The AMA News has an article out about how Obamacare is looking increasingly to bust the bank. It gets into the supposed need to restrict access to treatments based on ”evidence based” medicine, the propriety of which, it seems to me, depends on how that term is defined in the law.
But that’s not what I want to get into here. Rather, I contend that by seizing national control of health insurance, the Feds have all but guaranteed that insurance will not be affordable. It all gets down to what constitutes “essential health benefits” under the law. From the story, “IOM Panel: Insurance Exchanges Will Fail Unless Cost Factor is Faced:”
The health reform law requires HHS to establish a minimum health benefits package — known as essential health benefits — to be offered by health plans in the exchanges, set to begin operating in 2014. HHS Secretary Kathleen Sebelius asked the IOM to propose methods for creating and updating the benefits package. The IOM-convened committee said HHS should choose an essential health benefits package that costs about the same as an average small group health plan, provides a range of services backed by evidence of their medical effectiveness, and balances the competing needs of health plan affordability and covered benefits. “If that package of benefits is too narrow, health insurance might be inadequate to ensure access. If it is too expansive, insurance might become too expensive,” said John R. Ball, MD, chair of the IOM essential benefits committee and former executive vice president of the American Society for Clinical Pathology. The IOM committee did not suggest specific benefits to be covered because that was not part of its mission.
But the Feds have already demonstrated that they can’t be trusted to create a package that is truly limited to “essential benefits.” Remember Secretary of HHS Sebelius bragging about the “free birth control” that all policies must provide? As readers of SHS will recall, that was just the tip of the iceberg, that the new regulation actually threw in the kitchen sink under the “reproductive health” benefit—including services such as domestic violence screening that aren’t medical at all. From my blog entry, “Obamacare: Lard on the Goodies! Destroy the System!
The pattern is set. Special interest constituencies will continually demand ever more; e.g. coverage for illegal aliens, coverage for abortion, coverage for IVF, etc. etc. etc. At the same time, powerless people will be offered ever less, e.g., imposition of futile care theory and health care rationing against the morbidly elderly, the dying, and people with severe disabilities. See, these groups have no powerful political constituency groups grabbing pieces of the pie for them. They will matter little in the emerging corrupt system of exchanging health care benefit spoils in return for political support, which is the essence of Obamacare.
Government leaders have traditionally bought votes or rewarded special interest constituency loyalty by handing out jobs and government benefit goodies. But the American Government is beyond broke, so Obamacarians are now using their stranglehold over the health insurance industry to lard pork on the insurance companies’ dimes. That will either make insurance unaffordable or break the industry in two (or both). Given the utter irresponsiblility of our current governance, the Feds are the last people to look to as effective controllers of health care costs or regulators of what constitutes “essential health services.”
