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Healthcare Reform Revisited

Several months ago I offered some thoughts about how health reform might best be accomplished. What has happened in the meantime? Despite protests from doctors, seniors, angry voters and yes, the just plain incredulous, Washington moved forward to pass The Patient Protection and Affordable Care Act.

We now know that this bill was never about affordable health, but rather simply an access bill, that has now proven that the law of unintended consequence is always present when anything this radical is attempted.

As of last Thursday, Americans could expect: the elimination of lifetime maximums; coverage for children with pre-existing conditions; preventative care without co-pays; young adults enabled to remain on mom and dad’s insurance until 26; and, the prohibition of the rescinding of policies.  The obvious has already happened…..when you increase benefits you also increase costs, and when faced with selling an unsustainable product, insurance companies just leave the market. Almost every carrier, including Aetna, United, Cigna, Humana, Coventry and a host of Blues plans have simply stopped writing “child only” policies.

Even the most optimistic defenders of this terrible bill now admit that the rate of increase in total U.S. health spending will continue to rise and appears to be headed for 20% of our GDP by 2020. Politicians who voted for this bill are now running away from it as fast as they can and yes, even the president doesn’t seem too eager to use health as an election issue this time around.

Just what else can we expect from ObamaCare going forward? Just take a look at what has already happened.

In Massachusetts, the model for our proposed national plan, the waiting time to see a physician has nearly doubled in one year. Adding 50 million new patients to be seen by the existing physician population in the rest of the U.S. doesn’t seem to bode well for the rest of us. We face a shortage of 150,000 physicians by 2020 and not one dime has been raised or even suggested by the administration to turn up the crank for educating more doctors.

Second, “unreasonable” premiums would be struck down by regulatory powers given to newly created regulators to ensure that insurance giants would not benefit from unjustified price hikes. In Massachusetts, the four major insurance players (all non-profit, by the way) all asked for and were denied double digit increases. The Bay state tabled everything over 7.7%. All four companies lost money last year.

Any notion that this plan would decrease costs in the short, medium or long term is simply myth. Forcing attention on capping premiums, not by focusing on ever increasing healthcare costs and more importantly “demand,” will not work. Physicians, hospitals and clinics still make more money by providing treatments even if they don’t improve patient health. And, patients have no reason to refuse extra care because they pay no additional costs.

Thirdly, the Medicare cuts that were written into law so we could pretend to find real savings and reduce the deficit will never happen in the real world. The proposed 30% cut in physician payments (with the possible exception of those in Medicare advantage plans – ¼ of all beneficiaries) would mean that an unprecedented number of physicians would just stop seeing Medicare patients. Neither political party will stand for that. So, in other words, the benefits of the cost cuts will not happen as predicted by the White House.

What we really need to do now is stop and re-think this bill before it’s too late. The author of the bill, Senate Finance Chair Max Bauer, said recently, “Mark my words, several years from now, we’re going to look back and say “Well, that wasn’t so bad after all.”” That’s not exactly an endorsement any reasonable person could look forward to.

Americans have demonstrated an understanding about what government can and cannot do. They know that a huge new entitlement program, expanding coverage and increasing benefits just can’t be done for nothing. Given the nation’s current economic climate, “healthcare reform” sure doesn’t seem to be making it any easier for small, mid-sized or even corporate giants to hire new employees . . . who can blame them?

What can be done? That’s a topic for another day. We can, should and must reform our nations’ healthcare system. But we must do it in a way that makes sense for all Americans. Perhaps this fall’s election will be in impetus for real healthcare reform. I hope so.

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