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Grant Bosse

Grant Bosse: ObamaCare façade continues to crumble

“I know that there are millions of Americans who are content with their health care coverage – they like their plan and they value their relationship with their doctor. And that means that no matter how we reform health care, we will keep this promise: If you like your doctor, you will be able to keep your doctor. Period. If you like your health care plan, you will be able to keep your health care plan. Period. No one will take it away. No matter what.”

President Obama
June 15, 2009

“You can’t spend your whole life worried about your mistakes. You f-----d up. You trusted us.”

Eric Stratton, rush chairman, “Animal House,” 1978

For thousands across New Hampshire, and millions of Americans, ObamaCare is taking away their doctor and taking away their health care plan. That’s despite the empty promises used to sell a sloppy law passed by people who didn’t know what was in it.

Last week, Anthem Blue Cross Blue Shield informed the Legislature’s Joint Health Care Reform Oversight Committee that it would not be covering services provided by 12 of the state’s 26 hospitals. The smaller network will apply not only to the Anthem plans offered under the Affordable Care Act Exchange, but to Anthem’s individual and small business plans outside of the exchange. Anthem says letting patients choose any of New Hampshire’s hospitals is simply too expensive, and kicked a dozen hospitals, including Concord Hospital, out of its network.

Anthem will also refuse to cover referrals to out-of-state specialists, period. You’re still welcome to take advantage of the world-class hospitals located just a few south on Interstate 93, but you’ll have to pay for it yourself.

Anthem has since backtracked a little, putting Androscggin Hospital in Berlin and Littleton Hospital back in its network.

Gov. Maggie Hassan has known about this for a while, and Insurance Commissioner Roger Sevigny has endorsed Anthem’s plan to the Centers for Medicare and Medicaid Services, which is setting up New Hampshire’s exchange.

We still don’t know what kinds of plans Anthem will offer, or how much they’ll cost, because the state Department of Insurance clings to the ludicrous notion that its internal rules trump the state’s Right to Know Law, and that the details of a government-run health insurance scheme are proprietary until Jan. 1, 2014, the day the new policies are supposed to take effect.

Anthem argues that such drastic decreases in accessibility are necessary to prevent drastic increases in premiums. They simply can’t afford to let you see the doctor of your choice. If you’ve been paying attention since ObamaCare passed, you’ve known this was coming.

No insurance company could provide the services mandated under the law for a price anyone would pay. So they’re limiting the options. They’re rationing care.

As we socialize our health care costs, we also socialize our health care decisions. If you were paying my hospitals bills, you’d have an incentive to make sure I’m not wasting your money. But of course, I’m never going to spend your money as carefully as my own. So you step in, through the government and the insurance companies, to limit my choices.

Even if Obamacare had been well-written and properly implemented, rationed care would be inevitable. The incompetence of the Obama administration has been optional. It’s missed deadlines and delayed major provisions of the law. Employers are cutting staff, cutting hours, and dropping dependents for their health insurance plans in order to avoid the law’s costly implications.

Even though the exchanges are scheduled to open enrollment on Oct. 1, only 13 states and the District of Columbia are far enough along to know how much the plans will cost. Avik Roy, whose been tracking this slow-motion train wreck for Forbes, calculates that nine states will see higher rates for the plans offered by the exchanges, and five will get lower rates. On average, health care premiums will jump 24 percent. He hears the Obama administration will have the relevant data for the other 37 states by Sept. 19.

The Patient Protection and Affordable Care Act neither protects patients nor makes care more affordable. It is a bad idea, poorly executed. It was never going to bring down health insurance costs, but it didn’t have to fail quite so catastrophically. They are plenty of dead-enders who insist it’s either working just fine, or would be if people like me weren’t keeping it from speeding off the cliff.

Such delusions are going to get harder to justify as health care costs continue to climb, and patients are turned away from Concord Hospital and Mass General.

(Grant Bosse is editor of New Hampshire Watchdog, an independent news site dedicated to New Hampshire public policy, and a senior fellow at the Josiah Bartlett Center for Public Policy.)

