Is Obamacare now just a program for the poor? So it turns out that “The Shocking Truth about Obamacare’s Rate Shock” wasn’t that there was no rate shock, as Ezra Klein told us–but that insurers were achieving their low Obamacare rates by sharply narrowing the available choice of doctors and hospitals. I saw this story in Philip Klein’s column first, followed by the L.A. Times and, finally on Monday by Robert Pear of the New York Times. …
If only the Washington Post had a section of young, dedicated policy experts–they could call it, say,”Wonkblog”–who
weren’t in the tank rigorously analyzed Obamacare’s possible failings. Then maybe WaPo wouldn’t be embarrassed by all these unwonky competitors getting the big story first. …
P.S.: From the section of Pear’s piece on Obamacare in California:
Mr. Davila said the new network did not include the five medical centers of the University of California or the Cedars-Sinai Medical Center near Beverly Hills.
“We expect to have the broadest and deepest network of any plan in California,” Mr. Davila said. “But not many folks who are uninsured or near the poverty line live in wealthy communities like Beverly Hills.”
a) When did Obamacare become a program only for people who were uninsured or near the poverty line? Call me naive, but I expected it to be a program a bit like Medicare, where Americans of various income levels (and preexisting conditions) could go to find good health care. I even planned to sign up myself, from my home in Beverly Hills, and save some money to boot. Is that universalistic/communitarian part of the Democratic national health care ideal just dead now?
b) Have Democrats thought through the Hirschmanian implications of health plans that don’t have a health group of middle and upper class recipients who will kick up a fuss if docs start screwing up? ‘Programs for the poor make poor programs,’ and all that. See also “Killer King“;
c) According to Pear’s piece, insurers on the new “exchanges” are still trying to game the system to avoid having to sign up sick people, the very behavior Obamacare was supposed to suppress;
d) It may be true, as Mr. Davila says, that “not many folks who are uninsured or near the poverty line live in wealthy communities like Beverly Hills.” But plenty of poor people live within an easy drive (or walk) of Beverly Hills, and UCLA, and Cedars-Sinai–and it would be very convenient for them to get care there if they could afford it–i.e. if Obamacare made it possible. Davila’s remark is somewhat offensively off-point. …