3/27/2010

The Law Of Unintended Consequences - ObamaCare Edition

Reading and watching the reactions to the passage of ObamaCare has been educational if for no other reason that it illustrates the differences between those supporting the poorly thought out piece of legislation and those opposing it. Probably the biggest difference has got to be an understanding of economics in regards to the Law of Unintended Consequences. Those supporting ObamaCare (primarily the Left) apparently have a poor or non-existent understanding of economics or the effects of laws, taxes, spending, and mandates. Those opposing it (primarily the Right and the Center) understand economics all too well and particularly in relation to ObamaCare. They also understand the aforementioned Law of Unintended Consequences and how it is already coming into play.

The first and most profound effects will have far-reaching consequences, with large companies like Caterpillar, Verizon, and AT&T having to pay hundreds of millions, if not billions of dollars they might have used for other purposes...like expanding their businesses and hiring more people. Of course I expect the Left to say it's all smoke and mirrors and that heartless businesses are just using this as an excuse to hurt their employees. (Yeah, like successful businesses will purposefully hurt the very people they need to remain successful.) They don't understand that when you take that kind of money away from businesses they'll have no choice but to react in ways that will allow them to survive.

Another unanticipated effect of ObamaCare: Retirees presently receiving prescription drug benefits from their former employers may lose that coverage and be forced to convert to Medicare Part D. Why? Because ObamaCare just made it far more expensive for the former employers to keep providing the benefits by adding over billions in new taxes on those benefits, which is one heck of a disincentive to keep doing so. By not providing this benefit they won't have to pay the taxes. It also means the government won't collect the billions in new taxes they expected and they'll have to spend billions more to cover the now benefitless retirees. Between the lost revenues and the new expenditures the government will come out the loser on this, meaning the rest of us will have to make up the difference. We just don't know exactly how it is we'll be paying for it but it won't be cheap.

Another not so unexpected unintended consequence: Some of the very people we'll depend on to provide all this health care will bail out of the medical profession because they'll be heavily taxed on their income, won't be the ones deciding what care their patients require, and won't be reimbursed enough by Medicare to cover their costs under the 21% cut in Medicare payments that are part of ObamaCare, just to name a few. This is the same thing that happened in the UK and Canada when their governments took over control of health care – doctors and nurses left the profession or left the country and practiced elsewhere...like the United States.

Will ObamaCare initiate a rebellion among health care professionals as has happened in Canada, where some doctors have refused to take 'national insurance' and opened private cash-only clinics? Some practitioners here in the US have already shed themselves of the headache of health insurance, taking cash-only patients and/or offering concierge medical services (patients pay an annual retainer in return for a certain number of visits and services, which in the long run can be cheaper and easier than insurance).

In light of this I have a question for the ObamaCare proponents – Just because an additional 30 million people lacking health insurance will get it in the not so near future, what makes you think there will be any doctors willing or able to take them on as new patients?

Some may claim the only reason doctors will do something like that is because they're greedy bastards who really don't give a damn about patients, only about money.

A lot of the times, they offer treatments and surgeries for cancer or whatever that might cost $200,000 and they KNOW that they will only help the patient live MAYBE 4 months longer. The doctors have seen it happen over and over. It sure does make you wonder if the doctors are offering these treatments more for THEMSELVES financially or for the good of the patient.

A response to this piece of ignorant crap came from Dr. Ann Contrucci, MD, a pediatrician in Atlanta, Georgia:

Mr. Foster, I don't believe I saw M.D. behind your name? For those of us real doctors who assess real patients and make decisions regarding their treatments, your comments are nothing short of arrogant and insulting. Did you look this stuff up on, I'm sure, a reputable medical website so now you "get" what a doctor does and understand how he or she makes decisions? Do you actually have ANY idea how we make medical decisions? Do you have any idea what kind of education, training, and experience makes up what we do? We are given one of the biggest, if not the biggest, responsibilities of any job known and that is to heal. Unfortunately, despite even our best treatments sometimes, that is not the case. That is because medicine is still an art and not 100% exact science...therefore, bad outcomes still result. What used to be accepted as part of the circle of life is no longer so. Now it is patients coming in demanding this or that test, this or that medication because they "saw it on TV" or read it on the internet. If something bad occurs, well it must be the doctor's fault. There is no trust in physicians and with the bottom dwelling plaintiffs' attorneys lurking, frankly there isn't much trust in the patients. If I had a dollar for the number of times I've heard, "if you don't do the CT scan, I'm going to sue you," I'd be one of those "rich doctors" I always hear about. Funny, none of the docs I know are those "rich doctors."

I canNOT believe you would actually think that "doctors are offering these treatments more for themselves financially..." If you actually think that most physicians are of this mindset, you are a sick, sick man and there is no hope for you. Thank God you didn't go into medicine!

Here's the "DIRTY LITTLE SECRET" - physicians want to do the right thing for our patients, we do our best every day under, oftentimes, extreme circumstances and in stressful, chaotic environments with a risk to benefit ratio that is nearly always not in our favor. We do all of this while being held to an impossible standard of accountability while the politicians who are making all the decisions have none whatsoever. Perhaps your time would be better spent looking into those dirty little secrets...

By the way, I truly hope that you or no one in your family every needs a physician's services for anything - you really wouldn't want to have to trust one of us to help you, would you? If, God forbid, you or someone you love has to be rushed to the ER for, say, a heart attack, what dirty little secret do you think your ER doctor will be harboring? Hmmm, I would bet that you will be given any and every treatment there is to SAVE YOUR LIFE! But that's just a guess...

Unfortunately the attitude of the first commenter, Dan Foster, is all too common, particularly among supporters of ObamaCare. As Dr. Contrucci says, too many people like Foster have no idea what is involved in becoming a physician and the pressure they're under every single day they're treating patients. The problem is there are far too many others out there with the same attitude as Mr. Foster, which might be why they support ObamaCare – pure ignorance. It would also explain why they have overlooked the unintended economic consequences of ObamaCare.