“If the health care legislation passed in 2010 is implemented fully and on schedule, public attention will turn to features of the legislation that were perhaps less obvious during the debate. For example, who ultimately controls the new health exchanges-the states or the federal government? Resolution of this issue could determine the nature of health insurance in America. The so-called OPM alternative will soon be seen as an end-run for the public option and, if it remains on the statute book, could lead to a far stronger public option than anyone thought possible. Employers and employees will soon wake up to the fact that the legislation will accelerate the erosion of employer-based insurance. And rosy projections that health spending will taper down will most likely prove to be an illusion-forcing choices about price controls and budgets. However Congress responds to these decisions, it will mean big changes in access to services and control of the system.”

Details

ObamaCare is substantially worse than most people think. “The length and complexity of the legislation, combined with a debate that often generated more heat than light, has led to massive confusion about the law’s likely impact. But, it is now possible to analyze what is and is not in it, what it likely will and will not do. In short, the more we learn about what is in this new law, the more it looks like bad news for American taxpayers, businesses, health-care providers, and patients.”

Details

New ObamaCare regulations to increase tax revenues by adding paperwork to small businesses will sock businesses with onerous regulations. “An Internal Revenue Service watchdog warned Wednesday the paperwork burdens on small businesses may outweigh the benefit of tax collections generated as part of the new health-care law. Starting in 2012, about 40 million businesses, charities and other entities will be required to report to the IRS payments they make to suppliers and service providers, the IRS Taxpayer Advocate Service said in its midyear report to Congress.”

Details

The lieutenant governor of Missouri filed suit against ObamaCare on the grounds that it interferes with individual freedom and state authority. “In his lawsuit, Kinder contends the federal health care law could cause Missouri to raise state taxes to pay for the expanded Medicaid program and that it improperly affects the compensation of state officials by making changes to the state health care plan. He also contends the law is unconstitutional because he says it interferes with Missourians’ personal health care choices.”

Details

According to surveys, only about a third of Texas primary care doctors accept Medicaid patients, because the government-run insurance program sets very low doctor fees. Over half of the people who will become newly insured because of ObamaCare will be added to Medicaid, which means their insurance will likely not actually allow them access to medical care.

Details

“Administration officials argue that Republicans would have seized on any nominee as an opportunity to re-litigate the health-care debate. But Berwick offered opponents a loaded gun with his talk about rationing, his discussion of health reform as a matter of redistributing wealth, and his effusive praise for the British system. If the president wanted to buy a fight like this, he ought to have been better prepared to wage it.”

Details

ObamaCare’s expanded control by government will inevitably lead to rationed care. “The new law also dramatically expands Medicaid, a poorly performing welfare program with low physician reimbursement rates, and this expansion will account for roughly half of the 34 million newly insured Americans. Furthermore, the law creates an Independent Payment Advisory Board, which will recommend measures to reduce Medicare spending. Formally, the board is forbidden to make recommendations that ration care, increase revenues, or change Medicare beneficiaries’ benefits, cost-sharing, eligibility or subsidies. For the board, reimbursement for doctors and other medical professionals seems the only target left. But payment cuts can effectively ration care.”

Details

“The NICE precedent also undercuts the Obama Administration’s argument that vast health savings can be gleaned simply by automating health records or squeezing out “waste.” Britain has tried all of that but ultimately has concluded that it can only rein in costs by limiting care. The logic of a health-care system dominated by government is that it always ends up with some version of a NICE board that makes these life-or-death treatment decisions. The Administration’s new Council for Comparative Effectiveness Research currently lacks the authority of NICE. But over time, if the Obama plan passes and taxpayer costs inevitably soar, it could quickly gain it.”

Details

“Although administration officials are eager to deny it, rationing health care is central to President Barack Obama’s health plan. The Obama strategy is to reduce health costs by rationing the services that we and future generations of patients will receive.”

Details

When he takes control of Medicare and Medicaid, Don Berwick will begin to implement his vision of a more centralized, government-run health care system. This viewpoint is at the heart of ObamaCare, with the aim of putting Washington in charge of all health care decision-making. “Such a command-and-control vision is widespread among America’s technocratic medical left, but it is also increasingly anachronistic amid today’s breakneck medical progress.

Details