Tuesday, August 30, 2011

Reform Thoughts After Hurricane Irene

I’m the man they call Sudden Death and General Desolation! Sired by a hurricane, dam’d by an earthquake.

Mark Twain (1835-1910)

August 30, 2011 – It’s three days since I last wrote. I reside on the Connecticut shore. My wife and I evacuated to escape Hurricane Irene. Power outages meant no access to the Net.

But hurricanes, when preceded by an earthquake, concentrate the mind. The stagnating economy, mounting national debt, and growing concern over costs and consequences of Obamacare contribute to my sense of general desolation.

Before we evacuated and and perhaps because of the release of my book The Health Reform Maze, I was asked by two national organizations to: one, write a piece on why doctors resist adopting electronic health records and why health costs are rising; two, to give a talk before a national physician organization to give an “objective appraisal” of the state of Obamacare.

Doctors stay away from EHRs mainly because of costs, negative returns on investment, uselessness for communicating with patients, colleagues, and hospitals; and lack of evidence as a tool for improving care. More than anything , those who design EHRs have a management rather than a practice perspective.

As for Obamacare’s costs, they are just beginning to come into focus. Those who wrote the law envisioned it as a powerful way of reducing costs, widening access, keeping your health plan, and improving care. So far, it has done none of these things. In its first two years, costs are up 10% to 12%, access is down and narrowing, people are losing health plans and doctors, and many people, especially physicians, believe the health law will cause care to deteriorate.
A study just released in Wisconsin gives a sharp sense of the general state of affairs for Obamacare.

According to Chris Jacobs, health care analyst for the Republican National Committee, admittedly a biased source, a report, the governor’s office in Wisconsin.

• 150,000 individuals in Wisconsin will lose their current coverage to move to the government-regulated Exchanges. Another 100,000 individuals will lose access to employer-sponsored coverage, because the firms they work for will decide to drop coverage instead.

• Nearly two in five (38%) participants in Wisconsin’s individual market will be forced to buy richer coverage than they have now, due to the new mandates and insurance restrictions included in Obamacare.

• Government mandates will raise individual market premiums for more than four in five participants – more than 41% of participants face premium increases of more than 50% before federal insurance subsidies are applied.

• Even after federal insurance subsidies are applied, 59% of individual market participants will pay more – an average of nearly 31% more – for their coverage, so that a smaller minority can pay less. Costs in the individual market for Wisconsin residents aged 19-29 will go up 34%, so that costs for residents aged 55-64 can go down by $31, or a mere 1%.

• Wisconsin’s more than 5.5 million residents will pay higher federal taxes – on their drugs, income, and insurance premiums, to name but a few examples – so that only about 220,000 newly insured will receive taxpayer-financed insurance under Obamacare.

• 340,000 individuals in Wisconsin will obtain coverage under Obamacare, but that if the individual mandate were repealed (or struck down as unconstitutional), coverage would only increase by 60,000. In other words, nearly 300,000 Wisconsin residents will obtain health coverage not because they want to purchase it, but because the federal government is forcing them to do so.

A Democrat Governor commissioned the report last year, and Jonathan Gruber, a consultant for Obama completed the report. If the report for Wisconsin applies to the rest of the U.S., it has ominous implications for Obamacare and will make it difficult for Democrats to defend the law leading up to the November 2012 election.


BobbyG said...

"to give a talk before a national physician organization to give an “objective appraisal” of the state of Obamacare."

Nice chuckle, that one.

Richard L. Reece, MD said...

Dear BobbyG: Put aside your chuckle for a moment, consult your belt buckle, and give me your unbiased appraisal of the world as you see it.

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