Monday, July 27, 2009

Torinus Hits the Grand Slam on ObamaCare

Beyond the headline coverage ("ice-floe" treatment of older people, abortion coverage, etc.) are a number of very important and not-clearly discussed practical problems with ObamaCare. These are the 'macro-problems,' so to speak.

Torinus nailed a few of them. One that had been mentioned on this blog:

The House-passed 8% payroll tax on companies that don't provide coverage. My company, like many companies, is spending about 15% of payroll on health care. Why would Serigraph and other companies not opt for the 8% penalty, drop coverage and let our employees go to a public plan? We would save several million dollars a year at taxpayer expense. The Wisconsin Democrats and AFL-CIO were more realistic when they put a 15% to 20% payroll tax into their Healthy Wisconsin bill.

Indeed. This does not require an MS/Mathematics. And as much as the Wisconsin plan was justifiably derided by Conservatives, their numbers are, indeed, far more realistic.

The "public option" that would pay a little more than Medicare rates to providers. Medicare uses government price controls to reimburse at 40% to 50% of retail charges. Big private insurers pay 70% to 80%. How could the private insurers ever compete with the public insurance company and its price controls? Smart analysts predict a stampede out of private coverage to the cheaper public plan. The subsidies, direct and indirect, will rival the massive expense of Medicare and Medicaid

This disparity was supposedly resolved over the weekend, after Torinus penned the article. But the actual numbers have yet to be released.

The failure to deal with the glaring need to change from fee for service to bundled payments by treatment episodes. If you pay for procedures, that's what you get, lots of procedures, all piled into out-of-control, inscrutable bills.

Again, this is supposedly being addressed by some sort of commission in DC. So? It will be at least a couple of years before anything resembling an agreement is reached at the Commission, and then another long time before it is implemented.

Read the rest. He's batting 1.000 in this column.

1 comment:

Anonymous said...

I agree, that was his best column in a long time. Should be required reading for anyone who thinks that 0bamacare is going to work.