Looking at ObamaCare, Five Years On

By Sally C. Pipes

ObamaCare turned five years old March 23. But don’t break out the cake and candles. There’s not much to celebrate. When he signed his signature piece of legislation into law, President Obama guaranteed lower health costs, universal coverage, and higher-quality care. Five years later, the health law has failed to fulfill those promises.

“In the Obama administration,” candidate Obama boasted in 2008, “we’ll lower premiums by up to $2,500 for a typical family in a year.”

A recent report by HealthPocket, an online insurance marketplace, has revealed that premiums for individual Americans skyrocketed after ObamaCare became law.

Drug costs have jumped, too, despite promises to the contrary from the Obama administration. The majority of health plans offered on the exchanges have shifted costs for expensive medications onto patients, according to a study by Avalere Health. In 2015, more than 40 percent of all “silver” exchange plans―the most commonly purchased―charged patients 30 percent or more for specialty drugs. Only 27 percent of silver plans did so last year. Part of the problem is that the health law has quashed market competition.

The president promised in 2013 that “this law means more choice, more competition, lower costs for millions of Americans.” But that hasn’t turned out to be true. According to the Heritage Foundation, the number of insurers selling to individual consumers in the exchanges this year is 21.5 percent less than the number that were on the market in 2013―the year before the law took effect.

The Government Accountability Office reports that insurers have left the market in droves. In 2013, 1,232 carriers offered insurance coverage in the individual market. By 2015, that number had shrunk to 310.

With competition in the exchanges on the decline, quality is going down, too―just like President Obama said in 2013: “Without competition, the price of insurance goes up, and the quality goes down.”

Consumers who purchase insurance on the law’s exchanges have fewer options than they had pre-ObamaCare. The consulting firm McKinsey & Co. noted that roughly two-thirds of the hospital networks available on the exchanges were either “narrow” or “ultra-narrow.” That means that these insurance plans have refused to partner with at least 30 percent of the area’s hospitals. Other plans exclude more than 70 percent.

Patients may also have fewer doctors to pick from. More than 60 percent of doctors plan to retire earlier than anticipated―by 2016 or sooner, according to Deloitte. The Physicians Foundation reported in the fall that nearly half of all doctors―especially those with more experience―considered ObamaCare’s reforms a failure.

While more Americans may have insurance thanks to ObamaCare, they may not be able to find a doctor to see them. That’s a recipe for waiting lists and de facto rationed care.

Finally, five years on, President Obama’s declaration that he would not sign a plan that “adds one dime to our deficits―either now or in the future” looks more ridiculous than ever. In 2010, the Congressional Budget Office anticipated ObamaCare’s decade-long cost was $940 billion. This year, the CBO more than doubled that price tag, with a new estimate of $2 trillion.

The U.S. Supreme Court will rule this June on King v. Burwell, a case that threatens to negate the law’s subsidies. If the court rules against the administration, ObamaCare would unravel.

Obama has been proven wrong about what his health law would accomplish. Quality hasn’t improved, and costs continue to grow. That’s ObamaCare’s five-year legacy.

Sally C. Pipes is President, CEO, and Taube Fellow in Health Care Studies at the Pacific Research Institute in San Francisco. She is a guest contributor for Cascade Policy Institute. A version of this article was originally published by The Orange County Register.

Obamacare: Pain or Prescription for College Students’ Ailing Futures?

By Rebecca Phillips

Have you ever heard of someone waiting 18 months to get an MRI?

It’s a frequent scenario in Canada, a country that is noticeably free in most respects. The exception is health care, which is controlled by the government.

But waiting 18 months for an MRI rarely happens in the United States. In fact, I’d go out on a limb and say it’s never happened in the United States…yet. This week, a crucial event is taking place whose outcome very well could be the difference between waiting 18 months or 18 minutes for an MRI. The United States Supreme Court has begun to hear the long-awaited arguments on the Patient Protection and Affordable Care Act, popularly known as “Obamacare.” The Court is expected to rule in June.

It may be easy for college students to support Obamacare based on the idea that free health coverage for those who currently can’t afford it is a good thing or even a “right.” But according to John R. Graham, Director of Healthcare Studies at Pacific Research Institute, there’s poison in that prescription.

“A ‘right’ to healthcare is a positive freedom,” Graham said, “meaning that people (doctors, nurses, etc.) must give things to you for free. That requires government enforcement.”

