Thursday, December 12, 2013

Healthcare: Big Issues; Little Issues

Obamacare has two features that will make it wildly unpopular once implemented (if that day ever comes):  (i) sky-high deductibles; (ii) tight, low-cost doctor and hospital networks.  The media focus on the website and the premiums (and subsidies) misses the bigger issues.

The sky-high deductibles will mean that most lower and middle income Americans still won't be able to afford health care.  If your plan has a $ 10,000 deductible, that means you pay $ 10,000 before the plan really kicks in -- every year.  Once the plan kicks in, there are very few doctors and hospitals that are covered under the plan.  (In New Hampshire, for example, only ten of the state's 19 hospitals are covered by Obamacare providers).  And, who are these doctors and where are these hospitals?

The doctors covered in the networks will be those who work cheap, maybe because they must.  Ditto for the hospitals.  The only real guarantee is that the best doctors and hospitals will not be covered in these Obamacare networks. 

The net result: if you are insured under Obamacare, you will pay large deductibles and then once the deductible is exhausted, you will be confined to the cheapest (and probably least talented) doctors and the worst (and likely most crowded) hospitals in America.  Unless, of course, your name is Obama or Buffett or Mark Warner or Nancy Pelosi or Harry Reid, in which case you will get the best doctors and the best hospitals.  "Let them eat cake."

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