As for criticizing ObamaCare, the critics have no reason to lie. The reality is ugly enough. There are three big problems in health care: cost, quality and access. Health care is too expensive. The quality of care many patients receive is less than optimal. And too many Americans have difficulty getting care. So for its $1.8 trillion price tag, what will ObamaCare do about these three problems? It will most likely make all three of them worse.
• Almost every serious analysis predicts that spending will be higher, not lower, under ObamaCare.
• The results of pilot programs and demonstration projects leave us no reason to believe that the quality of care will improve ; and perverse incentives are likely to make the quality of care patients receive worse, not better.
• Access to care for our most vulnerable populations is likely to go down, not up — despite the fact that more people will have health insurance.
On this last point, ObamaCare makes the same mistake nationally as health reform in Massachusetts, which President Obama cites as the model for his reform. In both cases, more people get insurance, but there are no more doctors to deliver any additional care.
In Massachusetts, more people are going to hospital emergency rooms than ever before — presumably because they can't find a doctor who will see them. The wait to see a new doctor in Boston is about two months — longer than in any other U.S. city. In a sense, people in Boston have less access to care than people living anywhere else!
ObamaCare will greatly expand the demand for health care while doing nothing to increase its supply. That implies a huge rationing problem, and anyone who is in a health plan that pays doctors and hospitals less than what others are paying will be pushed to the rear of the waiting lines. Who are those people? They are the elderly and the disabled on Medicare, poor people on Medicaid, and (if Massachusetts is the model) low income families getting subsidized insurance in the newly created health insurance exchanges.
ObamaCare will impose its harshest impact on the most vulnerable populations.
John C. Goodman is President of the Goodman Institute and a Senior Fellow at The Independent Institute. He is the author of the widely acclaimed book, Priceless: Curing the Healthcare Crisis. The Wall Street Journal and National Journal, among other media, have called him the "Father of Health Savings Accounts.”
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