Top Obamacare Surprises in 2013, Starting With Health Sector’s Greed

Beyond the GOP’s efforts to overturn or cripple Obamacare, the wobbly rollout of the largest new government safety net in decades has led to some surprising revelations about healthcare in America in 2013.    

Most surprising is how many stubbornly greedy players there are in the medical-industrial complex. The foremost example is how the middlemen—insurers—have seized every opportunity to gouge the public before and after insurance-buying exchanges opened this past October 1. Not only did premiums jump by double-digit amounts from coast to coast for many policyholders after the law’s passage in 2009, but this fall the industry doubled down and jacked up prices or canceled policies for hundreds of thousands of people. That’s quite a way to say thank-you to the federal government for sending them millions of new customers.   

But insurers are not the only greedy sector. Hospitals—many of which are chartered as non-profits and get tax breaks—have been unmasked by astute reporters for shamelessly overcharging for just about anything that can be put in a bill. The New York Times reported that after a backyard fall, a leading San Francisco hospital charged $2,930 and $1,696, respectively, for three stitches and a dab of skin glue. The Times' detailed piece said, “There is little science to how hospitals determine the prices they print on hospital bills.”   

The same point can be made about the prescription drug industry and pharmacy chains, where the retail price on labels is off the charts and bears no relation to co-pays. And there’s also the not-exactly-compassionate decision by hospitals and doctors to reject patients under Obamacare via the new state or federal exchanges. That echoes physicians refusing to take Medicaid patients, saying government reimbursements are insufficient.

It’s no surprise that the GOP is blaming Obama for everything that keeps going wrong in America’s profit-driven healthcare system. But it is surprising that these brash business decisions are being thrust upon the public with impunity, where the blame game is to tar President Obama with everything the private sector was going to do anyway—and has been doing.

Obviously, the Obamacare website’s wobbly rollout was the administration’s fault, but there are some dimensions to that story that haven’t been appreciated. First is the surprisingly decrepit state of government’s information technology outside spy agencies. People who work with government always find different computer systems, outdated machines and incompatible software across counties, states and federal agencies. To get them to smoothly work together is a giant task—and signing up for healthcare is more complex than registering to vote.

Moreover, the firms that know how to get big federal contracts often don’t deliver what they promise on time. Add to that the refusal by red-state governors to help the feds set up insurance exchanges by sharing their data on residents, and the botched rollout is not surprising, especially since federal agencies have been run on the cheap for years by Congress. If anything, the over-reliance on the private sector for Obamacare builds an even stronger case for a fully public system.

Finally, another surprise about Obamacare in 2013 is the GOP’s determination to destroy a private-sector initiative that was proposed by one of its own think-tanks, the Heritage Foundation. The Supreme Court will decide next year if businesses don’t have to offer contraceptive services under their health plans because of the owner’s religious objections. Another GOP-led lawsuit is trying to stop premium subsidies in states that haven’t created insurance marketplaces. And there’s no shortage of GOP candidates who keep promising to repeal the law if elected.     

Despite the partisan rancor, frustrating website and premium hikes, people are slowly but steadily signing up for Obamacare—because they need healthcare. But that’s not a surprise.

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