We already know that Obama’s oft-repeated phrase from 2009 through September of 2013 that “if you like your plan, you can keep your plan” was a lie. The next half of that equation — “if you like the doctor you have, you can keep your doctor, too” — will shortly be proven false for millions of Americans. Debra Saunders, writing at Real Clear Politics, calls it “Obamacare’s Next Problem: Doc Shock”:
“The bottom line is this law is working and will work into the future,” President Barack Obama said of his signature Affordable Care Act on Tuesday. It would be easier to believe the president if he hadn’t said in 2009, “If you like the plan you have, you can keep it. If you like the doctor you have, you can keep your doctor, too.”
One million Californians who lose their individual plans in 2014 know that’s not true; when many saw their new premiums, they experienced “sticker shock.” Next comes “doc shock” — the revelation that many folks also won’t be able to keep their doctors.
Meet Chico, Calif., attorney Kenneth Turner. His wife found out that she has breast cancer two days before they received their cancellation notice. She’s scheduled for surgery Dec. 20 and will hear the prognosis Dec. 30. Two days later, she loses the doctor who will have operated on her, as well as other doctors she has seen for decades.
Because state Insurance Commissioner Dave Jones used a technicality to force Blue Shield to grant 90-day reprieves, the Turner family will be able to extend its plan — and face two years’ worth of deductibles in 2014.
Turner is just glad the family can afford that. “A lot of people couldn’t swing this,” Turner said. “I’m lucky I can.”
California Association of Health Plans President Pat Johnston acknowledged that the state’s 19 regions can restrict access to outside providers. Johnston believes that all consumers will have access to “quality care” but not necessarily the same doctors.
How bad is it? According to PJM alumnus Richard Pollock at the Washington Examiner, “An estimated seven out of every 10 physicians in deep-blue California are rebelling against the state’s Obamacare health insurance exchange and won’t participate, the head of the state’s largest medical association said.”
California offers one of the lowest government reimbursement rates in the country — 30 percent lower than federal Medicare payments. And reimbursement rates for some procedures are even lower.
In other states, Medicare pays doctors $76 for return-office visits. But in California, Medi-Cal’s reimbursement is $24, according to Dr. Theodore M. Mazer, a San Diego ear, nose and throat doctor.
In other states, doctors receive between $500 to $700 to perform a tonsillectomy. In California, they get $160, Mazer added.
Only in September did insurance companies disclose that their rates would be pegged to California’s Medicaid plan, called Medi-Cal. That’s driven many doctors to just say no.
Obamacare’s myriad problems are exacerbated because, as Michael Barone writes, “Obamacare’s architects plugged their ears and misled public”:
The legislation was unpopular when it was proposed, while it was passed and in the months and years afterwards.
Barack Obama seldom mentioned it in the 2012 campaign except for the provision allowing “children” under 26 to stay on mommy and daddy’s policies.
The architects of Obamacare also had to deal with loyalty.
Polls have consistently shown that about 80 percent of Americans are satisfied with their health insurance and doctors. They have chosen each at one point or another and were not eager to change absent some serious aggravation.
There was discontent in the late 1990s when health maintenance organizations limited options. But the move for restrictive legislation–voice–fizzled when aggravated consumers switched to different policies–exit–while those satisfied with HMOs stuck with them–loyalty.
Recognizing this, President Obama assured Americans dozens of times that if they like their insurance and their doctors they could keep them.
Unfortunately, that assurance was always intended to be false. A good short-term campaign tactic maybe, but bad long-term policy strategy.
Obamacare’s architects worked stealthily to prevent exit from the kind of insurance policies they think people should have. The president’s credibility has been shredded and serious liberals like the Brookings Institution’s William Galston worry that big government policies generally will be discredited.
So far the Obamacare Democrats have succeeded in ignoring voice — the public’s demand for repeal or major revision of the legislation. But despite their claims that once legislation has been passed it must remain law forever, voice can overturn it. The Medicare prescription drug plan passed in 1988 was repealed in 1989.
Which may explain this headline yesterday at center-left National Journal: “Young Americans Expect Obamacare to Be Repealed.”