“Gee, I hope this works.”
[Guest post by DRJ]
Now that ObamaCare has passed, what are the experts saying will happen to demand for health care after it’s implemented? Surprise! The Washington Post’s Ruth Marcus notes that demand for health care may go up and costs increase:
“A new National Bureau of Economic Research paper by Michael Anderson, Carlos Dobkin and Tal Gross questions this assumption. The researchers examined health-care consumption by 19-year-olds who had just been dropped from their parents’ coverage. They found that not having insurance resulted in a 40 percent reduction in emergency room visits — “contradicting the conventional wisdom that the uninsured are more likely to visit” the emergency room and a 61 percent drop in hospital admissions.
“Overall, these results suggest that an expansion in health insurance coverage would substantially increase the amount of care that currently uninsured individuals receive and require an increase in net expenditures,” the authors write. Emergency room visits could increase by 13 million annually, and hospital admissions by 3.8 million, they project.”
Marcus, who supports ObamaCare, also questions claims that “having health insurance lead to better health” (maybe, maybe not) and that more preventive care will lower costs (probably not). Not to mention these questions:
“Will the expansion of coverage create a shortage of health-care providers and result in higher prices, or will, for example, higher Medicaid payments for primary-care doctors stem an exodus of doctors from the program? Will employers add coverage because workers facing the mandate to obtain insurance will press for it, or will they drop it because it will be cheaper to pay the penalty and let employees fend for themselves?”
And yet, despite these unanswered questions (as well as earlier doubts about the reliability of ObamaCare’s CBO scoring), Marcus concludes members of Congress were right to cast yes votes … but only if they admit to themselves: “Gee, I hope this works.”
That’s it? Gee, Ms. Marcus, why not just admit the Democrats and the media oversold ObamaCare and now everyone’s trying to lower expectations? It’s a lot easier to swallow than this.
— DRJ
Any idiot who has spent 10 minutes working in medicine knows this true.
Insured consume more. Uninsured less.
Preventative care increases costs because (a) if not sick you get medicine and (b) if you end up sick you get the same medicine anyway.
Uh, duh.
HeavenSent (a9126d) — 3/24/2010 @ 9:52 pmHe is prolly a racist.
What say you, Myron?
JD (e429fe) — 3/24/2010 @ 9:57 pmAnd the next person who tell me with Preventative Care we can catch “things before it gets worse and more costly” please understand (MORONS) that living longer simply delays and/or increase the volumes of expensive procedures one has.
That is to say instead of missing early detection of cancer you die younger in an expensive fashion versus catching the cancer, spending money on that plus the other 62 things that you have later in life also.
Bottom-line, smoking, drinking and drugs cuts down on Health and Entitlements. Just a fact.
HeavenSent (a9126d) — 3/24/2010 @ 9:57 pmAs you say, Heavensent, if one’s primary goal is to reduce costs, stop childhood vaccinations. People will die young and cheap. (Not my original idea).
Once upon a time the primary goal of medicine was to prevent and treat illness.
I think what we are seeing is what happens when one forgets what the right questions are.
MD in Philly (59a3ad) — 3/24/2010 @ 10:05 pmFunny how they always express doubts after the deal has been passed.
Patricia (e1047e) — 3/24/2010 @ 10:07 pmquestions this assumption.
I’d guess “questions this assumption” actually should refer to a naive belief that ObamaCare will not result in more frequent and more budget-busting visits to the doctor’s office or hospital. And why not? It’s basic human nature that when fundamental goods or services are made more widely available and easier on the budget, a lot more people will use — if not misuse — those goods or services.
We can all see that in ourselves based on the way we’ll treat something when it’s plentiful and inexpensive compared with the way we’ll treat the exact same thing when it’s growing scarce and more costly.
but only if they admit to themselves: “Gee, I hope this works.”
I’d rather they admit something along the lines of: “my liberal, do-gooder sentiments — and politics — will not necessarily lead to nicer, more compassionate situations, and definitely and most certainly don’t mean I’m a nicer, more humane person.”
Mark (411533) — 3/24/2010 @ 10:13 pmMD in Philly,
No, you don’t get it, you do vaccinate young because you need to create human capital to then care for the elderly.
