Thursday, January 9, 2014
What We Do Not Know About ObamaCare
What is past I know. But what is for to come I know not.
The Apocrypha (The Hidden Books), Greek Scripture
What the future holds for ObamaCare, I know not. It is all Greek to me. But here is what I think we do not know.
· We do not know if Obama’s $1 million public relations campaign, with its parade of ObamaCare feel-good stories, will succeed in reselling the unpopular and controversial health law.
· We do not know if the demographic split among the old and young among those enrolling will result in a “death spiral” of the law because government says it does not know the true numbers.
· We do not know as a nation how to redistribute costs across the broad population, by taxation, penalties, fees, or mandates, or God Forbid, by market competition.
· We do not know if ObamaCare or economic conditions, is responsible for the overall slowing of total health care costs, to 1.8%, over the last four years.
· We do not know if government control of the health system will work in the U.S. The eight-of-center US culture rejects “socialized medicine,” with limited choices, rationing, and bureaucratic versus clinician-patient decision making.
· We do not know if reform-driven initiatives focusing on accountable care organizations, value versus volume health care, bundled payments, pay for “physician performance,” and ending of fee-for-service are workable or viable concepts.
· We do not know if trends toward direct payment (concierge or retainer medicine) without 3rd party involvement will reach enough critical mass to change US health care into a two-system, i.e, private pay for some versus government dependency or others.
· We do not know if government-selected “navigator” beginners can effectively replace experienced health care agents to increase the number of ObamaCare health exchange enrollees.
· We do not know if ObamaCare will ultimately deliver on its promises of reduced costs, expanded access, increased efficiency, and enhanced quality.
· We do not know if a GOP sweep in 2014 and 2016 would lead to repeal or radical restructuring of ObamaCare.
· We do not know if doctor shortages on non-acceptance of recipients of those on government programs will drive up emergency room visits and waiting lines to see doctors to politically intolerable levels.
· We do not know if the current unpopularity of the health law (56% against, 38% for) will grow or diminish once ObamaCare begins in earnest.
T Tweet: We do not know what the future holds for ObamaCare. It involves the unknowable and one cannot judge the future by the past.