Fix Health Care Policy

Heritage’s Kevin Dayaratna finds in a recent survey of academic literature that “Medicaid’s so-called safety net cripples the very people it is designed to help.”

The structural flaws in the program produce a cascade of failures, starting with underpaid and overburdened doctors, which produces longer waits for care, in turn leading to late-stage diagnosis of illnesses, finally resulting in more costly (though often less effective) treatments and higher mortality rates.

Recent statistics show that Medicaid enrollment has reached an all-time high of 70.4 million beneficiaries. In other words, one in five Americans now receives Medicaid benefits. Despite this, Obamacare’s intended expansion of Medicaid would add another 17 million beneficiaries to the already overburdened program.

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Tags: expensive treatments, failing, higher mortality rates, less effective, Medicaid, poor quality of care, private coverage, reform, safety net

Thought the “public option” was dead? Think again. Chief among the most dangerous provisions in Obamacare is the creation of government-sponsored national health plans, which are, in effect, another embodiment of the public option.

Through its multi-year implementation, the law steadily evolves into a national single-payer health care system.

Here’s the background: In 2014, the Office of Personnel Management (OPM), the small agency that runs the federal civil service, will administer at least two nationwide health plans to compete against private insurance. OPM will be responsible for negotiating the new health plans’ medical-loss ratio, profit margins, and premiums.

The OPM-sponsored plans will automatically qualify to compete against private health plans in the new state exchanges and thus will not be subject to the same qualifications and standards outlined in Obamacare for private plans in the exchanges. OPM must contract with an already existing large insurer, because such a plan must be offered in 60 percent of states in year one.

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Tags: medical loss ratio, Office of Personnel Management, premiums, private coverage, profit margins, public option, sponsoring health plans, state health exchange

Today, the U.S. Census Bureau released the 2011 findings on health insurance coverage in the United States.

Despite a small reduction in the uninsured by 1.4 million from 2010 to 2011, 48.6 million, or 15.7 percent of Americans, remain without health insurance.

Another area of disappointment comes from the number of uninsured young adults: 27.7 percent of the uninsured fall in this age group. While this group saw a decrease of 2 percent—partially due to Obamacare’s extension of coverage to dependents up to age 26—it is much less than President Obama and his Administration promised. In August, the President claimed, “Nearly 7 million young people have health insurance because they’re able to stay on their parents’ plans.”

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Tags: Census Bureau, health insurance coverage, ObamaCare, parents' plan, private coverage, public programs, uninsured, young adults

This week, The New York Times highlighted a study on Medicaid, the federal–state partnership to provide health care to the poor and disabled, and its failure to offer enrolled children access to care. The researchers used a “secret shopper” technique to see how many specialists in Cook County, Illinois, turned away children with Medicaid compared to private insurance.

The results were jaw-dropping. While specialists turned away 11 percent of privately insured children, 66 percent of children with Medicaid were unable to get an appointment. For those who did, the waiting time was 22 days longer than for other patients.  (Read the rest on The Foundry…)

Tags: children, federal-state partnership, Medicaid, ObamaCare, private coverage, The New York Times

While overall health care spending slowed in 2009, it is the underlying trend that is more troubling: the continuing decline in private coverage and the steady increase in government health care. These trends will only accelerate under Obamacare.

According to the Centers for Medicare and Medicaid Services (CMS), total health care spending grew by 4 percent in 2009 to reach $2.5 trillion. This represents a slower rate of growth from 2008, but the slower increase still outpaced spending as an overall percentage of GDP.

The 3.2 percent decline in private coverage and the slowing of out-of-pocket spending by consumers are attributed to the recession. Fewer people with jobs mean fewer people with traditional employer-based health care coverage and less income to pay for health care.

The decline in private coverage is reportedly offset by a massive increase in Medicaid as more individuals enroll in the government health care program for the poor. According to CMS, Medicaid spending grew at a rate of 9 percent, nearly doubling from 4.9 percent in 2008. Moreover, the federal share of this spending increased 22 percent as the federal government picked up a greater share of the cost as directed under the stimulus bill. (Read the rest at The Foundry…)

Tags: Centers for Medicare and Medicaid Services, national health care spending, out-of-pocket costs, private coverage

The White House’s assertion that you’ll be able to keep your health insurance if you like it is wrong given the incentives built into the House and Senate bills (i.e., employer mandates and creation of a government-run health plan). Companies will find it easier to pay a tax or fine and dump their employees out of their existing private coverage and onto a public plan or other alternatives. And it won’t just be the health insurance options that are limited.

Under current legislation, the government would have the authority to determine the benefit packages that Americans get, from medical treatments and procedures to drugs and devices. These decisions would be determined by the Secretary of Health and Human Services and an advisory committee on benefits. At the end of the day, Americans will get what the government decides they can receive in terms of health benefits.

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Tags: private coverage