There is one thing that all Republicans know: Obamacare is an unmitigated disaster that is destroying the great system that we had before — “The best healthcare in the world!” But their real problem with it is not the policy. As I’ve discussed a lot around here: Obamacare is the most conservative healthcare reform that could work. All the supposed conservative alternatives since have been brainless ideology that would have made the situation worse — things like tort “reform” (not allowing patients to sue when they’ve been harmed) and allowing insurance across state lines (destroying local control and causing a race to the bottom).
The one thing that Republicans have focused on has been the individual mandate. And that has been a winner. The truth is that no one likes it. It’s like how people like Social Security but don’t like payroll taxes. But you can’t have one without the other. The individual mandate is what allows Obamacare to work. Otherwise, people would have an incentive to put off buying insurance until they were sick. This would result in the risk pool being expensive, resulting in high insurance costs. After all this time, you probably know the drill.
But the Republican hatred of Obamacare has no bounds. And there is no rationality to it, so they hate everything in the healthcare law. Of course, if someone mentions pre-existing conditions or coverage of college students, Republicans will always claim that they too will have those things once their replacement comes out — right after America turns into a land of fairies and elves and everyone gets all the cotton candy they want. But one thing Republicans only scoff at are the measures in the law designed to lower healthcare costs. And not surprisingly, no amount of data is going to stop them from thinking that.
A recent study reported in Health Affairs highlights the way that one of those measures is working. Michael Hiltzik has the details, Here’s Another Way Obamacare Is Changing US Healthcare for the Better. One way that healthcare costs more than it should is by not properly treating a patient. If a patient comes in with chest pains, gets released with antacids, and then comes back the next day with a heart attack, it costs a lot more money than if the chest pains had been properly treated in the first place.
Obamacare deals with this issue by cutting back on Medicare reimbursements to hospitals that have too many of these kinds of re-admissions. This is an especially big deal because hospitals are probably the single most dangerous place to be in terms of getting a disease. So there really is a lot that hospitals can do to improve the situation. The authors of the study looked at these re-admission rates and found that Obamacare really was changing behavior and reducing rates. Hooray!
This didn’t stop Paul Ryan — now chairman of the House Ways and Means Committee — from saying this week, “The whole law’s a lemon.” But of course he would. For him, like all Republicans, the complete catastrophe of Obamacare is definitional. It’s interesting to contrast this with Medicare Part D. Many Democrats were against it. But after it was in effect and working as it was supposed to, the Democrats changed their position. But such open mindedness is asking far too much from Republicans.