Vol. 76/No. 33      September 10, 2012

The key feature of the bill was the decision not to set up a universal health care system funded by general government revenues. Instead, the government’s bloating health insurance bureaucracy will provide incentives for employers to offer some kind of insurance and subsidize plans for families with the lowest incomes who don’t get crummy plans from a boss.

Government funds will come from cutting payments to doctors and hospitals and fines levied on the uninsured. Insurance companies will rake in profits from millions of healthy people who will pay to be insured, which the White House says will keep down prices for the sick, elderly and infirm. Meanwhile, already inflated prices for care rise, government programs are slashed, and workers’ insurance covers less and less.

“Obamacare,” passed in March 2010, was upheld largely intact by the Supreme Court in June, which ruled that the administration has the right to force workers to buy private insurance or be shackled with mandatory fines, which the court characterized as a “tax.” By 2016 the tax penalty will rise to 2.5 percent of household income, at least $695 and as much as $2,085 per family.

As bosses slash wages and benefits and health costs continue to rise, insurance behemoths are responding by offering shoddier plans. The Wall Street Journal explained Aug. 2 that they are racing to install “tiered” coverage, limiting the choice of doctors and hospitals covered under their lower price plans and requiring referrals from primary care physicians before you can see specialists, as well as prior authorization from insurance companies before covering a number of medical procedures.

Health insurance premiums increased about 9 percent last year, according to Forbes.

The act considers employer-sponsored insurance “affordable” if workers pay out-of-pocket 9.5 percent or less of their household income. Above that amount, individuals can file paperwork to apply for subsidies and tax credits. But the Internal Revenue Service, which is responsible for implementing this part of the act, says this applies only to “self-only coverage,” not the huge amounts workers are forced to shell out for family coverage.

A 2011 study by the Kaiser Family Foundation said that most workers on company insurance plans pay an average of $920 annually for individual coverage and $4,130 for family coverage.

Medicaid and Medicare cuts

How will this work under Obamacare? asks an Aug. 17 Journal editorial titled “The Mediscare Boomerang.”

“The government will do things like arbitrarily commanding providers to deliver the exact same benefits except for $716 billion less,” the paper said. “When that doesn’t work, as it surely won’t, the feds will take control of the case-by-case decisions currently made between patients and doctors and substitute the judgment of technocrats.”

As Obamacare takes aim at federal Medicaid spending, it stipulated that state governments, which are slashing expenses across the board, had to extend Medicaid to those who earn below 133 percent of the federal poverty line or lose federal funding. The June 28 Supreme Court ruling that upheld Obamacare struck down that requirement. Even before the lawsuit, a growing number of state governments had been reducing what Medicaid covers and kicking people off the program, which 58 million people rely on.

In Maine, authorities are moving to eliminate 30,000 patients from Medicaid. Another 12 states are reducing benefits, tightening eligibility or paying doctors less, according to Kaiser Health News. In Illinois, more than 25,000 adults have been cut from Medicaid. In Florida, funding to hospitals that treat Medicaid patients has been cut by 18 percent over the past year.

Hospital corporations are also cutting back on health services. HCA, for example, which controls 163 hospitals from New Hampshire to California, has decided to not treat patients who come to emergency rooms if their conditions are considered “nonurgent.”

One doctor “was told to turn away a young boy with a deep cut in his arm because it was not bleeding profusely and he therefore did not meet the criteria,” reported the New York Times.

“Before the Affordable Care Act was passed, hospitals would get reimbursed every time a patient was readmitted to a hospital even if they were readmitted continuously for the same underlying condition,” Rep. Chris Van Hollen, the top Democrat on the House Budget Committee, told the Washington Post Aug. 18.

In other words, if you had a heart condition, each time it made you sick enough to go to the hospital, Medicare would pay. No more. “We’re now changing the model so hospitals don’t get reimbursed every time the patient gets readmitted,” Hollen said, adding this will give hospitals “financial incentive” to cut costs.

Government bureaucracy

After disingenuously saying that he was loath to have bureaucrats make such decisions, Obama replied, “If they’re not being made under Medicare and Medicaid, they’re being made by private insurers. We often make those decisions by just letting people run out of money or making the deductibles so high or the out-of-pocket expenses so onerous that they just can’t afford the cure.”

Obama said that having government intervene can help rule out “additional tests and additional drugs that the evidence shows is not necessarily going to improve care.”

The bottom line? “Maybe you’re better off not having the surgery, but taking the painkiller,” Obama said.
 
 
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