I want to urge my fellow senior citizens to do their research in order to understand how the Affordable Care Act (aka Obamacare) will affect them and their families before casting their ballots in November. Seniors are an important voting block and are being actively courted by both sides.
The ACA is the biggest expansion of health care since 1965. It restructures one-sixth of the economy, putting it into the hands of politicians and bureaucrats, a frightening prospect indeed, given the fraud and seemingly endless scandals associated with government agencies. The ACA establishes 159 new boards, commissions and agencies. It is front-loaded with ANTICIPATED tax revenues while the benefit costs are backloaded. It also authorizes $10 billion to hire 17,000 IRS agents to force compliance.
It is undeniable that the ACA cuts $716 billion from Medicare over the next 10 years ($308 billion from the Medicare Advantage Program; $294 billion from hospitals; $66 billion from home health services; $39 billion from nursing home payments and $17 billion from hospice providers). Medicare is being raided to fund a new entitlement for people of all ages.
Supporters erroneously claim that current seniors will not be impacted by these cuts. Even the Medicare Trustees 2012 report concluded that the cuts will likely result in approximately 15 percent of hospitals, skilled nursing facilities and home health agencies operating at a loss by 2019. This will likely result in cutbacks and/or termination of services, making it more difficult for seniors to access services. A 2008 survey by the Physicians Foundation found that 12 percent of doctors closed their practices to Medicare patients.
The ACA has a 15-member Independent Payment Advisory Board (IPAB) appointed by the president. They are charged with overseeing health care costs, and ultimately reducing per capita Medicare spending in years when it is expected to exceed target levels in 2015. The IPAB’s proposals will be adopted unless Congress offers equally effective alternatives. The IPAB is not supposed to raise taxes, change benefits or ration care. However, every country with government-run health care has had to cut costs by rationing, so why should we be any different?
The ACA is filled with accounting tricks used to hide the true cost. For example, the $245 billion “Doc Fix” was cut out of the bill and introduced as a separate bill by Nancy Pelosi. Other gimmicks include counting the same dollars more than once. A major criticism is that the dollars “saved” from the ACA’s massive cuts to Medicare cannot be said to enhance Medicare solvency, reduce the federal deficit and fund the ACA’s entitlement expansion, all at the same time.
Estimates as to the ultimate cost range between $1.5 trillion and $2.5 trillion over the next 20 years. Why trust the numbers when the government notoriously underestimates the costs of programs? In 1967, the government estimated that the entire Medicare program would cost $12 billion in 1990. It ended up costing $110 billion!
Another sobering aspect of the ACA is the prospect that 21 million health-care providers could become unionized government employees. Just think of the implications of that!
Most would agree that there is a need for health care reform and that the goal is to provide affordable, accessible, high-quality health care for all. Why the United States, which still has the best health care in the world, wants to go down the path of other countries with government-run health care with its issues of quality, long waits and rationing defies logic.
We might have one last chance to make it right via a transparent bipartisan process, gradually implementing the changes. Gov. Romney plans to retain popular provisions of the ACA, for example, no exclusion for pre-existing illness, allowing children to remain on their parents’ plan to whatever age is agreed upon. The ACA is an ill-conceived, poorly written bill passed by elected officials who didn’t even bother to read it and exempted themselves from it. We deserve better!
Susanne Meyer lives in Newburyport.