We were lectured by the Affordable Care Act's boosters, key among them President Obama, that reducing the number of uninsured was a chief goal that depended on decreasing COST barriers to obtaining health insurance. Like so many Obama statements, the use of a study cited to support this idiotic claim that merely having health insurance would solve our problems of cost barriers to obtaining health care, as if health insurance is some magical amulet rather than a consumer financial product that varies in what it provides and how much it costs, was manipulated into justifying Obama's agenda of amorphously "reforming" health care with the Affordable Care Act which in most measurable ways has made the COST barriers for the majority of Americans worse.
In Obama's repetitive self-promotion of the false equivalency that "health insurance=health care" it's increasingly clear that Obama deliberately misled consumers. Obama didn't accurately state what the findings of the study were. [See What if I Said that "Obamacare Was Killing Americans"? http://conoutofconsumer.blogspot.com/2015/02/what-if-i-said-that-obamacare-was.html].
The study used to justify the Obama government con that health insurance=health care was 2012 research, “Mortality and Access to Care Among Adults After State Medicaid Expansions,” by Benjamin D. Sommers, Katherine Baicker, Arnold M. Epstein, New England Journal of Medicine, online July 25, print September 13, 2012, that found that “…expanding Medicaid to low-income adults leads to widespread gains in coverage, access to care, and—most importantly—improved health and reduced mortality.”
Now with Obama in our rearview mirror, it should be less difficult for his protectors to notice that the "study" actually found that basically free health insurance (Medicaid) with basically free health care (Medicaid services) led to gains in coverage (some health insurance versus none) and access to basically free care, improved health and reduced mortality. It was not the FACT of simply having or not having insurance, but the FACT of what that insurance provided, meaning that the affordability of care was as integral as the affordability of purchasing health insurance in order for the study to prove anything.
Having no health insurance did not impact health EXCEPT to the extent it meant you could not afford health CARE. Similarly, having all the health care available to you in the world is only useful if you can AFFORD it, and health insurance was one way people afforded health care. The two are integrally tied together, health insurance doesn't equal health care except to the extent it covers the COSTS of needed health care. Obamacare worsened both and therefore INCREASED barriers to health care with increased costs.
So, the study found, unremarkably, that getting needed medical care improved health and reduced mortality and that when both obtaining Medicaid and getting that care is free, COST barriers are reduced and health and longevity improve. This is NOT AT ALL what Obama and Obamacare was selling with the false equivalency justifying the real meat of Obamacare, the creation of health exchanges.
Flash Back: With the false equivalent that health insurance = health care, Obama was off and running with the myth that having any health insurance would naturally improve health care, a fallacy because if you can't afford care, you are facing a cost barrier whether or not you have health insurance, therefore the QUALITY of that health insurance in terms of coverage matters. This part of the con is also borne out today as up to 66 percent of US bankruptcies cite medical expenses as part of the reason for families' financial ruin and most of those individuals HAVE health insurance.
Obamacare ignores that Obamacare WORSENED the COST BARRIER TO HEALTH CARE FOR THE MAJORITY OF AMERICANS WITH EMPLOYER SPONSORED HEALTH INSURANCE. Obamacare and its deals with insurance companies ended up in increased premiums (the cost of obtaining health insurance) and increased cost of using health insurance for getting needed medical care (increased copayments, coinsurance payments, higher deductibles) for the majority of Americans.
The cost of OBTAINING health insurance went up over a hundred percent in most cases, which as recently as 12/16/2019, Drew Altman noted the increased costs of private insurance https://www.axios.com/health-insurance-costs-private-medicare-medicaid-c40bb6f1-c638-4bc3-9a71-c1787829e62e.html. And the cost of using health insurance also has left Americans in need of medical care and services in increased financial jeopardy.
Even the LA Times, which bent over backwards to justify all things Obama including Obamacare, noted in May of 2019, in an article by Noam N. Levey, "Health Insurance Deductibles Soar, Leaving Americans with Unaffordable Bills," https://www.latimes.com/politics/la-na-pol-health-insurance-medical-bills-20190502-story.html, stating that of those polled with employer-based health insurance "Half said that costs had forced them or a close family member to delay a doctor's appointment, not fill a prescription or postpone some other medical care in the previous year."
Still eager to never criticize Obama, the article implied it was simply an oversight and that "as Democrats and Republicans fought over the law, Altman said, neither focused on the rapid run-up in costs for people covered through work." [LA TIMES, 5/2/2019, Noam N. Levey] in other words, lawmakers were stupid.
