At Work

How do you measure the success of Obamacare?

If you are Paul Rugman or like minded, you measure it this way:

And let’s be clear: The reason this assault failed wasn’t that Donald Trump did a poor selling job, or that Mitch McConnell mishandled the legislative strategy. Obamacare survived because it has worked — because it brought about a dramatic reduction in the number of Americans without health insurance, and voters didn’t and don’t want to lose those gains.

You can’t argue with the facts, Obamacare did lower the number of uninsured. But that’s a little like saying government efforts to increase home ownership in the years before 2008 were a success. 

You can’t measure success on one goal of a complex issue. Obamacare was also supposed to make health care affordable and improve quality. In other words, it was supposed to help all Americans and even today it’s presented in those terms. 

Making something affordable by having others pay most or all of the cost, accomplishes nothing. If I can obtain a prescription with a $10 co-pay but my employer plan pays $200 is the Rx affordable; to who? Is it still affordable when the $200 goes to $250, but my co-pay is the same? 

Obamacares troubles are exactly because of those subsidies; the need for them and because of adverse selection creating a higher cost enrollment pool of insured. And also because the political focus was on premiums while making little connection between health care spending and those premiums. 

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3 replies »

  1. The genie has left the bottle and will henceforth be free to grant healthcare wishes, as all eyes are on who’s willing to pick up the check.

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  2. My sister-in-law considers Obamacare a success because she pays less than $30 a month for medical insurance.

    I do not consider it a success because I pay ten times that amount and my costs continue to climb. Plus it is diverting my tax dollars from paying down the national debt. This is not even taking into account what my employer has to pay.

    But I don’t blame it all on Obamacare. One failed policy after another has driven medical costs through the roof. The fact that Medicare, by law, cannot negotiate drug prices might be one reason drug pricing has gone up with some drugs rising 100% to 1000%. All the drug prices increases started in the mid-2000’s before Obamacare with the signing into law Medicare part D. If you know you’ll have a blank check, why not charge higher prices for drugs.

    I think that maybe some patent laws might have to change. Yes this might stop innovations but do we need nitch drugs to treat a few thousand people to add 3 months to their life or do we need basic insulin supplies at very affordable pricing. Maybe the government should declare certain drugs in the public interest like a vaccine and have them mass produced which would be a better use of our tax dollars. I would like that. In ten years will can talk about a new kind of fraud.

    Lawyers and the AMA are not helping costs either. Medical companies and drug manufactures invent more tests. The AMA recommends more screening tests. Lawyers demand more tests to rule out why a doctor did not treat a person for this or that. As a patient, I have no idea which test is a good test and which test is looking for a one in a million condition, so I get the tests.

    The moral responsibilities must somehow be affordable. Morally, nobody will argue against putting a baby in a NICU for a $1 million in treatment. Young parents can’t afford that and who knows what that baby will do for the world. Cost wise it makes no sense, but nobody will argue against it.

    But at 85 years old, can I justify a heart valve replacement? I guess it all depends on your relationship to that person. My personal experience found that it bought only an extra 4 months. I’ll personally pass if I live to be 85, I already know what I did for the world.

    Morality is driving healthcare expectations and costs just as much as Obamacare does. People demand coverage from their congressmen to cover what they see on TV from medical shows and drug ads. Who knows what the Internet has done to problem. There is always some doctor, in some country, trying a new experimental procedure. How can you deny treatment if it can save their life. Until people expectations are capped, healthcare costs never will be capped or controlled.

    Life is always terminal and body parts just wear out. I am proud of every ach and pain and gray hair that I have. I did something with my life and have no regrets nor a desire to live an extra 4 months believing that at the end I can make up for not doing something with my life.

    The problem will Obamacare is that it tries to cover too much and is not controlling the causes which results in rising the costs even more.

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    • That $30 a month premium is the best example of Obamacare failure. It represents a false solution because nothing about the real underlying cost has changed. No problem has truly been solved. It’s like putting a small bandaid on a cut that needs twenty stitches.

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