Obamacare’s days are numbered. Either the Supreme Court will strike it down via rulings on cases like King v Burwell, it will be repealed in 2017, or it will implode on itself taking the health of many of our citizens with it.
The 10 year price tag for Obamacare is forecast to be $1.35 trillion1. In the first year, we spent $76 billion2 to insure roughly 14 million3 citizens while still leaving 41 million people without health insurance. That works out to about $5400 for each additional enrollee per year. Against this backdrop, a comparable individual health plan featuring Direct Primary Care Services coupled with a High Deductible plan for catastrophic care could be purchased on the open market for as little as $2,052/year4.
It is time to think about life without Obamacare.
If Obamacare were ever about care, it might be worth seeking ways to tweak the legislation. The stated objectives of Obamacare after all were to lower the cost of care, expand access to care, and protect consumer choice. In fact, the true objective was CONTROL not care.
It defies logic to assert that the addition of 159 organizations5 between a patient and a doctor would lower the cost of care. It defines logic to assert that the insertion of bureaucrats between a doctor and patient would actually improve the quality of care. These new organizations and bureaucrats do come in handy if your goal is control not care. Why do you think the IRS was designated as the enforcement arm for Obamacare?
Even the promise to protect consumer choice proved false when those with insurance they liked were unable to keep their plans unchanged under the implementation of Obamacare.
So…how do we truly achieve the stated objectives of Obamacare?
Return to free market principles. If we truly want lower costs and higher quality, we need less government involvement not more.
In practical terms, that means that Michigan needs to remain steadfast in our opposition to a government-run state-based exchange. These exchanges have the appearance of the free market, but behind the curtain are run by an army of bureaucrats accountable to the federal Secretary of HHS not the consumers on the exchange as outlined in the HHS Exchange Regulatory Blueprint.
So, we know what not to do. What should we do?
Implement what I refer to as a Patient-Centered Care Solution. For routine care, remove the need for 3rd party payers. Re-focus primary care on the doctor-patient relationship via Direct Primary Care Service contracts. Reserve insurance for catastrophic care.
Health plans featuring Direct Primary Care Services for routine care and High Deductible insurance for catastrophic care have been proven to reduce employer-based healthcare costs by 20%6 and reduce hospitalization by 60%7.
In other words, lower the cost of care for everyone.
But what about those who are still unable to afford access to quality healthcare? As it turns out, this Patient-Centered Care Solution would also lower costs and improve the quality of care for Medicaid enrollees. The State of Washington launched a pilot program of 1,000 enrollees and realized cost reductions of over 50% while also reducing hospitalization rates by 50%8. They have since expanded the program to 15,000 enrollees9. Michigan spends over $13 billion10 each year on coverage for 2.3 million11 of our 10 million citizens. A 50% reduction in Medicaid expenses could reduce the tax burden on the remaining 7.7 million citizens by as much as $6.5 billion. Since 34%12 of this figure comes in the form of state contributions, we have the opportunity to free up as much as $2.2 billion for other priorities such as roads or that elusive objective of tax relief.
President Reagan once opined in his “Time for Choosing” speech that the closest thing to eternal life on this earth is a government program. It is my hope that the prognosis for Obamacare is not so rosy. After all, Obamacare is about CONTROL not care. We live in the land of the free and the home of brave. It is about time that we acted like it by promoting free market alternatives to Obamacare.
4 Actual price of Direct Primary Care Service contract for males between 45-64 years old (See http://atlas.md/wichita/our-fees/) is $75/month. Actual price of High Deductible Health Plan (HDHP) available from eHealthInsurance.com (Same exchange used to re-vamp Healthcare.gov) pre-Obamacare rollout is $96/month (See GoHealthInsurance screen capture below). Total price of DPCS + HDHP is $2052/year.
6 State of Reform, “Qliance Study shows monthly-fee primary care model saves 20 percent on claims” (http://stateofreform.com/news/industry/healthcare-providers/2015/01/qliance-study-shows-monthly-fee-primary-care-model-saves-20-percent-claims/).
7 Ibid. Hospitalization means in-patient days.
8 Washington Medicaid cost savings, hospitalization rates, and number of enrollees provided by Garrisson Bliss, MD of Qliance during 2013 interview.
10 Senate Fiscal Agency – 5/6/15
12 Senate Fiscal Agency – 5/6/15