03.31.2010 0

Too Hot Not to Note: Flaws of health-care overhaul grow more apparent every day

  • On: 04/29/2010 09:56:34
  • In: Health Care
  • ALG Editor’s Note: In the following featured editorial from the Columbus Dispatch, it turns out Nancy Pelosi was correct when she said of ObamaCare “We have to pass the bill so you can find out what is in it”:


    Flaws of health-care overhaul grow more apparent every day

    Almost daily, the ill effects of the health-care overhaul passed by Congress last month are becoming apparent. As employers and government bureaucrats analyze the law’s effect on bottom lines for the private sector and for government, the alarm bells are ringing.

    The tragedy is that these ill effects could have been and should have been calculated before the law was passed, not after.

    In fact, many of them were prophesied before passage of the bill, but the prophets were ignored by President Barack Obama and the Democratic majority in Congress. That’s because their uppermost goal was not to pass the best health-care bill possible but merely to pass anything that could be called “health-care reform” and could be claimed as a political victory by a president desperate for one.

    The latest analysis of the bill’s likely effects comes from the Office of the Actuary in the federal Centers for Medicare and Medicaid Services. The report by Chief Actuary Richard S. Foster says that, far from reducing the cost of health care, the overhaul will add $311 billion to the nation’s health-care costs over the first decade the law is in effect.

    That’s just for starters. The report also warns that the $575 billion in Medicare reductions that are supposed to help pay for the overhaul are unrealistic. If the cuts are not implemented by Congress, then hundreds of billions of dollars will be added to the national debt.

    In the extremely unlikely event that Congress allows the Medicare cuts to occur, then
    15 percent of hospitals and other care facilities that rely on Medicare reimbursements would become unprofitable, meaning that they might drop Medicare patients.

    This would limit the availability of care for millions of seniors in the Medicare program at a time when doctors and hospitals already will be stretched thin by the addition of millions of other Americans clamoring to use the health insurance the overhaul will provide. (And to quantify the anticipated shortage of doctors, the American Academy of Family Physicians predicts a shortage of 39,000 family physicians by 2020.)

    The report notes that there are many overhaul effects that simply cannot be calculated but that could have a dramatic impact on the cost of medical care.

    For example, by extending Medicaid coverage to 18 million people and offering government subsidies to 16 million others to pay for health insurance, the overhaul will drive up demand for health-care services.

    The report says this increase “could result in higher total expenditures or in some of this demand being unsatisfied. Alternatively, providers might tend to accept more patients who have private insurance (with relatively attractive payment rates) and fewer Medicare or Medicaid patients, exacerbating existing access problems for Medicaid enrollees.”

    The actuary notes that a new, long-term-care benefit called the CLASS program that was included in the overhaul will become unsustainable in 15 years, and its deficits will be added to the national debt.

    Meanwhile, Monday’s New York Times reports that congressional Democrats are acknowledging that companies such as AT&T, Caterpillar, Deere and Verizon were correct for making filings to the Securities and Exchange Commission detailing the large earnings hit they will take as a result of tax changes in the health-care overhaul.

    Initially, Democratic leaders suspected that these companies were simply trying to undermine the new law by exaggerating its harm. U.S. Rep. Henry A. Waxman of California, chairman of the House Energy and Commerce Committee, intended to subpoena these companies and subject them to a public lashing before Congress.

    But after analysis of data substantiated the companies’ SEC filings, he is now saying in effect, “Um, never mind.”

    The Times also reported that AT&T documentation shows that it spent $4.7 billion on medical costs for employees and retirees in 2009, an amount far higher than it would pay in penalties imposed by the health-care overhaul if the company dropped health-care coverage altogether. Those employees presumably then would seek government-subsidized health-insurance paid for by taxpayers.

    Underlining the law’s perverse incentive, documents provided to Congress by Caterpillar included an e-mail from a company executive saying that provisions of the overhaul could “drive many employers to just drop coverage for retirees altogether, and let the government foot the whole bill.”

    Of the ostensible goals of the overhaul – to expand coverage, to curb costs and to pay for the program without adding to the deficit – only the first has any chance of being achieved under this law.

    And even the expansion of coverage may turn out to be an empty promise if there are too few doctors and hospitals willing to accept inadequate reimbursement for Medicare and Medicaid patients.

    As the weeks roll by, more and more unintended and should-have-been-anticipated consequences of this ill-conceived law will be revealed.

    This should be no surprise, considering that the law was slapped together behind closed doors without proper testimony and vetting by health-care, financial and insurance experts, and is a patchwork of political and special-interest deals rammed through Congress using procedural gimmicks.

    The nation deserved something much, much better than this.

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