Wednesday, April 07, 2010

So how does the Obama health care bill "provide" health care for almost everyobody?

Ignoring for a moment the millions of U.S. citizens who are not covered by the Obama health care bill, how will those who are now ( well, in a few years) eligible for health care actually get their care ? The answer- two ways, 1) through the current (though modified) private health insurance industry by the simple ( actually the details are anything but simple) expedient of making those who can afford insurance it to buy and subsidies for those who cannot and 2)making more folks eligible for Medicaid.

This is the same (OK, currently modified, so new and improved) private insurance industry that was so vilified in the run up to the bill's passage but we are led to believe that through wise regulation these powerful and evil snakes in the grass will be defanged, such defangation accomplished by not allowing different rate premiums for different risks and by disallowing rescission ( aka, an insurance company dropping the patient when they get sick).

The second mechanism is increased in enrollment in a plan that virtually no one says is a good way to get health care.Good luck finding a physician who accepts Medicaid patients as millions are made eligible.

Well, maybe these are not the absolutely best ways to go about it but we told we must not let the perfect be the enemy of the good but at least we can feel good about the fact that this bill will save us money and we have been told by the president that without it the country will go bankrupt.

There are few instances where anything like controlled experiments occur in the world of economics but we can look at how things have worked out so far in Massachusetts where a very similar plan has been in place for the last three years. Here is an assessment of that from a new publication not known for its anti-government bias.

The bottom line is it that the Mass plan costs multiples of what the purported projections were ( as did the projections for Medicare) and waiting times to see physicians is the highest in the country, that in a state with many more per capita docs than most.

So with Massachusetts as a model ( or canary in the coal mine) how could anyone expect the Obama bill to save money and save the country from bankruptcy. One way was the hokey- pokey accounting shenanigans that prevailed in congress. By that I mean the CBO had to count the saving from a 21% cut in Medicare payments to doctors while legislators played a wink wink nudge nudge game promising to some of the more easily fooled medical organizations to eliminate those cuts in a separate bill. Bait and switch written very large.

With a plan as sound as the above would suggest, it is no wonder that the president has launched a campaign to educate the populace about the virtues of the plan .Currently the tactic appears to be to talk so much that ultimately everyone will just give in so that he will stop talking about it. Even the Washington Post seems to taken back a bit by his verbal excess. See here.

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