Many suffering with Obamacare fatigue have spent the past months watching the president's handling of the Gulf disaster (ugh!), the war in Afghanistan (ugh!), the lawsuit against Arizona (ugh!), and jobs creation (ugh!). Just to make your day, I'd like to bring you up to date on the health care front.
As a starting point, I'd note that the bill which Obama signed on March 23, met the primary objective of extending coverage to 32 million folks; contained a very confusing jumble of variously-timed taxes, mandates, subsidies, and government expansions; and did virtually nothing to reduce costs due to vote-buying compromises with the lawyers, pharma companies, doctors, medical device providers, insurers, and hospitals. There will have to be a "Plan B".
Some things on a macro level:
- Some 60% of voters now believe that the legislation should be repealed, but only 41% believe that it will be. Pelosi's "build it and they will come" hope lies in the future.
- In April, Obama promised that everything would be "on the table" for the Budget Deficit Reduction Commission, whose recommendations are due December 1. Hopefully, that will include Paul Ryan's recommendations on health care. In a bad sign, one of the commission's first acts was to request more funding for the commission.
- Since the bill passed, the health care stock index has declined 12.2%, while the S&P 500 has declined 11.8%. Wall Street already got its way.
And a bit more micro:
- Some 20 states have joined in lawsuits to invalidate the law, particularly the provision requiring citizens to purchase health insurance. The relationship between required participation, pre-existing conditions, and rates is vital and there is some chance that the Supreme Court may favor individual liberty.
- The insurance industry will have many companies stop some coverage as the requirement that 80% of premiums be paid in claims is defined by the bureaucrats. (So much for that "no cancellation" claim.) Meanwhile, in California Blue Cross has withdrawn its proposed 39% increase due to "calculation errors" - after its announcement on the eve of the Senate's March vote sparked outrage (and helped obtain 30 million more mandated customers for the industry.)
- Early indications are that the $5 billion for interim "high risk pools" (for pre-existing conditions cases until coverage is mandated in 2014) will probably be inadequate - an early harbinger of the plan's real costs.
- Conventional wisdom is now acknowledging that 16 million more Medicaid beneficiaries will mean more crowding in emergency rooms, and that the 10% increase in medical school enrollees between 2009 and 2014 will run into a bottleneck with little increase in residency positions. And, predictably, the currently-stalled "unemployment benefits bill" contains a 21% increase in payments to Medicare doctors- which had been left out of the CBO's cost estimate of Obamacare.
- Obama has used a recess appointment to bypass Congressional discussion of his leader for Medicare and Medicaid- a Harvard doctor who views health care as inherently redistributive, opposes private care providers, and acknowledges the need for rationing. See for yourself.
- And it is becoming harder for the media and politicians to ignore the Massachusetts experience - the highest premiums in the country, spreading price controls, and proposals to limit preventive examinations and physician private practice.
There will be a Plan B.
And for the decreasing minority who still respect this administration, here's the head of the National Aeronautics and Space Administration telling al Jazeera that the foremost mission of NASA is improvement of relations with the Muslim world. Truly.
bill bowen - 7/9/2010