Legacy Comments56

Monitor Columnist Grant Bosse presents a distorted picture of the Affordable Health Care Act and of insurance practices in general. First of all, only Medicare permits you to see any appropriately licensed health care provider of your choice. All private insurance companies require that providers apply for inclusion to a panel of providers, and prospective patients must choose from within that panel. The Affordable Care Act does not create greater restriction. The way each state implements it may create additional restriction. The Affordable Care Act is a brilliant step forward in providing healthcare for virtually the entire population of the U.S., reducing healthcare cost (it absolutely will!) significantly. If we can be successful in implementing this program, we will join the majority of other countries that emphasize and support health care for their citizens. As it stands now, we have the most expensive healthcare in the world except for Switzerland, and we have a remarkably sketchy level of health. If you have followed Affordable Care from its inception to the present, you will be cognizant of the fact that certain groups persist in trying to undermine the program, never presenting alternatives. They have not made implementation any easier, and they’ve wasted lots of taxpayer money trying to undermine the plan. Also, if an employer cuts employee hours to avoid contributing to their healthcare, shame on him/her. Don’t blame Affordable Care for that. Look to the slipperiness of the employer.

Gen_X, gracchus, Publius, DevilDoc and Hunter. This whole line of comments is very similar to a conversation with a small child. No matter what you say or what you ask, you really only get gibberish in response. It's also hard to claim something was rammed down your throat when your party refused to even participate in the first place. If you are not part of the solution, you are part of the problem. Right now the GOP is the problem. They only complain and offer no solutions of their own. So let's hear it Van - what part of my view is incorrect?

There was NO problem with Health Care in America - it is a democrat made up illusion. the USA health care is the best in the world.What democrats want is for someone else to pay for it. That kind of thinking in America IS the problem

No, believing things that are demonstrably untrue is the problem.

(Like)

Show me your source for your claim that the US has the best health care in the world. According to all the google sites I found, when it comes to health care efficiency we rank near last. While we rank at the top when it comes to cost. In general it appears we rank about 46th. So where do you get we're number 1 from, the 1950's??

I'll answer for him: Obamakare, democrats evil, liberals wicked evil, Republicans good, Reagan demigod, Obamakare, low information voters, and one more Obamakare for good measure. Please supply the verbs of your choice.

Yes, Anthem is going to still profit. Yes, I may have to change doctors and hospitals. Premiums could/should be cheaper. Businesses with over 50 employees may be unhappy. But yahoo! I can purchase health insurance as an individual without being turned down for prior health conditions. Smells like progress to me.

Getting someone else to pay for your expenses should never be called a success to a real man

For a reader to be informend they should do a google search for this article:"GAO: HHS Already Rationing Enrollment in Obamacare’s Pre-Existing Condition Plan"

There are at least 35 million Americans who go without regular health care because they don't have health insurance. Contrary to what Grant implies here: "Even if Obamacare had been well-written and properly implemented, rationed care would be inevitable..." we already ration care. Only we ration care based on whether one is rich or poor. Health care should not be a zero-sum game. Opponents of the ACA make it seem as though adding the uninsured to health insurance rolls will diminish their own quality of care. That is neither inevitable nor necessary. But don't pretend we don't already ration health care in this nation--we do.

CBO says that delaying ObamaKare will save America 35 Billion Dollars. Lets exempt all of America from ObamaKare and save even more money. http://dailycaller.com/2013/09/09/cbo-obamacare-individual-mandate-delay-would-save-35-billion/

Let's not. Repealing the ACA would cost at least $100 billion over 10 years, according to the CBO.http://thehill.com/blogs/floor-action/healthcare/299895-cbo-obamacare-repeal-will-increase-the-deficit

liberals are like a drunk sailor and a lamppost. They use it to stabilize their wobbly argument - never to illuminate it.

You are incorrect Publius. The public option was dropped because President Obama made a backdoor deal with the healthcare lobbyists who were against it, mainly those representing hospitals. He also made deals with the drug companies.

This week .... IBM plans to move about 110,000 retirees off its company-sponsored health plan and instead give them a payment to buy coverage on the OBAMAKARE exchange........ mONDAY - TIME WARNER to move retirees to ObamaKare exchanges....Way to go democrats - this is a 100% DEMOCRAT CREATED TRAIN WRECK.

