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Obamacare's Best Days May Be Behind It


Obamacare supporters have been touting California’s lower-than-expected premiums as a sign of ACA success for months now. That claim is bogus; many people are still facing premium price hikes over their current rates. Now new data suggests that the tradeoffs required to bring premiums below the expected average will be very hard to live with. LA Times:

To hold down premiums, major insurers in California have sharply limited the number of doctors and hospitals available to patients in the state’s new health insurance market opening Oct. 1.

These diminished medical networks are fueling growing concerns that many patients will still struggle to get care despite the nation’s biggest healthcare expansion in half a century.

Consumers could see long wait times, a scarcity of specialists and loss of a longtime doctor.

“These narrow networks won’t work because they cut off access for patients,” said Dr. Richard Baker, executive director of the Urban Health Institute at Charles Drew University of Medicine and Science in Los Angeles. “We don’t want this to become a roadblock.”

Basically, price mechanisms are re-asserting themselves in the only way the new law allows: rationing by the provider side. Liberal wonks have assumed that Obamacare will eventually get more popular as its implementation kinks get worked out and the basic features of the law show their true value. Perhaps they are right, but if temporary savings are secured at the price of long-term constraints on health services available, we may get the opposite outcome. Obamacare’s approval ratings, as bad as they are, could actually be the highest they’re going to get.

That possibility may still seem remote, but as more subsidies increase the taxpayer cost of the law and patient choice is restricted, opposition could actually climb. Obamacare’s best days may be behind it.

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  • ColoComment

    For health care, there are three general factors that you can change: the quality of the service, access to the service, and the cost of the service.
    You can improve on any two of those but only at the expense of the third.

    • Reticulator

      The operative word is “you.” That’s also the tragedy of this comment.

    • wrecktafire

      In engineering we say, “good, cheap, and soon — you may pick any two”.

  • crabtown

    Congress refuses to go in. But they force us to.

  • Self Pay Patient

    Just wait until the ‘young invincibles’ with fairly moderate incomes (between 200 – 400% of poverty) realize that their subsidies are either non-existent or close to it. I can’t imagine they’re going to be all that happy after being told repeatedly that ‘everyone under 400% of federal poverty will get subsidies.’

  • TheRadicalModerate

    Surprise, surprise: price controls cause shortages. Who knew?

    I’m actually sort of a supporter of the skeleton of ACA, i.e., guaranteed issue and community rating at the cost of mandatory coverage, but it seems to me that the place where things went seriously off the rails was community rating only allowing 3x the premium for the elderly over the young. This turns out to be yet another way of getting the young, who are the least wealthy segment of the population, to pay for stuff for the elderly, who are the most wealthy.

    Yes, yes, there’s always going to be the little old lady who’s eating cat food and can’t afford her digoxin, but we’re not really talking about her, are we? We’re really talking about people under the age of 65 (i.e., not on medicare yet), the vast majority of whom are still working and probably have some savings. So exactly why are we doing things that inhibit family formation and professional development?

    Has anybody run the numbers on what happens if you move the 3x community rating to 5x, or 8x?

  • Boritz

    Two potential ways to fix it: less legislation or more legislation. Which is your money on?

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