[Soon] the new GOP-controlled House of Representatives will be voting on and is expected to pass a bill to repeal the Affordable Care Act (ACA) – lock, stock, and barrel. There is virtually no chance the repeal bill will get through the Senate, though, which maintains a narrow Democratic majority, and President Obama would veto it if it did.
But let’s say that the seemingly impossible happened, and the ACA was repealed. What would the impact be on healthcare coverage, costs, and the federal deficit?
In a letter to Speaker John Boehner (R-OH), the Congressional Budget Office (CBO) released its preliminary estimates of the impact of repeal on the deficit, uninsured, and costs of care, and found that it would make the deficit worse, result in more uninsured persons, and higher premiums for many:
– Deficit: repeal of the ACA would increase the deficit by $145 billion from 2012-2019, by another $80 to $90 billion over the 2020-21 period, and by an amount “that is in the broad range of one-half percent of the GDP” in the decade after 2019* — or about a trillion dollars. Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
The consolidation of physician specialty practices into larger corporate healthcare systems in urban areas is creating a new challenge for today’s doctors when the music stops: There might not be a chair available.
There are simply many fewer hospital systems in large urban areas than there are specialy practices, so the number of specialist positions a large healthcare system is willing to absorb might be limited. As doctors and hospital systems coalesce into as-yet-to-be-clearly-defined “accountable care organizations,” the cost of too many specialists in an organization is being carefully weighed. Read more »
*This blog post was originally published at Dr. Wes*
A friend who works with the unemployed called me up the other day huffing with indignation. The local charity clinic, apparently overwhelmed, had changed its policies so that her unemployed uninsured would no longer be able to seek care there.
“Someone has to do something!”
Um, what exactly would that be? I’d love to help, but I have bills to pay (as do charity clinics) so I can hardly provide medical care without seeking payment. I understand her desperation (and that of the people she so valiantly helps) but who, exactly, is supposed to do what, precisely?
Things are going to get worse before they get better, I fear. The unemployment issue goes way beyond a devastating economic downturn. It’s a reflection of the most basic economic principle of supply and demand. Wages are the “price” of labor — prices go down when supply goes up. In the case of labor, it’s when you have large numbers of people willing to accept lower wages. Can you say “outsourcing?” Watch as the jobs flow overseas while we’re still left with all these people, but not enough jobs to support themselves. In the meantime they all still need healthcare, but can’t pay for it.
Someone has to do something!
Guess what? It just so happens that we really do have a healthcare infrastructure in this country. Between the Veterans Administration (VA) and public healthcare clinics, we have rather a good start at building a truly national healthcare system. Perhaps now is the time to expand it. Read more »
*This blog post was originally published at Musings of a Dinosaur*
Yes, it’s true – most doctors may soon be government employees. No, not the Lasik surgeons, the plastic surgeons, or the dentists — they were clearly more focused on career day. But is it necessarily a bad thing if all of your income comes from federal, state, or local governments?
If your business is caring for the medical needs of the less fortunate, a Medicaid doctor or a VA doctor perhaps, then your luxury box may be something more Thoreau-like, maybe some nice lawn furniture in the backyard. On the other hand, if your business model involves caring for recently-released prisoners or drug addicts, then you are in the financial sweet spot. Read more »
*This blog post was originally published at Dr John M*
New reports peg Medicaid’s future as dismal and unsustainable, as states struggle for ways to pay for the rising costs of caring for their poorest residents. The Deloitte Center for Health Solutions study, “Medicaid Long-Term Care: The Ticking Time Bomb,” estimates Medicaid costs will nearly double as a percentage of state budgets by 2030, or perhaps nearly triple.
Meanwhile, the Urban Institute for the Kaiser Commission on Medicaid and the Uninsured estimates Medicaid expansion will cost $464.7 billion by 2019. The federal government will cover $443.5 billion (95.4 percent) and the states will cover the remaining $21.2 billion. Minnesota won’t expand its Medicaid program until 2014 because of budget fears. Connecticut will. (The Fiscal Times, MedPage Today, Reuters, U.S. House Rep. John B. Larson)
U.S. Senators, meanwhile, are looking to phase out federal subsidies Medicaid as a way of pushing through stalled legislation – the same package that had included the “doc fix.” Speaking of that, Sen. Majority Leader Harry Reid said the Senate may soon turn its attention away from that toward other issues. (Wall Street Journal, The Hill, ABC News)
*This blog post was originally published at ACP Internist*