Scott W. Atlas, M.D.OP/ED | 10/02/2012
Despite the attempt to highlight the new Census Bureau’s reported net decrease in uninsured of 1.3 million people, or 0.6%, as a success story for the Affordable Care Act, we know the reported drop in the number of uninsured actually reflects increases only in government insurance, including 2 million newly insured under Medicare merely by aging, and another 2 million joining Medicaid; likely as a consequence of the economic stagnation under this administration.
A key source of the ACA’s projected savings, the CLASS entitlement designed to provide unlimited, lifetime benefits for long-term care, was quickly abandoned. Recognizing that its premiums, $86 billion by 2021, would finance the rest of ObamaCare instead of its own costs, Sen. Kent Conrad (D-N.D.) called CLASS “a Ponzi scheme of the first order, the kind of thing that Bernie Madoff would have been proud of,” and vowed to block its inclusion in the Senate bill. Medicare Chief Actuary Richard Foster calculated the program needed to enroll more than 230 million— more than the entire nation’s workforce — to be financially feasible. HHS Secretary Kathleen Sebelius was forced to admit last October that the plan simply wouldn’t work, even backpedaling to Congress that “my comment was that it was unsustainable as the legislation was crafted.” CBO Director Douglas Elmendorf noted that month that the “CBO would have estimated that the Repeal the CLASS Entitlement Act would increase federal budget deficits by $83 billion over the 2012– 2021 period, relative to the March 2011 baseline,” thereby eliminating 40 percent of the CBO’s previous budgetary savings of the ACA.
The ACA’s Accountable Care Organization (ACO) blueprint was unworkable from the start. Touted as a new model where doctors and hospitals work together to eliminate unnecessary care, the Centers for Medicare and Medicaid pilot program did not work, saving only $100 per beneficiary annually. Even though President Obama put forth Mayo Clinic and Geisinger Clinic as models of what he wanted to achieve, the American Medical Group Association, representing those very same organizations – Mayo Clinic, Cleveland Clinic, Geisinger Clinic and many other premier health care groups – wrote the administration that a full 93 percent of its members would not participate, because the rules were “overly prescriptive, operationally burdensome, and the incentives are too difficult to achieve.”