Sunday, May 23, 2010

Obamacare - The More You Know It The Less You Like It

It’s beginning to be apparent that all we said about Obamacare was true. Nancy Pelosi said, “Let’s pass this bill first, and then we find out what’s in it”. Mr. Obama said “those who like their current coverage will be able to keep it” (not true), and “your coverage and quality of care will remain unchanged”, again (not true).

Soon millions of American workers will discover that they no longer have employer-provided health insurance because employers now realize that it is cheaper to pay government fines than to insure their employees. According to the House Energy and Commerce Committee several major companies have made internal calculations to determine how much can be saved by dropping their employer-provided insurance, paying a $2,000 fine for each employee, and leave their employees the option of buying government subsidized insurance in the newly created private health insurance exchange created by Obamacare.

Well, if the answer is what AT&T just came up with, you can kiss the 50+ year system of employer-sponsored health insurance, goodbye. Last year, AT&T paid $2.4B to cover the medical costs of its 283,000 active employees. By dropping its health plan and paying the annual fine for each uninsured worker, the cost will total $600M, leaving AT&T with a handsome profit of $1.8B. That may be better than the deal they got with Apple on the iPhone! A new income stream compliments of Obamacare.

The unfortunate thing is now that cost will be subsided by the government (or the U.S. taxpayer) across all income levels by those who pay tax. The problem is that with this new set up, low income employees (i.e. $30,000/yr) paying no income tax get an annual subsidy in the new insurance exchange of about $19,400, almost $17,000 more than the current employer-sponsored system as the government pays almost all the premium and most of the out-of-pocket costs. The employees making $100,000/yr get no subsidy in the insurance exchange.

In Massachusetts, people who get subsidized insurance from an exchange are put in health plans that pay health providers Medicaid rates plus 10%. That’s less than Medicare pays, and significantly less than rates paid in private plans. So now that we pushed 32 million more people into the system with Obamacare, and employers will eventually push millions more into subsidized health plans, and no one is doing much about adding new doctors, it looks like people with low reimbursement rates will have to get in the rear of the line.

My doctor just told me that her income went down by 1/3 last year and it may be 1/2 this year. If you have a government subsidized plan, how long will you wait until she gets to you? And how much time will she spend with you? So, Mr. Obama said this will lowers costs, with no change in the quality of your care. Do you believe it?

2 comments:

  1. Alan Bachers, PhDMay 24, 2010 at 3:53 PM

    Mightn’t this plan be exactly what the insurance cartel lobbyists intended – disintermediate employer insurance coverage by making it hugely advantageous to shed all those employees into millions of individual policies that reap far greater rewards to the insurance companies? The insurance exchanges will provide bottom feeder coverage for those insured and unsurvivable reimbursement for physicians while further lining the pockets of insurance companies. As a psychologist I daily saw both consumers and myself screwed by insurance companies, along with dwindling numbers of subscribers having “Cadillac” coverage.

    I’ve been on Medicare for over a year now and impressed with the excellence of care I’ve gotten vs. being on a “health care fast” for the previous three years with a $3000 deductible and six months I couldn’t afford insurance at all.

    My solution would be to let anyone who wants to, to join Medicare and work it out from there.

    Educate me further from the conservative perspective, George, as you continue to do in your interesting blog posts.

    Just trying to stir things up a bit on your blog.

    Alan Bachers

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  2. Alan:
    Thanks for your comment you are absolutly right. The health insurance lobby actually liked Obamacare and that was one reason it passed. However,it will mean higher costs and poorer quality for everyone and we were sold the opposite of that. Sure Medicare is great, but it is bankrupt and now with $500B cut out of it you may not find it as great,particularly after they make another cut of 25% in provider reimbursements. Providers will either take no more Medicare patients or raise their base rate by 25%. I'm already seeing that in recent visits. Remember the purpose of this "reform" was lower costs and get better care from those nasty doctors who do all those unnessesary tests.
    George

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