Tuesday, January 22, 2013
Future of Obamacare
It’s as simple as AB
January 22, 2013- You. Yes, you. You out there trying to fathom the effect what President Obama said in his inaugural address. It’s as simple as the ABCs with a D added on for his distractors.
Access – Likely to decrease for families because of higher costs and employers dropping coverage. Likely to decrease for Medicaid and Medicare recipients who will be unable to find a doctor accepting Medicaid and Medicare patients.
Accounts, as in Health Savings Accounts or Flexible Savings Accounts - Likely to suffer because HAS holders can now set aside only $2500 rather than $5000 for retirement. Likely to add $13 billion in increased taxes.
Accountable, as in Accountable Care Organizations - Hospitals and doctors likely to resist in significant numbers because ACOs are designed to “save”government money by decreasing doctor incomes and hospital revenues.
Businesses - Likely to drop benefits for as many as 20 million employees because of costs and uncertainties of government-sponsored health plans. Likely to switch millions of full-time employees to part-time status to avoid reaching 50 full-time employees which would compel them to afford comprehensive government plans.
Bureaucracy - Likely to grow and metastasize as government releases avalanche of rules enforcing Obamacare provisions
Belittlement , individual and small business. - Likely to increase increase importance of “collectivism”and decrease importance of “individualism,” as in “We are all in this together.” The tax will hit every small business and every individual who buys insurance in the commercial market place
C’sControl - Likely to enhance government controls over what care be provided, what government will pay for, and whom it will pay.
Cost, as in cost containment - Likely to prove to be a myth. Costs have increased dramatically since ACA passage. Actuaries say premiums to escalate by 20% to 50%, even to 100%, in individual market next year.
Consolidation, as in hospitals and physicians –Likely to grow again next year and likely increase costs of seeing a physician. Hospitals now “own” more than 50% of physician practices, may grow to 80% by 2020/
Dismantle - Likely to go soon- The Independent Payment Advisory Board, The CLASS Act, a long-term-care insurance program that had been championed by late Sen. Edward Kennedy, was blessedly dismantled. .Ditto. nonprofit insurance co-ops, 1099 reporting provisions, free-choice vouchers.
Defund - Likely to defund the $29 billion tax on medical devices that threatens to cripple a dynamic new industry that employs 400,000 people in 12,000 factories around the country, especially in Democratically controlled states like California, Minnesota, and Massachusetts.
Delay - GOP House and Republican governors and legislators in 30 states likely to delay implementation or refuse to set up health exchanges designed to expand access to Medicaid and to subsidize those making less than 4 times poverty level.Tweet: In all likelihood, the future of Obamacare will entail more government spending, more regulations, and more health inflation. It's as simple as ABCD.
Posted by Richard L. Reece, MD at 1:56 PM
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