Friday, September 12, 2014

Five Reasons ObamaCare Is in Trouble

What we've got here is a failure to communicate.

Cool Hand Luke, screenplay 1967

As we approach the midterm elections, five things are evident.

Election results will hinge on 1) ISIS, 2) the economy, 3) jobs, 4) ObamaCare, and 5) perceptions of Obama as a leader and his ability to communicate his message to ordinary Americans.

As a leader, Obama is regarded(and regards himself as a cool customer – detached, isolated, dispassionate, rational. On the other hand, others think of him as narcissistic, overly cautious, and ideological to a fault with a distorted image of the world.

In times of crisis, which we are in now, temperament, decisiveness, clarity, and a sharp sense of reality are important, even critical.

President Obama's vision of the future is based on the long game - government as the principle means of transforming America into an egalitarian society, more equal and less dominant compared to other countries

But Americans are an impatient and proud people. They like being the world's number one power. They admire results more than rhetoric. They are more interested in economic growth and prosperity than in economic stagnation in the names of equality and fairness. Six to eight years, in the eyes of many, is too long to wait for the economy to turn around, for our enemies to be subdued, for health care reform to show results.

Outside of President Obama’s favorite constituencies – minorities, environmentalists, the liberal elite, unions, and single women - he has failed to communicate his vision to the broader American public. Consequently his political future and that of the Democratic party and Big Government liberalism are endangered.

With ObamaCare, here are five reasons why his vision of health care has failed to impress the majority of American voters who continue to oppose it by double digit margins.

Incompetence - The rollout of was a bungled disaster and smacked of administrative incompetence. Although 8 million enrolled after 6 months, many proved to be ineligible and may yet be disenrolled , many have showed up at their doctor’s offices to find their doctor had not be notified of their enrollment, and many have found to be their disappointment and amazement that their doctor refused to participate in exchange problems. There are other “back-end glitches” as well that persist to this day. All of this has taken place despite more than $840 million spent on healthcare. gov, and that does not count the millions more poured into failed state health exchanges.

- ObamaCare requires that health plans meet federal standards. These standards include that plans meet 10 arbitrary essential standards: ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, 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. Perhaps 5 million policies have been cancelled, and more are certain to come. It is not the insurers fault. They are required to comply with the health law. Health plan holders who pay more in premiums to meet these standards are often resentful because these requirements to not apply to their individual situation, particularly if you are young, healthy, male, single, and childless.

Deceptions - Americans feel deceived. They were promised they could keep their doctor, their health plan, and the hospital of their choice. With the narrowing of networks, changes in the plans they hold, and cancellations these promises have not been kept.

Faileconomics - The freakoecnomics of health care coverage have not worked out planned, particularly for the middle class whose premiums and deductibles and co-pays have gone up unpredictably with the redistribution of benefits and subsidies to those 4 times below the poverty line. Obama promised that premiums for a family of four would drop by an average of $2500 by 2016. Instead premiums have skyrocketed for many with individual or small group coverage. For many these increases come as an unpleasant, unjustified surprises.

Frustrations - For the population as a whole, frustrations abound because of the uncertainties and complexities of the law. One of five Americans have decided not to have a health plan at all. Others are turning to direct cash payments, to retail clinics, to urgent care clinics, to Medicaid, or to care in emergency rooms if necessary because they know hospital ERs are legally required to treat them. Doctors are turning to direct pay to unchain themselves from third parties and government. Businesses are turning to part-time pay, dumping employees onto exchanges or Medicaid, and shifting health costs to employees.

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