Monday, June 30, 2014

Obamacare Schadenfreude - Working Hard for the Money

A few days worth of accumulated Obamacare Schadenfreude, which despite the storm of VA and IRS scandal, keeps putting out bad news:

Did ObamaCare screw up the GDP report?
Yesterday’s (June 25th, ed.) cliff dive of an economic-growth report from the BEA had a lot of people scratching their heads over the last 24 hours. How exactly did the BEA start with an advance estimate of 0.1% annualized GDP growth in Q1 to a final estimate of -2.9%, a full three points of difference? The Wall Street Journal’s Eric Morath and Louise Radnofsky explain that the BEA bought into the Obama administration model of ObamaCare, and just assumed that the enrollment figures for Medicaid and private insurance on the exchanges meant that a deluge of spending would follow. Instead, the actual numbers turned out to be significantly more sour:
Spending on health-care services declined at a 1.4% annualized pace in the first quarter, compared to an earlier estimate of a 9.1% increase. That revision contributed to a revision of gross domestic product to a 2.9% annualized decline from an earlier estimate of a 1% decline.
The revision in the health-care category was the largest in recent memory, said Nicole Mayerhauser, an official that oversees GDP statistics at the Commerce Department’sBureau of Economic Analysis. …
For the first two estimates of any quarter’s GDP, the Commerce Department doesn’t have direct figures on health-care output. Instead it uses wage and employment data to make estimates. Sometimes government economists consider other measures to augment their approximations.
Initially, they considered Medicaid benefit figures and the number of Americans enrolling in coverage made available under the new health-care law. That data showed an increase in Medicaid outlays and that millions of Americans were signing up for healthcare insurance, leading the Commerce Department to forecast an increase for health outlays.
In the initial reading of first-quarter GDP, released in April, the Commerce Department noted this methodology. With more reliable data now available from a Census survey, those early assumptions have essentially been replaced with more reliable figures.
Ms. Mayerhauser said the Commerce Department doesn’t plan to regularly incorporate data related to the Affordable Care Act into its standard methodologies.
In essence, then, the administration’s assumptions about ObamaCare promoting usage turned out to be incorrect, at least in the short term. Daily Beast analyst Daniel Gross warns that ObamaCare seems to be disturbing health care deliveries, if not the rest of the economy . . .
And the "Death Spiral" takes another whirl. Obamacare's Prognosis Grows Dimmer
A nightmare for Affordable Care Act supporters has been the possibility that only the sick would be left to purchase insurance through its exchanges, driving premiums up and insurers out. While the law’s boosters have been quick to dismiss the possibility that such a so-called death spiral could occur, data published in the Wall Street Journal suggest that this chain of events may not be so far-fetched after all.

The findings are significant not just for what they say about how Obamacare is working now, but also for their impact on the political debate over its future.

At its base, the data show that people insured through the law’s exchanges have higher rates of serious medical conditions. Of the enrollees who have seen a doctor or other health-care provider in the first quarter of this year, 27 percent have significant medical problems, including diabetes, cancer, heart trouble and psychiatric conditions. That rate is substantially higher than that for patients in nonexchange market plans over the same period. And it’s more than double the rate of those who were able to hold onto their existing individual market insurance plans after President Barack Obama was forced to allow them to keep them.
Ya think? Kathleen Sebelius: I 'made some mistakes'
Former Health and Human Services Secretary Kathleen Sebelius acknowledged Friday that she made mistakes leading up to the rollout of the Affordable Care Act, worrying too much about whether there’d be a market for Obamacare and spending “too little time clearly on the technology side.”

“I sure made some mistakes along the way in terms of focusing on some things and not on others,” she said at the Aspen Ideas Festival. Instead of confirming what she was being told about’s readiness “was actually accurate and getting enough eyes and ears on that,” she said she concentrated on the insurers, consumers and regulators who needed to come together in the health exchanges.
You believed the bureaucrats would tell the truth?

Confusion over doctor lists is costly for Obamacare enrollees in California
Limiting the number of medical providers was part of an effort by insurers to hold down premiums. But confusion over the new plans has led to unforeseen medical bills for some patients and prompted a state investigation.

More complaints are surfacing as patients start to use their new coverage bought through Covered California, the state's health insurance exchange.
. . .
Insurers insist that pruning the network of doctors is a crucial cost-cutting measure and a major reason that so many Californians could find affordable coverage in the health law's first year.

"These narrow networks are making a huge difference in terms of affordability," said Mark Morgan, president of Anthem Blue Cross, a unit of industry giant WellPoint Inc. "We found in convincing numbers that people value price above all else."
Giving people skin in the game was part of the point of health care reform, but when done too suddenly, it ends injuring their skin.

And of course, there's another side; make life harder for doctors, and you get less doctors:

Supply won't meet growing demand for primary care
The U.S. is expected to need 52,000 more primary care physicians by 2025, according to a study by the Robert Graham Center, which does family medicine policy research. But funding for teaching hospitals that could train thousands more of these doctors expires in late 2015.

Population growth will drive most of the need for family care doctors, accounting for 33,000 additional physicians, the study says. The aging population will require about 10,000 more. The Affordable Care Act is expected to increase the number of family doctors needed by more than 8,000, the study says.

Farzan Bharucha, a health care strategist with consulting firm Kurt Salmon, says the ACA should have focused more on the primary care shortage "because we already knew there was a problem -- and we knew implementation of ACA would potentially make it worse."
But the democrats are resentful of the money doctors make, unlike, say Hillary Clinton, who works hard for her money:

Wombat-socho has the great "Rule 5 Tuesday – Belated Independence Day Weekend Edition" up at The Other McCain.

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