Au contraire, Itsa. Republicans have been trying to get rid of Social Security, Medicare since they were first enacted. If Mitt had been elected, Ryan's budget would right now beginning the dismantling of these programs. I remember Newt's comment about letting Social Security wither on the vine. Don't hear much about replace anymore, do we? It is all Repeal, repeal, repeal.

Van - "Blaming Republicans and Conservatives for ObamaKare is just off the scale bold faced lying " I don't think anyone is directly blaming the GOP. The basic plan for ACA was developed by a conservative think tank, The Heritage Foundation working with the GOP years back. Republican Mitt ran with it in Mass and then distanced himself when it came back to haunt him with the low information conservatives. You may hate ACA all you want but until the GOP is ready to address the issue of healthcare in this country we can only go with the plan at hand. It is so very easy to stamp, shout, rant and scream while not offering any alternative. Got a better plan lets hear it, got nothing then come back when you do and that goes for Mr. Bosse.

Van seems to create his own version of reality and then tell those who don't inhabit his world of make-believe that they are either "low-information" people or liars. Now he's hanging his hat on the fact that no Rs voted for the PPACA, which is true. But you are also correct that it is based on the Heritage plan, and shares its DNA with the plan enacted in MA by Governor Romney. I also remember the Gang of Six - three Democratic and 3 Republican senators who made numerous suggestions and recommendations - many of which ended up in the PPACA. The most memorable was the dropping of the "public option," which was done at their request, and to try to make the bill more palatable for the Rs. But despite their inclusion in the drafting of the bill and the impact they had on its final form, no Rs voted for it. I won't speculate as to why. So to deny that a) PPACA was based on Republican plans and b) that Republicans had nothing to do with its drafting - i.e., it was "rammed down our throats" is hyperbole at best, and mendacity at worst.

Mauser and Publius it is nice to see you left wingers run from ObamaKare because you know it is a train wreck.

Where did you get that? I'm simply pointing out the facts about the PPACA's origins. I find it incredibly bizarre to hear die-hard Republicans such as yourself deny them, and I have to wonder if this was passed by a Republican administration, as it was in MA, what you would think of it. You seem to think Mauser1 and I are "blaming" the Rs for this legislation. Not so. I won't speak for Mauser, but I'm trying to keep the same falsehood from being repeated over and over until people just accept that it is true.

Publius, everybody calls it ObamaKare, why aren't you using that term? Are you ashamed of it. It certainly doesn't protect patients and it is far from affordable. I know you want to Con and Confuse the Low Information Voters. The Heritage Organization is leading the way to fight ObamaKare. Here is another fact that you have yet to refute. Zero Republicans voted for ObamaKare. Here is another fact you have failed to refute that ObamaKare was a purely partisan vote. Finally here is another fact you fail to refute is that the vote against ObamaKare was bipartisan. So no matter how fast you foaming at the mouth rabid liberals/democrats run from ObamaKare you own it 100%.

Reply to Van below: I don't try to refute facts that are demonstrably true - that's more your style than mine. With that said, however, I don't see what your facts prove that is contrary to anything I said, and you've done nothing to refute those facts that I pointed out. So, nice try, but you're once again way wide of the target. And not that it's any of your business, but I prefer to use the law's actual name because that's my style. "Obamacare" is pejorative, and I would be ashamed of myself if I used it.

Who's running from it?? Not me. Just where do you get off calling anyone who disagrees with your narrow definition of voters. Lets look at it for a second - agree with Van = conservative, disagree = left winger. Well where do moderates, independents and non-zealot conservatives fit in? A better classification would be your (Van) group of zealots, then the more rational group of voters. Why don't you, sail, gwtw or itsa answer one simple question that I have repeatedly asked - If you don't like ACA what do you suggest in it's place?" Well, how about an answer? Or can you just complain and be a waste of space?

"The most memorable was the dropping of the "public option," which was done at their request, and to try to make the bill more palatable for the Rs."....Nope....it was dropped to make it more palatable for the d's.

Will you guys get your stories straight, please? Either the public option was dropped to make it more acceptable to the Democrats or because of some back-room deal with hospitals. Which is it?

Since hospitals dont have a vote in congress, I'll go with my answer.