Hold it right there. This claim is not supported by the facts which more closely support an assertion that OF COURSE Obama's Administration knew they were screwing the majority of Americans by creating the entitlement program of Obamacare exchanges with the false equivalency that any health insurance improved health care, even if the insurance is so bad that it leaves individuals unable to afford to get needed medical care.
Instead, Obama prioritized his political agenda and focused on the falsehood that ANY HEALTH INSURANCE improved HEALTH CARE and therefore the fewer number of uninsured there were, the healthier the population would be. Nonsensical. If you can't afford to use your health insurance because like Obamacare it costs you more than you can afford to get NEEDED HEALTH CARE, then health insurance is meaningless EXCEPT for satisfying the political agenda of a President like Obama. This is borne out by the LA Times poll of December, 2019, "Half said that costs had forced them or a close family member to delay a doctor's appointment, not fill a prescription or postpone some other medical care in the previous year."
Obama KNEW his false equivalency was a lie, otherwise he wouldn't have made sure that public employees like Congress not only got taxpayer funded health insurance, but that those plans provided superior coverage to the garbage that was deemed good enough for the rest of us.
So early on we got duped into believing that ANY insurance would improve access to health care because of the false equivalency laid out by Obama et al that health insurance=health care, therefore having health insurance meant you had health care. Clearly not true and only used by Obama as a means of claiming that reducing the number of uninsured was the solution Americans needed.
Obama ignored the quality of the insurance necessary to make that claim true…Health insurance is a tool to help us afford needed medical care, if we can't afford needed medical care with health insurance then it is a failed tool. Therefore, having mislabeled the problem as one of merely having health insurance, and thereby misidentifying the solution as just making sure people were insured without caring that his ideas encouraged insurers to cover less and charge more, Obama worsened the problems facing the American public in need of medical services.
And if they knew then, as outlined below, then they know NOW as the same garbage is included in Medicare for All that will again injure consumers and further worsen COST as a barrier to needed health care for the majority of Americans.
Obama claimed that his exchange plans sought to "equalize" the playing field for consumers (NOT public employees like himself, just other consumers). Obama supported a law that established bare minimum, low-hanging fruit coverage for individual insurance shoppers (the exchanges) as an entitlement that the rest of us would pay for to address those "uninsured." So the exchanges began.
First, using taxpayer money, Obama had to figure out how to get insurance companies to offer plans on his pet project entitlement, the exchanges, and since this was not group insurance, the government wasn't negotiating but arranged for a legislative quid pro quo for insurance companies: The law promised that if insurance companies participated on exchanges then the Federal government would make sure they didn't lose money. That was the three Rs, reinsurance, risk corridors and risk adjustment. The first two of which were temporary, only through the end of the 2016 benefits year.
Not only did Obamacare establish a new low bar for insurance coverage opening the way for employers to glom onto savings (but not the FEDERAL GOVERNMENT 'EMPLOYER') by providing cheaper options to their employees with the same low-bar coverage, but Obamacare intended to PENALIZE employers who provided better coverage (remember the Cadillac tax that never was put into practice that would put a 40 percent tax on generous employer-provided health insurance plans?) clearly indicating that Obama, having misidentified the problem as not having insurance, didn't care about the quality of insurance that people had (outside of public employees like Congress) because his political goals merely meant he'd declare victory as long as he reduced the number of uninsured.
Then Obama had to figure out more ways to force people to purchase besides having enacted legal penalties by federal law if we didn't (the individual mandate). Obama's Administration realized they weren't getting enough forced purchases by the law as it stood and went to court to expand who was forced to purchase off exchanges in King v. Burwell, which the government won in expanding the credits of "state-established exchanges" to the federal government in states that didn't establish exchanges. Still enrollment was low and lopsided, with money-conscious consumers forfeiting the discount in cost sharing available on more expensive silver plans and opting instead for bronze plans with premium assistance only. In 2015, Obama's Administration did two more things to try to force people onto his exchange vision, raising the cost of bronze plans significantly more than those of the silver plans to try to get people to enroll in more silver plans and further restricting the availability of short-term health insurance which was capturing a portion of the population unable to overcome the COST barrier of purchasing exchange health insurance.
