Monday, December 31, 2012

Obamacare Predictions for 2013
Prediction is very difficult, especially if it’s about the future.
Neils Bohr (1885-1962), Danish Physicist

Weather forecast for tonight: continuing darkness for tonight with scattered light by morning.
George Carlin (1937-2008), American Comedian
December 31, 2012 – It’s come at last, the last day of 2012, and nearly the first day of 2013, which promise to be an unluckily numbered year for Obamacare and  for most American citizens,  if one excludes the young covered under their parents’ policies,  the preferred thousands covered for pre-existing illnesses , and certain seniors falling into the dreaded Donut Hole.

I  will trust  that  things work out better than I predict, that these predictions are not self-fullfilling dark prophecies, that I am not akin to  the proverbial groundhog that makes its statement, then disappears until next year.
I will avoid the obvious – that taxes are going to rise sharply in 2013 – by 2.3% on total revenues of device manufacturers, by 0.9% on the payroll tax for Medicare, by limiting deductions for medical expenses to  7.5% to 10% of income,  by 3.8 % on incomes for couples making $250,000 or more, by a variety of surtaxes on capital gains, dividends, estate taxes, and other items;  and by $1.76 trillion from  2012-2021,  and $2.5 trillion form 2014 to 2023.   

These are facts, not predictions.
I will touch briefly on my series of books -  New Voice of Health Reform – Rhyme, Rhetoric &  Reality, with the emphasis on Reality, which will begin appearing in 2013.
And I will make these dark predictions which may be accompanied by scattered light.
·         Employers will begin dropping workers from coverage and converting full-time workers to part-time workers  at they realize they can no longer afford comprehensive government plans with “guaranteed issue” for every worker,  young or old, healthy or ill, able or disabled.
·         Implementation of health exchanges, the core Obamacare issue for covering Medicaid and subsidizing those under 4 times poverty, will be rocky and difficult because of failure of 30 or more states to set up their own exchanges and to hand over the job to the federal government to run the state-shows.

·         Premiums will spike by 20% to 30% for most Americans, even double says Aetna’s CEO. 

·         The physician shortage will intensify as reimbursements fall and  regulations skyrocket. 

·         Physicians will go to work for hospitals in droves, and this will result in soaring costs to see a doctor for ordinary visits and extraordinary reasons.

·         Consolidation of hospitals and large physician groups, with waves of previously unthinkable mergers and acquisitions, will occur, as providers seek ways to cope with Medicare cuts,  and administrative, technological, and regulatory challenges. 

The good news is that the bad news will be good news for consultants, government bureaucrats, auditors, accountants, and IRS agents who will be required to take care of and to track developments on multiple reform fronts.

Tweet:  2013 promises to be a dark year for Obamacare with scattered patches of light for certain population segments.

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