That 90% of customers will not be affected is incorrect. What Anthem has said in other states is that the folks who had insurance prior to 2010 will not be "immediately" affected. That means once their policy comes up for renewal, they will have to purchase in the narrower network. In CA, Anthem reduced the hospitals in the network to only 39% of the hospitals they use to cover. Cost of premiums went up 13%. A great deal, less choice at a higher cost. Anthem not revealing any info because what they are offering is bad news.

FACT: The Right came up with this plan(or a version of it) first. FACT: When Obama wanted to pass it into law, they said "no" because they hate him. FACT: In order to get it passed, Obama had to cow-tow to the right until his healthcare idea had morphed into the closest thing to what theirs was. So . . . all you people who are denouncing Obamacare are really denouncing the right's version of comprehensive health care for all citizens.

So Dan, that is the liberal talking point now. It doesn't matter that not a single Republican voted for it. The left wing is delusional.

Van, congratulations! You've finally got one point right, but only one. Here it is: "It doesn't matter that not a single Republican voted for it." It doesn't matter because every Republican vote was whipped to vote NO, and that was because publicly stated Republican policy was to assure President Obama's failure. It would be nice if Republican votes were motivated by policy not politics. On the other hand, maybe I'm just a low information voter (this was to save you the time and effort).

your story is nothing more than revisionist history - the legislative maneuvering that the democrats contorted to get ObamaKare passed is well published. For instance the bill was pushed through reconciliation and the Federal take over of student loans had to be included....do the readers know why?

Fact....you have never ever read what the Heritage Foundation plan was. It was catastrophic health insurance, much like your car or home insurance.

You are correct - The Heritage plan was a catastrophic health insurance proposal. But Dan is also correct - the Heritage plan was the right's response to the proposal that Hillary Clinton was expected to produce. It was designed to provide an alternative to a single-payor government-run healthcare system that would maintain private insurance. It also included the individual mandate, which has generally been the primary objection to the PPACA. When Governor Romney put his program together, he borrowed heavily from the Heritage plan, especially regarding the individual mandate. HIs program seems to be working rather well - the last report I heard indicated that over 90% of people in MA had health insurance. My concern is that all this carping (and I've contributed to that, which I think may have been a mistake, because I don't think I've moved the ball down the field) about who thought what and who said what is really immaterial. Whether we like the PPACA or not, it is the law. It is the healthcare system we have to work with. I don't pretend to know how it will work or if it will work - and those who say they do know really are pretending. This is an incredibly complex issue with lots of moving parts. I certainly hope that it does work, because we all have a vested interest in it. I think that it will change as the people who are responsible for implementing it and for working within it make their concerns known. In other words, I don't think that it is all darkness. But things will be different. And we don't know what things will be like 5 years from now. But there are lots of good people who are committed to making sure that people have access to the healthcare that they need. It will work out.

Our token Conservative spins once again. Doc

From what I read about Anthem, quite a few hospitals in Maine and NH were not even contacted to join. They had no clue they were not on the list till it was published. They are keeping the network narrow for a good reason. Profits. They are also being very sneaky with revealing the costs and coverage also. I am amazed yet again that folks are defending Anthem when they have no clue what they are up to. You know those nasty insurance agencies that screw people over. Now all of a sudden Anthem is a hero. Many here think that they will not have to change their healthcare. If you have a policy that came in existence in 2010 and that policy does not have the mandates in it that the ACA demands, you have to get a new policy with Anthem. The one they are hiding now, with the narrow networks. Good bye to your Docs and hospital. Get informed folks. This is not politics, it is your health care.

This is the most accurate, most honest and most inspiring column from Grant Bosse which I have read. Right on Grant!!!! But the naysayers are coming.......be ready.

All the problems of the the monstrosity that is the Affordable Care Act arose because the creators tried to accommodate conservative representatives and senators who weren't going to vote for it anyway. Every objection that Grant and his sycophants have expressed could be overcome with a one-sentence bill, something like: "Effective immediately all residents of the United States, its commonwealths, territories and protectorates shall be included in Medicare."

Gracchus that is not true and you know it. You are depending on the low information voter. Democrats had majorities in both the house and the senate and Obama had the White House. Not a single republican voted for this bill and some smart democrats voted against it making it partisan support for it and bipartisan support against it. Obama and the democrats shoved this down our throats and they had to bribe few wavering democrats to get it. Democrats own this 100% and then some. It is interesting to hear the lies come out now.

