The Coming Two-Tier Health System

Wall St. Journal ^ | April 30, 2014 | Scott W. Atlas

[grundle]

ObamaCare is already creating one class of care for the poor and middle class and another for the affluent.

One will be for the poor and middle class, and a separate system will be for those with the money or power to circumvent ObamaCare.

The hidden truth is just around the corner—those more dependent on public insurance, mostly the poor and middle class, will have limited access to medical care. About one-third of primary-care physicians and one-fourth of specialists have already completely closed their practices to Medicaid patients. Over 52% of physicians have already limited the access that Medicare patients have to their practices, or are planning to, according to a 2012 survey by Merritt Hawkins for the Physicians Foundation. More doctors than ever already refuse Medicaid and Medicare due to inadequate payments for care, and that trend will only accelerate as government lowers reimbursements.

At the same time, ObamaCare is squeezing out the middle class from affordable private insurance that correlates with far better disease outcomes than government insurance. By bloating coverage requirements and minimizing the consideration of risks fundamental to pricing insurance, the law has already increased premiums by 20%-200% in more than 40 states, according to a 2013 analysis by the Manhattan Institute's Avik Roy and others.

[Sergio]

bkmk

[tbw2]

To quote Frank Herbert, every revolutionary is a closet aristocrat.

They advocate overthrow of the current order on the assumption they get to be in charge or members of the comfortable court.

[tbw2]

I’ve heard that concierge medical doctors are denied hospital admitting privileges. If this is true, how do you get an MRI, lab work, X-ray or other tests done at a hospital if the doctor doesn’t have admitting privileges?

[nascarnation]

I suspect you’ve heard wrong.

I’d assume they are at the front of the line.

They are the top dogs with the patients who have the best insurance and money to pay well beyond that.

What hospital wouldn’t love that kind of patient?

[steve86]

To make matters worse, three of the kids (nieces) in our family had plastic saline-filled bags inserted in their chests

I'll pray for them.

[steve86]

I’ve heard the same thing but are are admitting privileges required for outpatient and same day referrals?

[Yardstick]

I wonder if this might converge on something like the French system, which, if you’re going to have statist healthcare, is probably the way to go. Apparently they’ve got a private system that runs relatively unmolested alongside the government system. If push came to shove, I could probably live with something like that. At least you would have the option of making your own healthcare arrangements. Ironically it’s the anglophone world whose public healthcare is the most draconian — e.g. England and Canada. They make it nearly criminal to operate outside the government system.

[P.O.E.]

Third-world thugs at the helm.

[Twinkie]

Thanks. Two of the girls (well, women actually) have divorced their husbands; one has remarried,the other one has, I feel sure, looked around at the men on the market. Of course, they are “pretty” and much pursued by the men out there. The one on her second marriage is having trouble with her current husband; but she’s lazy and had better hang on to him as he makes big $$$$ at his job. Her first husband like to have worked himself to death trying to upkeep her big $$$ demands, but finally veered off course himself and strayed after 10 yrs. Of course, after that his name was MUD. My MIL tried pitchforking him around me; but I told her I wasn’t going to listen to Sean being pitchforked. - The third girl, so far, is still in the marriage to the nephew. He’s an engineer and makes good money, and so does she. - I just don’t really feel comfortable with my husband being around these girls; but surely it’s okay as he’s their uncle. The one in-law niece has been sort of snobby to him; otherwise I really wouldn’t feel comfortable around her either. I don’t trust too much in the decency of people any more. - I’m just at the point in my life where I am what I am; and have no energy or wish any more to “compete” with plastic saline baggies hanging on women’s chests.