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Obamcare does little to address the problem of healthcare expense

Posted: November 3, 2013 - 12:07am

The launch of the healthcare insurance exchanges on Oct. 1 was nothing short of a travesty.

Of the 3 million people that jammed the healthcare Web site during the first 24 hours, a grand total of six were able to navigate their way through the electronic labyrinth and actually enroll.

This key centerpiece to the Affordable Care Act, otherwise known as Obamacare, was the sort of massive failure that, unfortunately, one has come to expect from the bloated, heavy-footed bureaucracy in Washington.

Now that it has stumbled and crashed at the starting line, extraordinary efforts are being made to bring the behemoth to its feet so it can lumber away toward the Jan. 1 deadline. No doubt, they will fix the Web site problems, and millions of Americans who do not have health insurance will enroll in the system and Obamacare will truly be on its way. To what destination, however, no one seems to know.

If you recall, one of the main reasons Obamacare was created was because how much healthcare costs in this country. As anyone who has experienced a hospitalization or trip to the emergency room, the costs are astronomical. Healthcare is so expensive, it is hard to make any sense of it.

This is not only for individuals but for the nation as a whole. Healthcare absorbs 18 percent of the nation’s economic output, more than just about every other developed country in the world. The World Health Organization ranked the United States 37th out of 191 countries in healthcare efficiency – that is comparing what we spend versus the overall health of our citizens and the medical outcomes we get for services rendered.

Obamacare, however, does very little to address the problem of cost. It does spread the costs over a larger group of people, which could reduce costs over a very long timeline, but that still remains to be seen. The logic of requiring everyone to carry health insurance makes sense up to a point, but the way this mess is being implemented doesn’t appear to save a lot of people money and it doesn’t reduce what it costs to treat people.

In Georgia, we can expect costs to rise. Part of that has to do with our governor’s refusal to participate in the Medicaid expansion, which was another cornerstone to the Obamacare foundation. When Gov. Nathan Deal refused federal funding to expand eligibility for Medicaid, he may have thumbed his nose at the President, but he really put the screws to the state’s hospitals.

When the grand bargain of Obamacare was being negotiated three years ago, the nation’s hospitals agreed to forgo billions in payments they would expect to receive between 2014 and 2019 for taking care of the poor and indigent. In return, they expected more of these same poor people to be covered by the expansion of Medicaid.

Now Georgia’s hospitals will receive neither – no extra payments to cover treating the poor and no additional health insurance for the approximately 400,000 poor that could have been covered by Medicaid.

Where will the money come from? Hospital CEOs will surely be looking to cut costs wherever they can, but the poor will still be crowding emergency rooms looking for treatment that they can’t get elsewhere.

Those extra costs will be absorbed by everyone else who has insurance. We pay either way.

What’s the answer? If anyone tells you they have a simple answer to the massive problem they are either deluded or just plain lying.

A number of things need to occur in this country to fix our healthcare problem. We need to change the way we think about what good healthcare is and what is really necessary. We need to change our unhealthy lifestyles, the way we produce food and what we actually eat. And above all, we need a more transparent healthcare system, one that will allow consumers and patients to make more informed decisions.

As patients, we want to know one thing: Where can we get the best, most reliable, safe and efficient care for the lowest cost? Our system makes answering that question almost impossible.

Until the time comes when we can get those answers, we will still be paying through the nose for healthcare.

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Little Lamb

Medicaid Eligibility Expansion

Okay, we need to get to the bottom of this Medicaid “expansion” shell game. The editorialist says this:

When the grand bargain of Obamacare was being negotiated three years ago, the nation’s hospitals agreed to forgo billions in payments they would expect to receive between 2014 and 2019 for taking care of the poor and indigent. In return, they expected more of these same poor people to be covered by the expansion of Medicaid. Now Georgia’s hospitals will receive neither — no extra payments to cover treating the poor and no additional health insurance for the approximately 400,000 that could have been covered by Medicaid.

The logic of the editorialist’s premise is absurd. The nation’s hospitals did not agree to anything. The deals were being worked out between small cabals in Washington. Do you think Burke County’s hospital was being consulted? Do you think they agreed to anything in the Obamacare negotiations?

Next, the hospitals were not expecting to forgo any payments. They were expecting Medicaid eligibility to expand — thus increasing payments from Medicaid (some from federal tax payments, some from state tax payments).

Now that Medicaid eligibility is not going to expand in Georgia, the status quo will prevail. Those low income persons who did not qualify for Medicaid before, will not qualify for Medicaid now. There will be no change. Those persons can go to emergency rooms, receive whatever treatment they were receiving before, and the hospitals will recover their costs the same way they always have — by burying the costs in overhead and getting reimbursed from paying customers.

Though I have disagreed with Governor Deal on many issues since his becoming governor, I certainly support his stands regarding Obamacare. Medicaid eligibility should not be expanded. And the state does not need to burden itself setting up an "exchange" for buying health insurance. There are licensed brokers and direct-sell insurance companies abounding. We do not need new, artificial, governmental programs set up to do what the market is already doing in a more efficient manner.

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