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

ObamaCare creates numerous expert panels to make determinations about the worthiness of many medical treatments. Supporters say these decisions will never amount to rationing, but the experience we already see with similar boards suggest otherwise. “If there’s an American precedent for the medical central planning of ObamaCare, it’s the Food and Drug Administration. Witness a looming FDA ruling that may deplete the drug arsenal for terminally ill cancer patients.Last month, an FDA advisory board recommended withdrawing government approval of Avastin as a treatment for advanced breast cancer. The decision betrays a bias that puts costs above treatment, and unless the FDA leadership overrules its own experts, the 40,000 women killed by breast cancer each year will be denied an important clinical option.”

“ObamaCare expands coverage to millions of Americans, but, warns Professor Shirley Svorny, without stronger measures to expand the supply of healthcare providers and contain costs, we can expect a physician shortage and soaring premiums. The California State University, Northridge economist suggests options for lowering costs and dismantling state-level regulations that restrain competition and innovation.”

According to an analysis by Weiss Ratings, several small insurers will be driven out of business by ObamaCare’s new restrictions. “Martin D. Weiss, president of Weiss Ratings, said in a statement that provisions in PPACA, such as the removal of certain reimbursement limits and mandated coverage for pre-existing conditions, will force health insurers to spend more on medical care. ‘Most large health insurers will be able to handle it. But we are concerned that weaker, less profitable insurers will be forced out of the market, reducing competition and ultimately leading to fewer choices and higher premiums for consumers,’ he said.”

The presidents of Texan medical schools are concerned about new costs from ObamaCare that will cause them to train fewer doctors. Teaching hospitals rely on Medicare and Medicaid patients, and they will be reimbursed less per patient by the government according to ObamaCare’s new payment schedules. Given that new insurance subsidies will drive up the demand for medical services, a restriction in supply could result in higher premium costs or rationing of care.

ObamaCare encourages preventive care, which is of dubious value and wastes the valuable time of doctors who are already stretched thin. “Several notable studies of the supply side of preventive care suggest how ObamaCare, as the healthcare legislation is often known, plans to make a difficult situation impossible. In 2003, a team of Duke University researchers first estimated the amount of time required for a primary care physician to provide then-recommended preventive services to an average patient panel… They concluded that the preventive services recommended for the U.S. population back then simply required an unreasonable amount of physician time. The authors emphasized that the large number of screening recommendations for each patient, coupled with the large numbers of patients in a practice, were likely a major reason for the failure to provide these services.”

“As businesses starts grappling with health reform, it’s becoming clearer that the Obama plan is predicated on some false assumptions about the health care industry. Three assumptions underlying the legislation are simply wrong, making it hard to see how the plan ever reduces costs. It assumes that health insurers are highly profitable, that doctors and hospitals operate on lean margins, and that the source of change and innovation in health care delivery is going to come from hospitals and medical practices that consolidate into more closed provider networks.”

ObamaCare cut over $500 billion in Medicare payments to health care providers over the next 10 years. These cuts were in an arbitrary, across-the-board manner, and are unlikely to work properly because it’s difficult to second-guess how medicine will advance over the next decade. “This is an inherent defect of Medicare not found in markets.  Competitive markets automatically translate productivity gains into lower prices for consumers.  Medicare protects providers at the expense of enrollees and taxpayers.”

“In the 2010 Annual Report of the Board of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds, the Board warns that ‘the actual future costs for Medicare are likely to exceed those shown by the current-law projections.’ The Trustees Report is necessarily based on current law; as a result of questions regarding the operations of certain Medicare provisions, however, the projections shown in the report do not represent the ‘best estimate’ of actual future Medicare expenditures. The purpose of this memorandum is to present an alternative scenario to help illustrate and quantify the potential magnitude of the cost understatement under current law.”

Seeing rising health costs on the horizon, employers are scaling back their insurance plans to put more costs on the consumer. This is despite pledges from the White House that families will see their premiums decrease without any quality reduction because of ObamaCare. “That could come as a surprise to many who remember the repeated assurances from President Obama and other officials that consumers would retain a variety of health-care choices.”

“Starting on Oct. 1, 2012, Medicare payments for hospitals with high readmission rates for certain conditions, including heart failure, will be reduced. This means Obamacare may actually punish hospitals and physicians for providing better quality care. As Dr. Eiran Z. Gorodeski of the Cleveland Clinic put it, ‘I think that the message to patients and the general public is that they should be wary of seemingly simple measures of quality of care.’ There’s also a message here for lawmakers: health care is too large and complex to expect central planning to yield positive results. Unfortunately, the passage of Obamacare and the recent recess appointment of Dr. Donald Berwick as Medicare head only move the U.S. further in that direction.”