Tuesday, December 16, 2014

Obamacare Schadenfreude Not Dead Yet

Despite reports to the contrary, Obamacare Schadenfreude is still alive and kicking:

Obamacare Blamed for Killing Hospitals
Eighteen acute-care hospitals across the United States shut their doors in 2013.

At least 12 more hospitals have closed this year in rural areas alone. More are getting out the plywood to nail over windows and barricades for doors.

Don’t worry, it’s just the new normal under Obamacare, says Lee Hieb, M.D.

“Events happening now give us some idea of what medicine will be reduced to in the future,” Hieb writes in her forthcoming book, “Surviving the Medical Meltdown: Your Guide to Living Through the Disaster of Obamacare.”

“Today, all over America, small and midsize hospitals as well as hospitals in inner-city, poor areas are closing,” she said.

Hieb is an orthopedic surgeon and past president of the Association of American Physicians and Surgeons.

She said the reasons for the closures aren’t complicated. Most of the victims are smaller hospitals or those in poor areas, which often serve the greatest number of Medicare and Medicaid patients.
A report at Modern Health Care just a few weeks ago confirmed that among just the critical-access hospitals, which have 25 beds or fewer, there were 14 closures in 10 states in 2013.

And the federal bureaucracies that set reimbursement rates for needy patients simply aren’t keeping up with the costs, she said.
That's one way to cut medical spending, cut the amount doctors are paid for theirs services, and let them stop treating folks. I would say something about unexpected consequences, bu they were fully expected by those who understood.

Health Law Hurts Some Free Clinics
Some free health clinics serving the uninsured are shutting their doors because of funding shortfalls and low demand they attribute to the Affordable Care Act’s insurance expansion.Nearly a dozen clinics that have closed in the past two years cited the federal health law as a major reason.

The closings have occurred largely in 28 states and Washington, D.C., which all expanded Medicaid, the federal-state insurance program for low-income people, and are being heralded by some clinic officials as a sign the health law is reducing the number of uninsured.
. . .
“As soon as there was the perception of universal health care, the likelihood of receiving donations goes down,” said Colin McRae, a lawyer who served on the board. “You fight a battle of perception.”
As often happens, government largess is becoming a replacement for personal charity, and not all people prefer it that way:
Ella Relford, 60, a former patient, said it took her three weeks to find a new doctor. She had used the clinic for years for regular exams and blood-pressure medication before she obtained Medicaid in the spring. “If I could have stayed with the clinic, I would have,” she said.
If the Supreme Court Breaks Obamacare, Will Republicans Fix It?
Republicans want the Supreme Court to blow a major hole in Obamacare next year, but they are still debating whether they would help repair it—and what they should ask for in return.

There's a very real chance the high court will invalidate Obamacare's insurance subsidies in most of the country, which would be devastating for the health care law. It would become almost entirely unworkable in most states, and the cost of coverage would skyrocket.
. . .
That would leave Republicans with a difficult choice: Do they continue to push for an all-out repeal of the law—creating a standoff with Democrats who will dig in in the hopes of legislation undoing the Supreme Court's decision—or do they seek a deal that alleviates the law's burden on those who've lost their subsidies? Such a deal would likely include pullbacks of major parts of the law, but it would also require Republicans to give up on a full "root-and-branch" repeal.
I suspect full on repeal is politically impossible, but a major free market revision should be attempted. Then, if Obama won't sign it, let it's death be at his hand.

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