Wednesday, November 20, 2013

Dropped Promises, Dropped Doctors, and Dropping Poll Numbers
“The time has come, “the Walrus said, “To talk of many things – of shoes – and ships-and sealing wax –
Of cabbages and kings -
And why the sea is boiling hot -
And whether pigs have wings.”
Lewis Carroll (1832-1898), Through the Looking Glass
Waiting for shoe to drop.
Idiom, meaning waiting for the next inevitable step or final conclusion
Dropped Promises
A second ObamaCare shoe and a second promise have dropped.
The first shoe was the promise that if you like your health plan, you can keep your health plan.
The second was that is you like your doctor you can keep your doctor.
Tens of millions of health plans are being dropped, and health plans are dropping tens of thousands of doctors.
Dropped Doctors
As Gail Wilensky (born 1943), formerly Head of Medicare and Medicaid for the first President Bush, says in the current issue of Time, “Many people are going to find out that the second part of the promise – that if you like your doctors –simply isn’t true.” (Alex Altman “You Can Keep Your Doctor: Obamacare”s Next Broken Promise,” Time, November 19, 2013)
The health law regulates profits of health plans. Consequently, health plans are pruning their network of doctors who are costing them money through higher rates of testing and performing procedures. In my opinion, quality is not the issue. Costs are.
Doctors throughout the land are receiving notices that their services are no longer needed. This comes as a shock and a surprise to many doctors.
My cardiologist at the Yale Medical Group, and his partners were taken back when they learned that United Health was dropping the 1200 physicians who practice under the auspices of Yale. Doctors have 30 days to repeal, but many who are appealing are finding the methods behind the madness of managed care are not disclosed or explained to their satisfaction.
Dropping Poll Numbers
Other things are dropping too, namely, President Obama’s and ObamaCare’s polls numbers.
The latest Quinnipiac poll numbers indicate new approval lows, even among his strongest constituents
· President Obama overall approval, 39%, disapproval, 54%
· ObamaCare approval, 39%, disapproval, 55%
· Obamacare, young voter approval , 36%, disapproval, 54%
· Obamacare, Hispanics approval 41%, disapproval, 47%.
Moreover, 46% of those polled think President Obama knowingly misled them when he said over and over and over again people could keep their health plan.
Results of this week’s CBS poll are even worse.
· President Obama approval, 37%, disapproval,57%
· ObamaCare, approval, 31%, disapproval, 61%.
Other news released this week, that President Obama’s advisors were told by a tech expert last April that was not ready prime time  and Henry Chao, Obama's IT Informatiion Office, thought 40% of the website had to be rebuilt,, contributed  even further to the ObamaCare malaise.   
The controversy over ObamaCare is “boiling hot,” and people are debating whether ObamaCare “ has wings,” whether it will collapse or be repealed.
The Heart of the Matter
At the heart of the controversy sits this question: While he was repeatedly making his promises, did President Obama know in advance and not tell Americans they might lose their health plans and their doctors and that the website was not ready to launch?
The public’s answer increasingly is, yes, he knew, and “ I am mad as hell that I might lose my plan and my doctor. I’m even madder when I learn my premiums and deductibles on a new plan are off the chart and beyond my ability to pay.”.
These twin angers are revitalizing talk about repeal, delay, or scrapping the whole health law and starting all over again. There is even talk of ObamaCare going the route of the 1988 Medicare Catastrophic Coverage Act, which Congress retracted when millions of seniors objected and said they were unwilling to pay a new tax to support it.
And so the shoes are continuing to drop.
Two Lessons
Two lessons are being relearned:
· One size – comprehensive plans with 10 essential benefits in all plans for the young and old, the healthy and the sick, the have’s and the have not’s – does not fit all, especially when it drives up premiums and deductibles and asks one group to pay for the other.
· When you introduce sweeping social legislation, keep these maxims in mind: Put yourself in your constituents’ shoes before you act; the shoe that fits one person pinches another; and you can’t put the same shoe on every foot.
Tweet: Because the public thinks President Obama misled them, his signature legislative achievement is in deep trouble, triggering repeal talk.

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