Sunday, March 9, 2014

ObamaCare and the Unexpected

The unexpected always happens.

Common Saying

If you read Ezekial Emanuel’s Reinventing American Healthcare (Public Affairs, 2014),   and you read his unqualified affirmation of ObamaCare,  you would expect:

·         The  health law to lower costs,  raise quality, and expand access.

·         Waiting times to see doctors to decrease.

·        Health exchanges to replace health plans.

·        Digital medicine, remote care outside of hospitals,  measurable quality outside of hospitals, price transparency, and increased effectiveness to flourish.

·         Health inflation to diminish or even cease.

·         All, courtesy of the U.A. government, and you would be right.

But not for the reason you expect.   As David Goldhill, CEO of GSN, a media company, and author of  a 2013 book, Catastrophic Care: How American Health Care Killed My Father and How We Can Fix it  explains in his March 6 WSJ review of Doctor Emanuel’s book.

One of the immediate unanticipated consequences of the ACA – the rapid spread of high- deductible  insurance  among employers and on the exchanges – has the potential to turn the whole system on its head.  Early reports suggest that many are responding to the mandate by choosing lesser insurance and using the savings for other necessities.  And it appears that many of the uninsured are choosing not to buy insurance at all, even with generous subsidies.  This means that the cash portion of the health-care  economy will expand – in direct contradiction of the goals of the ACA.”

ObamaCare, by accident, not by  complex rules, subsidies, penalties, and mandates,  has turned consumers back to simpler, more intimate,  direct cash, more economical  personal relations with primary care doctors .    

As Dr. Josh Umbehr, a direct cash concierge physician, commented to me, “ObamaCare is our salesman of the year.”

Tweet:  ObamaCare has an expected consequence, raising premiums and deductibles,  driving health consumers into concierge direct cash practices.

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