The year was 1989, and the law was the MedicareCatastrophic Coverage Act, which was supposed to protect older Americans from bankruptcy due to medical bills. Instead it became a catastrophe for Democratic and Republican lawmakers, who learned the hard way that many older Americans did not want to be helped in that particular way.
Seventeen months after President Ronald Reagan signed the measure with Rose Garden fanfare, a series of miscalculations and missteps in passing the law became painfully evident, and it was unceremoniously stricken from the books by lawmakers who could not see its demise come quickly enough.
The tortured history of the catastrophic-care law is a cautionary tale in the context of the struggle over the new health law, the Affordable Care Act. It illustrates the political and policy hazards of presenting sweeping health system changes to consumers who might not be prepared for them. And it provides a rare example of lawmakers who were willing to jettison a big piece of social policy legislation when the political risks became too grave.
As Americans have begun shopping for health plans on the insurance exchanges, they are discovering that insurers are restricting their choice of doctors and hospitals in order to keep costs low, and that many of the plans exclude top-rated hospitals.
As you’ll see in the video below, he breezes right past that 80%, presenting the assumption that the vast majority of Americans are simply unaffected by Obamacare and goes on to talk about the tiny sliver of people who might be experiencing problems. (That must be a real treat for the literally millions of people who fall into some of those other categories, but that’s a story for another day.) This is a constant theme being pushed by Obamacare supporters in the media these days, and the reason I wanted to highlight it is that it’s complete garbage. For some admittedly anecdotal testimony on this, I present two examples I’ve run into personally.
Obamacare is intensifying the doctor shortage--though not in ways that were anticipated.
US hospitals are exploring ways to buy “Obamacare” insurance plans for their sickest and poorest patients as they strain under the weight of tens of billions of dollars in uncompensated costs from the uninsured.
Probably the last thing on the minds of office-based physicians is whether they are running afoul of antitrust regulations.
However, according to Dr. Edward J. Diamond, a pulmonary specialist, a faculty member of the American College of Chest Physicians, and president of Suburban Lung Associates – a large network of pulmonary care offices near Chicago – physicians can add that to their list of concerns about the Affordable Care Act.
Important last words--for now--from economist Arnold Kling:
Start by asking why it is that Healthcare.gov is not as good as Amazon.com or Kayak.com. One answer is that the government is not good enough at deploying information technology. However, I think that is only a shallow answer.
The deeper answer is that when we look at Kayak and Amazon, we are seeing the survivors that emerged from an intense tournament. In this tournament, thousands of competing firms fell by the wayside. Competitors tried many different business models, web site designs, business cultures, and so on.
Healthcare.gov did not emerge from this sort of competition. It came about because Congress passed a law.