Posted on 04/11/2015 5:06:16 AM PDT by Kaslin
By one estimate, 14 million people are newly insured because of the Affordable Care Act. In addition millions of others have more generous insurance, promising new benefits. So you might expect that doctors’ offices would be flooded with a host of new patients seeking more care than they had before.
It’s not happening.
To avoid the effects of the 2008 financial crisis, the recession, and the slow recovery, John Graham compared the latest estimates from the Centers for Disease Control and Prevention (CDC) with their survey from a decade ago. The result:
"The proportion of people of all ages with a 'usual place to go for medical care' was 87.8 percent last year, the same as it was in 2002-2003. Further, 5.7 percent reported that they failed to obtain needed medical care due to cost last year, the same as it was in 2003-2004."
[A possible explanation (noted by Graham) is that the percent of the population that is uninsured is not much different than it was a decade ago.]
Another study focuses on what happened last year – the first year of access to expanded Medicaid and the health insurance exchanges. New data from 16,000 providers across the country, collected by AthenaHealth, shows that requests for new appointments just barely edged upward in 2014. The proportion of new patient visits to primary care doctors increased from 22.6 percent in 2013 to 22.9 percent in 2014. (See the graph.)
More evidence comes from a study of Massachusetts health reform – the supposed model for national health reform. A new study, published in the BMJ policy journal, examined hospitalization in Massachusetts for 12 medical conditions that wouldn't normally require hospitalization if a patient has good access to primary care. These are thought to be a good measure of access to health care, according to Danny McCormick of Harvard Medical School, the study's lead author.
However, the rates of preventable hospitalizations were practically the same in the first few years of the Massachusetts health reform. Further, even though Blacks and Hispanics experienced the largest gains in insurance coverage under the Massachusetts law, they continued to have higher rates of hospitalization for these conditions and the disparity gap didn't narrow in a meaningful way.
As Jason Millman, writing in the Washington Post, observes:
"The landmark 2006 Massachusetts health-care law that inspired the federal overhaul didn't lead to a reduction in unnecessary and costly hospitalizations, and it didn't make the health-care system more fair for minority groups."
Interestingly, 50 years ago many people expected a surge of demand for care in response to the creation of Medicare. It didn’t happen. Sarah Kliff quotes from a 1966 Washington Post article:
"It was a smooth transfusion, undramatic as a bed change. At 12:01 a.m. yesterday, Uncle Sam began paying the bills of close to 1,000 patients over 65 in area hospitals.
The transition to Medicare, the federally financed health plan, was as uneventful as it was historic. The influx of card-carrying Medicare patients was a trickle, not the storm that had been predicted by some."
My own view is that the importance of health insurance has been enormously exaggerated by the health policy community. People without health insurance often find a way to get insurance when a family member develops a serious health problem. Even when they don’t, they often find ways of getting health care.
In addition, the kind of insurance that people are acquiring is not conducive to more doctor visits. Because of the high deductibles in the plans sold in the (Obamacare) exchanges, most people with newly acquired private insurance are paying the full bill out of pocket. It’s as though they were uninsured!
For example, last year the average deductible for a bronze plan on the exchange — the least expensive coverage — was $5,081 for an individual and $10,386 for a family. Silver plans had average deductibles of $2,907 for an individual and $6,078 for a family – about twice the typical deductible for employer plans.
On the other hand, those people who are newly insured through Medicaid, are in a health plan where access to care is notoriously bad. In fact there is some evidence that the uninsured have an easier time making a doctor’s appointment than people on Medicaid.
The last piece of evidence comes from the mental health field. Although an estimated 62 million patients now have better coverage because of the Affordable Care Act, a new report from the National Alliance on Mental Illness concludes that “patients with mental illness are no better off under Obamacare.”
One problem is the high deductibles, discussed above. A second problem is that health plans are keeping premiums down by choosing narrow networks that leave out many mental health providers. Previously, I have called this a “race to the bottom.” A third problem is that the networks themselves are frequently deceptive. Writing in US News, Kimberly Leonard notes that:
"Even if the medical provider is included in a health care network, he or she may not be available. In January 2015, the Mental Health Association of Maryland published a study that revealed only 14 percent of psychiatrists listed in the qualified health plans in the Maryland marketplace were actually accepting new patients and available for an appointment within 45 days – the suggested wait time."
Here is a comment I received from reader Derek Dye:
"In the volunteer work I do at a free clinic in Arlington I’ve recently had the unfortunate task of trying to help evidently mentally ill patients find providers after being forced on the exchanges or Medicaid after losing their insurance, their job, or their access to the clinic, depending on their situation….
