Monday, May 12, 2014

ObamaCare’s Fatal Flaw: One-Size-Does-Not- Fit- All

All animals are equal, but some are more equal than others.

George Orwell (1903-1950),  Animal Farm

What is ObamaCare’s most serious flaw?

·         The Individual Mandate?

·         The Employer Mandate?

·         The Religious Mandate?

·         The manner in which it was passed without a single GOP vote?

My answer is: None of the Above.

The answer is: The  Essential Benefits Requirement that all health plans must offer to qualify for ObamaCare.

The Affordable Care Act, (sections1302) lists the ten  “essential benefits” as,

·         Ambulatory patient services
·         Emergency services
·         Hospitalization
·         Maternity and newborn care
·   Mental health and substance use disorder services, including behavioral health treatment
·         Prescription drugs
·         Rehabilitative and habilitative services and devices
·         Laboratory services
·         Preventive and wellness services and chronic disease management
·         Pediatric services, including oral and vision care.

In other words, one- size-fits-all.  Everybody gets something, and there's something for everyone.   Everyone is equal.  Everyone receives the same benefits.  Nobody  can be questioned whether they need these benefits or not.  Nobody except  members of Congress and their staffs, who will be exempted from participating in the exchanges.   Some animals, particularly Congressional animals,  are more equal than others.

Whether you want to receive this “benefits, is not a matter of whether, you are:

·         Young and healthy
·         of sound mind and body.
·          do not take prescription drugs.
·     Have any need for laboratory have no need for maternity, newborn care, or pediatric services.
·          You are single,  and do not have a child who needs dental care, or eye glasses.
·    You do not want to seek preventative, substance abuse, behavioral health treatment, wellness, chronic disease management, or rehab or habiliative (whatever that is).
What Matters
 What matters is that we are all in this thing called life and health and citizenship together.  It’s all for one, one for all, one size fits all. that’s what counts.
But now,as many as 6.3 million Americans may lose their health plans they liked and wanted to keep.  No matter that routinely including these benefits drives up costs on average by 41% on the exchanges.
Middle class Americans who do not qualify are aghast and angry that routine inclusion of ten essential benefits for services they do not seek or want, is causing them to lose plans they chose and drives up health premiums and deductible to unaffordable levels in a health law ironically title “The Patient Protection and Affordability Act.”
How could this be?    It’s really quite simple.  Their plans do not meet federal standards.   Ergo, their plans are “substandard.” 

This state of affairs stems from the doctrine of “essentialism,” namely, that all health care services are essential to society and should be available to all regardless of individual abilities, skills, need, education, or economic status. 
Essentialism ignores merit, risk, and economic growth. These factors apparently deserve no special rewards. Presumably, when government homogenizes and standardized humankind into one lump, all will be well, and the nation's level of health will be elevated.
Every American, in more prosaic language, should have equal access to comprehensive care, regardless of age, health, pre-existing illness, geographic location, insurance coverage, or citizenship status.
  • If you are young and healthy, you should pay the same as the old and sick, even if you cost society nothing in the short run. In the long run, you will become old and sick.   
  • If you are poor, the government should subsidize you to raise you to the level of more affluent citizens.
  • If you are in a small business, you must pay for comprehensive coverage of your young healthy employees as you would for a more mature and older work force.
Charity for all and all eggs in one basket is the goal of progressive, as long at government is directing the effort and the "rich" are paying their "fair share”, and you are spending  OPM, "Other People's Money."
No doubt universal coverage  is a  noble goal.  The problem is, of course, that even an affluent society like America cannot afford "Silver, " “Gold,” “Platinum,” and “Cadillac” plans for all and still provide services that allow for personal freedom and choice that fits the needs of individual segments of the population.
In America, the land of capitalism, individualism, meritocracy, entrepreneurialism diversity, and regional variation, one-size-fits-all does not fit all and  raises the cost for most of us.
One-size-fits-all cannot be achieved without the assistance and intervention of the massive bureaucratic apparatus in Washington that unfortunately stifles innovation, limits choice, increases costs, and cannot deliver on its promise of the same universal coverage for all.  
 The RAND Corporation says that only one-third of health exchange enrollees were uninsured; the Kaiser Family Foundation found only 50% of the uninsured plan to buy insurance; and the Congressional Business Office estimates after 10 years of ObamaCare,  31 million will remain uninsured.  Furthermore,  more than half of American physicians are no longer accepting Medicaid patients or are restricting access to Medicare patients.  
 What good is universal care without access to doctors?  The answer for as many as 100,000 doctors is cutting out the government middlemen and health plans  and seeing patients individually for reduced, direct fees.
Tweet:  The principle flaw of ObamaCare may be the provision in the law that one-size-fits-all, that all plans must provide 10 essential benefits, whether people need them or not.
Source: Nancy Pfotenhaer, “O-Cares One-Size-Fits-All Failure,” The Hill, May 7, 2014

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