Wintery Knight

…integrating Christian faith and knowledge in the public square

Ezra Klein on the costs of Obamacare: then and now

Consider this article from Forbes about Obamacare and how it was presented by Ezra Klein, a well-known journalist from the left-leaning Washington Post. (H/T Bernie M.)

Excerpt:

The key thing to remember is that back when Obamacare was being debated in Congress, Democrats claimed that it was right-wing nonsense that premiums would go up under Obamacare. “What we know for sure,” Obamacare architect Jonathan Gruber told Ezra Klein in 2009, “is that [the bill] will lower the cost of buying non-group health insurance.” For sure.

In 2009, was Ezra saying that it’s ok that premiums will double for the average person, because a minority of people will pre-existing conditions will benefit? No.

Earlier that year, AHIP, the private insurer trade group, commissioned a report from Price Waterhouse Coopers to analyze the impact of Obamacare on health insurance premiums in the individual market. That report, which I reviewed here and elsewhere, found that the version of Obamacare then being considered by the Senate Finance Committee would increase premiums by 14 to 32 percent, depending on the year you looked at. In retrospect, the PwC report was a bit optimistic.

But Ezra described the PwC analysis as “the insurance industry’s deceptive report,” comparing it to sham research put out by the tobacco industry and Big Oil. Ezra did concede at the time that “buying better insurance will cost somewhat more,” because insurers would no longer be able “to sell a deceptive and insufficient product.”

But high-deductible, catastrophic insurance isn’t cheaper because it’s dishonest. It’s cheaper because it’s more efficiently designed. And it’s precisely that sort of efficiently-designed insurance that Obamacare abolishes.

I blogged about that study from Price Waterhouse Coopers before, too. In fact, I fully explained why specific provisions of Obamacare would necessarily raise health insurance premiums.

Before the 2012 election, I linked to an article from Investors Business Daily, which confirmed that premiums had indeed risen since the passage of Obamacare.

Excerpt:

During his first run for president, Barack Obama made one very specific promise to voters: He would cut health insurance premiums for families by $2,500, and do so in his first term.

But it turns out that family premiums have increased by more than $3,000 since Obama’s vow, according to the latest annual Kaiser Family Foundation employee health benefits survey.

Premiums for employer-provided family coverage rose $3,065 — 24% — from 2008 to 2012, the Kaiser survey found. Even if you start counting in 2009, premiums have climbed $2,370.

What’s more, premiums climbed faster in Obama’s four years than they did in the previous four under President Bush, the survey data show.

Despite these facts, the American people went along with the mainstream media and re-elected Obama for a second term in 2012, blocking any repeal of Obamacare.

I think that the American people need to realize that most journalists cannot be counted on to handle research and evidence accurately. Most of them probably never even completed a high school math or science course. They studied journalism. Journalism is not computer science. Journalism is not petroleum engineering. Journalism is not nursing. Journalism is an area where students are graded based on their ability to parrot what their leftist professors tell them to believe.  At best, left-wing journalists are not competent. At worst, they are outright liars. Study after study on media bias has confirmed that left-wing journalists cannot be trusted to report the news fairly. That is not my opinion, that’s a fact.

Unfortunately for us, our failure to fix our little Obama mistake in the 2012 election is going to cost us all dearly – especially young people.

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Americans finding out the true costs of Obamacare

The Daily Caller has a sobering article about the true costs of Obamacare.

Excerpt:

Millions of Americans are receiving double-digit premium hikes. For many people under 30, their health insurance premiums are going up much more — by as much as 189 percent. What happened to candidate Barack Obama’s 2008 promise that every family’s health care costs would go down by $2,500 by the end of his first term? (Costs actually went up by $3,000.)

The Congressional Budget Office projects Obamacare will cost tens of billions more over the next decade than the agency projected just three years ago. Those increases were not budgeted for, and will add to massive deficits.

So much for the promise that the law “will not add one dime to the deficit.”

Millions of workers at places like Wendy’s and Olive Garden are now being preemptively reclassified as part-time, and an estimated 7 million to 20 million employees face the loss of workplace health benefits altogether.

