AMA Morning rounds 5/20/13: An editorial in the Washington Post says the Affordable Care Act’s “most contentious days” may still be in front of it. The Post argues that while the law’s potential problems “shouldn’t be swept under the rug,” neither should “the law’s noble and useful goal: ensuring that as few Americans as possible go without health care.”
Blogfinger Medical Commentary by Paul Goldfinger, MD , FACC
This Washington Post editorial says that there “might be some bumps in the road ahead.” Are they serious? There will be cavernous sink holes in the road ahead. The ACA may have a “noble goal” in ensuring quality healthcare for everyone, but noble goals do not necessarily translate into reality.
As with the administration, the WP refuses to be honest and wave some warning flags about foreseeable problems in providing quality care to those new millions of patients who will get insurance by 2014. These issues include finding providers of care and then figuring out where to go for the best quality.
Recent polls show that 64% of young people (under age 40) believe that the cost of health insurance premiums will go up, although many of them are willing to pay those increases. Young people will help cover the costs of those who are older and sicker.
Let’s force young people, who have the least money, to buy a product they don’t want or need. And if they don’t buy this product, we will unleash the IRS on them and make them pay fines. And while we’re at it, let’s set in motion a process that will progressively eviscerate the employer-based health system. Add explosive costs and huge new government beurocracy. No wonder the ACA is controversial.
Joe: Starting in 2014, anyone who doesn’t sign up for health insurance will be fined (The Supreme Court called it a “tax”). This “individual mandate” is aimed at the young and the healthy. The policing of this policy will be done by the IRS. They are hiring 2000 new agents to collect these fines.
In 2014, the fines will be minimal (eg about $90) but each year they will get larger and will rise substantially. Insurance premiums for young adults age 18-29 will be a few thousand dollars per year unless they can latch onto their parents policies(up to age 26) for less.
Here is a link that you should find interesting:
http://www.washingtonpost.com/national/health-science/health-law-lets-young-people-stay-on-a-parents-plan-or-buy-their-own-insurance/2013/05/13/d85e6e18-b8b9-11e2-b94c-b684dda07add_story.html
Seems like that poll states young people believe premiums will rise, but provides no citation or evidence that they are willing to pay.
I think, and this is purely speculation and opinion; that they don’t think they have a choice. Do you just not have health insurance? For a while they were saying that you would get fined or go to jail if you dont pay your Obamacare share
Id be wiling to do a lot of things when the government has the threat of judicial action pointed my way
1) US has (by far) the highest corporate tax rate among the wealthy G9 countries — it’s 40%. In comparison, the average for all EU countries is 22.7%.
2) Corporations such as Apple or Pfizer are doing what they can to avoid paying any unecessary tax using legal, fully legitimate tax strategies blessed by independent auditors and by the IRS itself. They have done nothing wrong whatsoever. Not even a tad bit shady. Failure to avoid paying unnecessary tax would be a violation of their fiduciary responsibility to shareholders.
3) The fact that companies do not choose to repatriate their money earned overseas is entirely a function of the excessive rate of corporate tax that our government wants to charge. Similar to individuals, the higher you raise taxes, the less tax you get because folks change their behaviors to avoid exposing themselves to the high taxes. If the corporate tax rate was lowered to 20%, you would see 100’s of billions of dollars coming back into the US.
4) Compelling a U.S. citizen to pay additional tax to fund and particpate in a program (the ACA) they do not want or need seems wrong. Polls show that about 60% (according to Gallop) of Americans are satisfied with thier current healthcare situation. Seems like we are letting the tail wag the dog.
5) I remember seeing a sign back in the 1970’s that said “If you like the post office, you’ll love national healthcare.” Not an indictment of individuals who work in the Postal Service, I’m sure, but rather an indictment of the efficiency and cost effectiveness of government bureaucracy. The ACA looks like it will fullfill or exceed the expectations of this sign.
Any rise in personal taxes of the new ACA law might well be off set if Congress would address the provisions CONGRESS has put into law which do not tax the trillions of dollars of profit that US corporations generate. Yesterday’s hearings in DC are testament to whose Interests are being taken care of by our elected pofficials in Washington. The ACA is to protect many of the uninsured, the loopholes protect the very few. Complaining about one law deserves equal complaining about some others, don’t you think?
Joe: From the AMA Morning Report, May 20, 2013:
“Poll: Large number of young people believe ACA will raise premiums.
The Hill (5/17, Baker, 21K) “Healthwatch” blog reported that nearly two-thirds of people “younger than 40 expect their health insurance premiums to rise because of President Obama’s healthcare law, according to a new poll – but most are willing to pay.” According to the survey, “sixty-four percent said they believe their premiums will rise,” while “only 9 percent believed their premiums would fall; 17 percent thought costs would stay the same.”
Source on young people willing to pay those increases?
Most of my generation is still in that <26 threshold and are on their parents plans. When that ends, i dont think they would carry anything other then the cheapest major medical/catastrophic. Only because they are being forced to is why they are doing so. Most will probably buy in to their families plans as another adult payer if allowed.
This is going to be a mess
I think what bothers a lot of people is that they are being forced to support/participate in/help pay for the ACA system, when they are very happy with what they now have for coverage and insurance. Medicare is a voluntary program (you can choose to not join), the ACA is not (the IRS will come after you).
Agree with Paul that both quality of care and access to care will be decreasing as a result of the ACA. And once Congress honestly confronts how much of a budget buster this new program is, they will begin to agressively cut services, deny/delay care, and really sock it to the taxpayer — as is the case with all existing national health care schemes across the world.
I don’t quite understand what is dishonest about the WP editorial, which is largely comprised of a discussion about the many uncertainties attendant to implementing our country’s very belated effort to extend health care coverage to the uninsured.
It is passing strange to complain that the uninsured — particularly younger, healthier people — will now be placing demands on the health case system. Yes, caring for people who now have been frozen out of our medical system will cause problems. But that is why we have — and why massive resources have been devoted to building — a health care system, to care for people who need it.
As for the prior commenter’s request that the government “stay out” of her health care, I request that she pledge to stay out of any any all government benefit programs, including Medicare,
Few would argue that this program will be very expensive (for taxpayers) and dramatically grow the Federal Government. One example is that there is now an entirely new division created at the IRS to enforce this law (isn’t the IRS already too intrusive?). There are numerious taxes that are being added too, like a tax on real estate transactions and one on all medical devices sold. The biggest issue for US citizens, however, is that we will be paying far more for health care than now (that is, the ACA will accelerate premium increases according to both the Congressional Busdget Office and the health insurance industry) and that quality/access to care will be progressively worse.
This is a textbook “level the playing field” big government program that will benefit about 33% of the US population that now get substandard care at the expense of the 67% of Americans that are satisfied with the current system. As I do not run my life as a charity project for the 30%, I resent this and wish the government would stay out of my health care.