Don’t blame Obamacare for these 10 things

There is a new report out from the Congressional Budget Office (CBO) titled “The Slow Recovery of the Labor Market,” and as its title implies, it predicts a slow recovery from a labor perspective. Among other things, the CBO report is now making headlines in the political game of Obamacare because it forecasts a 2.5 million job reduction by 2024 due to the effects of the health care law. You should read the report itself (it’s not very long and it has lots of pictures), because it is practically impossible to find objective coverage of its contents in today’s media, which is full of ideology driven experts and completely devoid of old school reporters.

I don’t know about you, but I for one am growing tired of the incessant drumroll crediting or blaming Obamacare for everything from the price of gas at the pump to the demise of penguins in Argentina, so let’s show some magnanimity and absolve Obamacare from, at least, the following 10 naturally occurring phenomena.

10. The CBO labor forecasts. Starting with the most recent development, we should observe that the CBO report is not stating that Obamacare will create a shortage of jobs or increase unemployment, which will remain high independent of Obamacare. These 2.5 million jobs are projected to be voluntarily forgone by people, or as the White House press secretary put it, “Americans would no longer be trapped in a job just to provide coverage for their families, and would have the opportunity to pursue their dreams.”  And for 2.5 million able bodied folks, those dreams are projected by the CBO to include no work. Instead of having to toil from dawn to dusk in large offices or start small businesses of their own, Americans now have a choice, and we should rejoice in utter disbelief that in a country where one in five children is living in poverty and unemployment is rampant, citizens finally have the liberty to earn no income.

9. Health insurance cancellations. Much ado about nothing was made of millions of insurance cancellations sent in bulk to those who purchased health insurance on the individual market. In case you weren’t aware of it, this type of mass turnover has been occurring in this hapless segment of the market since the beginning of time. Every year, all insurance companies rescinded all policies for all their customers. If your experience is different, then you are definitely an outlier. Besides, it is a well-known fact that individual market policies, as opposed to those issued by benevolent employers, such as Walmart or McDonald’s, were pure garbage before Obamacare, as any retired executive, or middle class family can tell you.

8. Health insurance premium hikes. Seriously? We wouldn’t be having Obamacare if insurance premiums wouldn’t have crippled our economy, impoverished the nation and rendered Apple and Google incapable of competing in the global markets. It is true that Obamacare is forcing insurers to pay out a fixed share of revenues to doctors and hospitals, but Obamacare is also delivering millions of fully subsidized customers to private insurers, allowing revenues to grow through volume in addition to the customary growth in unit margin. This should help avoid wanton increases in premiums beyond originally projected ones.

7. Price of care. Yes, prices for medical services are exceedingly high in the U.S., but Obamacare was obviously not the catalyst for those. The hospitals started this trend many years ago, and private insurers who like any honest enterprise, get to keep a percent of their revenues, had little incentive to curb the hospitals’ enthusiasm. It is true that Obamacare is providing incentives to hospitals to consolidate into price gauging monopolies, but aren’t monopolies the natural outcome of a free market? The cost of health care in the U.S. was almost double its nearest European competitor before Obamacare, and it still is, and Obamacare had absolutely no ill effects, or any other effects, on that sad statistic.

6. Narrow networks. It seems that people signing up for new Obamacare plans are having trouble getting to see their old doctors, because health insurance companies have concluded (based on extensive and nonexistent research) that folks prefer cheap insurance over actual medical care. Thus, all consumer centered benefit designs include less doctors, less hospitals (particularly popular ones), less of what consumers don’t need or want, and more insurance stuff, such as peace of mind. This cost containment strategy has been initiated long before Obamacare was even contemplated (remember the nineties?), and it worked exceedingly well when combined with #8 above. All Obamacare did, was to create the healthy transparency needed for us to observe this highly beneficial trend towards value for our most esteemed citizens, such as AARP and United Healthcare.

5. Shortage of doctors. Ah, the scare tactics of the rabid right are at work again. Supposedly, Obamacare and its millions of uninsured will be flooding doctors and hospitals, squeezing paying customers out of their place in line. Nothing could be farther from the truth. First, as any Obamacare advocate can tell you, we’ve been having a shortage of doctors long before Obamacare kicked in a month ago, so this has nothing to do with the health care law. Second, Obamacare contains many provisions aimed at finding ways to liberate doctors from the practice of medicine, and to liberate medicine from practicing physicians, so consumers can avail themselves of health care uninhibited by ancient guilds. Also, when insurance plans are firing doctors from their networks by the thousands (see #6 above), how can any free-marketer in his right mind suggest that there is a shortage of doctors?

