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Obamacare’s Naive Bargain with Hospitals
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  • Jersey McJones

    I believe the theory goes like this – the hospitals no longer have to be the first line of service, that gets passed over to private practices, so the hospitals will be free to concentrate on other things they should be doing (we do have a large aging population right now), and now we audit them, so we know much more about how and why they spend and can reduce even further there, going after they’re producers, etc.

    It’s too early to see how or whether at all that will work, or how hospitals will fare in the end.


  • Andrew Allison

    Leaving aside the naivete of ACA, this post (like its predecessors on this topic) demonstrates confusion about insurance in general and medical insurance in particular. Insurance has absolutely nothing to do with helping financially struggling families, ACA is about is subsidizing insurance for them at the expense of those marginally better off. This is simple extortion requiring purchase of inflated price insurance by some in order to provide below market insurance for others. While it is hardly surprising that providing subsidized insurance results in abuse, the proposition that it increases ER use is suspect: part of the rationale of the ACA is that the ER (which is required to provide care to all) has been the refuge of the uninsured. If providing insurance increases ER use, there’s something dreadfully amiss.

    • SisyphusRolls

      Oregon saw the same increase in ER usage for Medicaid expansion. People with insurance may have less concern about the costs of using the ER for non-acute problems.

      • Andrew Allison

        True, but (another recording) Medicaid is not insurance but welfare. As such, it is even less popular with providers than Medicare and goes to the supposedly indigent.

  • R. Howell

    Costs are “reined” in, not “reigned” in.

    • M Snow

      True, but with Obama royal references are always appropriate.

  • Gary Hemminger

    Does anyone seriously think that less hospitals + same number of doctors + more regulation + more patients = lower costs? What planet do they live on?

  • ljgude

    Your problem America, should you choose to accept it, is that you went into the ACA at 16%of GDP for healthcare which is double the OECD average which produces the same health outcomes for half the price. The ACA caps increases at 17.5% of GDP by 2017. It has always been going to cost more. I suggest Peter Brill’s Time Magazine article last year entitled ‘Bitter Pill.’ The healthcare system already had unsustainable costs before the ACA. No one is going to rein them in with 1.5% of GDP up for grabs.

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