Barack Obama is only halfway through his term, but it's not too early to ask: What is the biggest whopper he has told as president? So far, the hands-down winner is, "No matter how we reform health care, we will keep this promise to the American people. If you like your doctor, you will be able to keep your doctor, period. If you like your healthcare plan, you'll be able to keep your healthcare plan, period. No one will take it away, no matter what."
Obama made that particular pledge in a speech to the American Medical Association in June 2009, but he said the same thing, with slight variations, dozens of times during the healthcare debate. And now, exactly eight months after he signed the Patient Protection and Affordable Care Act into law, we're seeing just how empty the president's promise was.
The New York Times reports there is a "growing frenzy of mergers" in the healthcare field in which hospitals and other care providers, pressured by the new law's provisions, are joining forces to save money. "Consumer advocates fear that the healthcare law could worsen some of the very problems it was meant to solve," the paper reports, "by reducing competition, driving up costs and creating incentives for doctors and hospitals to stint on care, in order to retain their cost-saving bonuses."
The Obama administration's answer to the problem will undoubtedly be more regulation. But the wave of mergers is just one of many signs of trouble with the new law.
For example, we know that the government's Centers for Medicare & Medicaid Services has found that the new law will increase healthcare costs, rather than reduce them, in the coming decade. We know that cuts in Medicare, with the money saved going to pay for expanding coverage to the poor, will jeopardize seniors' access to care. We know the law will make it impossibly expensive for companies that currently offer bare-bones health coverage to low-income employees to keep doing so. We know several corporations are taking giant write-downs because the bill will increase the cost of providing prescription-drug coverage to retired employees. And perhaps most important, we know the law offers an enormous incentive for employers who currently provide coverage to workers to stop doing so, sending those workers to buy coverage in government-subsidized healthcare exchanges.
In sum, what the law means for millions of Americans is: No matter what the president said, if you like the coverage you have now, you can't keep it.
And a lot of people do like their coverage. A new Gallup Poll found that when Americans are asked to assess the quality of their own health care, the results "are among the most positive Gallup has found over the past decade." A total of 82 percent of respondents rate their health care as excellent or good, while just 16 percent rate it as fair or poor."
The key question of healthcare reform has always been how to make things better for the 16 percent while not messing things up for the 82 percent. Obama decided to blow up the system for everyone.
In doing so, he has created not just well-founded anxiety in those who are skeptical of the new law but also unrealistic expectations in those who support it. "We just told millions of people that they can go to the exchanges in 2014 and buy insurance," writes Aaron Carroll, an Indiana University School of Medicine professor who blogs on healthcare issues at a site called the Incidental Economist. "There won't be any lifetime or annual limits. There won't be denials for pre-existing conditions. There won't be any surcharges for having such conditions. And it's going to be 'reasonably' priced." Carroll talked to lots of insurance executives, and concluded it's just not going to happen. "I feel like many people think they will have choice of doctor, choice of hospital, and the ability to dictate care," he writes. "I'm not seeing how insurance companies will be able to offer such products at prices people can afford."
Is any of this a surprise? The fact is, the president knew or should have known that his healthcare scheme would have these effects. He paid a political price for his actions on Nov. 2. There might be more to pay on Nov. 6, 2012.