How Obamacare Is “Benefiting” Americans … the facts and long term view

The Center for American Progress has updated its assessment of Obamacare. What I find striking is the nearsighted perspective of this organization. Below is an excerpt from their paper on this subject relative to costs. What the heading should say is “Lowering health care costs for consumers … sort of.”

From the Center for American Progress (I numbered the paragraphs):

Lowering health care costs

The Affordable Care Act is also improving the quality of our health care while controlling rapidly rising costs.

1. Health care reform requires insurance plans to cover important preventive services, including critical immunizations, numerous health screenings, and counseling services, with no cost-sharing by women. In 2011 alone more than 85 million people—32.5 million Medicare beneficiaries and 54 million Americans with private insurance—including seniors, women, and persons with disabilities, accessed these critical preventive services for free.

WOW for free, do they mean the services were donated by health care providers? The law also requires self-funded employers to provide these “free” benefits as well. You see, many of these people accessed these services before they were “free” and while we understood the purposed of INSURANCE.

2. In the first half of 2012, more than 16 million Medicare beneficiaries received at least one preventive service at no cost to them, including 1.35 million seniors who took advantage of the Affordable Care Act’s annual wellness visit.

Took advantage may be a good phrase here. They are right about the “no cost to them” part. But there is a cost to a massive program that is in very poor financial shape

3. Millions of women will take advantage of more comprehensive preventive care beginning in August 2012, including free mammograms, well-woman visits, contraception, and breast-feeding support and counseling.

Ah, didn’t we cover this in # 1. Sorry, you can’t sell me on the idea that these services must be “free”, especially when most were already covered with normal co-pays or coinsurance for tens of millions of American women. There are politics at work here for sure. It’s okay for women and men to pay co-pays for life-sustaining medication, but not for contraceptives that are not only completely discretionary but affordable … Give me a progressive break!

4. Seniors and persons with disabilities enrolled in Medicare saw significant savings thanks to the law. The Affordable Care Act works to close the Medicare Part D prescription drug coverage gap, also known as the “donut hole” In the first three months of 2012 alone, more than 220,000 seniors saved an average of $837 a year—and will save even more in the years ahead. The average Medicare patient will save $4,200 from 2011 to 2021 while those with higher prescription drug costs will save as much as $16,000 over the same period. Since 2010, more than 5 million seniors have saved $3.2 billion.

The fact is most seniors never reach the donut hole. Here is a provision of Medicare rammed through Congress by Republicans with no revenue to cover the new liability and claimed by Democrats as one factor in the Country’s massive debt who then turn around and increase the liability to benefit perhaps 8% of those on Medicare each year.

5. Further, the Affordable Care Act will strengthen Medicare benefits while controlling its costs in other key ways. Medicare Advantage (Part C) enrollees benefited from 16 percent lower monthly premiums since 2010. Enrollment in the Medicare Advantage program also increased 17 percent since 2010 with more beneficiaries in higher quality four- and five-star plans, reflecting the act’s commitment to giving seniors choices for quality, affordable care. In February 2012 enrollment in Medicare Advantage was more than 2 million people higher than the Congressional Budget Office previously projected in 2010.

Did we forget to mention that next year the Affordable Care Act begins reducing funding for these plans thereby likely to result in increased beneficiary premiums and lower benefits in the next several years.

6. Thirty-two leading health care organizations across the country are also participating in an initiative to provide better, more coordinated care to Medicare patients with potential savings of $1.1 billion. The Pioneer Accountable Care Organizations initiative rewards care providers for improving Medicare patients’ health and lowering costs through improved care coordination. The payment models the participating organizations are piloting will allow providers to move away from a volume-based, fee-for-service payment system to one based on the quality of care provided.

I will give them this one. It is a good idea, but with major flaws. First, Medicare beneficiaries won’t even know they are in such plans. The quality measures will be based on a retroactive look at the care provided and finally, Medicare beneficiaries may still see any provider outside the ACO thereby negating the full coordination of care.

7. The Affordable Care Act’s Partnership for Patients: Better Care, Lower Costs public-private initiative brings together leaders of major hospitals, employers, physicians, nurses, and patient advocates along with state and federal governments in a shared effort to make hospital care safer, more reliable, and less costly. The initiative aims to reduce preventable hospital-acquired conditions and preventable readmissions by 40 and 20 percent, respectively, by 2013.

Nice try, good effort, let’s wait for results before cheering. To date the effort to reduce readmissions is not working. There has not been any reduction in such readmissions. 

8. And in 2011, the Department of Health and Human Services and the Department of Justice cracked down on fraud and abuse in Medicare, saving billions for taxpayers. The departments’ joint efforts halted $4.1 billion in fraudulent claims, which is the largest sum ever recovered in a single year from individuals and companies attempting to defraud seniors and taxpayers.

This is one of my favorite all time absurd claims. They cracked down on fraud and abuse in 2011. If I recall Medicare has been around since 1965. Who has been minding the store at HHS for the last 47 years? The fact is Medicare fraud is rampant because there is insufficient oversight and claims management and that has been the case for decades. Proponents of government-run health care like to point to the low administrative costs; fraud and abuse (and inflated claims) is the result.

Related articles

• Does Obamacare cut Medicare spending? (quinnscommentary.com)
• Does Obamacare add to or cut the deficit? (quinnscommentary.com)