Kinda Funny But Kinda Sad
Perhaps the saddest and funniest story in recent days comes from Forbes. Merrill Matthews, himself an insurance industry leader, writes about how his industry was led on by the golden visions of Obamacare only to find itself in a waterless desert. While being courted by the president they were shown fleeting glimpses of gold and jewels. But what they got instead was a website that wouldn't accept payments and a set of rules that forced them to accept non-paying customers, retroactively.
Much of the “credit” for health insurers’ initial embrace of Obamacare has to go to the head of the industry’s leading trade association, Karen Ignagni, the president and CEO of America’s Health Insurance Plans (AHIP). Ignagni is a registered Democrat and former director of the AFL-CIO’s Department of Employee Benefits….
As the ACA was being written and debated, I spent some time talking to the CEOs of some of the member companies. One explained to me how he thought Obamacare would be very good for the industry, another was convinced the Democrats crafting the law were taking their suggestions. They may have been smart businessmen, but they were woefully naive about politics …
They decided early on they wanted a “seat at the table,” only to discover that the most dishonest presidential administration pulled the chair out from under them.
He concludes that "health insurers are being battered by Obamacare and they deserve it." And while he feels sorry for them he's looking for a violin small enough to do justice to the suffering they are experiencing.
Maybe he can find an even smaller one for Pajama Boy. After he finishes his chocolate he might try his Obamacare policy on for size. Running a close second for the story of tragi-comic news of the year is an article in the Huffington Post which is somewhat jarringly headlined: "Doctor Shortage Looming As Obamacare Rolls Out". Signing up hard as it was and paying your premium, difficult as it may be, turns out to be the easy part.
The really dicey part, lots of health policy experts have always feared, will come on Jan.1.
That is when Americans who have enrolled in health insurance for the first time under the ACA are likely to discover that having coverage doesn’t guarantee them easy access to a primary care doctor, dentist or mental health professional.
Some changes in the works, such as the use of new technologies and allowing mid-level medical providers to perform some functions usually reserved for doctors and dentists, should improve health care access in the long run. “In the meantime,” said Linda Rosenberg, president of the National Council for Behavioral Health, “people are going to suffer.”
My favorite line in that story is: "lots of health policy experts have always feared", which sounds suspiciously like "and they knew all along".
They knew all along that enrollees would take a number and wait. But now that everyone is here, or will soon be cajoled and hornswoggled inside, listen to a recorded message from a mid-level professional on work-life balance while u-wait or until someone sees you "eventually".
But they'll get quality care. Did you know for example, that among the essential features built into some Obamacare policies is acupuncture? Bet you didn't have that in your old bare-bones policy.
According to the New York Times, special interest lobbyists succeeded in getting acupuncture considered “essential” in California, Maryland, New Mexico, and Washington. Also, “insurance plans will have to cover weight-loss surgery in New York and California, for example, but not in Minnesota or Connecticut. Infertility treatment will be a required benefit in Massachusetts, but not in Arizona.” Under such a system, the winners will be those with the most political “pull.”
The Voice of San Diego helpfully tells us that "according to a spokesman for the state-run health exchange, Covered California, chiropractic services and massage therapy are not considered essential, but acupuncture is if it’s used for pain and nausea management. This applies to Medi-Cal patients, as well." But the lawyers are suing and soon they too may be included. Acupuncture, massage therapy, mid-level professionals, all at your beck and call. Doctors not so much.
The article in the Huffington Post goes on to say that one minor problem with Obamacare that you might be interested in by the way is that it has done nothing to create more medical resources to treat all the people who now expect to be treated.
According to the Association of American Medical Colleges (AAMC), unless something changes rapidly, there will be a shortage of 45,000 primary care doctors in the United States (as well as a shortfall of 46,000 specialists) by 2020.
In some ways, the shortage of providers is worse than the numbers indicate. Many primary care doctors and dentists do not accept Medicaid patients because of low reimbursement rates, and many of the newly insured will be covered through Medicaid. Many psychiatrists refuse to accept insurance at all.
And since many new Obamacare patients are in fact being put on expanded Medicaid they will soon learn there's a difference between getting a health card and actually being treated -- by a doctor. Supply and demand rears is ugly head again. Reforming America's health care system was always going to be hard. But any real solution was sure to involving increasing competition, removing excessive legals burdens and technological advance. But the cure in this case is witchcraft.
If there's a moral in here anywhere it is probably that you never get something for nothing. And my New Year's resolution is to constantly remember that if something looks too good to be true, it probably is.
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