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Sunday, April 18, 2010

Health Care Coercion Will Get Worse

Obamacare will have the unintended consequence of creating a two-tier system which is far more dramatic than the current system.

We all know about the coercive nature of the individual and employer mandates under Obamacare. Those mandates, however, merely are mandatory (brilliant, I know).

The mandates do not prohibit people from purchasing extra insurance on their own or paying privately for medical services.

What we will see is that "the wealthy" will opt out of the system by paying privately for excellent insurance coverage or for medical coverage directly. While the costs to such individuals from the destruction of the private insurance system will be high, those with the resources can insulate themselves from the inevitable state-controlled rationing simply by paying for it privately.

Large segments of the population which currently have private insurance will be forced onto government run or subsidized coverage which is the equivalent of one big HMO. Another much smaller segment of the population will dip into their own pockets to maintain the health care life-style to which they have become accustomed.

The result will be a two-tier system which will become a target for the same mentality of redistribution which led to Obamacare. And the only way to enforce "fairness" will be to create disincentives for patients to pay privately for medical care or to purchase anything but government-mandated insurance.

In Britain, although private insurance is available for purchase, there remains a punitive attitude towards private-pay patients, as witnessed by this report in The Times of London, NHS bars woman after she saw private doctor:

A WOMAN has been denied an operation on the NHS after paying for a private consultation to deal with her severe back pain.

Jenny Whitehead, a breast cancer survivor, paid £250 for an appointment with the orthopaedic surgeon after being told she would have to wait five months to see him on the NHS. He told her he would add her to his NHS waiting list for surgery.

She was barred from the list, however, and sent back to her GP. She must now find at least £10,000 for private surgery, or wait until the autumn for the NHS operation to remove a cyst on her spine.

“When I paid £250 to see the specialist privately I had no idea I would be sacrificing my right to surgery on the NHS. I feel victimised,” she said.

Coercion is the heart of Obamacare. If the mandates do not have the desired effect, expect more punitive measures.

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  1. Part of the plan. We have seen incrementalism for 50 years. You'd think we would recognize it when it came by.

  2. "Obamacare will have the unintended consequence of"

    I don't believe for a second that this consequence is unintended.

  3. I don't believe that the end-result will be to penalize the wealthy, privately insured. I believe that single payer insurance will be instituted long before that since the middle class who may still be able to carry some vestiges of their old coverage will be the most severely hurt for what they are paying and will back the public plan. I say we liberate Monaco and all go live there on a first-come-first serve basis. We have been gambling with our future anyway.

  4. I do hope that the option to obtain private medical care and/or insurance does remain. However, given the law's new taxes on medical devices, etc., and the likely result of less research and fewer medical advances, even if we are able to get treated (privately) by the best doctors, won't these doctors be stuck using old/outdated technology and equipment, because nothing else will be available?

  5. 250? Wow, here in the free market of Texas, we paid $120 for the initial consultation and then $70 for each appointment when paying cash for an orthopaedic doctor.

  6. You are absolutely correct about what Obamacare will do to our healthcare system Mr Jacobson...though like another poster..I'm not sure it's unintentional!!

    As well as arriving at a two tier system..we will first experience a severe shortage of health care providers.

    How do I know?

    I'm a physician myself.. and the day after the healthcare bill passed, I spent 2 hours with my financial advisor discussing early retirement...and speaking with other physicians ..I'm far from alone.

    Look me up some time Mr Jacobsen..we are almost neighbors.

    My name is Dr Tom Taylor and I work at the Arnot Ogden Medical Center in Elmira.

    I can't tell you how thrilled I was to learn that there was a Conservative law professor fighting the good fight so close by at Cornell!

    It's nice to know that Mark Finkelstein isn't alone there in in Ithaca.