Obamacare has to go

Dorian Davis Adjunct Journalism Professor, Marymount Manhattan College
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T-mobile gets better reception than Obamacare. Support for the law cratered to just 43 percent — an all-time low — in last month’s Washington Post poll. And since two more provisions took effect on January 1, repeal ought to be Republicans’ top priority — come Hell or high water.

Meant to cover 32 million uninsured, Democrats’ trillion-dollar boondoggle at least sprang from good intentions. But most of the assumptions on which it was based have turned out to be wrong. The Health and Human Services Department admitted last November to overestimating the demand for pre-existing condition coverage, fielding 98 percent fewer applicants than expected since the program’s inception. It’s also been forced to hand out waivers to over 200 companies representing more than a million people to keep them from dropping employee healthcare plans altogether instead of complying with Obamacare mandates. And that’s just the tip of the iceberg. This law’s had more unintended consequences than a sleepover at Kobe Bryant’s.

It was supposed to help rein in health insurance premiums, for instance. But NY-based EmblemHealth raised rates 25 percent in September and blamed Obamacare for the increase. Anthem Blue Cross and Blue Shield of Connecticut hiked rates 47 percent on some policies a month later. And AARP upped rates 13 percent in November citing Obamacare as the culprit, even though it endorsed the plan in 2009. Stories meant to exonerate Obamacare just dig it in deeper. A Salon.com piece that tried to prove insurers blame Obamacare for their premium hikes to divert blame from themselves had to admit that Obamacare had resulted in big chunks of the premium hikes in each of the cases it mentioned.

It was supposed to help doctors too, introducing a new pool of insured patients. But the Association of American Medical Colleges found last October that the law’s Medicare reimbursement cap could result in a 50%-higher-than-expected doctor shortage over the next half-decade. That’s in part because the cost of running a private practice is expected to increase by 20 percent over that time while Medicare reimbursements are expected to drop by 25 percent. So to make a decent living, doctors will have to be good at both treating patients and greeting Wal-Mart shoppers. Last month, Democrats froze reimbursement cuts for 12 more months to keep doctors onboard. But 60 percent of private practice owners said in a recent poll that Obamacare could force them out of business.

And despite the $4.4 billion annual price tag of unneeded emergency room visits according to RAND Corp.’s September study, hospitals — the law’s other supposed beneficiaries — are greeting Obamacare with similar skepticism. Last spring, Nancy Pelosi wrote in Roll Call that healthcare reform would stop uninsured patients from turning “to the emergency room for medical care.” But two-thirds of hospital administrators polled told the Schumacher Group last month that ER traffic could increase under Obamacare as 16 million people enter Medicare over the next decade.

The two provisions that rolled out on New Year’s Day are, likewise, bound to backfire. The requirement that insurers spend 80 percent of revenues from premiums on healthcare, for instance, is so bad it should go straight to DVD. It caps internal spending — not the premiums themselves — and therefore exerts no real cost control over health insurance. In fact, it could force bigger hikes as overhead costs increase. The 50 percent senior discount on drugs, on the other hand, means savings at least for some. But the cost has to be made up somewhere else. Either drug companies spend less on innovation to lower the price of medicine or the public covers the cost of the “discount” through taxes.

Obamacare is a lot like Obama himself. It seems great beforehand but once it gets going it spends too much and disappoints everybody. Charles Krauthammer wrote in the Washington Post that Republicans should let Obamacare fail on its own merits. But the Congressional Budget Office estimates a possible $500 billion in savings if Congress repeals Obamacare now. Granted, Democrats control the Senate and White House. But 46 percent of Americans — including 24 percent of Democrats — support repealing Obamacare in the latest Gallup poll. And some Democrats up for reelection — Claire McCaskill, for instance — are backtracking on some of the law’s major provisions. After the Arizona shooting, the GOP bumped a repeal vote set for tomorrow in the House. Fine. But that can’t be an excuse for them to drop it altogether.

There has to be healthcare reform. But that can happen through tax breaks for people in need of expensive care and increased competition among health insurers. Putting the government in charge of it is like putting Courtney Love in charge of her sanity; it’s misplaced confidence. Obamacare has to go.

Dorian Davis is a former MTV HITS star turned Libertarian writer. He’s been published in Business Week, NY Daily News, XY & more. He’s an NYU graduate and National Journalism Center alum. He teaches journalism at Marymount Manhattan College.