It's Not Just the Mandate: ObamaCare's Other Infringements
ObamaCare supporters were hit with more bad news recently when the Congressional Budget Office announced that the health care law would cost nearly twice the original estimates: $1.76 trillion over ten years rather than $940 billion. Of course, such “unexpected” cost overruns are nothing new for government programs. When Medicare was passed in 1965, it was predicted to cost $12 billion by 1990. In reality, it cost a whopping $110 billion, almost 10 times more than predicted.
But the escalating economic costs of ObamaCare will pale in comparison to the escalating losses of freedom.
The infringement of personal freedom receiving the most attention lately has been the “individual mandate” requiring Americans to purchase health insurance. This issue is at the heart of the current legal challenge before the U.S. Supreme Court. But ObamaCare imposes numerous other mandates and controls, including the following:
- Doctors must purchase and use expensive electronic medical record systems.
- Doctors must electronically record certain patient data such as ethnicity, BMI (body mass index), blood pressure, and smoking status -- and turn over patient data to the government upon request.
- Doctors treating Medicare patients must practice according to government “quality” guidelines or face economic penalties.
- Insurance companies must offer numerous “free” benefits, including various preventive health services, birth control, and coverage of “children” up to age 26.
- Insurers may not raise their rates to cover these new expenses unless the government agrees those rate increases are “reasonable.”
- An Independent Payment Advisory Board (IPAB) of unelected bureaucrats will set prices for Medicare services that will lead to de facto rationing.
The administrative costs associated with complying with these regulations will accelerate the trend of doctors leaving traditional private practice. Instead, doctors will increasingly work for large Accountable Care Organizations where they’ll practice according to government protocols, with their compliance monitored by the mandatory electronic medical records.
As Dr. Donald Berwick (President Obama’s former head of Medicare) once noted:
The primary function of regulation in health care, especially as it affects the quality of medical care, is to constrain decentralized, individualized decision making.
In other words, restricting physicians’ freedom to practice is not some “unintended consequence” of ObamaCare, but rather an explicitly desired goal.
Simultaneously, ObamaCare will also squeeze private insurers out of business. In a recent Forbes article, Sally Pipes notes:
ObamaCare effectively forces insurers to pay out more generous benefits but limits their ability to raise the revenue needed to do so. Consequently, many firms will go out of business.
The decline has already started. Aetna has pulled out of the individual insurance market in Colorado and Indiana and out of the small-group market in Michigan. The Iowa-based Principal Financial Group stopped selling health insurance entirely, leaving 840,000 people without coverage. And Unicare has stopped selling policies in Virginia.
Once the private insurance market has been destroyed, Americans will be forced to buy their health insurance on government-run “exchanges” where the government decides which health services should or should not be covered.