John C. Goodman
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Are you in an HMO? If you are a senior on Medicare the answer is probably "yes." And if you’re not in one now you soon will be.

So why don’t you know about this? It’s all part of health reform (ObamaCare). For the past few months the federal government has been quietly and secretly enrolling millions of elderly and disabled people into a new type of health maintenance organization without their knowledge or consent.

By "quietly" I mean that the government isn’t telling you about it and it has no plans to tell you about it. By secretly, I mean the whole procedure is being conducted under the radar screen. I haven’t even seen a single news article about it. I know of no place you can write or call or go online to find out what HMO you’ve been assigned to.

What do I mean by a new type of HMO? I’m not talking about Medicare Advantage plans that currently count one in every four seniors as members. Medicare Advantage plans complete in the marketplace. They don’t get enrollees unless seniors voluntarily decide to join. No federal bureaucrat is able to enroll you in one without your knowledge or approval.

The new type of HMO is called an Accountable Care Organization, or ACO. As I explain in my new book, Priceless: Curing the Healthcare Crisis, ACOs are HMOs on steroids. Like the traditional HMO, doctors in ACOs will have financial incentives to withhold care (something the American Medical Association used to consider unethical). In most cases, they will get to keep part of any money they don’t spend. What makes them different from the traditional HMO is that they will be under intense pressure to practice medicine according to guidelines written by people you will never meet or see.

For example, Medicare has announced it will start paying more to hospitals that follow a dozen procedures, including administering antibiotics prior to surgery and anticlotting medication to heart attack patients. It will pay less to hospitals that don’t comply. The same thing is about to happen to doctors. Those who comply on up to 194 different metrics — including adopting electronic medical records — will get higher fees. Those who resist will get lower ones.

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John C. Goodman

John C. Goodman is President and CEO of the National Center for Policy Analysis, Senior Fellow at The Independent Institute, and author of the 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." He is also the Kellye Wright Fellow in health care. The mission of the Wright Fellowship is to promote a more patient-centered, consumer-driven health care system.