care coverage than they had before. Not just welfare mothers, but Bill Gates, Bill Gates’ father, Warren Buffett — everyone in the whole country is going to have access to a long list of preventive care services with no deductible or copayment. If they respond to their new incentives, they will all try to get more care than they were getting before.”

“Bottom line: after we get through 10 years of spending our $1 trillion under ObamaCare, there is no convincing reason to believe that the bottom half of the income distribution will have more care, better care, or better access to care than they have today.”

“There’s ample evidence in the literature that physician productivity declines when doctors become owned employees rather than entrepreneurs. How then will the new marketplace that ObamaCare creates deliver efficiencies is downright quizzical.”