“What would you think if bureaucrats confiscated your iPhone because they decided it didn’t provide enough value? State regulators may help the federal government do just that to the health-care benefits of millions of Americans. The most important element in implementing ObamaCare will be the requirement for health insurers to meet what is called a medical loss ratio.”
“Does President Obama have any idea what’s in his own health-care reform law? Since he signed the Patient Protection and Affordable Care Act a bit more than 100 days ago, the president has given a number of speeches and interviews in which he continues to say things that, well, just aren’t so. Just last Friday, he told MSNBC’s Chuck Todd that the law ‘not only makes sure everybody has access to coverage but is reducing costs.’ Wrong on both counts.”
“[S]pending on health care is clearly the most important source of the spending explosion. Remember that these data came out after Obamacare was passed. Thus, Obamacare does not address the explosive health care spending problem, which will come as no surprise to its critics, but is clearly contrary to the claims of those who supported it. Moreover, to the extent that Obamacare slowed growth in Medicare it more than offset this with new entitlements, making controlling health care spending even more difficult now. The data are clear: In order to control government spending, you have to start over on health care reform. Whether you call that “repeal and replace” or “repeal and reduce (the deficit)” the message is the same.”
“I think what is interesting is how poorly the law stacks up against its proponents’ own criteria. The new law fails to control rising health-care costs or increasing health-insurance premiums. In fact, the legislation will actually increase U.S. health-care spending by $311 billion over ten years. Insurance premiums will roughly double over the next six years, roughly what was expected before the law passed. It doesn’t restructure programs in a way to improve quality… By 2019, there will still be 21 million uninsured Americans, and nearly half of those who do get coverage under this law are merely thrown into Medicaid. Many other touted reforms come with surprisingly high price tags. For example, sure you can now keep your children on you insurance plan through age 26, but it will cost them an average of $3,380 per year per child in higher premiums. Even if you believed completely in President Obama’s goals, it’s hard to see what there is to like about this law.”
“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.”
“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.”
“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.”
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. There isn’t a single ‘ideal model’ in a world of treatments tailored to the genetic patterns of specific cancers, or for the artificial pancreas for individual diabetics, or other innovations that are increasingly common.”
“Some have speculated that the White House chose to make the recess appointment because the answers to some of those questions might cause some problems for the nomination or the administration. Perhaps. But it seems more likely that the primary motivation for the recess appointment was to avoid a clear and transparent fight over the merits of the competing visions of health care reform. Dr. Berwick is an unvarnished governmentalist of the first order. The debate over his nomination would have been the perfect opportunity to present clearly to the public the consequences of handing over so much power in the health sector to the federal government.”
While the White House highlights their favorite parts of ObamaCare, the real work is being done in the depths of the federal bureaucracy. “Track two is the regulatory process, where Obamacare is sinking its roots deeper and deeper into the bureaucracy and the health sector. This is below the radar of most Americans, but the implementation rules are beginning to frighten many industry groups that thought their seat at the table would inoculate them against the wrath of the regulators. The Centers for Medicare and Medicaid Services just issued a 1,250-page proposed rule on Medicare payment policies for 2011. That follows a 121-page proposed rule limiting how companies can grandfather their employee health-insurance plans to avoid even more onerous federal mandates.”