What you don’t do is spend lots of money doing “Just in Case Medicine” which doctors do way too much of today.
Used to be medicine was HYPOTHESIS driven and you did testing around it …. now MDs just spam and check off all the boxes. Boiling the ocean.
It is why Preventative Care is a boondoogle. They check you, find an anamoly and start hyperventilating, 3 months and $25K later you have nothing and you are still 30 years old.
Most folks from 13 to 55 don’t need medicine beyond acute care, are very productive and if they were to drop dead at 60 (on average) we’d spend lots less on health care.
Now …. the reality is spending more on Health Care IS A GOOD THING!!!!!!!!! If this is how a free society wants to spend then let them. Once it get too expensive they will cut back …. which is why all these subsidies hurt because their is never an incentive to cut back.
HeavenSent (a9126d) — 3/24/2010 @ 10:29 pmI notice they overlooked tort reform. Anyone know why?
Wasn’t the original premise the bill would lower costs and increase quality of care? well, wasn’t it why we need to spend trillions and bankrupt America, because only 84% were satisfied with their health care.
bill-tb (541ea9) — 3/24/2010 @ 10:43 pmWell, now that the ship of health care is safely anchored in port all the good academic and media liberals are free to start second-guessing it’s voyage and looking for the breaches in the hull (am I straining this metaphor too far?). This way, you see, the liberals can all claim years from now — once the effects of this nightmare of a bill have been fully unrolled — that they were skeptical from the get-go. Of course, by then, it will be far too late to do anything about it save for move even more rapidly to a single-payer plan.
JVW (54b133) — 3/24/2010 @ 10:59 pmIn a tribute to one of the most blue — true-blue — states in America, where lots of people get goo-goo eyed over Obama, where the Democrat Party is given wide latitude, and where feel-good liberalism is almost a religion….
Mark (411533) — 3/24/2010 @ 11:16 pmI wonder how many physicians will now retire early due to Obamacare? I wonder how many bright young people will now take a pass on a medical career due to Obamacare? And here is my guess on how the coming shortage of doctors is handled by our wonderful president– by lowering standards to medical school in the interest diversity, underserved populations….I think you get the idea. You can bet that there will be legislation along these lines once the shortages become noticable.
BT (74cbec) — 3/24/2010 @ 11:50 pmHeavensent-
The no vaccine was tongue in cheek, the point being that if people die young, they won’t cost more as they age, as stats say the most dollars are spent for the older age group. It wasn’t meant to be a serious suggestion.
As far as “just in case” medicine, there are at least two components. Some of this is tied in with litigation fear and the need for tort reform.
MD in Philly (59a3ad) — 3/25/2010 @ 12:05 amAnother part is that advances in technology and how to use them may improve med care in some ways but they also contribute to uncertainties. Everyone would agree that if one could find an “inexpensive” and “easy” screening test for early aggressive prostate cancer it would be a good thing. The problem is, over the last 30 years technology changes (alk phos, alk phos from prostate, PSA, prostatic ultrasound…) and the consensus of experience changes, and we still aren’t sure if we do anyone a favor by doing a PSA and pursuing a work-up for a mildly elevated value- but you sure as shootin know that if it wasn’t done and prostate CA is discovered a year later there will be lawyers circling.
I’ve figured it out, this is Obama’s plan to bail out social security. Don’t pass the ‘doc fix’, have all the doctors bail from medicare as well as hospitals, install new quality standards which allow those few doctors who still try to make a living to be sued into poverty and make it impossible for any but a privileged few get medical care. This will kill off the baby-boomers before they can bankrupt social security, and the situation will be bleak enough to actually nationalize healthcare (and prioritize it). Brilliant even if it is pretty evil,
max (383bf5) — 3/25/2010 @ 12:13 amObama and his party have created conditions that ultimately must result in the failure of the health insurance companies. Obamacare reduces the profits of these companies (they are, after all, for profit organizations) while increasing operating costs and taxes.
When the insurance companies start going out of business in about 2-3 years, the government will step in, claiming they are “too big to fail”. Suddenly, we’ll have “single payer” with no muss or fuss, and another industry comes under direct government control (following Chrysler and GM).
