The Problem

Less than half of the 24 million proponents of Obamacare who said they would sign up during the legislative process in 2010 actually did so in the last eight years.

Why?

Well, they ran up against the cost of socialized healthcare.
Premiums doubled in the first four years of Obamacare. Last year, the average monthly premium for individual insurance was $476 per person per month in the 39 states participating in HealthCare.gov.

Here is Alaska, premiums in the individual and small-group markets doubled in those first four years and have tripled in the three years since. Alaskans in the small-group markets pay an average premium in excess of $1000 a month.

It gets worse than that, however. As premiums have gone up, choices have gone down. In more than 80 percent of counties across the US, there are only one or two health care plans available on the Obamacare exchange. That means millions of Americans now have far fewer choices when it comes to their doctor and health care network.

For the 11 million who did sign up for Obamacare, over 86 percent of them were enrolled in Medicaid. That didn’t ensure they have access to medical care because increasing numbers of doctors and other medical providers are no longer accepting Medicaid because they are reimbursed at an unsustainable level for the amount of staff required to handle all the related paperwork.

Medicaid is notorious for long wait times and poor health outcomes. It is a costly and unsustainable welfare entitlement program that delivers low-quality medical care to many of its enrollees. Because most doctors don’t accept Medicaid, recipients have little choice but to seek non-urgent care in expensive and overcrowded hospital emergency rooms where they often receive inferior medical treatment. When they do need to seek urgent care, they are routinely assigned to less-skilled surgeons, receive poorer post-op instructions, and often suffer worse outcomes for identical procedures than similar patients both with and without medical insurance.

Medicaid has become too large to provide good services to people who genuinely need public assistance. Eligibility expansions have crowded out those who need care and can’t afford it because taxpayer funds are being spent on individuals who could afford private insurance coverage. This diverts resources from the genuinely needy populations of the program.

You could perhaps make an argument for this if states that have expanded Medicaid had experienced better health outcomes for their poorer populations, but there’s no evidence that has happened. While most of those enrolled in Medicaid are relatively healthy children and their mothers, a small subset of enrollees have serious diseases like diabetes, HIV, anemia, or psychosis. These Medicaid patients are typically in worse condition at the time of their diagnosis than either the insured or the uninsured. They also typically have worse average health outcomes after treatment than either of those two demographics.

Compared to the privately insured, Medicaid patients have a 22 percent great chance of complications and a 57 percent greater change of dying following colon cancer surgery. They are more likely to die in the hospital than the uninsured. That’s right – the uninsured. That statistic comes courtesy of the University of Virginia, by the way.

Medicaid patients typically spend longer in the hospital (10.5 days) than both the insured (7.4 days) and the uninsured (7 days). This is because they are more likely to experience complications and that might explain why Medicaid patients have a 21% higher cost for hospitalization than the uninsured and and a 26% higher cost for hospitalization than the privately insured.

These sad statistics are not limited to adults with cancer, but also show up in stroke recovery and in pediatrics. The vast majority of children in and out of Medicaid enrollment are healthy, but of course that’s not always the case. Researchers have found that a child with asthma is five times more likely to see an asthma specialist if she has private coverage rather than Medicaid. Children with Medicaid are 50% more likely to be seen by an emergency room doctor, in large part because of the dearth of private doctors who will accept Medicaid patients. Those same doctors will accept someone paying case, so uninsured patients actually have more access to medical treatment than those insured under the Medicaid system.

The worst part of all of this is that Obamacare’s shifting of lower-income coverage to Medicaid has resulted in a crowd-out of private insurance and patients it used to cover. Yes, some few uninsured who were not previously covered by Medicaid may now have insurance (with no assurance of actual medical treatment), but even for the previously-insured, getting into see a doctor is now much more difficult, resulting in higher prices and longer wait times. Obamacare’s paperwork requirements on doctors have reduced the amount of time they can spend with patients, increasing diagnosis and treatment errors.

And, none of it was necessary. There are better solutions.

Cousin Rick is a world-renown research doctor who works for a major medical center and    would like not to identify himself, as that would likely ruin his career under the current tyrannical environment of the medical community. He is a frequent guest on my blog whenever the current  medical insurance stupidity becomes so great that he feels it necessary to vent.