In other words, the federal government takes control of your access to health care. It may sound harmless at first, but there is real-world evidence to suggest otherwise. Graham highlighted Canada, where the government has controlled access to health care for the past 40 years. The goal was to grant equal access to health care. The reality is equal denial. There is a lack of access to health care resources across the board. Patients have extreme difficulty seeing a specialist or even a primary care physician. OB/GYNs hardly exist. And receiving tests or treatments often takes exorbitant amounts of time.

Under Obamacare, these inefficiencies will become a very real threat to our own access to health care. “Obamacare is not an equilibrium,” explained Graham. “Government will need – and want – more control. It would eventually become a single-payer system.”

In college, with tests and parties and internships occupying your time, it can be difficult to envision the impact Obamacare would have on your immediate and long-term future. But college students, of all demographics, should be among the most concerned. Obamacare places a huge financial burden on businesses through taxes tying up funds that otherwise could be used to hire or to invest. If you think it’s difficult to find a job now, it will be significantly more difficult under Obamacare’s full implementation. Free health care sounds nice right now, but will it retain its luster when so many students have degrees and student loans but no job because businesses can’t afford to hire?

Ironically, one only has to look at the medical field for evidence. As Graham pointed out, these medical industries already suffer from heavy taxes – so much so that layoffs are gaining prevalence in medical professions from clinicians to research scientists. Students looking to enter the medical field will face an even bleaker job market under Obamacare.

There’s also your own health to consider. Forty or fifty years from now, you likely will need more substantial medical care than you have needed in your teens and twenties. Will you want to face the same time and resource constraints that accompany government-controlled access to health care? Even 10 years from now, you may hesitate to start a family because specialized prenatal and OB/GYN care isn’t as readily available.

A “right” to health care may sound like a good idea, but what about the government having a “right” to tell you what you do or do not have access to – whether that’s medical care, a job, or a family? It has been said that a government big enough to give you everything you want is big enough to take away everything you have. Obamacare may force providers to expand their coverage on paper, but no one can promise you will get the treatment you need or the services you want – just look at Canada.

In the real economy, there is no such thing as “free” – it’s paid for by someone or not provided at all. When we cede individual control of our health care decisions to the government, the government decides who pays for what care, how much they will pay, who will get benefits, and when they will get treatment. When you are waiting 18 months for an MRI, the cost of “free” will be awfully high.

Rebecca Phillips is Student Freedom Project Coordinator at the Freedom Foundation in Olympia, Washington. She is a recent graduate of Berry College, Georgia, and a guest contributor for Cascade Policy Institute, Oregon’s free market public policy research center.

The Truth about the Canadian Health Care System

By Frank S. Rosenbloom, M.D.

President Barack Obama and supportive members of Congress were able to get the Patient Protection and Affordable Care Act (ObamaCare) passed, in part by extolling the virtues of the Canadian health care system. In speech after speech, Obama has touted the alleged lower cost, “universal coverage” and better medical care of that system. All of the mentioned supposed benefits are untrue, but the most disconcerting fact is that Mr. Obama has never discussed any deficiencies of the Canadian system.

Other influential people have shared their concerns about the serious deficiencies in the Canadian health care system. Perhaps the most important of these is the man some call the ”father” of the Canadian health care system, Claude Castonguay. Although several provinces had government involvement in health care from 1946, Castonguay was the pioneer of socialized medicine in Quebec, which gave impetus to the establishment of a nationwide socialized medical care law in 1966.

However, in 2008 Castonguay had this to say about the health care system: “If nothing is done, at one point we will reach a crisis point. This is why we say it is urgent to act. There’s no miracle solution, there is no simple solution.” He has urged some privatization in the health care system to increase choice and fees of up to $100 for doctor visits. How could this be? Haven’t we been led to believe that the Canadian health care system is financially stable? In fact, the system is close to collapse.

Let’s review the facts. The Canadian health care system was established in the 1960s, when the government was spending like a drunken sailor trying to promote economic growth. Sound familiar? The assumption was that the economy would grow at a predictable rate and that the system therefore would be affordable. However, Canadians made the same fundamental mistakes governments always make when establishing entitlement programs; that the economy would act predictably and that the program’s costs would grow in a predictable linear fashion. These two assumptions have proven to be incorrect in all cases, as they were in establishing our own Medicare system.

Health care reform has been a serious issue in Canada for over fifteen years, as the financial burdens of socialized medicine have put increasing strain on resources. Canadian media regularly trumpets fears about escalating health care costs. Furthermore, since accurate statistics are kept only on government spending, substantial hidden costs are associated with that system. Some Canadians are even breaking the law by opening private clinics to relieve a system that is imploding. One significant reason the Canadian system has lasted this long is the safety valve provided by the U.S. system, where Canadians can receive timely care at a fair price. Yet, if you believe President Obama, the Canadian health care system moves along like a well oiled machine.

