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Forbes.com

 

Your Health Care May Change: Please Stand By

November 11, 2009

By David Gratzer

On Nov. 7, in the dead of night, the House of Representatives voted 220-215 to pass the ObamaCare health bill. It’s a staggering 1,994 pages long--almost twice the size of versions tabled this summer. Buried in this encyclopedia is everything from a “Office of Indian Men’s Health” to a new, voluntary government insurance plan for assisted living. If passed by the Senate, it will change everything about American health care.

Or will it?

Here’s what it will change. First, there will be an immediate surge in employment (in Washington). In the bill, the secretary of health can spend billions right away to staff the new public insurance, to fund the National Health Corps and to pay for new committees, agencies and studies--a list that’s actually too long to fit onto a newspaper page.

Second, there will be an immediate shift in medical power. Federal agencies and legislators will have undisputed authority over health care decisions once made by doctors or state legislatures. A committee, for example, will decide which preventative care treatments must be covered in every insurance policy--an added cost for you, yes, and potentially without benefit. States and health innovators will likely defer new initiatives while they wait in limbo for Washington to resolve regulatory questions unanswered in the bill.

Finally, your premiums should rise. That’s right--rise. Most Americans’ first experiences of ObamaCare will be higher premiums, just as RomneyCare in Massachusetts led to higher costs. That’s because new federal regulations will change how insurance is priced and sold.

Thirty-four states, for instance, do not force insurers to cover orthotic (think shoe inserts) or prosthetic equipment--partly because it’s not worthwhile for most people to have this extra coverage. But this bill makes it a requirement nationwide, adding to insurance costs in all of those thirty-four states.

While most of these new rules don’t take effect immediately, insurers are free to act as if they do, hiking premiums steeply to profit from “tough new national standards.” And since the bill includes a vague plan to eventually force insurers to justify increases, insurers have extra incentive to jack up rates now while they still can.

What won’t change instantly is just as important. You might want to avoid higher premiums by signing up for the public-insurance option--but it won’t be sold to anyone until January 2013, by law. Most Americans won’t be eligible to use it until 2015 at the earliest. If you’re a cash-strapped parent hoping for insurance subsidies, keep hoping: While Democrat-friendly community groups get their billions in grants right up front, subsidies for ordinary Americans don’t start until 2013 either.

2013 is two congressional elections, one presidential election and three giant federal budget deficits away. If you believe the Mayan prophecies, the world will already have ended by 2012, long before any Americans see the supposed benefits of these “historic” reforms.

It gets worse. Remember the national health exchange that will increase insurance market competition? If Congress had simply let you buy insurance from the same exchange federal employees use, you’d see that competition tomorrow. But the president’s plan calls for a new exchange, a new bureaucracy and new rules to micromanage every sale. So, once again, you’ll have to wait years for the promise of more choice and competition (unless you already have the good fortunate to work in Washington).

The federal budget will change forever too. Spending on new bureaucracy, Medicaid increases, grants and seed money for new insurance plans comes immediately. Financing this trillion-dollar binge depends on literally hundreds of billions worth of unspecified Medicare and Medicaid “savings.” Congress habitually reversed previous cuts to Medicare once they were specified. So it’s no great leap to expect the federal deficit--and the net cost of reform--to grow quickly once the bill becomes law.

So, what changes? If the Senate votes yes, you’ll immediately pay more for insurance, more for bureaucracy and see growing federal micromanagement of health decisions. Family subsidies, a public insurance option and more competition? Well, please stand by.

Original Source: http://www.forbes.com/2009/11/11/health-care-reform-bill-opinions-contributors-david-gratzer.html

 

 
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