Wednesday, March 30, 2011

Why Obamacare Is Wrong for America: A Book Review

Why ObamaCare is Wrong for America: How the New Health Care Law Drives up Costs, Puts Government in Charge of Your Decisions, and Threatens Your Constitutional Rights is an appropriately named 259 page paperback (HarperCollins, 2011, USA, $14.95).

The book is current and accurate. Its authors are Grace-Marie Turner, president of the Galen Institute, which she founded in 1995 to promote free-market reforms of health care; James C. Capretta, a fellow at the Ethics and Public Policy Center and former associate director of OMB from 2001-2004; Thomas P. Miller, resident fellow of the American Enterprise Institute; and Robert Emmet Moffitt, senior fellow at the Heritage Foundation’s Center for Policy Innovation.

The authors are recognized authorities on health reform. Each has published extensively in national newspapers and prominent health care publications and has appeared on multiple television programs.

Paul Ryan, the Republic Congressman from Wisconsin and author of A Roadmap for America’s Future, writes the foreword, where he says,

“In health care, as in any other economic arrangement, control of money is power. The question remaining is: who gets the power, the government or the patient? Patient power will always serve the needs of the people far better than bureaucrats managing the decline of a government-run system on the verge of bankruptcy.”

This, then, is a book about power: who gets it and who controls it. The authors believe power (and health-care decision-making) should lie with the people, doctors who serve them, and in the states in which patients reside and doctors practice.

I agree with the authors, but rather than express my opinions, I shall cite ten facts they think the public and voters should know before the 2012 presidential election, which will determine the fate of ObamaCare.

1. Higher costs: If you buy a family policy in the individual market, you can expect to pay $2,100 more a year in premiums by 2016 than you would if Congress has not passed ObamaCare…Americans will spend an average of $265 more per person a year on health insurance....more than $1000 for a family of four.

2. Tax hikes: ObamaCare includes $569 billion in tax hikes, which will be passed through to health consumers as higher drug and device prices and higher insurance premiums.

3. Seniors losing coverage: Seven million seniors in Medicare Advantage plans will lose coverage because ObamCare cuts reimbursement from that plan by $145 billion. Senior costs may go up by $346 a year in 2011 and by as much as $923 by 2017.

4. More bureaucracy – the health law establishes an estimated 159 new boards, advisory commissions, and programs.

5. Higher government spending: Rick Foster, Medicare chief actuary, says the health law will increase national health expenditures by $131 billion between 2010 and 2019.

6. Larger deficits- ObamaCare starts collecting new and higher taxes in 2010, but entitlement spending doesn’t start until 2014 – six years of spending and ten years of taxes. The real cost will be $2.3 trillion if ten full years are counted.

7. 23 million uninsured: The bill will leave an estimated 23 million people without insurance by 2019.

8. Insurance death spiral: The individual mandate will force individuals and young people to pay higher premiums to subsidize older Americans. If the young and health choose to pay penalties rather than buy expensive insurance, premiums for the rest of us will soar.

9. Losing your current coverage: As many as 80 to 100 million will find themselves with different coverage when Obama care takes full effect, despite the president’s repeated promise that “you will be able to your health care plan.”

10. Medicare provider losses: The Medicare Actuary says the number of hospitals, nursing homes, and hospice centers facing financial losses would jump, decreasing access to care for Medicare beneficiaries. People may also face a severe doctor shortage, as doctor’s pull of Medicare because of low federal reimbursements.

The authors address this book to the general public. They frequently use of the word “you.” They describe its impact on you and your family, you as a young adult, you as a senior, you as a vulnerable Americans, you and your doctors, you and your employers, you as taxpayers, and you and your constitutional rights.

As I physician, I found their 21 page section on patients and their relationships with doctors particularly powerful. Here is how they describe the plight of doctors.

“It will drown doctors in red tape and bureaucracy. It will limit physicians’ autonomy and their ability to help and advocate for their patients. Their job satisfaction will be drained, and the doctor-patient relationship will be serious compromised. As federal regulators require physicians to do more, they are likely to be paid even less. As the situation worsens, older doctors will retire, and young doctors will look to switch careers. This will come as a time when the demand for physicians’ services will be higher than ever. Ultimately, ObamaCare will translate into restricted access to and inferior quality of care.”

The book concludes that to get reform right, the health system needs defined contributions for health care benefits, creating a national market for health insurance, and leveling the tax playing field.


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