4. The insurance gap. This is the bleak spectrum of folks who are not poor enough, old enough, young enough, or otherwise demographically endowed enough, to enjoy the opportunity of pursuing their dreams of not working while having the peace of mind that comes with an insurance card. Obamacare tried its hardest to liberate these folks, but a conservative Supreme Court and recalcitrant Governors in red States have come together to obstruct the expanded Obamacare subsidies in many States. It looks like the Governors are beginning to soften their stance though, so we should see more Medicaid cards issued soon. Either way, Obamacare did not cause folks to be in this category to start with, and if you must blame someone, blame the Governor or the judicial branch of government.

3. The website. We’re talking about a website, a minor technical detail that has absolutely nothing to do with the essence of Obamacare. Yes, Healthcare.gov and several other local health insurance exchanges have been a good example of how not to build and deploy software. It was a learning experience for the nation, and there is clear value in that. As any entrepreneur can recite in his sleep, failing early and failing often is the only way to achieve success. And the website seems to have accomplished that, at the modest cost of less than half of what it would cost to build, say, a new Space Shuttle.

2. Redistribution of wealth. Yes, Obamacare is providing subsidized insurance to the poor, and yes, Obamacare is forcing the young and healthy to pay more so that the old and sick can be charged less, and if you look at the chart published by the Brookings Institute, your heart will sing with joy at the sight of two huge positive columns of gains for the very poor, and the tiny loss columns for everybody else. Until you read the full report, that is. Those huge income gains for the poor, you see, include the money paid by the government on their behalf to insurance companies, and as Brookings wisely shifts the terminology, these are gains in “well-being”, not cash in your pocket. We could use similar logic to divvy up what the government pays defense contractors, agribusinesses, all foreign aid, government salaries, and pretty much the entire federal budget, and show a vast increase in “well-being” for the poor. The President’s recent lukewarm inequality rhetoric notwithstanding, rest assured that Obamacare is not even remotely trying to alter the Darwinian redistribution of wealth in use today.

1. Dysfunctional government. Obamacare, although the most hotly debated federal undertaking in recent memory, cannot be blamed for the present impotence of our federal government, no matter what they tell you from the right or left side of the aisle, or the TV.  If President Truman were alive today, he could write volumes on his own “Do Nothing” Congress. Obamacare is actually the one rare incident where a significant law has been passed in the five years following the election of President Obama. It is testimony that Congress can indeed legislate, and it is proof that our government is working as redesigned by an invisible hand. Sure, Obamacare has been the favorite football for the biggest exhibition game on earth right now, but you don’t usually blame the football if your team just doesn’t show up in New Jersey.

Margalit Gur-Arie is founder, BizMed. She blogs at On Healthcare Technology.

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  • NewMexicoRam

    This is satire, right?
    Because for anyone to believe this has to be living a joke.

    • http://onhealthtech.blogspot.com Margalit Gur-Arie

      I’m glad you appreciate the humor :-)

  • ninguem

    I thought we were supposed to blame Dubya Bush for all that.

    • http://onhealthtech.blogspot.com Margalit Gur-Arie

      We only have ourselves to blame… personal responsibility and all that….

  • swatdoc

    Thanks for the Obama talking points too bad you are totally clueless

    • http://onhealthtech.blogspot.com Margalit Gur-Arie

      Yeah…. a bit too clueless, don’t you think? Care to give it another whirl and see what it really says?

  • Deceased MD

    satire at it’s best. The problem Margalit is there are too many idiots that write things that are inane but they are dead serious.

  • http://onhealthtech.blogspot.com Margalit Gur-Arie

    Thanks. I am an old fashioned left wing zealot :-) Unfortunately our wing has been discarded by the Democratic party in favor of cash.