So much for the oft-heard promise that “If you like your health care plan, you can keep your health care plan.”

[...]Seniors were assured that the new system wouldn’t affect their benefits, despite Obamacare’s $716 billion in ten-year cuts to Medicare (to help pay for the new entitlement).

That promise was broken recently, when the Medicare agency issued surprise regulations cutting Medicare even more deeply than Congress had directed — cuts that target a popular and very successful part of Medicare, one that actually features consumer choice and competition, namely, Medicare Advantage (MA).

Seniors who opt into MA enjoy greater care coordination, disease management for chronic conditions, and on-call nurses available by phone. Those extra services — which in some cases mean the difference between life and death — are now slated for the chopping-block.

Rosemarie Battaglia will be among the millions of victims of these new regulations, which beginning April 1 will effectively shave MA plan payments by about 2 percentage points. On top of prior cuts enacted in Obamacare, that spells an 8 percent cut next year — a level higher than the profit margins for these plans.

Actuarial experts at the American Action Forum predict the cuts will cause between 2 and 5 million seniors to lose their MA benefits, and that MA recipients face health care cost increases averaging $2,235 a year.

When a President makes promises about economic policy, we shouldn’t believe him unless we have reasons to believe that he understands business and economics. We had no reason to believe that Obama understood economics. And, when given the reins of the economy, he’s proven that. Instead of electing people who sound nice in speeches, we should be electing people who have shown that they know how to solve the problems we’re facing in the economy. A track record of success at creating jobs, reducing the costs of health care, improving health care quality and choice, etc. should have counted for more than rhetoric. We chose the rhetoric and now we’re getting the screws.

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Sally Pipes: how Obamacare causes doctors to quit practicing medicine

Sally C. Pipes is one of my favorite health care policy analysts. She has written several books on topics like the Canadian health care system, the American health care system, and the Obamacare health care law. She has debated health care with that damnable leftist Paul Krugman, among others. She heads up a think tank based in San Francisco, CA called the Pacific Research Institute.

Here is her latest column in the Orange County Register.

Excerpt:

Thanks to Obamacare, America’s corps of doctors appears to have a case of the blues.

The Physicians Foundation recently asked more than 13,000 doctors about their morale, their career plans, their practices and their views of the Affordable Care Act. The results were grim.

Nearly six in 10 doctors said that they are less positive about the future of health care in America under Obamacare. Almost two-thirds have a negative attitude toward their jobs – nearly twice as many as before the health law was passed in 2010.

As a result, many doctors are cutting back on their workload or shuttering their practices. Worse, their collective frustration is exacerbating our nation’s troubling doctor shortage.

More than three-fifths of doctors say they would retire today if they could, compared with 45 percent before Obamacare. Eighty-four percent say the medical profession is in decline. Fewer doctors say they would enter the profession today if they had it to do over again, and fewer would recommend it to their children.

This decline in doctors’ morale is taking a toll on Americans’ ability to access care. Physicians report working almost 6 percent fewer hours than they did four years ago. That’s about two and a half hours less per week per doctor. Add up all the hours, and it’s the equivalent of losing more than 44,000 full-time physicians.

Doctors also report seeing some 16 percent fewer patients than they did in 2008. That represents tens of millions fewer doctor-patient encounters each year.

More than half those surveyed say they plan to cut back further on the time they devote to patient care, to work part time, to retire or to switch to direct-pay “concierge”-type medical practices, which are beyond the reach of many of Obamacare’s rules and regulations.

Even before the law, America faced a chronic doctor shortage, with a gap of 14,000 physicians in 2010. And the problem will only grow worse.

According to the Association of American Medical Colleges, Obamacare will push the doctor shortage up to 63,000 by 2015 – and more than 91,000 by 2020. That’s in addition to the full-time-equivalent losses from doctors working fewer hours.

