In a previous post I cautioned about believing everything you hear about Obamacare and to get the facts before making up your mind or taking action. In an ongoing effort to discredit the Law and raise concerns that are not real concerns a new add campaign is being launched by Americans for Prosperity. In commercials the campaign questions the ability to continue to receive good health care and select your own doctor. Both are non issues as far as the law is concerned.
While Obamacare is a massive law affecting many aspects of health care, relatively few Americans will even use the new exchanges, the centerpiece of the Law. Virtually all attempts to restructure payment systems and encourage more efficiency are focused on Medicare. For the vast majority of Americans who receive health insurance through their employer, there is nothing in Obamacare that forces changes in health benefit options and certainly not health care providers. This is not to say employers will not seek changes in benefits in an ongoing quest to control costs, but this is nothing new.
Take a look at one of the new ads here.
QUINNSCOMMENTARY 
One time where I have to disagree with you. I do believe many aspects of PPACA will end up limiting providers, and provider selection … And well beyond Medicare. – To include the exchanges, Medicaid and employer-sponsored plans. Even if you disagree with provider access concerns, there is little doubt that ppaca will have a dramatic impact on costs and access for those employers who continue to offer coverage – given the new taxes, new cost shifting and the decline in the number of people with employer sponsored coverage (worsening the trend we have seen since the turn of the century).
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I’d like to hear more about you insight on this. I cannot see aspects of PPACA that will change the ability for people to select their doctor. Employers changing or limiting networks may affect access, but that is nothing new. Actually even the Medicare attempt at ACOs allows patients to go anywhere for care.
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Sure, we have seen it before … In Massachusetts, where wait times have increased significantly.
We have seen it in the arcane “cost” of services, long in effect, where cost shifting to meet Medicare, Medicaid and other price limitations/controls has been confirmed to add costs to employer sponsored plans … prompt actions to curtail networks, benefits, or limit the inflation born by employers. Why would you not agree that we are likely, over time, to see a repeat of the retiree medical marketplace changes … in the working population, once there is a practical alternative priced to buy with taxpayer subsidies … Particularly once coverage is decoupled from employment among small employers.
How do we add 15 – 20 million people to Medicaid in the next few years, where Medicaid reimburses less than 70 percent of the actual cost to providers to deliver services – without triggering cost shift? How do we add 3 – 5 mm people each year over the next 15-18 years to Medicare, while trimming 720b in spend, plus another 300b in sgr “savings” – again without triggering cost shifting?
Just who is to pay the $130B or more in new taxes each year … That PPACA calls for to fund new, subsidized coverage … Without it affecting working Americans ability to fund out of pocket medical or other expenses – the French?
For sure, there was no mention, no mention nor discussion in any way, what the impact would be on worker budgets, or those of retirees, etc. the focus was solely on the federal deficit, and you know how they fudged the assumptions there.
So, Econ 101 tells me inelastic demand, funded with third party dollars, either tax dollars or borrowed money will, sooner or later, cause shortages … And potentially rationing, not rationing by ability to pay, but through a mix of bureaucratic limits that have yet to be developed.
Consider the 600 plus page regulation issued last Friday… More, much more to come. We are only getting started.
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I don’t disagree with anything you say. My point was the ad has a women talking about a sick child asking if she will be able to see the child’s doctor under Obamacare. That to me is intentionally misleading.
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The ability to tax is the ability to destroy…
The ability to delay is the ability to deny.
The ability to limit is the ability to nullify.
Many working Americans already pay more for others coverage than they pay for their own. Laying PPACA’s added burdens on employer sponsored plans may lead to very skinny networks. Out of pocket and other limits may all but eliminate the ability, financially, for many Americans to choose a non-network provider.
I mentioned the wait times before. Time for all who need medical services to queue up, get in line and hurry up and shut up and wait. Health reform does little to expand and much to constrain the number of health professionals … As you mentioned in another post, they are circling the wagons and demanding cash.
Read yesterday’s wsj opinion piece about medical device tax and the regulatory burdens. Or, read Friday’s 606 page regulation. Just wait until ipab starts to have an effect.
The concern about access, either in policy design, in ability to pay, or from regulatory limits is real and palpable.
I can’t predict the future. But to assert some concern is not in the code and that your concerns are unfounded, and that raising those concerns is misleading ignores how laws, and this law in partiicular has been implemented. It ignores the (un)intended consequences. It ignores the dynamics of the marketplace. Think about your posts for aarp, medicare and social security – would those who gave us those programs have suggested it was misleading for someone to say this is a path of fiscal irresponsibility that will someday lead to $100 trillion in unfunded liabilities (indefinite projection)?
PPACA is legend in terms of ignoring the dynamics of market activity – assuming employers, providers and others will simply shut up, take their medicine and shoulder on.
They won’t.
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