    Here is my wing: http://www.rawstory.com/rs/2014/02/21/noam-chomsky-how-to-ruin-an-economy-in-three-simple-steps/

    • swatdoc

      Oh that wing I thought the communist party was just those in the current white house forgot about Chomsky.
      Wow got your education in a free market country that lets you spout this left wing radical crap. I have spent my career working hard and helping others not planning to have all my hard earned assets given to the collective.
      I personally like to choose those I help and resent the government taking my assets and spreading it around to an increasingly non productive multi generational group that will never work as long as the current ruling body insists that they be compensated for all their needs.
      Obamacare will further perpetuate this taking from those whom are productive and spreading to those who are not. Some are truly in need and that’s fine to help them but many are not and have worked the system since the 1960s 3-4 generations who live not to be productive but merely to get a check.
      Once Obamacare is fully implemented there will still be 30-35 million uninsured although not the current ones in all cases. So why the takeover of our lives and profession ? Why destroy a system that yes had some problems but could have been adjusted rather than destroyed.
      I think it is a motive of central planning and control no one really gets better care in fact most get worse care. Longer waiting times less available appointments with specialists
      I really think many of the parts of Obamacare are purposefully designed to fail so that single payer will be called on to “rescue” medicine. Oh but the people imposing this on us don’t have to worry Obama and his cronies (congress) will get unlimited unrestricted care while the under classes get substandard care.
      But in some worlds Obamacare is saving medicine just not mine

      • http://onhealthtech.blogspot.com Margalit Gur-Arie

        I think we are in agreement that Obamacare is a bad solution, but we seem to disagree on why it is so. My take is that the basic wrong here is that the law is distributing your wealth upwards to the “masters of mankind”, not downwards to the recipients of substandard care (if any), and I believe that as many other honest conservatives and the vast majority of “progressives”, you are a victim of an intentionally created optical illusion.

  • http://onhealthtech.blogspot.com Margalit Gur-Arie

    So true. Nowadays I find myself more often in agreement with Rand and Ron Paul than with the Democratic party. I think it’s probably high time that we reshuffle the traditional aisle and concentrate on ending the rule of corruption. If we do, there will be plenty of time to bicker about certain items in the Bill of Rights later. If we don’t, there will be nothing left to argue about.

    • ninguem

      Occupy Wall Street:
      Big Business is in bed with Big Government, and Big Business is the bad guy.

      Tea Party:
      Big Business is in bed with Big Government, and Big Government is the bad guy.

      The media emphasizes their difference of opinion on the second part of the sentence, and ignore their complete agreement on the first.

      • http://onhealthtech.blogspot.com Margalit Gur-Arie

        love it! I can see a new political coalition between the Tea party and the far left folks…. maybe call it Chai-Latte Party…. like Teddy’s Bull-Moose….. :-)

  • Bob

    You always seem to miss the $1 million in waste fraud and abuse in the $3 trillion spent on Medicare and Medicaid that President BO spoke o when it was brought up at the Healthcare Summit by Sen. Tom Coburn at the start of his mess!
    “Well, Tom, I appreciate what you said. I just want to make this quick point: Every good idea that we’ve heard about reducing fraud and abuse in the Medicare and Medicaid system, we’ve adopted in our legislation. So that’s an example of where we agree. We want to eliminate fraud and abuse within the government systems”.
    BO missed all the good ideas and substituted bad ones.

    • http://onhealthtech.blogspot.com Margalit Gur-Arie

      I assume, you meant $1 trillion, of course…. and we are not spending $3 trillion on Medicare and Medicaid alone.
      Anyway, I don’t know what the fraud and abuse number is, and lately Medicare seems to be on a mission to unearth all sorts of fraudulent activities. Perhaps not enough though. I remember Se, Coburn suggesting in that meeting that they should use “undercover” patients…. Not sure how many doctors would appreciate that :-)

      • Bob

        Yes I meant a Trillion not a Million and since you don’t know what we spend on CMS the Last I heard was $2.7 trillion combined. It takes years before the treasury comes up with annual totals. If these are less that makes a trillion in loses a year even worse though doesn’t it? http://about.bloomberglaw.com/practitioner-contributions/just-the-rac-facts-controversial-program-roots-out-fraud-waste-in-medicare/ Coburn said “Medicare and Medicaid spending is most of that
        and is out of control. And when
        you look at, when it’s studied, if you look at what Malcolm Sparrow from
        Harvard says, he says 20 percent of the cost of federal government health care
        is fraud. That’s his number but I just went through last night, if you add up what Thomson
        Reuters, which looked at all the studies that have been done and combined them
        in, they say between $625 billion and $850 billion a year of health care
        dollars are wasted. My how things change in just 4 years!
        And doctors, are far behind pharmaceuticals manufacturers, and hospitals who are the most common firms sued and who settle for a pittance of the loot they steal. Check out Eric Holders HEAT on Medicare that shows it costs more than recovered.