Although Canadians spend less per capita than we do in the U.S., the rate of rise in their health care costs has been at times equal to or greater than ours during the past decade. So, how can we be told that Canadian health care costs are rising at a slower rate than our own? The rate of rise in Canadian health care expenditures can be seen by reviewing the widely available graph below.

Canadian Institute for Health Information

The graph shows total expenditures in constant 1997 dollars. A quick review shows Canadian health care costs rose about 240 percent from 1996 to 2009, by which time they actually exceeded $180 billion.

By contrast, the rise in U.S. health care costs can be reviewed below.

Centers for Medicare & Medicaid Services, Office of the Actuary. National Health Expenditure Accounts – Projected, Table 1: National Health Expenditures; Aggregate and Per Capita Amounts, Percent Distribution, and Average Annual Percent Growth, by Source of Funds: Calendar Years 2003-2018

We see that in 1996, U.S. health care spending was about $1 trillion. By 2009 it had reached about $2.4 trillion, which is an increase during that period of about 240%. Now, wait a minute! The rate of rise of Canadian health care costs is really no lower than ours? Yes, President Obama, (and Governor Kitzhaber), there is no Santa Claus, and no Shangri-La. The often reported, widely disproportionate cost increases between the Canadian and the U.S. health care systems are a myth.

Statistics can be adjusted to promote a particular ideology, as was seen by the graph above adjusted to constant 1997 dollars and the addition of the “projected” 2018 spending in the U.S. graph. Despite these difficulties, the truth about the Canadian health care system and socialized medicine is available to anyone who diligently studies the matter. Unfortunately, many Americans have relied on liberal politicians for their information, and nothing but higher costs and lower quality medical care will be the inevitable result. If we really want costs to decrease while maintaining quality health care, we need real free market reform before the inevitable complete collapse that will occur nationally under ObamaCare and the disaster that will befall Oregon under Gov. Kitzhaber’s reform proposals.

Frank S. Rosenbloom M.D. is a practicing physician and president of the Docs 4 Patient Care Oregon chapter. He is a guest writer for the Cascade Policy Institute, Oregon’s free market public policy research organization.

States Defend Citizen’s Right Not to Purchase Health Insurance (But Not Oregon)

Now that ObamaCare is the law of the land, it’s not surprising that attention is turning to the supreme law of the land, the U.S. Constitution, in an attempt to derail it in the courts. So far, it appears that seventeen states will join forces in a single suit against the federal government. Virginia is filing its own suit, based on the newly signed Virginia Health Care Freedom Act that protects its citizens from being forced to purchase health insurance or to participate in any health care system against their will.

The lawsuit’s main legal claim is that Congress does not have authority to require citizens to purchase a service they would not have purchased voluntarily, namely, health insurance.

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Individual Accounts Can Save Medicare

Eric FruitsCascade Commentary

Click here to read the full report in PDF format

Summary:Medicare is a “pay-as-you-go” system in which today’s workers are taxed to pay for today’s spending. Unfortunately, demographics and economic reality make this model unsustainable. A pay-your-own-way system of individual accounts will ensure that today’s workers receive high quality medical care when they become tomorrow’s retirees.

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Astoria Tea Party Hears from Cascade Policy Institute

Steve in Astoria
On Saturday, September 12, Cascade Policy Institute founder and Senior Policy Analyst Steve Buckstein [center photo] spoke to an enthusiastic crowd of about 80 people from the courthouse steps in Astoria. The event was one of hundreds of such “9-12” events around the country, including a massive rally in Washington, D.C.

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Health Care Overhaul: Congress Can Learn From the Costly Mistakes of the States

Eric FruitsQuickPoint!

While many members of Congress have been heading to their home districts to face town halls filled with concerned citizens, some Americans’ thoughts have drifted overseas. As we find ways to overhaul the U.S. health care system, pundits have pointed to other countries’ experiences with government-run health care. Some say that Canada has the solution. Others look to the United Kingdom, France, Switzerland and even Cuba as a model for a U.S. overhaul. Little attention, however, has been paid to the lessons from several U.S. states. During the Congressional recess, I have crossed the country talking about the Oregon Health Plan while learning about the costly mistakes of other states’ experiences with government-run health care.

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