My guest commentaries have claimed for two years the Affordable Care Act is wrongheaded and would cause major dislocations. Although I stuck to facts with little personal opinion, some readers thought my comments political because they were so negative. Now those forecasts are happening.
There is no longer time for political posturing. Obamacare is such an unmitigated disaster on so many fronts that President Barack Obama must end his circus-barker blathering (sorry, but that’s how it sounds) and make presidential changes.
The first must be for the people most in danger. It is hard to imagine federally mandating expansive new coverages inevitably costing much more, leading to cancellation of policies for millions of individual policy owners with the intention of driving them into his exchanges even before they are proven to function and regardless of whether they are affordable to the insured.
That patients in the midst of life-or-death cancer treatments can be left dangling without coverage they’ve had since their illness began or robbed of physicians they have had for continuity of treatment so vital at this critical stage is beyond comprehension, regardless of the numbers. That doctors might be driven from the business by reduced payments from Medicare allowances and punishing new paperwork as millions are added to the insurance roles is absurd.
The president has been blatantly unrealistic in using artful wording to escape the undeniable commitment he made to Americans about keeping the coverage and doctors they had rather than finding a solution. Now, too late in the game for it to work, he seeks a solution basically driven by his need to head off an imminent Senate revolt by his own party. Just removing the Cadillac-level coverage the ACA required insurers to add to policies would have removed a major contributor to the cancellation of policies. Then he would have needed to talk insurers into restoring the renewals that would have been sent; not an easy sell but one his new proposal still requires.
On the subject of expanded benefits (children covered to 26; no lifetime limit to coverage; accepting those with pre-existing conditions and now mental illness treated like other ailments) without clarifying the significant additional costs these impose and their effects on a fragile economy, implies a lack of reality.
The opportunity to encourage all uninsured Americans to buy the exchange plans has been squandered, with immense financial implications, as these exchanges load up on high-risk individuals without the compensating spread of risk over a diverse group. Once again, the administration is silent about where the money will come from to level out these costs. Do they believe the private insurers will keep absorbing huge losses, that the $63 short-term penalty imposed on every employee’s plan will be enough?
Under the heading of misleading if not duplicitous, the new taxes spreading across the economy to pay for this program have not been explained in terms of how these will affect segments of the economy; e.g., how will the 3.8 percent Medicare tax on capital gains (including the sale of your high-priced house), dividends, interest, etc., on gross income exceeding $200,000/$250,000 affect businesses, including house sales?
These are huge issues. As they leak out, more like an opening floodgate now, the administration continues to function in denial. That the White House press secretary must squirm so uncomfortably at each press meeting is telling. The press no longer sits in quiet subservience but is confounded about the right questions to ask. Perhaps they fear asking the right question in error and further drawing attention to the Rube Goldberg nature of this monstrosity.
I never have been so outspoken as in this essay, but we are deeply into the time when the ACA must be called for what it is.
The federally required minimum benefit requirements must be withdrawn.
People who understand group behavior and participation in mass benefit programs have to be brought in and listened to.
Proven enrollment methods that bring everyone to the table must be employed.
The product must be shaped to be affordable to those who have to pay for it, while liberal demands for benefits we cannot afford must be rejected.
Except for the canceled policies, the insurance industry must stop kowtowing to the requirements of the administration, believing that will preserve its business.
The accumulative level of financial subsidies that are now needed have to be identified.
The methods for and implications of covering these losses must be shared with the public.
The causes of wait time for services, as experienced in Massachusetts, need examining.
The devastating effects on small businesses, now postponed to 2015, must be revisited.
We need real transparency and real information from our president that allows us to make decisions. Touring the country to shore up an enrollment disaster with little but rhetoric is fiddling while Rome burns.