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home : features : features April 28, 2016


9/17/2013 6:00:00 AM
Column: Why Obamacare cannot succeed
Alieta Eck, MD
National Columnist

Question: If a $600/month insurance policy only costs the individual $33, what does it REALLY cost?

Answer: $600, with $567 less in purchasing power for the hard-working taxpayer who is subsidizing it.

Smoke and mirrors make for bad policy. When we buy any type of insurance, we weigh the benefits of the policy against the loss of the money we must put out to purchase the policy. When we ask the taxpayers to subsidize our policy, all such reasoning disappears.

Most of us have limited funds, so we must choose carefully. Wise people insure against major loss, such as our house burning down. Most of us believe that paying $1,000 per year is reasonable, as the cost to rebuild a house is hundreds of thousands of dollars. Insurance gives us peace of mind, even though the chance of our house burning down is statistically very low.

For many reasons, we have allowed health insurance to defy all the principles of insurance. There is something emotional about health insurance. Maybe it is because we fear death and want to be sure it does not happen to us any time soon. Maybe it is watching others suffer from illness and want insurance to assure that they get well, do not suffer, and have all their bills paid.

We have actually been duped into thinking that someone else ought to pay for all the health care we need. Politicians gain support and votes when they assure the masses that they care about their health. And insurance companies are more than happy to offer generous policies since commissions and CEO compensation are a percentage of the premiums.

Never mind the premiums approach the price of a home mortgage - we want the best, especially if we can convince others or the government to pay for it.  The problem lies with the fact that with health insurance we are covering something where no actuary can assess the real risk. New medical breakthroughs are constantly being added to items that are covered, and insurance companies are happy to comply as long as they can jack up the premiums.

Insurance, by its very nature, invites overuse, especially if the deductible is low. There is a sense that we can "get our money's worth" if we access more services. 

But there comes a tipping point, when employers and citizens just say "no." Premiums cannot rise further. The health insurers figure out ways to minimize their losses, so they tie the patient or physician up in bureaucratic knots, pre-authorization paperwork and hour-long phone calls that wind up causing everyone to throw up their hands in frustration and despair.

One example is getting pre-authorization for an MRI. Several phone calls establish the date of the injury, the attempts at medical or physical therapy treatments, the time elapsed, the symptoms and physical findings. If the physician's office can make the case, the insurance company approves and the patient is happy. But the costs incurred by the physician and the insurance company serve to ultimately increase the cost of the monthly premium.

When all is said and done, it would have been far less costly for the physician to explain to the patient the value of the MRI, what we can hope to learn, and let him decide to use his own funds or medical savings account to pay for it.

So why will ObamaCare fail? By promising to cover everything, the premiums will be unaffordable - whether paid by the patient, his employer or the taxpayer subsidies. People will quickly learn that earning more at work will cause the subsidies to disappear, and thus incentives to advance in their jobs and careers will be stifled. Employers will learn that they can avoid paying for insurance or paying fines if they keep their employees at part-time. Lower yearly income will require more taxpayer subsidies. Fewer people working and higher taxes spell economic disaster.

ObamaCare is a $1.7 trillion experiment in the ultimate Big Government program. It is sheer hubris to expect it to save money or increase access to care, and many will be hurt in the process of showing that it can't.



Alieta Eck, MD, has been in private practice with her husband, Dr. John Eck, MD in Piscataway, N.J., since 1988. Visit http://www.aapsonline.org/ for more information.


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Reader Comments

Posted: Saturday, October 5, 2013
Article comment by: me me

I want to know that if i go to the doctor on my subsidy insurance, Will I truly get the same treatment and care- as if i was paying with my own money? Will doctors think of you as a " charity case". and give you 2nd class care?

Posted: Wednesday, September 18, 2013
Article comment by: Health Crisis

How do we fix the millions of uninsured?

Linda has the answer: "Just tweak insurance"

Tweak ??

Are you suggesting that the government lay its heavy hand upon a commercial, privately held business, to demand they "tweak" the premiums so that the insurance company takes a LOSS on those who file too many claims??

What?!

I always thought you were a "FREEDOM" kind of person??



Posted: Wednesday, September 18, 2013
Article comment by: Linda Athens

BM: What WOULD you do if you couldn't call people names?

And "it won't fail any more than Social Security failed?" Great reason right there to not fund it.

Perhaps you could explain all the "opt outs" allowed and why.

If it goes through, we will see the a tsunami hit, stifling paperwork, people not applying, noone knows how to implement it, noone is ready for it, most won't sign up, people's information will be stolen.

Are you simply unable to recognize a communist takeover when you see one?

Attacking women is your MO, however Dr. McCaughey is a fighter, not a whiner.

Incidentally, Mr. Kerry supporter, it's an impeachable offense providing terrorists with weapons. So obama is simply ignoring that in Syria. I suppose you agree with him. Let's give Al Qaeda anything they want...after all...we owe them for both Trade tower bombings, right?


