US Supreme Court Upholds Affordable Health Care Act

[ShadowHM]

Either we are discussing apples and oranges, or you misunderstand the Canadian healthcare system and my opinion on how healthcare should operate in a first-world country. I cannot walk into my doctor's office and demand a free MRI just because "free healthcare". Doctors have the ultimate say on what treatment is administered (as I said more than once in my previous post).

I visit my doctor for checkups or when I have a medical issue. He decides on treatment, and that's it. I can discuss optional treatments with him, but my doctor is the ultimate arbiter.

People with access to free healthcare do not rush to their closest hospital for whatever free stuff they can get. They go there when they need to, because no one likes going to a hospital.

There may well still be some sources of extra cost due to the doctors being the gateway, especially when there are some serious conflicts of interest possible in the private health care sector. We Canucks don't have that concern or that cost because the hospitals are not privately owned, although some clinics do offer 'full-service' and hence may still over-prescribe on testing.

I now work in a peripheral area of healthcare, and thus receive a number of newsletters that are targeted to Canadian physicians on healthcare topics. I got an email at work yesterday from Parkhurst Exchange. Here was their take on the news of the SCOTUS decision:

OBAMACARE LIVES ON!
In a decision that has bowled over most expert prognosticators, the US supreme court has upheld the centrepiece of President Obama's signature healthcare legislation, the individual mandate that compels millions of Americans to buy health insurance. The Affordable Care Act, popularly known as Obamacare (or Obamneycare in some circles) came through its months-long ordeal slightly singed at the edges but largely intact, and the next 18 months will see a good deal of its provisions implemented.

Much ink will be spilled dissecting the ruling and its implications for healthcare, spending, and of course the upcoming US election. But perhaps the most telling indicator is the market reaction: shares in for-profit hospitals jumped while health insurers' stock fell sharply. This reflects the growing belief among more engaged observers on left and right that Obamacare isn't really going to support a viable health insurance industry, because it's really a halfway house on the road to a single-payer system.

Private insurers aren't directly to blame for the upward spiral in US health costs. They don't want more expensive procedures any more than they want more floods and hurricanes. Perverse incentives and naked greed on the part of many US hospitals and doctors play a more direct role. But private insurers are a middleman that needs to be gotten out of the way if the government is ever to get to grips with those doing the billing. There is no doubt that Obamacare will shrink their margins from day one, and the squeeze is only likely to get tighter. Insurance companies will be encouraged to lose interest in the health marketplace – leaving room for the public option to step in.

For the best explanation we've seen of the real nature of America's health cost problem, read this great investigation by Harvard Medical School professor Atul Gawande. During the tense passage of the 2009 bill, Obama was rarely to be seen without a copy of this article. He cited it frequently and handed out dozens of photcopies to White House staffers. It provides the most direct insight we have into Obama's thinking on healthcare. It may make uncomfortable reading for many American doctors.