Monday, July 20, 2009

Obamacare Predecessors And Their Failures

Systems like Obamacare have been tried all over the world, including a handful of states here in the U.S. In addition to all the previous posts in which I've relayed the disastrous effects of such systems, here are a few more.

Failure in Canada
A critically ill premature baby is moved to a U.S hospital to get the treatment she couldn't get in the system we're told we should emulate. Cost-effective care? In Canada, as elsewhere, you get what you pay for.

Ava Isabella Stinson was born last Thursday at St. Joseph's hospital in Hamilton, Ontario. Weighing only two pounds, she was born 13 weeks premature and needed some very special care. Unfortunately, there were no open neonatal intensive care beds for her at St. Joseph's — or anywhere else in the entire province of Ontario, it seems.

Canada's perfectly planned and cost-effective system had no room at the inn for Ava, who of necessity had to be sent across the border to a Buffalo, N.Y., hospital to suffer under our chaotic and costly system. She had no time to be put on a Canadian waiting list. She got the care she needed at an American hospital under a system President Obama has labeled "unsustainable."

Jim Hoft over at Gateway Pundit reports Ava's case is not unusual. He reports that Hamilton's neonatal intensive care unit is closed to new admissions half the time. Special-needs infants are sent elsewhere and usually to the U.S.

In 2007, a Canadian woman gave birth to extremely rare identical quadruplets — Autumn, Brooke, Calissa and Dahlia Jepps. They were born in the United States to Canadian parents because there was again no space available at any Canadian neonatal care unit. All they had was a wing and a prayer.

The Jepps, a nurse and a respiratory technician flew from Calgary, a city of a million people, 325 miles to Benefit Hospital in Great Falls, Mont., a city of 56,000. The girls are doing fine, thanks to our system where care still trumps cost and where being without insurance does not mean being without care.

Infant mortality rates are often cited as a reason socialized medicine and a single-payer system is supposed to be better than what we have here. But according to Dr. Linda Halderman, a policy adviser in the California State Senate, these comparisons are bogus...

Failure in Maine

Passed in 2003, Maine’s Dirigo Health initiative was lauded as the first state-based universal coverage program this decade. Governor John Baldacci promised that Dirigo Health would (1) provide coverage for all of Maine’s 128,000 uninsured by 2009; (2) not require any new taxes; (3) be paid for by savings created in the health care system in Maine; and (4) reduce health insurance and health care costs for all.

The core element of the Dirigo Health initiative was the DirigoChoice “public option” insurance product – designed by state government, administered by a private insurer, subsidized by state tax dollars, and mainly marketed by state government to Maine small businesses and individuals. What has been the result?

  • Dirigo Health has cost taxpayers $155 million over five years in subsidies and administrative costs alone.
  • Today, DirigoChoice covers just 3,400 uninsured (less than 3 percent of Maine’s uninsured population).
  • Incredibly, the DirigoChoice premiums for sole proprietors and individuals have skyrocketed 74% in 4 years (4 times faster than the Maine State Employees health plan (17%) and 7 times faster than inflation [10%]).

Failure in Tennessee

[In 1994...] Employers moved employees onto TennCare because the subsidized public plan appeared to cost less. “As a result of this, insurance rates for those who have private coverage were going through the roof,” said Blackburn who spoke at Heritage’s weekly Blogger Briefing today.

Costs rose everywhere, however, not just within the dwindling private sector. “This program started to consume every new dollar that was generated in the state,” said Blackburn. The budget-busting program grew at a 1.5-percent annual rate, with costs skyrocketing from $2.5 billion in 1995 to $8 billion by 2004. “[Supporters] were willing to guarantee that it would save money - and it ends up eating 38% of the state’s budget.”

When costs explode in a public plan, there’s only one thing to do: ration health care. We reported on TennCare’s problems back in 2000.

Chronically low reimbursement rates for doctors and hospitals have led to rationed care, which means less care in most cases.

A March 1999 actuarial review by PricewaterhouseCoopers found that managed care organizations reimbursed providers at a rate of about $11 per member per month (about 10 percent) below what would be considered an “actuarially sound” level.

“There is no example that you can point to that shows where having private insurance in competition with the public option brings the costs down. It leads to exploding costs,” said Blackburn.

Failure in Massachusetts
As more people became insured, more people demanded the care of doctors. These doctors became overloaded with patients and waiting lists for doctors got longer and longer. As a result, ERs in Massachusetts have not seen a downturn in visits. On the contrary, it seems that ER visits are actually on the upswing in the Bay State. In fact, in 2007 they were higher than the national average by 20 percent.

Then there is another problem unaccounted for by the politicians. You see these citizens newly covered were given no reason to worry that the costs at an Emergency Room are higher than just waiting for their doctors to have room on their schedules to see them. So, off to the ER they went. After all, it’s covered!

Additionally, after initial gains in “reducing care barriers and boosting affordability,” the system is showing signs of reverses in areas that were thought to have been “fixed” by Romneycare.

The percentage of non-elderly adults that claimed they were not getting the care they want initially dipped but as of June of 2009 that success has been reversed back to 2007 levels. The reason? Not enough doctors for the increased demand.

The simple fact of the matter is that there are only so many doctors and they are beginning to be so overloaded that they cannot or will not see new patients.

The same report also shows that some gains in affordability have eroded.

And then the recession hit the state’s tax receipts causing the state to reduce its expenditures to its healthcare plan by $100 million. And guess who was hardest hit? The poorest residents, exactly the sort of people that universal healthcare is supposed to help.

And what has the state started doing to “fix” this latest problem? Price controls, a strategy that has never worked every time it has been tried. And they are considering price controls because costs are skyrocketing.

Simply put the politicians never came clean with the people of Massachusetts about the costs of the plan. All sorts of rosy scenarios were drawn and everyone smiled and backslapped to get these unfunded mandates passed. But now reality is setting in and the system is crashing down around them.

This is the fate of Obamacare on the national level.

Remember, it's one thing when your state does something stupid; if you have to, you can move to another state. But, when the federal government mandates something stupid nationally, there is no escape unless you leave the country. Is this the road we want to go down all across the country?

There's my two cents.

Related Reading:
Romneycare failing, Obamacare will follow
Tomorrow's health care headlines today

No comments: