Actually, Sen. Baucus, ObamaCare Is Facing Multiple Train Wrecks
May 09, 2013
Senate Finance Committee Chairman Max Baucus’ gaff--defined in Washington as when someone inadvertently tells the truth--about ObamaCare being a “train wreck” was actually an understatement: ObamaCare faces multiple train wrecks.
Baucus was referring to the implementation of ObamaCare: the missed deadlines, the confusion, and perhaps most importantly, the political fallout. But there are several other train wrecks, abject failures that have received little attention. And Republicans have had little or nothing to do with them.
Train Wreck No. 1 -- Electronic health records, or EHRs, were supposed to create an electronic version of patients’ medical records that could be transferred from doctor to doctor or hospital to hospital, known as “interoperability.”
The Obama administration included $20 billion in the 2009 “stimulus bill” to promote the adoption of EHRs. Doctors and hospitals would be paid if they implemented EHRs in a “meaningful” way. The oft-repeated justification was that EHRs would save money—Obama cited an $81 billion savings that no one now believes--and improve the quality of care.
Well, the title of a January New York Times report reveals what many health policy experts predicted: “In Second Look, Few Savings from Digital Health Records.” As it turns out the only ones benefiting from EHRs are the companies that lobbied for the legislation, doubling some of those companies’ profits. As the Times points out, “the legislation has been a windfall to top executives at the leading health records companies.”
Had anyone taken the time to look at the VA and its hospital system, which has had versions of electronic health records for decades, they might have been a little less optimistic. A recent National Center for Policy Analysis report explains, “efforts to integrate Department of Defense medical records for service members with VA electronic health records for new veterans have failed, hamstringing attempts to provide a continuum of care for veterans with service-connected conditions, as well as costing taxpayers more than $1 billion dollars.”
Electronic health records may eventually become the gold standard in health care, but we’re not there yet and Obama’s billions of taxpayer dollars may have even slowed the progress.
Train Wreck No. 2 -- President Obama rammed through the first major new entitlement in 45 years, but instead of people embracing it, most don’t want it; not businesses, not insurers, not doctors, not individuals. Apparently, not even Democrats who voted for it.
Reuters reports that the largest insurers, most of which initially supported the legislation, are very reluctant to enter the health insurance exchanges, where millions are supposed to have access to numerous health insurance options. “In recent days, executives at the four largest U.S. health insurers say they are likely to sell insurance plans on less than a third of the exchanges, reluctant to venture out beyond the states where they already offer coverage.”
And insurers aren’t alone. A majority of the public has supported repeal since the legislation passed, and the “repealers” have recently grown. Of course, business trade associations like the U.S. Chamber of Commerce and the National Federation of Independent Business have been fighting ObamaCare from the beginning.
The reception has been so bad that the Obama administration signed a $20 million public relations contract a year ago in an attempt to convince the public they want ObamaCare, and it just signed two more for another $10 million. That’s $30 million of your tax dollars to sell something most of you don’t want.
Train Wreck No. 3 -- Health insurance premiums will explode. In January retired actuary Mark Litow and I published an opinion piece in the Wall Street Journal explaining why ObamaCare will push up premiums for some people by 100 percent.
In the last two months, as insurers have begun to announce their ObamaCare premiums, it’s clear we were right. States that largely destroyed their health insurance markets, like Massachusetts and New York, may not see much change--at least for a few years. But states that did a good job of ensuring access to affordable coverage will see their premiums skyrocket, especially in the individual market for younger adults.
Note that the rise in premiums is not a result of Obama’s sloppy implementation efforts; it’s due to the fact that the people writing the legislation didn’t have a clue how health insurance works or how it affects consumer choices. They thought--and Obama repeated it several times--that getting everyone covered would lower health care spending. They also thought that adding free services would reduce health care costs, when virtually any actuary would have told them the opposite.
Train Wreck No. 4 -- And let’s not forget those with major pre-existing medical conditions, the uninsurables. ObamaCare put $5 billion aside to fund a new system of high risk pools to cover them--even though 35 state-based high risk pools already existed with about 220,000 people enrolled.
While Democratic planners expected some 375,000 people would be eligible to enroll in the program, only about 100,000 have. And yet the program is running out of money, and so the administration has closed it to new enrollees.
Let me repeat that: One of Obama’s primary justifications for demanding health care reform was to help the uninsurables get coverage, and he has closed that provision to new entrants.
Yes, ObamaCare will be a train wreck, many times over--just wait until the IRS cranks up its enforcement efforts or it becomes clear that people cannot get health insurance subsidies in the federally created exchanges.
Democrats went to great lengths to completely restructure the U.S. health care system and get all the “credit” for it. And now they are increasingly afraid they will.
Merrill Matthews is a resident scholar at the Institute for Policy Innovation in Dallas, Texas. Follow at http://twitter.com/MerrillMatthews