Talk of repeal of Obamacare is IN for 2015. Talk of repeal by Republicans is not going away as both Boehner and McConnell have confirmed. With renewed confidence in response to the unpopularity of Obamacare as well as victories in this past election, TALK of repeal of Obamacare is IN for 2015. Likely, it’s just talk.
With King v. Burwell scheduled to be heard in March by the Supreme Court, SUBSIDY AVAILABILITY is IN in 2015. With a stretch of the English language to include anything that doesn’t support their point of view as a “typo,” this year we’ll hear the fate of Obamabucks, the subsidies paid to Obamacare subscribers who signed up for Obamacare through the Federal portal rather than State exchanges. As I’ve discussed ad nauseum, I don’t like the subsidy entitlement created by Obamacare and I don’t believe there is any sign of intent to supply subsidies to state residents in states that rejected the opportunity to work on their own exchanges but we’ll see.
Obamacare FRAUD is OUT. It’s a poorly kept secret and little surprise that fraud goes hand-in-hand with Obamacare signups. There was a small spike in interest during the summer when the Government Accountability Office issued its report that fraud is rampant in both the verification process and in the payouts in the form of subsidies provided by the Federal government to individuals who never should have received the go ahead for either (July, 2014). But, with media hyper-focus on enrollment and with claims that actually verifying eligibility before paying out Obamabuck subsidies (as required by the PPACA) should have been a priority, we’re unlikely to see any real work or effort put in by the government before it writes checks.
Obamacare ENFORCEMENT is IN-ish. The IRS is giving lip-service to enforcing the provisions of the Obamacare regarding the individual mandate. However, with the delay of employer verification requirements (until 2016) and with the expansion of exemptions from Obamacare, and with a self-attestation provision on tax forms (yes, I bought insurance) which supposedly would be matched with insurance company reports of coverage, although some may find their tax refunds reduced, it’s unlikely that the IRS will really GO AFTER a large percentage of those who should be paying the individual mandate tax and equally likely that there will be many mistakes made in who they do impose the tax on.
Obamacare’s Failure to Address Key Issues in our healthcare system is OUT as it has been since we’ve allowed ourselves to be manipulated into discussing Obamacare merely in terms of “enrollment,” which numbers have been so fudged and qualified that it’s almost idiotic to listen to. Key issues of our healthcare crisis, specifically the COST OF MEDICAL SERVICES (highest in US) and the WORST in terms of efficiency, equity and outcomes, those things that are important to consumers (as reported this summer, look up 2014 US healthcare worst or some other such search) have been unconscionably avoided as politicians with their excellent health plans and benefits packages look to persuade consumers to buy-in to their political agendas. People putting off physician visits (look to utilization rates) and people facing bankruptcy due to medical expenses remain in peril under Obamacare.
Patient privacy could very well be IN this year as the insecurity of patient records and therefore patient privacy gets attention in the wake of situations such as those that occurred at SONY. Individuals have little recourse when the situation arises and therefore perhaps will argue for stronger OPT-OUT choices when it comes to sharing their personal health information.
Medical Mistakes with EHRs is OUT as it has been since Obamacare paid dollar incentives for providers to switch to electronic health records. It’s strange because there have been reports of massive errors because of human failures, software failures and lack of oversight and tracking of such errors by the Federal government of the EHRs put in place.
But until the experience of LACK OF BETTER MEDICAL CARE as a result of the sacrifice of privacy and dependence on EHRs trickles down to become more than a passing story such “Hazards Tied to Medical Records Rush,” by Christopher Rowland, Boston Globe, 7/20/2014, or, “Deaths by Medical Mistakes Hit Records,” Healthcare IT, 7/18/14, by Erin McCann, we are unlikely to make progress.
Instead, we’ve got misleading headlines that try to mislead the public such as HHS’ December 3, 2014 report by Carla K. Johnson with the headline, “Hospital Medical Errors Down 17 percent, Reports HHS,” which you have to read further to realize is a change reflecting the Federal government’s refusal to reimburse for infections, drug mistakes, bed sores and other preventable errors from 2010 to 2013 but fails to address the issues raised by the medical personnel who have focused on the INCREASED NUMBER OF medical mistakes such as failures in diagnosis, follow-up, failure to “count” deaths that occur one at a time instead of in groups, and deaths mistakenly attributed to underlying disease rather than medical error.
