Right Thinking From The Left Coast
If everything seems under control, you're not going fast enough. - Mario Andretti

Tuesday, March 22, 2011

Happy Birthday, PPACA

It’s now been one year since Obamacare was foisted on the American public.  What have we got to show for it?  Besides declining popularity, legal troubles and the failure of the uninsured to take advantage of it, here are the big problems:

3.  The budgeting problems are even worse than I thought I argued at the time that the spending cuts were not sustainably structured, but I didn’t predict just how difficult they would prove to sustain.  Already, Congress is resorting to ever-more-desperate health care budget gimmicks, like dipping into the health insurance subsidies in future years in order to pay for higher Medicare physician reimbursements.  A month or so after it passed, a healthcare reporter of my acquaintance said that he thought that Congress had pretty much used up every conceivable pay-for in order to pass PPACA, and history is so far proving him right: having exhausted their pay-fors, they’ve now started cannibalizing ObamaCare itself.  And it’s three years to go before we actually set the Rube Goldberg machine into motion.

4. Unintended consequences have started kicking in As the Official Blog Spouse points out, the administration is granting waivers to virtually anyone who asks, presumably because they think that absent the waivers, people would be losing their insurance.  And not without good reason--thanks to the rules making it illegal to exclude children with pre-existing conditions, insurers have now stopped selling child-only policies in 34 states.  Both the government of Massachusetts and the administration are eagerly exploring the option of simply commanding insurance companies to sell policies at the price they would like to pay, a tactic that doesn’t really have a great track record in modern industrial economies.

I would also add, purely on anecdotal data, that insurance has gotten more expensive in the last year.  But I’d be interested in seeing some hard number on it.

The defenders are arguing that Obamacare will become really popular in 2014 when the massive subsidies start kicking in.  Of course, by 2014, the accounting gimmicks that made this bill appear to reduce the deficit will have evaporated and we’ll be staring down the barrel of hundreds of billions in new debt (which, no doubt, will be blamed on the on the Republicans).

Unfortunately, the bill is attaching itself to the healthcare system, thank to almost all the governors, including Republican ones, accepting money and setting up exchanges to run the system.  By the time the full impact of this bill is felt, it may be too late to do anything about it.

Posted by Hal_10000 on 03/22/11 at 06:13 PM in Health Care  • (0) TrackbacksPermalink
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