Monday, March 31, 2014

Laszewski and Goodman on the ACA (Obamacare)

Robert Laszewski ( and John Goodman ( each have interesting posts about Obamacare today.

Laszewski asks, "Was Obamacare Worth It? How Many of the Previously Uninsured Have Really Signed Up?" He writes

Are enough people getting coverage who didn't have it before to justify the sacrifices the people who were already covered––in the individual, small group, and large employer market––are making or will make?

He asserts it is easy enough to get the data on how many people have insurance now that didn't have insurance before the ACA. Just ask the insurance companies. It is a piece of data many proponents of ACA seem singularly uninterested in knowing.

John Goodman's, "Why Contraceptives Are Important," would be more appropriately titled, "The Politics of Medicine." Goodman observes in any one year 5 percent of the population spends 50% of the healthcare dollars and 10 percent spend 70%.

Now suppose you are a Minister of Health. Can you afford to spend half of all health care dollars on 5 percent of the voters? (Even if they survive to the next election, they are probably too sick to get to the polls and vote for you anyway!) Can you afford to spend virtually nothing on the vast majority of voters just because they happen to be healthy?
The answer is clearly “no.” The inevitable political pressure is to skimp on care for the sick in order to spend on benefits for the healthy. Put differently, the politics of medicine pushes decision makers to underprovide to the sick in order to overprovide to the healthy.
In Goodman's opinion, this is why we ended up with a law that mandates
free contraceptives but leave people exposed for thousands of dollars of out-of-pocket costs if they need bypass surgery? 
It is unfortunate the Democrats are so deeply committed to this law they refuse to admit its failure.

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