Excellent points. I think the middle class is really getting squeezed and the poor are also getting the shaft if they are being given substandard medical through medicaid. What concerns me is will physicians continue to practice if they are forced to accept patients who are not going to reimburse them as well as those with “good insurance”. I have some friends who lived in England and they said there were two levels of insurance. You used the government for some things and your own if you needed treatment that would not wait. These folks were millionaires and could afford to pay for their own and are now here and not worried about Obamacare because they know they can go anywhere to get what they need. Unfortunately, we all do not have that option.
I hope things get worked out before more people drop or are dropped from their insurance because they cannot pay for it and more people start going to the ER. Last time I had to go there, there was a really long wait and yes, it did look like the cafe scene in Star Wars. I think we all want high quality and affordable medical care, but I am not sure that this bill provided that. And yes, Heritage is biased, but it is hard to find any media that do not have either a left or right leaning bias to quote.[/quote]
I think the fallacy that you’ve kind of alluded to (based on this and prior comments) is that somehow the reform law is responsible for the middle class getting squeezed, or the poor getting the shaft in the quality of care. More people, including more of the middle class and poor will be covered, and more will be covered by higher quality insurance than prior to the new law. (At least once it fully takes effect in 2014.) It is possible that some may lose coverage (or more likely, have to pay for 100% of the cost of their insurance) as a result of the ACA, though many fewer than opponents of the bill claim. And tens of millions fewer than those newly insured solely as a result of the bill.
The law, as enacted will be a huge windfall for the insurance industry. The mandate will more than make up for additional burdens placed on insurance companies. (Without the mandate, probably not so much.) And if the mandate remains, it should not increase the cost of medical insurance. (Please don’t read this as my support for the mandate. I think it was bad law, policywise. But in the context of the full law, it was a necessity. As a whole, the law does not work without it.)
But there is nothing that will require physicians to accept medicaid patients nor medicare patients. Medicaid is a problem. Particularly for hospitals. Medicare, currently not so much. Over 85% of primary care physicians accept medicare reimbursements. Pending changes will make that more problematic (particularly in cities like San Diego, which is reimbursed at rural rates, rather than the higher rates in Los Angeles). Those problems may, in part, be mitigated by shared savings programs designed into the law, but the results of those programs are mostly untested and unknown.
Overall, I think most of your arguments are ill timed. Doing nothing would not have cured any of those problems. They should have been made when the bill was being negotiated. Many in both houses of congress, and the white house wanted a stronger bill. Instead, they negotiated with an opposition that would not support any bill presented, regardless of the content. A humungously flawed tactic which resulted in a humungously flawed bill. Substantially better than nothing. But still flawed.
