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The Real Beneficiaries and Victims of Obamacare

There's more to who ends up a winner or loser with Obamacare than who pays less or more.

by
Jean Kaufman

Bio

November 22, 2013 - 12:00 am
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The success or failure of Obamacare is often looked at in terms of “winners” versus “losers.”

For example, in Thomas B. Edsall’s analysis of Obamacare in the New York Times, Drew Altman, president of the Henry J. Kaiser Family Foundation, is quoted as stating:

I think the bottom line here is that the “winners” greatly outnumber the “losers” in general and in the individual market in Obamacare, but the media and political math is different from the actual math. A significant minority of “losers” or self-perceived losers and a few high profile bad outcomes…are more than enough to cause real political problems.

Kaiser is an organization that does research on health policy issues, but I would wager that even the learned people at Kaiser have no real idea at this point whether there will actually end up being more “winners” than “losers” under Obamacare compared to the health insurance system that preceded it, much less that the winners will “greatly outnumber” the losers. With Obamacare, there are just too many known unknowns as well as unknown unknowns.

But let’s just stipulate, for the sake of argument, that Altman knows a great deal about number crunching and health insurance. What he may not know so much about is how people might feel about having been lied to by the president, even if some of them might have ended up as “winners” paying lower premiums. He may also not know how some people feel who used to be economically independent but who now need the government subsidies in order to afford their compulsory health insurance: are they “winners” too, or do some perceive the change as a blow to their self-respect? Do some “winners” get angry on behalf of their friends and relatives who are “losers,” through no fault of their own, or does everyone only react to his/her own situation? And how might “winners” who are paying a little less money for premiums factor that against losing their trusted doctors and their favorite hospitals as part of the bargain?

When Obamacare was just a gleam in its advocates’ eyes, there was already a system of health insurance in place that had been cobbled together over the years. It was admittedly imperfect, although it had been tweaked repeatedly to try to improve it. It was set by the states and overseen and regulated by state insurance departments and commissioners. Obama and liberal Democrats, and even some conservatives, have consistently pointed out what they perceive as unfair discrimination and/or inequities on the part of insurance companies under that system, although there were all sorts of laws in many states to help remedy the situation: limits on what restrictions could be placed on covering pre-existing conditions, laws forbidding the cancellation of policies when someone became sick unless fraud had been involved on the part of the patient, the establishment of high-risk pools, the provision of Medicaid for the poor, and prohibiting hospitals from turning away indigent patients.

Did those rules make the system completely fair? Of course not. But the inequities that remained in health insurance were a subset of the more general inequities of life — such as the reality that some people are wealthier than others, and the wealthier can afford more — combined with the fact that insurance is a profit-making business. For example, allowing people to sign up with pre-existing conditions without charging them significantly more would tend to reduce profits and could even make that business go out of business rather rapidly. In sum, the unfairness was mostly understandable and not arbitrary, whether people thought it needed remediation or not.

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Top Rated Comments   
We had two tiers of medical care in the US. Pretty good but expensive care funded mostly by employers and not so good medical care associated with Medicaid and the VA. Nobody with the money to buy up would tolerate the life threatening bad care associated with the lower tier doctors and hospitals. The losers in Obamacare are the people who had access to the upper tier doctors, but are being forced down into the world of longer wait times and less competent care. Taken to the extreme, Obamacare becomes Medicaid for all except rich people who can afford to bypass insurance completely. Do you want to battle cancer or heart disease with your physician network limited to the Medicaid/VA type doctors or do you want to be able to pay a little bit extra to gain access to the doctors that can save your life?
47 weeks ago
47 weeks ago Link To Comment
The problem with the debate is that the proponents and their not-so-unbiased think tanks, conflate health insurance with health care. If there are fewer doctors and more patients there will be less health care per patient regardless of what is claimed on your insurance card. And if these doctors are getting paid less and individual finds himself unable to leave a doctor with whom he is not satisfied, there is going to be a train wreck.

BTW, it looks like I'm going to be a "winner" moneywise. I still want this program scraped.
47 weeks ago
47 weeks ago Link To Comment
The Weathermen are storm troopers with leaky galoshes.

They pre-judge losers...the "winners" are a fabricated class of "oppressed have nots". You see, it does not matter if any "oppression" is actually taking place. The "victim class" is simply a prop in the staged play of small c communism.

"Redistribution" is simply the hidden joker in the deck. It gives small c communism the "Robin Hood" cover. What they really want is to overthrow free market constitutional democracy, with a Biblical/family based foundation.

The "victim class" must be kept on their entitlement Jones...AND angry against the "enemy"...the free market patriot.

So, the gamut has two essential layers. A phony victim-oppressor conflict...and an equally phony need to "redistribute" wealth from the "oppressor" to the "victims"...via the "savior government".

