My support for ObamaCare is not ideological, it's practical. "This is not personal; it's business." And, healthcare reform clearly is an urgent priority.
We all agree that the United States spends the largest share of the largest economy in the world on healthcare ... even more than other members of the Organization of Economic Cooperation and Development, a group of developed industrialized nations of which U.S. is a member. More than 10% of American citizens and permanent residents are uninsured.
(Above graphs compare U.S. healthcare spending versus the complete Organization for Economic Cooperation and Development ... of which the U.S. is a member)
Uncompensated Care: Health care for the uninsured and under-insured.
Currently, we pay for the health care of the non-insured and under-insured in our own higher health insurance premiums due to charity care at hospital emergency rooms and lost economic productivity.
The 2008 Kaiser Family Foundation (www.kff.org) study "Covering the Uninsured: Key Facts" estimates spending on the uninsured was $57.4-billion -- of which $42.9-billion (or 75%) was paid by federal and state funds, mainly through Medicaid payments to hospitals, and that $14.5-billion (or 25%) was paid by private funds, mainly physicians and hospitals, and that this $14.5-billion represented nearly 2% of the $829.9-billion spent by insurance plans.
McKinsey & Company, a major consulting firm as published several research articles on the health care trends and technologies -- here now and emergent -- that support the premises of the Affordable Care Act on continual, significant cost savings through productivity and outcome savings.
Industry association America's Health Insurance Plans (AHIP) reports that "A 2009 study by Families USA (a health care consumer group) found that uncompensated care costs in 2008 imposed a "hidden tax" on family health coverage of $1,017 (per family)."
The 2009 study goes on to say: "As more people join the ranks of the uninsured, the hidden health tax is growing,' said Ron Pollack, Executive Director of Families USA. “That tax hits America’s businesses and insured families hard in the pocketbook, and they therefore have a clear financial stake in expanding health coverage as part of health reform.”
Together, the point might be made that we already pay for uncompensated care -- health care for the uninsured -- through higher taxes and insurance premiums. Also, the current spending on health care for the uninsured is not cost-effective (inefficient) because it's so heavily weighted on hospital use for primary care and late-stage care for undetected & untreated care.
ObamaCare is not a government take-over of our health care system.
The Affordable Care Act actually is a boon to private insurance companies -- in terms of the numbers of paying insureds and in terms of more efficient application of the basic premise of insurance: Based on the statistical Law of Large Numbers, many people pay premiums so that those among them who happen to need expensive treatment will be able to afford it.
The Basic Premise of Insurance in Health Insurance.
During the Great Depression of the 1930's, physicians and hospitals suffered, as did American families, because most people could not afford to pay out-of-pocket for sick care treatments ... because of the depression. So, Blue Cross and Blue Shield were born: Originally, one for physician insurance and the other for hospital insurance.
However, a comprehensive insurance system like the Affordable Care Act has to work fully in order to work efficiently ... as soon as possible.
I question why the Obama Administration continually issues waivers and delays implementation of the Affordable Care Act. And this is the central issue of this post.
Comparison of Implementation Time for ObamaCare vs. Y2K
Compare the ObamaCare situation to the challenge presented by Y2K -- just 15 years ago. every company had to change the dates part of every software from a 2-digit year to a 4-digit year by the year 2000 because, during the 1960's and 1970's, in order to be minimize development costs, software was programmed to accept the last 2 digits of the year and start again at 1900 ("00") after 1999 ("99"). Government feared nuclear launch glitches and companies feared erasing of all their records since 1900!!
Updating for Y2K became a high-profile only 2 years prior to the big day!! The big software investments and rush to prepare for Y2K began in earnest in 1998.
Changing the software for nearly every computer in America (perhaps the world) was achieved in just 2 years!!!!!!!!!!!!!
Health insurers and employers have had 3-4 years to prepare software and decisions for implementation the Affordable Care Act ... Obamacare ... yet all businesses, worldwide, had 2 years to prepare software for Y2K. Even the governments, like our Defense Department, raised the Y2K issue in 1998 and their 1999 budget requests.
The Y2K "bug" was a huge issue and challenge!! It dominated the news from 1998-2000. Jobs and spending to repair-prepare legacy systems directly boosted the economy. For example, even supermarkets, like Whole Foods, spent a fortune on it.
Think about it. Personal health records and physician-hospital-insurer-employer electronic medical records (EMS software) have been around ... and booming businesses for several years!!!
Healthcare providers have been living with the federal mandate to implement electronic medical records.
Since 2011, the federal government also has imposed penalties as of 2014 but also immediately offered financial incentives ... up to $44,000 for a family medical practice ... to help the millions of physician practices afford to implement "significant use" of electronic medical records EMR.
So what's the real problem?
My opinion
Rescind all of the waivers. The Affordable Care Act ... Obamacare ... should continue to implement as enacted.
by Steve Reichenstein
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