        • http://onhealthtech.blogspot.com Margalit Gur-Arie

          Bob, CMS (i.e. Medicare and Medicaid) spend about 35% of the total expenditure on health care in this country which totals $2.7 trillion. The remainder is spent by private insurance and by individuals out of pocket and various other small programs such as the VA.
          Medicare alone spends less than $600 billion per per year and Medicaid hovers around the $450 billion. Those waste figures you are quoting are most likely across the board for all payers, public and private, and most likely include administrative complexity which is a huge waste of money in the private insurance sector.
          See more here about the numbers, if you are interested: http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/downloads/proj2012.pdf

          • Bob

            If you start on the premise that CMS has all the facts and reports them accurately, I think you are naïve.
            From your answer including a “small” VA amount which happen to get the best prices for everything, you essentially are saying half the costs are CMS and the rest are commercial insurance and they are defrauded as much as the government is, because they are profit mongering insurers, which is why they are defrauded the least as this saps profits.
            Where in this scenario are the 40% of the population claimed as poor or uninsured, and where does the government place hospital DSH payments? Then there are the FSS, DOD, Government employees plans, and the list goes on and on; but meanwhile nobody looks at the states licensing bodies to check how many docs and nurses we are short and how millions more each year are going to be given care free, or how much more or less we will have to pay. .

  • Judgeforyourself37

    OMG the “I have mine and to h3ll with you,” crowd is alive and well on the topic of the ACA aka “Obamacare,” aka ” Romneycare” in MA, and a plan that the Heritage Foundation and the Republicans embraced in the mid 90s.
    However, I completely agree with the person from Australia who likes their “Health care for all,” We must care for our neighbors, attitude. The sad thing in our nation, now, is that the politicos who tout “what great Christians” they are, do not give a rat’s patootie about anyone but themselves. Perhaps the definition of “Politics” that I once heard runs true to form:
    Poli=Many
    Tics=Blood sucking insects
    Politics=Many Blood Sucking Insects.

  • ninguem

    Degrees on a circle……

    Under Capitalism, man exploits man.

    Under Communism, it’s the other way around.

    That sort of thing?

  • http://onhealthtech.blogspot.com Margalit Gur-Arie

    Yes, thank you for the Aussie view, which I would fully support for this country. Unfortunately, Obamacare is not about that. It’s about enabling private insurance companies to maintain healthy profits by serving them with more customers, and at the same time regulating the availability of services down. It may help, if you note that for American private insurers, the amount spent on patient care is called Medical Loss.

  • http://onhealthtech.blogspot.com Margalit Gur-Arie

    Thanks, Dee.

  • Dorothygreen

    The exchange part of the ACA is not a government run program. It is “administered” by insurance companies and unfortunately uses the exchange to deal with with the administration of the of subsidies and Medicaid.

    If this is the best the US can do to “reform healthcare” it will never have affordable, accessible, universal. Here is what it will take:

    1. get rid of Medicaid, subsidize the poor to purchase insurance (but not through the exchange) and let insurance companies administer” their care.

    2. Negotiations at Federal level on pharmaceuticals, equipment and lab.

    3. outlaw for-profit (ie market driven, free market) for basic or essential services and have same basic premium rate for all for managed care.

    4. insurance companies would negotiate prices for docs and hospitals (not individually but with all) in each state given the above mandates.

    5. Everyone must have to pay something up front, even if reimbursed later. Skin in the game.

    6, No mandate for employer health insurance. Use exchange for all. Employers can contribute to health insurance and also increase wages. This will give employees way more mobility.

    6. Let whoever wants and can afford to pay additional premium for supplemental (including choice), private
    rooms in hospitals, adult dental etc. A al carte.

    7. Tax all sugar (except honey, molasses and maple syrup) in all products as it has surpassed tobacco as the leading risk factor (through chronic high glucose, to glycation and inflammation) resulting in chronic preventable diseases.

    Spoiler alert: The US is the only country who does not have such policies be it a single payer or social insurance like Switzerland. The US cannot be a world leader unless it is a leader in the health of its own country.

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