Posted: Wednesday, September 18, 2013
Article comment by: mr. parker

Doctor, thank you for your informative comment. You're someone who has been in the front lines of medicine and realizes the frustrations of dealing with the government.

As someone noted above, Social Security and Medicare are still with us, well for a while. Even the trustees of SS and Medicare are warning about solvency. http://www.ssa.gov/OACT/TRSUM/index.html

The unknown factor in this scheme is people who are here illegally. Immigration reform advocates are saying that they won't be eligible for benefits but as they do now, they're using emergency rooms for primary care. They don't pay a thing. That raises costs for all of us, especially us saps who pay out of pocket or deductibles.

The US should bill Mexico for their citizens health care. Along with school and prison expenses.

The way the Demonrats and their allies are running away from this monstrosity should speak volumes.
Maybe we should let King Barack launch a few cruise missiles into Syria in return for his agreeing to repeal this horrible bill.
175w/c


Posted: Wednesday, September 18, 2013
Article comment by: Linda Athens

Kman:
We don't need the Congress to work together, we need every Republican to stand up and fight against the left destroying our country. Why would you want to work with a party that is hell bent on destroying the last best hope for the world? I hope they get a backbone soon and don't fund obamacare before it's too late. We sent them there to fight against socialists and obama - they aren't doing a very good job of it.

Socialized medicine has worked NOWHERE on earth, it was how Hitler took over.



Posted: Wednesday, September 18, 2013
Article comment by: Dave In Golden Valley

Kelly Ward must have xeroxed this article. Linda, if you don't believe in socialized health care, give up your Medicare, now. Live your principles. Funny how Obamacare, was Mitt Romneycare before, and the "personal responsibility" rhetoric is still being used by right wing think tanks, but it is no good anymore in Romneycare, gone national.

Posted: Wednesday, September 18, 2013
Article comment by: Frank Lee Speaking

@ansons nephew

"Hey guys – how about working on JOBS, JOBS, JOBS like you promised?"

No need, in this BOOMING obama recovery.
(extreme sarcasm, off)

LOL



Posted: Wednesday, September 18, 2013
Article comment by: Anson's Nephew

Ms Athens

“… Dr. Betsy McCaughey's articles … She has read the entire disaster of a bill when noone else has…”

Again, who is this “noone” guy you keep referring to? And BTW, I have told you multiple times that I have read the entire bill. As to Betsy Wetsy she has been proven as a liar many, many times in her incorrect assessments of the ACA, so anything she says cannot be trusted. She is a shill for the insurance industry – nothing more.

“… experts say, it will cost everyday Americans $6000 out of pocket once Obamacare goes into effect.”

What “experts”? The right wing loon idiot fringe shouting heads? We are seeing almost daily that the anticipated costs are going down rather than up. Why do you keep posting all of this outdated nonsense?

And I still question why – since you seem to be thriving on government health care – you want to deny the same kind of health care access to every American? Those of us on Medicare should really keep our mouths shut about the ACA.


Posted: Tuesday, September 17, 2013
Article comment by: Kman InKingman

There are several countries that provide universal healthcare to citizens and it seems to work. The Affordable Care Act might not be the answer right off the bat but perhaps it is a starting point. The real problem seems to be that we can't get all of our congressional representatives and the President to work together and make revisions/adjustments. Everything is a tug of war.

Posted: Tuesday, September 17, 2013
Article comment by: Anson's Nephew

Another whining "doctor" with no actual facts.

What the Republiscums should do is just let the program go into effect and when it fails they can go, "We told you so!" But they know it is not going to fail anymore than Social Security has failed or Medicare has failed. And as we see more and more people actually benefiting from the ACA it is scaring the Republiscums to death because they know people like it and will like it even more as it comes into full effect.

41 votes to repeal it! What a bunch of maroons!

Hey guys – how about working on JOBS, JOBS, JOBS like you promised?


Posted: Tuesday, September 17, 2013
Article comment by: Linda Athens

Here's one Dennis. Just tweak insurance for the ones who don't have it and need it (was estimated at no more than 15 million in a country of 300 million) and leave everyone else alone.

You need to read many of Dr. Betsy McCaughey's articles on it. She has read the entire disaster of a bill when noone else has, knows what a nightmare and America destroyer this bill is. Search engine her name and start reading.

Consider this. You cannot find a poll where the majority of Americans want Obamacare. They do not including Democrats in Congress and everyday citizens. The middle class and elderly will be hit the hardest. The middle class in 20 new taxes or hikes, the elderly in 700 Billion taken out of medicare, more services denied. Already happening.

Obama doesn't care about citizens, this is all about power and a government takeover. Wake up people.

And how is it fair that the unions and others have been allowed to opt out?

I addressed aspects of it in a blog which has not appeared yet I guess but experts say, it will cost everyday Americans $6000 out of pocket once Obamacare goes into effect.
199 WC


Posted: Tuesday, September 17, 2013
Article comment by: Dennis Jablonski

Well, its no secret what is wrong with health care in America: It costs too much. If not Obamacare, then what? Give us a reasonable alternative, now!



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