Does anyone see a pattern here?
navyvet (ef35a9) — 3/25/2010 @ 5:02 amWhen you go to that doctor’s office, you will find a nurse practitioner there who is supervised by an MD who will read his/her charts on the one day a week he/she visits that office. If you want to see a primary care doctor, you will pay cash and many people are already doing this. I have nothing against nurse practitioners but they are not trained to sort out the serious illness from the daily load of minor illness. Of course, that is one more method of cost control.
MIke K (2cf494) — 3/25/2010 @ 5:14 am“Obama and his party have created conditions that ultimately must result in the failure of the health insurance companies.”
What happens if people start to think that insurance companies don’t really offer much?
“When you go to that doctor’s office, you will find a nurse practitioner there who is supervised by an MD who will read his/her charts on the one day a week he/she visits that office. If you want to see a primary care doctor, you will pay cash and many people are already doing this”
I’ve gone to both. When I actually saw a doc, my insurance company forbade him from taking blood (though of course he had the gear and could do it, they would not pay him) so I had to go to a different place on a different work day.
imdw (c5488f) — 3/25/2010 @ 5:43 amMarcus is one of the dimmer bulbs on the WP Editorial Board (which is quite an achievement in itself).
So now she will want the government to come up with a plan to graduate more doctors and nurses and hospitals to meet the demand. Probably based on those excellent five year plans the Soviet Union was so good at producing.
MU789 (6a1add) — 3/25/2010 @ 5:44 amJust like the “news” after clinton was elected, “oh, by the way, he’s a rapist,” or, the “news” after obama was elected, “oh, by the way, he’s a communist.”
Now, we find out after the bill is signed into law that there’s a “new” study showing “oh, by the way, healthcare costs will rise.” Probably from the same people who were saying last Friday “not in my lifetime.”
Jim (582155) — 3/25/2010 @ 6:36 amWhen you go to that doctor’s office, you will find a nurse practitioner there who is supervised by an MD who will read his/her charts on the one day a week he/she visits that office. Mike K.
If someone asks me about a career in medicine, I suggest they consider going the NP or PA route unless they specifically want to do things only an MD can do. If a person basically wants to spend time being with patients the NP/PA route may be more enjoyable with less debt and less hassle. If I had to spend 3 years at Gitmo vs repeating residency, I would do Gitmo. No reason to go through medical training to argue with insurance companies and oversee someone elses paperwork.
MD in Philly (59a3ad) — 3/25/2010 @ 6:48 amWhat say you, Myron?
Myron has long left the building, as we expected. Cowards never stay long after their lies have been exposed.
Dmac (ca1d8c) — 3/25/2010 @ 7:33 amSee? He just went to another thread.
Dmac (ca1d8c) — 3/25/2010 @ 8:11 amI am SHOCKED, shocked I tell you, to see that Myron does not wish to discuss the dishonest nature of the finances for this boondoggle. As we know, he does not care in the least, as they will just fix things later on.
JD (5375e6) — 3/25/2010 @ 8:23 amOn “Schoolhouse rap” I posted a threat/warning/promise:
Pons-
Maybe I will post the same thing any time I see Myron post until he answers.
Comment by MD in Philly — 3/24/2010 @ 11:45 am
I hadn’t seen him since, until he showed up on the thread thanking Karl.
Should I insert into that thread the following?
..There’s a big, wide America out there, and I would wager Americans main concerns right now are getting or keeping their jobs…
They will wait to see how the bill affects them and watch the tweaks… Myron
Correct, they will see taxes go up, the price of insurance and everything else in healthcare go up over the next 4 -5 years with no visible benefits. They will get laid off because their employer can no longer afford to keep them on the payroll. They will anticipate going onto medicaid or some other govt. plan that will give them no choices.
I think Republicans in particular have not figured that maybe Americans are just tired of talking about health care period and won’t want to hear another several months of a GOp plan to replace one bill with another, and kick people off of care? – Myron
Maybe many politicians and MSM folks have not figured out that the American people are just tired of being lied to, like your straw man that the conservatives just “want to kick people off of care“.
