Obamacare

Health care reform means different things to different people. Most people worry about a major illness such as cancer wiping out their savings. Others worry about rising medical and insurance costs. President Obama has listed this as a major concern since unrestrained costs will ruin Medicare and Medicaid in the foreseeable future. In addition to this, many people are fairly happy with their current coverage and don't want it to change in the name of reform. Obama has promised that no one will be forced to change their coverage.

So how does the proposed Obamacare stack up against expectations? Poorly.

The issue of illness wiping out savings is not addressed at all.

Rising costs are addressed indirectly through the public option. This will be an insurance plan offered directly by the government, "to keep the insurance companies honest". It will work like Medicare in which a government bureaucrat decides how much the government is will to pay for procedures and the provider is obligated to accept this as payment in full, regardless of actual costs. This will potentially keep costs down by underpaying for services.

What about Obama's promise that people will not be forced to change their coverage? There are three likely cases where this is untrue. The first is someone who is young and healthy and has only signed up for catastrophic coverage. These people will be fined and assigned to an approved insurance plan by the IRS. The other two cases involve the public option. Many employers will switch coverage to the public option. Germany allows this choice and 90% of Germans are covered by the public option. It will be cheaper because the government doesn't have to pay actual costs. The third case is people with really good coverage. Obamacare is going to be expensive and Congress is looking at taxing benefits over a certain amount as a revenue source.

So Obamacare does not cover the two topics that most people want fixed when they talk about health care reform. What does it do? It has two goals. One is to slowly switch the country over to the public option. The other is to increase the number of people who have insurance. It will make it illegal to be uninsured. The ideal is to cover everyone but newest estimates say that it will not.

Because this "reform" does nothing about rising costs, the bill for Obamacare is impressive - somewhere between $600 billion and $1.5 trillion over the next decade. There is talk about trying to pay for it through higher taxes. Right now this is limited to the "rich" but they don't have enough money to pay for all of Obama's wish list. Regular people are going to end up footing part of the bill.

One interesting provision - seniors will be required to have a counseling session about death with dignity every five years. This could easily turn into a push for euthanasia.

Another interesting point - there was an amendment that would force Senators and their staffers to take the public option rather than the coverage that they now enjoy. This was voted down by the Democrats. The public option may be good enough for most of the country but not for the Senators.


Note:
At this point there is no Obamacare. There are multiple bills going through Congress which President Obama endorsed. Given the schedule that the White House is pushing - passage by early August, it is likely that the final bill will be voted on before anyone in Congress has a chance to read it. That's how this administration likes to work - give an arbitrary deadline to vote on a massive bill before anyone can possibly understand the contents and implications, to say nothing of objecting to specifics.

Since Obamacare does not exist yet, I am referring to the bills that the President is supporting as if they were in the final version.