Obama's Administration even unapologetically counted fraudulent enrollees to keep those enrollee numbers up. When Obama's own government called the Administration out for fraudulent applicants and enrollees in Obamacare, CMS revealed it didn't worry about fraud. In 2015, CMS explained to the GAO regarding its findings: "According to CMS, its document processing contractor is not required to authenticate documentation; the contractor told us it does not seek to detect fraud..." GAO-14-705T: Published: Jul 23, 2014, repeated in July 2015,"HealthCare.gov's document-processing contractor 'is not required to seek to detect fraud,' said Bagdoyan." That's right, authenticating documentation is unnecessary as is detecting fraud…That'll help boost numbers, and it's only taxpayer money anyway.
Obama continued his claims of victory based on the false premise that health insurance=health care, that individuals seemingly bought into, yet we also know that the number of enrollees on exchanges didn't separate out those who had insurance before Obamacare that was no longer offered because of Obamacare and therefore were forced onto exchanges, rendering them not "newly" insured in terms of reducing the uninsured number, but merely newly insured on Obama exchanges.
We also know that Obama's Administration, after repeated anemic enrollment numbers decided to change the number of uninsured downward, as if to explain why more people hadn't grabbed onto exchange participation (as stated by the CBO in 2015, “…slightly lower estimate of the number of people who will gain insurance coverage because of the ACA,” (CBO, Pub. 49973, page 19).
Deliberately miscommunicating what the study on the relationship of health insurance was to better health care, Obama fraudulently identified the basis of "success" for his pet project as whether he could reduce the number of uninsured. This commitment was a deal with insurance companies that they wouldn't deny anyone coverage (pre-existing conditions) in exchange for the federal government forcing people to purchase the consumer financial product of health insurance.
The quality of health insurance dropped the bar to low-hanging fruit so that again, Obama could argue about the free stuff he was guaranteeing, without explaining that it was at the cost of coverage for NEEDED medical care which would cost more (and has proven to cost more) in terms of copays, coinsurance and deductibles.
Again, Congress made sure that public employees like themselves would not be exposed to the HIGHER premium costs or the HIGHER costs of using their health insurance since they effectively exempted themselves from Obamacare, indicating that Congress KNEW that the Obamacare plans were sub-par.
Obamacare included PREMIUM ASSISTANCE and COST SHARING for exchange plans to help DISGUISE the costs of the coverage to the consumers in the marketplace because the government picked up the tab for Obamacare enrollees, but for the majority of Americans, we were simply price-gouged more by the costs of premiums and of using our health insurance.
Flash Forward: So Medicare for All fans SHOULD read the next installment of the Obamacare con. In this scenario, according to the published Senator Sanders Medicare for All plan, the continuation of bare minimum sub-par coverage will be provided for all, for free.
Of course, Medicare for All preserves the untrustworthy government as the decider of what is covered and what is not. Of course, it will be bare minimum coverage which is why the Medicare for All Plan specifically creates the opportunity for private provider contracts, basically all sorts of new supplemental policies consumers can PURCHASE for all the things not covered (Section 303).
Of course, the public employees in GOVERNMENT are again exempted and promised a continuation of their superior pre-Obamacare benefits paid for by taxpayers. (See Section 701, "Bernie Sanders and President Trump Agree About Health Care and Consumers Lose," http://conoutofconsumer.blogspot.com/2019/10/bernie-sanders-and-president-trump.html.
Of course how much our taxes will increase is also up to government.
Of course, even if the tax increase is kept remarkably low until post-election they will go up.
Of course, the problem of drug coverage is preserved and will likely be as bad or worse what is currently going on with formularies where Medicare for All uses preserves big pharma's chokehold on us: Under Section 614: Payments for Prescription Drugs and approved devices and equipment: (a) Negotiated prices.—The prices to be paid for covered pharmaceuticals, medical supplies, and medically necessary assistive equipment shall be negotiated annually by the Secretary."
NOTE "Prices paid for COVERED pharmaceuticals…" That's right, the ever -shrinking formulary game whereby drugs covered are often omitted from insurance company lists leaving patients in the catastrophic position of being unable to afford whatever-the-market-will-bear drug prices is preserved by Medicare for All.
The first step to believing any candidate-described, Congress endorsed solution to the Obamacare WORSE problems of access to needed HEALTH CARE based on cost as a barrier is that consumers demand that if we're being sold something then public employees like Congress better be bound by it too, without a blatant exemption like under Obamacare or a more insidious exemption where they're given pay increases to cover increased costs. If it's good enough for us, it should be good enough for them.
