Nov
03
2013

A random thought about #obamacare, and cash on the barrelhead.

Fascinating thing about, say, laser eye surgery; the price has been trending downward, largely because it’s not covered by health insurance. Which is a polite way of saying Lasik is subject to market forces.  When people have to pay their own money, they take prices seriously.

Anyway: I’m seeing more and more folks visibly deciding that, instead of paying Obamacare’s new sky-high deductibles, they’re going to keep that money, eat the tax (which is not going to be insanely high in 2014), and pay out of pocket if they need health care treatment. If this turns out to be a common reaction, you may very well see doctors and hospitals ready to take advantage of that situation…

Moe Lane

PS: This will, of course, do nothing to keep the healthcare exchanges from going into a death spiral.  Then again, neither does expanding the Medicaid rolls.

5 Comments

  • acat says:

    I predict a vast underground network of doctors…
    .
    Mew

  • lineholder says:

    Question: As of yet, it has not been defined as illegal for a doctor to operate outside the scope of Obamacare. But there are some folks wanting to see that take place. Could states put laws into place protecting a physician’s right to practice concierge medicine? For both social and economic reasons, it would be better by far to do this than to lose them.

    • acat says:

      They won’t use laws, gets too close to slavery.
      .
      I expect that the next move will be to change licensing standards to make it easier (cheaper?) to get licensed if a doc or nurse is in a practice that takes government dollars…
      .
      Mew

      • Bartlett says:

        Licensing is too blunt an instrument. You apply once per state, are investigated for about six months (not an exaggeration), and then renewal is pretty much automatic every couple of years unless you have disciplinary action against you. No opportunity for fine tuning or caprice.
        .
        Malpractice insurance could be a big lever. If they were smart, they’d tie participation in exchange-based plans to tort protection (and if it were meaningful, it would bag HUGE numbers of docs). Since they aren’t smart, they’ll probably try to jack up rates on doctors who lack “social responsibility”, but there will be a major political backlash to get through and multiple levels of insurance regulation to screw up.
        .
        For now, I think the advantage is still with the doctors, but only because our would-be Machiavelli in the White House is really more like a six-year-old who wants THAT toy, RIGHT NOW.

        • acat says:

          Yes, but remember the Dem playbook..
          .
          When in control, move the ball as far as you can, when on defense, splinter the GOP weaklings.
          .
          Just because Obama is an idiot doesn’t mean they all are… Adding a “community responsibility” clause to licensing seems better – for government – possibly with a federal “for consistency” license (hint – look af pharmacist licensing changes recently) – than trying to influence the now-pissed-off insurers, eh?
          .
          Mew

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