Tuesday, June 1, 2010

Political and Economic Turn-Offs and Turn-Offs of Obamacare Two Months after Passage- The Uncertain Transformation of Vast U.S. Health System


1. Finally , equitable and compassionate coverage of 34 million uninsured

2. Mandate to cover all “children” up to age on 26 under parents’ health plans

3. Tax credits for small businesses of up to 9 employees and employees making less than $25,000

4. Coverage of patients with pre-existing illnesses

5. End of arbitrary lifetime(coverage) caps

6. Closure of Medicare Part D donut hole

7. Limits on medical-loss ratios and profits of health plans

8. Ten year framework for testing, changing, improving , and even reversing Obamacare provisions.

9. Demonstration projects on accountable health organizations, medical homes, tort reform, and formation of medical innovation center

10. Powerful narrative of first president and administration in history to pass “universal coverage” bill, thereby joining other progressive nations


1. Real costs of over $1 trillion from 2010 to 2020 rather than promised $940 trillion

2. Real costs over first real decade, 2014 to 2023, of over $2 trillion

3. Increased $350 billion costs for major corporations causing them to drop employer-provided insurance plans and drug benefits for retirees

4. Bureaucratic nightmare for businesses - having to file 1099s for every person they pay over $600 and for every vendor with whom they do $600 in business.

5. Federal requirements leading to creation of 159 new federal agencies, office, and programs

6. Costs, about $10 billion, of hiring 1600 new IRS agents to assure compliance with new federal individual mandates

7. OMB projections that new law would raise U.S. health costs by $311 billion and shift 14 million people off of employer-based insurance and into federal programs

8. Discouragement of new hiring by costing small businesses $5600 for employing a 25th worker in addition to wages and benefits

9. Marriage penalties as high as $10,425 a year when couples avoid marriage

10. Penalties on small businesses when employees spend more than 9.5 percent on insurance premiums

11. Increased loads on emergency rooms to care for newly insured.

12. No help to alleviate doctor shortages when newly insured and new Medicare patients seeking care

13. News that nominee to head Medicare and Medicaid under ObamaCare openly advocates British National Health Services’ rationing programs

14. Long government history of failure to cut Medicare and Medicaid costs with resulting cost overruns

15. Inadequate Penalties for non-coverage to encourage businesses to comply with new law

16. Failure to fix the Sustainable Growth Rate (SGR) formula, which calls for a 21% cut in physicians Medicare reimbursement, scheduled to take effect on June 1.

17. Failure to address growing problem of physicians opting out of Medicare and Medicaid

18. Failure to tackle tort reform, which, according to OMB, costs the system $54 billion, and many times more, if one factors in the practice of defensive medicine.

19. Actions by 20 state attorney generals to declare Obamacare mandates unconstitutional, a position now joined by National Federal of Independent Business

20. Opposition of young voters to individual mandates

21. Opposition of seniors to plans to cut $535 billion out of Medicare

22. Fear among middle class that new law, “Patient Protection and Affordability Act,” neither protects against loss of current coverage nor makes it more affordable

23. In electoral contests so far – Virginia, New Jersey, and Massachusetts – where exist polls indicate voters main negative concern has been Obamacare

24. Growing distrust of government spending and unsustainable national debt


Perceptions are growing that adverse consequences of Obamacare may outweigh benefits. Voters will express their opinions in November mid-terms. Rasmussen, whose polls includes only likely voters, has recently dramatically shifted against ObamaCare. In the two months after the overhaul’s passage, Rasmussen showed strong and consistent support for repeal. The average gap between those who supported Obamacare versus those opposed averaged 16 points. This week, the gap has ballooned to 31 points. Americans now favor repeal by a margin of almost 2-to-1, with 63 percent favoring repeal and just 32 percent opposing it.

Yet repeal and replacement is unlikely, given President Obama’s veto power, and a likely Democratic Senate majority after November even if Republicans take the House. Political paralysis could ensue. To date, Obama’s health care reform’s political strategy of let’s-just-apply-lots-of-band-aids-to-the-present-broken-system has produced widespread disappointments.

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