Except...the have nots get hosed too. You see, it was NEVER about them...it was always about cratering capitalism...the rest is all a front to keep the patriots and the entitlement junkies at each others throats while the small c communists seized everything. The small c communists simply strapped on galoshes over their large c brethren's jackboots.
47 weeks ago
47 weeks ago Link To Comment
All Comments   (46)
All Comments   (46)
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Dylan. if you think Laura`s stori is inconceivable, on sunday I got a brand new Mercedes when I got my check for $6494 thiss month and over $10 thousand last-month. it's actualy the best job Ive had. I began this 7-months ago and right away started bringin in more than $76... per hour. view it now http://www.jobs64.com
47 weeks ago
47 weeks ago Link To Comment
The only winners are cronies of the regime and the rest are losers. It's as simple as that. Health care is what you do to/for yourself. If you want good health, you eat sensibly and get a modicum of exercise. Health insurance is what you purchase to deal with a health catastrophe e.g., quadruple bypass surgery. This whole Obamacare nonsense is sold to the same morons that purchase insurance i.e., seven dollar extended warranty, for the twenty dollar small appliance they got from WalMart.
47 weeks ago
47 weeks ago Link To Comment
"Neither is true of Medicare or Social Security" re: redistribution. THANK YOU for mentioning this. Then from whence the objection to "Medicare for all", which, if I remember was one of the solutions shot down during the health care debate. OK, conservatives, now quit-cher byat-ching about SS & Medicare.
47 weeks ago
47 weeks ago Link To Comment
"... [T]here are just too many known unknowns as well as unknown unknowns."

When actuaries see this they tend to double or more the premiums to account for the unseen costs.

When the Losers, the healthy who are paying outrageously high premiums, see their bill, they tend to drop out of the system.

Since no one accurately knows what the eventual healthcare or premium costs will be in the new system, everyone will charge more to cover themselves or cancel policies that they think are no longer financially viable.
47 weeks ago
47 weeks ago Link To Comment
Neo, for whatever arcane reason I can't comment on your blog- but this guy there?

artfldgr

Trashes the comments. You really need to "encourage" him/her/it to get its own blog. It is ruining your otherwise thoughtful comment section.
47 weeks ago
47 weeks ago Link To Comment
Two aspects: financial [even if you Do get a subsidy, does the policy pay for your medical expenses? not if it only handles 60% of regular visits and 50% of hospitalization! -- Bronze plans].
Moral: Being forced onto a dole queue is degrading, humiliating, infuriating, and destructive to the human spirit. If you care about that kind of thing.

I saw some commenter on a blog, a liberal asshat, who kept saying we were all fools for not taking the "free money." That it's extorted from his fellow humans bothered him not a whit. He would have made a good Kapo.
47 weeks ago
47 weeks ago Link To Comment
But when all become supplicants, we are all losers.

And as soon as Obamacare became mandatory, it was no longer about fairness. There is nothing much wrong about most of the ideas behind it, and nothing much right about how they try to fix things. They know there's a fire, but they insist on throwing gasoline on it instead of water. Thanks.
47 weeks ago
47 weeks ago Link To Comment
Mathematically, it is more or less certain that 90% or so will be losers.
47 weeks ago
47 weeks ago Link To Comment
Did you mean "is it?" instead of "it is"?
47 weeks ago
47 weeks ago Link To Comment
With Socialism, everyone loses. The "winners" play the system, get enough to barely live off of, and lose their dignity and then whine on TV that they aren't respected. The "losers" have to pay to keep the "winners" from starving to death. It's a great system.
47 weeks ago
47 weeks ago Link To Comment
What Obama and the other socialists in our society don't get is sometimes losers are just losers and sometimes winners are just winners. It has nothing to do with fairness. If you took the entire wealth of the US and divided evenly to all citizens, how long would it take before income distribution was uneven again? Not very long. It's the old 5% 95% rule. In any group the 5% get the 95% done. A majority of people just don't want to work that hard to really become superior. Ergo that is why these socialist programs can't and don't work.
47 weeks ago
47 weeks ago Link To Comment
There have been a few TV shows about lottery winners that bear this out. After a few years many of the lottery winners ended up bankrupt, in prison or even dead. A few had doubled their money, bought businesses, and were living well. Character and self-control has more to do with who is a winner and who is a loser than blind luck.
47 weeks ago
47 weeks ago Link To Comment
RR: It's also why capitalism works.
47 weeks ago
47 weeks ago Link To Comment
If we are all losers when we all become supplicants, then the system is unsustainable and collapse of the system inescapable.

The Obama administration's Justice department argued in court, while Obama made his assurances, that the majority of American would have their health plans cancelled. The majority will lose their doctors. Many will lose the ability to see a doctor for all but the gravest of health problems with nurse practitioners filling in for doctors, so the quality of care will go down. A majority will lose their hospitals. Many American children will lose their Pediatrician...

On top of all that, premiums have to skyrocket because many of the 18-30 yr olds, who MUST be enrolled, don't have jobs. it won't be a matter of affordability, it will be a matter of not having any money.

Collapse isn't a possibility, it's "baked into the cake".
47 weeks ago
47 weeks ago Link To Comment
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