[W]hat I found even more troubling were the calls I was placing to providers who aren't even real. I thought I was crazy or just calling the wrong offices as I was getting answering machines at gas stations and restaurants at numbers listed on Carefirst's website as psychiatrists (this happened on multiple calls). In talking to the savvy receptionist she confirmed that this is not uncommon, especially in ACA plans….
[T]he providers I finally got through to were very obviously pill mills in this particular Carefirst plan per Yelp and public records of their prior run ins with the law."
Potemkin healthcare
that’s it
Obamacare puts more money into health insurance companies with everyone forced to buy and expands Medicaid administered by private insurance companies.
The healthcare industry like insurance and hospitals get more money (its a bailout for them). Romney once made a speech pointing to the “freeloaders” which caused the healthcare business to ask for political help called “healthcare reform”.
The death panels in Obamacare help cut costs for insurance and hospitals and improve their bottom line again.
Crony capitalism and the politicians team up at the expense of the little people again.
My tax attorney was sick so his assistant took over. She basically tooted that I did not enroll in obamacare and there was an exemption for those who did not have it. Then she stated it will double to 180 the next year. My answer was the same “uh huh”.
Don't discount the influence of the beltway bureaucracy machine. Obamacare means billions of dollars for departmental budgets, thousands of new jobs for Affirmative Action hires and membership dues for the federal employees unions.
A government regulatory environment to help business elites in the modern corporatist state we seem to have where all elected officials must subordinate themselves to corporate elites on Amnesty and even chuck the First Amendment’s guarantees of freedom of religion and speech.
[W]hat I found even more troubling were the calls I was placing to providers who aren’t even real. I thought I was crazy or just calling the wrong offices as I was getting answering machines at gas stations and restaurants at numbers listed on Carefirst’s website as psychiatrists (this happened on multiple calls). In talking to the savvy receptionist she confirmed that this is not uncommon, especially in ACA plans...
(snipped from above posted article)
Wow! This anecdote points to collusion on a very large scale. These people have obviously been told to just fill in the blanks and not to worry about anyone complaining or any consequences of their actions. The human cost will be huge in death, disability and misery. There will be no one to accept responsibility - we are living in a shameless society. I’m afraid we are in some very, very deep trouble.
Mrs. AV
A deal at twice the price.
Articles such as these are based on the premise that Obamacare was really about improving people’s access to health care and reducing costs. It was about none of the the things they told us it was about. Instead, it was about income redistribution and more power and control over our lives, pure and simple.
It's not just that. As Lois Lerner demonstrated, the beltway bureaucracy is steeped in the liberal "big government does it better" mindset, and is ready, willing and able to turn it's regulatory authority into a political weapon to be used against anyone who disagrees. The more regulatory authority they have the more powerful that weapon becomes.
PEople on the margins who bought obamneycare don’t have enough money after paying their monthly premium to afford the copay required to see the doctor. They would have been better off keeping the money and just paying cash. A lot of doctors offer a discount for not having to do all the insurance paperwork.
So it basically forces us into the paradigm of fee-for-service for routine care with catastrophic coverage for the big stuff. To me this is the most rational approach, but of course Obamacare does it through force of law which means it's full of inefficiencies and bad side effects and cronyism, not to mention that it's an insult to your liberty. So, for instance, you get all these narrow networks and other downgrades to the quality of care forced on you which never would have happened in a freemarket system.
“A deal at twice the price.”
Exactly. Paying an average $250 per month on obamascam and she’s twisting her panties to point that out, and I pay once a year as a “penalty”. Sheeesh.
My tax accountant told me that the penalty (for 2014 tax year) is $95 ... per person ... PER MONTH not insured. That was never mentioned during all the hoo-hah on Obamacare that I can remember. It was touted as a $95 one time penalty. If you were uninsured for 12 months, that’s $1,140 per person whether a child or an adult. That could add up fast!
I asked him if he had seen people caught out by this and he said yes. And they are hopping mad.
And the penalties for 2015 are going to be higher.
I’m wondering why we haven’t heard more about this. Maybe when people start getting big bills from the IRS or big chunks taken out of their refunds?
Nope. They’re forced in to paying a higher premium for less healthcare when they can find a provider that will take it.
My son had to pay $900.00.
It's hard for me to believe I was the only self-employed person out of hundreds he's seen this tax filing season to suffer the Obamacare penalty.
Just curious. Was the penalty $95 per month or just a flat $95 for the year?
My accountant said it was per month but I had never heard that in all the Obamacare publicity. I’m trying to find out if that’s right.
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