The Democrats' Fallback Plan For When Obamacare Inevitably Fails
Will Single Payer Healthcare Emerge as the Next Battleground?
With the reelection of President Obama, the Affordability Care Act known as ObamaCare will begin its implementation. The voters have ensured that ObamaCare will now move forward, even though this election was really not a referendum on the unpopular law; only five percent of voters ultimately said the ACA was the biggest factor in determining their vote for president, and the electorate, although divided, still generally opposes the law. Predictably, since the election, the president’s favorability ratings have improved, and along with that, the unpopularity of ObamaCare among Americans has diminished, with the margin of “for repeal” over “against repeal” narrowing down to single digits. Perhaps Americans are beginning to accept what seems inevitable, or maybe they are experiencing some fatigue about the political battles on this issue. Time will tell, and sooner than most voters realize, the next congressional elections and the chance to express an opinion where it counts will be upon us...
...But there also seems to be a naïve misunderstanding by many about the consequences of the state-by-state resistance. Regardless of who sets up the health insurance exchanges, the federal government will now define the details of coverage for the majority of health insurance policies. Massive taxpayer money will now be funneled into subsidizing health insurance, while medical care access will diminish with the reductions in payments to doctors and hospitals. More Americans will be shifted to Medicaid, even though some states will reject its expansion. More employers will reduce their health benefits or shift away from scenarios where they are required to offer the coverage. More employees will be forced to change their coverage and, necessarily, their doctors too. Many private health insurance options, including some of the most popular lower cost plans, will be eliminated by the actuarial and benefits-design dictates of the law. Most policy experts on both sides of the aisle understand these realities.
Even if the actions by the states weaken ObamaCare and hasten its failure, the truth is that its failure will not open the door for reconsideration of alternative reforms advocated by the Republican opposition. The notion that refusal to advance the ObamaCare implementation at the state level will generate a sincere discussion of meaningful compromises by this Administration is naïve, given this president’s method of passing the bill in the first place, let alone his now characteristic pretense of repeating the hollow promise of “compromise” to a sycophantic press corps while failing to offer even a single concession. No, none of the predictable failures of ObamaCare in reducing health care expenditures, in providing meaningful access to quality health care beyond simply labeling someone as insured, in improving the economic prospects of individual Americans and their families, and eventually in maintaining the excellence of U.S. health care will provide major leverage for compromise.
Even focusing on the possibility that compromise is forthcoming misses the bigger, more important point. To the contrary, looming over health care but ignored by those whose arguments focus only on ObamaCare is the next step in President Obama’s plan for transforming America. The unspoken reality is that President Obama and the Democrats’ fallback plan for ObamaCare’s failure is fully nationalized, single payer health care.
As the evidence rolls in after ObamaCare takes hold, proving its failure to reduce health care expenditures, combined with the predictable decrease in access to care for those with government insurance and the non-viability of private insurance, Americans will understandably voice an increasing dislike of the reformed system. So, specifically, what might we expect during the next phase of this transformative presidency, either from this administration or more likely the next Democrat to profess expertise about health care reform?
First and foremost, watch out for the reemergence of a “public option” likely marketed by Democrats as “Medicare for all”, as Democrats revive their already stated original goal of forging a single payer, wholly government-controlled system. We know that President Obama wants it. In June 2003, Obama said “I happen to be a proponent of a single-payer health care program … a single-payer health care plan, a universal health care plan. And that’s what I’d like to see.” And we know that Senator Max Baucus, the chair of the Senate Finance Committee during crafting of the ACA and its ramming through Congress by Democrats, admitted in February 2009 that “There may come a time when we can push for single-payer. At this time, it’s not going to get to first base in Congress,” a sentiment echoed by then House Speaker Nancy Pelosi who said “For 30 years I have supported a single payer plan, but our next best choice is to support an exchange and a public option.” There is no secret about the ultimate goal of the president and leading Democrats.
Congressional Democrats unmistakably anticipate the failure of ObamaCare, given they had already asked the CBO to price a formal public option for 2014. The proposal’s co-sponsor Rep. Raul Grijalva (D-Ariz.), now reelected to a sixth term, said “By reintroducing it, we make sure that people don’t forget this is a viable option…. as the health bill is implemented, more and more people are going to come to the realization that cost containment and competition aren’t as robust as they should be, because of the absence of the public option”. Later, John Conyers (D-Mich.) in 2011 re-introduced his nationalized single payer system called “Expanded and Improved Medicare for All Act” in his H.R. 676 bill to the House of Representatives, following President Obama’s State of the Union in which the president said that the ACA was open to change “if you have ideas about how to improve this law.” Conyers was quite direct when he unabashedly stated the Democrats’ end-game along with their standard canard: “Improved and Expanded Medicare for All is inevitable in America– it is just a matter of when it will happen. Single-payer health care systems have successfully contained health care costs and provided high quality health care in countries in Europe, Taiwan, Japan, and Canada.” And let’s not overlook proposed legislation aiming for total take-over of health care by Democrat-dominated state governments, such as in Vermont and Delaware.
Second, or perhaps in advance of single payer legislation, watch for the federal government to restrict doctors from practicing, or possibly even criminalize them, unless they accept all patients with insurance paying government-defined rates for medical tests and treatments. We know that ObamaCare and its Independent Payment Advisory Board, IPAB, will force prices for medical services lower and lower by direct design, so that by 2019, payments for Medicare will be even lower than Medicaid. While some doctors will swallow government-dictated low reimbursements, undoubtedly more and more physicians will refuse to see patients under such health plans – easy to foresee, since this has already happened to Medicaid and Medicare patients across the country. But this presumably will not be tolerated by HHS Secretary Sebelius and our President. It is not at all unimaginable that the federal government will soon tie all medical licensure to accepting the new edicts, as has already been contemplated in Massachusetts by state legislators...
The gutless wonder Speaker of the House John Boehner has said Obamacare will be part of any negotiations on the "fiscal cliff". If you believe that I have a bridge to sell you. There is a case coming up from the 4th District Court on the Individual and Employee mandates. That is a prayer that a man who made a massive mistake (saying something that is clearly unconstitutional constitutional) will get his head out of his ass. I am not hopeful.
Having to endure socialized medicine I am not hopeful for the country if this continues.
No comments:
Post a Comment