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Day 9 & AHA has already cured cancer

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POSTED January 9, 2014 1:11 a.m.

Are you jumping for joy yet?

Zealot backers of the Affordable Healthcare Act contend you should be now that the annual report of the Center for Medicare and Medicaid Services has been issued.

The report notes for the fourth straight year America’s overall spending on healthcare has slowed down. It went up just 3.7 percent last year to $3.7 trillion. Prior to that healthcare costs were climbing 7 percent a year. Now we are spending 17.2 percent of our gross national product on healthcare. That’s down from 17.3 percent.

To the architects of the AHA law such as former budget director Peter Orszag it is vindication that Obamacare is working.

The law in its entirety, however, only just went into effect nine days ago. But when you’re playing politics nine days is an eternity.

First give the devil his due.

Some aspects of the AHA have been around for a few years and have had solid impacts on reducing costs.

There are more providers being paid flat fees for patients than fees for services and tests. It has reduced unnecessary tests and procedures. And while the healthcare industry was moving in that direction, the looming AHA implementation — which requires flat fees — prompted more conversions.

Medicare rules changed several years ago that prohibit hospitals from billing for a patient if they are readmitted within 30 days of being discharged. The Center for Medicare and Medicaid Services notes that has reduced costs for Medicare hospital admissions by 10 percent.

The cheerleaders however forget a couple of details.

The recession prompted a lot of people to forgo routine healthcare. At the same time a number of businesses were able to get contract concessions that reduced the cafeteria of services available to covered members. In many cases things that weren’t pressing healthcare issues that employees now have to pay for went to the wayside. That has also helped to reduce costs and had nothing to do with the AHA law.

The report doesn’t include increased healthcare costs for millions of individual policyholders who have been forced under how the AHA is structured to look for new coverage after their policies were cancelled. The new policies that go into effect in 2014 typically have higher monthly premiums and much higher deductibles. And while policyholders may not access anymore services, they will definitely be paying more just to be insured.

Then there are the healthy younger people who the AHA is trying to force to obtain coverage in the event they need services. They will be paying a lot more for healthcare just in the fact they actually have insurance, assuming they buy it. The plan, of course, is to use the premiums paid by younger and healthier people to cover those who have serious health problems and basically older people who tend to access healthcare a lot more as a group.

None of this touches on the Medicare bombshell. The AHA law expands who can be covered by Medicare. The idea is to avoid having them going to expensive emergency rooms when they get sick.

The goal is admirable. But as they say, the highway to hell is paved with good intentions.

Look around Manteca, as an example. Try to find a physician that takes Medicare.

What is going to happen when there is a big jump in card carrying Medicare patients who want to use their insurance coverage?

Here’s a clue: Try to navigate a hospital emergency room in a few months.

Instead of back slapping or trying to pull the rug out, perhaps proponents and opponents of the AHA might want to do some fine tuning to prevent a major overhaul from being needed in a few years.

We are told fine tuning is unacceptable to opponents.

We are told changing anything won’t work by the proponents.

One thing is clear to everyone else who isn’t trying to make or break a political career on how the AHA does: The major reworking of healthcare and insurance is looking more like Dr. Jekyll and Mr. Hyde at best or Frankenstein at worst.

The one-size-fits-all approach is costing individuals that don’t need or want certain coverage as shown by the individual insurance plans.

The AHA is obviously far from perfect. That said the AHA is the best answer on the table unless you want healthcare to continue gobbling up more of this nation’s economic wealth.

So instead of cheering its “success” or lam-blasting it, perhaps Congress might want to stop the bickering long enough to realize the AHA is being treated like the Titanic in terms of invincibility.

And because health care costs can sink the economy whether it is in the form of old ice floes or the new and improved AHA iceberg, someone had better alter the course enough to make sure we stay afloat.



This column is the opinion of executive editor, Dennis Wyatt, and does not necessarily represent the opinion of The Bulletin or Morris Newspaper Corp. of CA.  He can be contacted at dwyatt@mantecabulletin.com or 209-249-3519.

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