I have been talking to people in my office who voted for Obama all week to see why they did what they did. Surprisingly, not many people I talked to voted for him. But for those that did, a popular reason is that they wanted to tax the rich more. I asked them what would happen if you taxed the rich more. They told me that Obama can tax people who are “rich” more and more and that the “rich” will just keep paying those higher taxes while still continuing to work and work to provide the goods and services that we all use. I asked them about regulations, and they said that Obama can just keep heaping burdensome regulations on these “rich” people more and more, and they won’t mind at all. They’ll just keep working and hiring people and providing goods and services even if they make less money and have to work more to comply with regulations.

One of the Indian contractors who voted for Obama told me that rich people do what they do because they like it, and they will keep doing it no matter how much we tax and regulate them. “They will do it for love of fairness, and because Obama is such a good man – they will be inspired by him to pay the higher taxes and to fill in the extra paperwork”, he told me. For him, people just do whatever they like. The reason why some people work is because they like working, and the reason why some people don’t work is because they like not working. Another Obama-voter told me that people should be able to do whatever they like and everyone should end up equal in the end. Some people will work because they like to, and others won’t. Taxes don’t affect what a person does. Nor does the difficulty of the work. Nor does the exposure to malpractice lawsuits.  Nor does the higher medical insurance premiums. Doctors do what they do because they like it, and the conditions and profit margins don’t matter. Rich people like doctors will keep working at whatever they do even if they are taxed so much that they earn the same amount of money as people who work at McDonald’s.

That’s the worldview of the people who voted for Obama. They don’t understand incentives at all. They don’t understand the profit motive. They think that people who go to medical school until they are 35, racking up tens of thousands of dollars in debt in the process, will be happy to work 80 hour weeks and to pay 50% of their income in taxes so that other people can have free contraceptives. That is the worldview of the left – they have no idea what the consequences are of raising taxes on “the rich”. They don’t think that there are any consequences.

If you would like to see Sally Pipes talk a bit more about Obamacare, you can watch her explain it here:

Eight minutes long.

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California: Obamacare exchanges will raise health insurance premiums up to 25%

The radically leftist Los Angeles Times reports on it. (H/T The Cato Institute)

Excerpt:

California’s health insurance exchange said more than 30 plans are expected to vie with one another for spots in the state-run marketplace opening next fall.

State officials, and those in other states, are eager to flex their purchasing power under the federal healthcare law by selecting only certain individual and small-business health plans for 19 different regions across California.

The exchange, branded Tuesday as Covered California, will negotiate with insurers for the best rates and will assist consumers and small businesses in choosing a plan by separating them into five categories based on cost and level of benefits.

[...]The ability of the exchange to lower healthcare costs remains unclear. Experts said average premiums could rise in the exchange because the Affordable Care Act requires improved benefits, but consumers’ out-of-pocket medical costs could decrease under those same changes.

California insurance officials have expressed concern about substantial rate hikes for some existing policyholders going into the exchange.

Under a new rating map approved by state lawmakers, the Department of lnsurance estimated that premiums for similar coverage could increase as much as 25% in West Los Angeles, 22% in the Sacramento area and nearly 13% in Orange County.

Do you want to pay higher medical insurance premiums? Can you afford it? We’ve already seen massive drops in average household incomes under this President.

According to Forbes magazine:

New income data from the Census Bureau reveal what a great job Barack Obama has done for the middle class as President. During his entire tenure in the oval office, median household income has declined by 7.3%.

In January, 2009, the month he entered office, median household income was $54,983. By June, 2012, it had spiraled down to $50,964. That’s a loss of $4,019 per family, the equivalent of losing a little less than one month’s income a year, every year. And on our current course that is only going to get worse not better…

[...]Three years into the Obama recovery, median family income had declined nearly 5% by June, 2012 as compared to June, 2009. That is nearly twice the decline of 2.6% that occurred during the recession from December, 2007 until June, 2009. As the Wall Street Journal summarized in its August 25-26 weekend edition, “For household income, in other words, the Obama recovery has been worse than the Bush recession.”

[...]Obama has failed the poor as well as the middle class. Last year, the Census Bureau reported more Americans in poverty than ever before in the more than 50 years that Census has been tracking poverty. Now The Huffington Post reports that the poverty rate is on track to rise to the highest level since 1965, before the War on Poverty began. A July 22 story by Hope Yen reports that when the new poverty rates are released in September, “even a 0.1 percentage point increase would put poverty at the highest level since 1965.”

Additionally, medical insurance premiums, which Obama promised to lower, are actually up.

From Investors Business Daily.

Excerpt:

During his first run for president, Barack Obama made one very specific promise to voters: He would cut health insurance premiums for families by $2,500, and do so in his first term.

But it turns out that family premiums have increased by more than $3,000 since Obama’s vow, according to the latest annual Kaiser Family Foundation employee health benefits survey.

Premiums for employer-provided family coverage rose $3,065 — 24% — from 2008 to 2012, the Kaiser survey found. Even if you start counting in 2009, premiums have climbed $2,370.

Why should we go forward with Obamacare, which requires the construction of these exchanges? Obama already broke his promise to cut health insurance premiums, and the full implementation of these exchanges would raise the premiums even higher. This is nothing but a ploy to justify the imposition of price controls on private health insurers so that they go out of business, and we are left with a fully government-controlled system. Then there will be no choice, no competition, waiting lists, a shortage of doctors and rationing of health care by un-elected bureaucrats. Do not give this man a second term.

Here are a few articles that I have been using lately to inform people about the problems with Obamacare:

It’s important to understand that people who oppose this law don’t oppose because we are just being contrary.  We have reasons.

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Canada’s “free” single-payer health care system costs each family $11,000 per year

From the Vancouver Sun.

Excerpt:

The true cost of Canada’s health care system is more than $11,000 in taxes each year for an average family, according to Vancouver-based think tank The Fraser Institute.

The institute’s report calculates the amount of taxes the average family pays to all levels of government in a year and the percentage of the total tax bill that goes towards public health care insurance.

A family of two parents with an average income of $113,226 and two children will pay $11,401 for public health care insurance, the report says.

[...]Institute senior fellow Nadeem Esmail said in a news release sent out this morning: “There’s a widespread belief that health care is free in Canada. It’s not; our tax dollars cover the cost of it. But the way we pay for health care disguises exactly how much public health care insurance costs Canadian families and how that cost is increasing over time.”

The release noted that since 2002, the cost of health care insurance for the average Canadian family increased by 59.8 per cent before inflation.

“By way of comparison, the cost of public health care increased more than twice as fast as the cost of shelter, roughly four times as fast as the cost of food, and more than five times as fast as the cost of clothing,” the release said.

This is the system that Obamacare is trying to force onto us by eliminating private sector health care. But proponents of single payer health care tell us that it’s better for patients than the American free enterprise system. Is it? Let’s take a look at the numbers.

A defense of American health care

Story from the Hoover Institute at Stanford University.

The article compares American health care to health care in other places like Canada, the UK and Europe.

The full article. I almost never cite the full article, but this is a must read.

MEDICINE AND HEALTH:
Here’s a Second Opinion

By Scott W. Atlas

Ten reasons why America’s health care system is in better condition than you might suppose. ByScott W. Atlas.

Medical care in the United States is derided as miserable compared to health care systems in the rest of the developed world. Economists, government officials, insurers, and academics beat the drum for a far larger government role in health care. Much of the public assumes that their arguments are sound because the calls for change are so ubiquitous and the topic so complex. Before we turn to government as the solution, however, we should consider some unheralded facts about America’s health care system.

1. Americans have better survival rates than Europeans for common cancers.Breast cancer mortality is 52 percent higher in Germany than in the United States and 88 percent higher in the United Kingdom. Prostate cancer mortality is 604 percent higher in the United Kingdom and 457 percent higher in Norway. The mortality rate for colorectal cancer among British men and women is about 40 percent higher.

2. Americans have lower cancer mortality rates than Canadians.Breast cancer mortality in Canada is 9 percent higher than in the United States, prostate cancer is 184 percent higher, and colon cancer among men is about 10 percent higher.