Our local paper yesterday had a front page story on the anticipated changes to health care, the main source was the CEO of the local hospital/health system who basically said it was going to increase their costs and overhead on everything, and they would be in trouble if the general economy in the area did not pick up. And this is a health system that already supports (with financial and logistical help) a community non-profit that provides care for the uninsured. I doubt that is what the reporter expected to hear.
As far as the CBO score, as said before, just like a computer, garbage in, garbage out.
Myron you apparently didn’t see this on a previous thread, so I’m giving you another chance to respond:
61.We just have a fundamentally different view of what government’s role in health care should be, and it won’t be bridged.Comment by Myron
And just what is that role, if I may ask for clarification?
Do you think health care should be rationed by the federal government, de facto because of an overall limit of supply at least, if not by direct limitation of specific services?
Do you think the healthcare disparity in America should increase between those truly wealthy (or connected) and the rest of us?
Do you think pharmaceutical companies that bring new drugs to market should be financially penalized for it?
Do you think the further erosion of medicine as a profession will improve healthcare for anyone?
Do you trust a government clerk or administrator with no medical training to tell your doctor what to do?
Do you want doctors to worry about ordering too many tests, so that you don’t get the head CT since you’re the third person this month complaining of severe headaches?
Do you want many of the brightest students to decide to do something other than go into medicine?
I’m not sure if that is really your view of the government’s role in health care, but that’s what you are getting.
If you were thinking of ensuring that everyone would have access to the kind of health care you want for yourself and your family, I’m afraid you will be sadly mistaken (or you have very low expectations).
I say this as a doctor who saw patients whether they had insurance or not, whether they could pay or not, like a lot of doctors in decades past before medicare and medicaid came into being.
Remember, Medicare rejects services about twice as often as private insurers and is about to collapse under it’s own weight. Just how is giving that kind of system the reponsibility for even more people going to cost less and provide better care?
The liberal view is to have the government run it, whether it actually helps people or not. Apparently you are of the mindset that everybody (except the few) having a worse but equal outcome run by the government is better than a free system that provides better for everybody, but not necessarily equal, run by private citizens with the minimum government oversight as necessary.
I prefer systems that actually provide better services for the individuals involved, and other than a standing military, I don’t see where government does that.
Oh, my bad, there is another place where the govt. does it better, enforcing the taking of personal earnings from the populace through the IRS, the one place that will be hiring over the next few years.
Comment by MD in Philly — 3/24/2010 @ 10:06 am
Of course, I just did insert it here again, but it is in response to Myron’s going AWOL for a short period.
MD in Philly (59a3ad) — 3/25/2010 @ 10:20 amCrickets chirping is the only response you will get, MD.
JD (7a6b3b) — 3/25/2010 @ 11:00 amMD in Philly,
I’m impressed with your comments. I wish you would think about combining them into an essay that could be posted here or at The Jury.
DRJ (daa62a) — 3/25/2010 @ 11:32 amMD in Philly,
If had to make an economic and human argument for Govt in Health it would be for the very old and and very young.
The rest of medicine “in between” is much a waste of money unless it is Acute Care.
PSA is a classic example of a test which produces tons of biopsies and unremarkable results.
It would be as efficacious if any man interested simply get a biopsy at a “biopsy factory” staffed with hyper-trained non-MD staff. Same for women and Paps — if you think …. just go for the conclusive test and stop with the in-between.
rr
HeavenSent (a9126d) — 3/25/2010 @ 11:56 amAs any kid who ever played musical chairs will tell you, when the music stops, somebody loses. With the new “HC Reform” we aren’t going to be short just one chair, we are going to be short a helluva lotta chairs. And when the music stops, everybody, except those exempt government employees are going to lose!
PRM (310ebf) — 3/25/2010 @ 11:56 amWhat will happen when the government is forced into limiting or denying medical services? Just as “medical costs will continue to rise” (shocka!) things will start to get sticky when that projected one trillion per year expense gets up into the 4-5 trillion range. Remember, Medicare was projected to cost $2 billion a year by 1990. I believe the actual cost is about 25x higher.
These people in Congress know what the actual costs of “free” health care will be. They just don’t plan to be around when the bill comes due.
navyvet (8e1431) — 3/25/2010 @ 4:06 pm