DOMESTIC
FALL 2015
the Romney-Ryan campaign, “I did
not know whether to laugh or cry. It
takes some brass to attack a guy for
doing something you did”. President
Obama did what was right for seniors.
Many other theories like ‘death
panels’ and ‘insurance death spirals,’
and fear of ‘free riders’ were simply
not true. Sarah Palin talked of ‘death
panels,’ drawing from draft legislation, words that were never adopted by
the Affordable Care Act. It was a case
similar to what is currently happening
with the Iran nuclear deal: politicians
across the aisle criticized the law without even reading it. The main remaining argument is the one that will remain
unresolved: will Obamacare reduce
health care costs and bring down our
budget deficit? One policy maker commented that “costs will go up because
Obamacare is front loaded with revenue and back loaded with benefits;”
and that the CBO is making an error
trying to estimate revenues and costs
(the CBP has countered their prior
projections on Medicare and Medicaid
have been accurate). Most economists
believe that broadening the risk pool
by 20-25 million more insurers will
enable hospitals and insurance companies to keep costs under control and
yet provide higher quality care. Critical to cost control will be the freedom
with which federal and state exchanges will operate, and their ability to provide the free market competition that
is essential for bending down slope
of the cost curve. Other innovations
like electronic medical records, focus
on preventive screening, and limits
on corporate profitability would create an impact that may be difficult to
predict. However, the most important
driver of cost control – tort reform – is
completely missing from Obamacare.
It is therefore a matter of judgment if
cost savings from emergency care and
preventive screening would offset the
rising costs of defensive medicine.
So what has been the policy impact of Obamacare so far? As per con-
firmed estimates, there are 27 million
fewer uninsured people we have in
the country today; uninsured percentage has dropped from 18 to 11 percent
(CBO estimates the uninsured to plateau at about seven percent or 23 million people – made up of eight million
illegal immigrants, six million who
will pay penalties and oters). Eightyseven percent of the new insured population has availed of federal subsidies.
Seventy-three percent of insurers are
satisfied with the coverage they are
getting. In the past five years, the rate
of growth of insurance cost has reduced from 12 percent per annum to
less than five percent per annum; everyone realizes that cost needs to come
down much further. There is progress
but more needs to be done, especially in the area of fine tuning market
exchanges and passing tort reform.
The last question to ponder is that if
Obamacare has impacted us positively
so far in terms of coverage, quality and
cost, why is the majority of American
people either against it or indifferent?
The answer lies in the numbers and the
intent. Before comprehensive health
care was passed, 82 percent of Americans already had private health care
coverage and were reasonably happy
with it. Therefore, it is not practical to
expect that a large portion of American
public would embrace a government –
sponsored change that had some probability of adversely impacting their
current private plans. However, the
main target of Obamacare is the 47
million uninsured legal Americans.
Most developed countries do not have
citizens who have no access to health
care, as it is considered a basic human
right; the lack of proper health care
in America has long been considered
a travesty of justice. Therefore, if a
large percentage of under-privileged
Americans are now happy with newly-acquired health care coverage for
themselves and their families; therefore, no other macro approval percentages should matter. Justitia servierunt.
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