3. Americans have better access to treatment for chronic diseases than patients in other developed countries.Some 56 percent of Americans who could benefit from statin drugs, which reduce cholesterol and protect against heart disease, are taking them. By comparison, of those patients who could benefit from these drugs, only 36 percent of the Dutch, 29 percent of the Swiss, 26 percent of Germans, 23 percent of Britons, and 17 percent of Italians receive them.

4. Americans have better access to preventive cancer screening than Canadians.Take the proportion of the appropriate-age population groups who have received recommended tests for breast, cervical, prostate, and colon cancer:

  • Nine out of ten middle-aged American women (89 percent) have had a mammogram, compared to fewer than three-fourths of Canadians (72 percent).
  • Nearly all American women (96 percent) have had a Pap smear, compared to fewer than 90 percent of Canadians.
  • More than half of American men (54 percent) have had a prostatespecific antigen (PSA) test, compared to fewer than one in six Canadians (16 percent).
  • Nearly one-third of Americans (30 percent) have had a colonoscopy, compared with fewer than one in twenty Canadians (5 percent).

5. Lower-income Americans are in better health than comparable Canadians. Twice as many American seniors with below-median incomes self-report “excellent” health (11.7 percent) compared to Canadian seniors (5.8 percent). Conversely, white, young Canadian adults with below-median incomes are 20 percent more likely than lower-income Americans to describe their health as “fair or poor.”

6. Americans spend less time waiting for care than patients in Canada and the United Kingdom. Canadian and British patients wait about twice as long—sometimes more than a year—to see a specialist, have elective surgery such as hip replacements, or get radiation treatment for cancer. All told, 827,429 people are waiting for some type of procedure in Canada. In Britain, nearly 1.8 million people are waiting for a hospital admission or outpatient treatment.

7. People in countries with more government control of health care are highly dissatisfied and believe reform is needed. More than 70 percent of German, Canadian, Australian, New Zealand, and British adults say their health system needs either “fundamental change” or “complete rebuilding.”

8. Americans are more satisfied with the care they receive than Canadians. When asked about their own health care instead of the “health care system,” more than half of Americans (51.3 percent) are very satisfied with their health care services, compared with only 41.5 percent of Canadians; a lower proportion of Americans are dissatisfied (6.8 percent) than Canadians (8.5 percent).

9. Americans have better access to important new technologies such as medical imaging than do patients in Canada or Britain. An overwhelming majority of leading American physicians identify computerized tomography (CT) and magnetic resonance imaging (MRI) as the most important medical innovations for improving patient care during the previous decade—even as economists and policy makers unfamiliar with actual medical practice decry these techniques as wasteful. The United States has thirty-four CT scanners per million Americans, compared to twelve in Canada and eight in Britain. The United States has almost twenty-seven MRI machines per million people compared to about six per million in Canada and Britain.

10. Americans are responsible for the vast majority of all health care innovations. The top five U.S. hospitals conduct more clinical trials than all the hospitals in any other developed country. Since the mid- 1970s, the Nobel Prize in medicine or physiology has gone to U.S. residents more often than recipients from all other countries combined. In only five of the past thirty-four years did a scientist living in the United States not win or share in the prize. Most important recent medical innovations were developed in the United States.

Despite serious challenges, such as escalating costs and care for the uninsured, the U.S. health care system compares favorably to those in other developed countries.


This essay appeared on the website of the National Center for Policy Analysis on March 24, 2009. An earlier version was published in theWashington Times.

Available from the Hoover Press is Power to the Patient: Selected Health Care Issues and Policy Solutions, edited by Scott W. Atlas. To order, call 800.935.2882 or visitwww.hooverpress.org.


Scott W. Atlas is a senior fellow at the Hoover Institution and a professor of radiology and chief of neuroradiology at Stanford University Medical School.

Note that the author is a professor of radiology and chief of neuroradiology at Stanford University Medical School. Stanford and Harvard are generally regarded as the two best universities in the United States.

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