To Van below, they are feigning "fairness and balance" in reporting. You are correct, however, it was 'shoved' down our throats.

ObamaKare was absolutely Shoved Down our throats Bingo ItsaRepublic

Social Security, Medicare and the 40 hr week had to be shoved down Republican throats. Just try to take any of them away now. That is really your big fear. Once people realize how good the ACA is, they won't stand for Republicans trying to get rid of it.

No one is trying to get rid of any of those tillie. No One! The folks who seem to support Obamacare either feel that they are entitled to something and have everyone else pay for it or their hearts bleed for the propaganda about those who don't have health care. Either way, it is not about Republicans, never has been, this was voted for by a Congress of the past and they played every dirty trick to force it down the throats of Americans.

Van...you seem to have forgotten how often the House Republicans tried to stop the ACA. Did you ever read any part of it?? Especially the part that required that 80 % of client fees were to be used for health costs NOT administration-that was the remaining 20 %. HOW could any capitalist corporation EVER survive if it couldn't provide multi-million dollar compensation to its CEO, CFO, etc?? You can now see the main reason that the House Republicans fought so hard to thwart ACA. I find it amazing how those who support the GOP fail to see how little the Republicans support the middle class or poor.

Wow, two articles in one week in the Monitor exposing Obama. Maybe the Monitor doesn't want to get get caught in the Obama Train Wreck. Perhaps the Monitor is sick and tired of shilling for the Worst President Ever: Barack Hussein Obama.

Van, your posts remind one of some sort of pub game (for those who lack the physical skills for darts): Put a number of easily recognized buzzwords in a box, shake it up, start the timer, and try to put the results in a complete sentence. Points are awarded for sentence length because the ideas can be counted on to be worth no points. Oh, by the way, sir, Grant doesn't write "articles"; he writes "columns." The distinction is not to be missed.

Your words are pure projection, bill. Always directed to those who have difficulty with critical thinking. People like me are amused by the lack of facts and depth of your discussions.

First, Anthem is not "kicking a dozen hospitals" out of it's network. The hospitals chose not to join the network because payments were not high enough for them. Second, according to yesterday's Monitor article "the network limitation does not affect employer-sponsered coverage not purchased on the exchange". It affects "individuals and businesses who purchase insurance through the [new] marketplace, and individuals who purchase insurance through Anthem outside the marketplace". "…about 10% of people insured by the company next year…". Presumably these 10% can switch to a different insurance company who does business with their current providers. As usual, Grant cherry-picks his facts and chooses to omit others. And as far as rationing health care goes, it's already rationed: the wealthy get plenty of great care, the poor get very little--if any at all. But of course, we could do the sensible thing (the thing that every other industrialized country has done many years ago) and go to single-payer and have 100% coverage and still pay less for our health care.

Gen X it is you who is cherry picking: If you like your doctor, you will be able to keep your doctor. Period. That means: If you like your doctor, you will be able to keep your doctor. Period. With Concord Hospital out of the picture for the poor people who get stuck with ObamaKare and go to doctors throughout the CH system they will lose their doctors. It is simple ObamaKare sucks. When employers are cutting staff, cutting hours, and dropping dependents for their health insurance plans in order to avoid the law’s costly implications. People will lose their health care plans that they like. It is simple ObamaKare sucks. It was as if the the democrats planned ObamaKare to ruin our health care system.

You nailed it Van, supporters of Obamacare tell us it is about "fairness" but in reality, they are just as concerned about how much it is costing "them" and they want something for nothing or at least something paid for by others. They told us that emergency room service for those without insurance cost us all more. It seems as if Obamacare is not the answer as we can see it will cost exponentially less. Yes, they will speculate and project that long term it will save all of us, blah, blah blah. This is about self serving people getting everyone to "chip in" to cover others. Now we can all feel so good that we pay for health care for our families and some other folks we really don't know as well. How great of progressives to put us on that path!

Obama's army of mind numbed robots's message isn't even coherent. Blaming Republicans and Conservatives for ObamaKare is just off the scale bold faced lying they will attempt to do just to con and confuse the low information voter.

Van, no one's blaming Republikans or Konservatives for Obamacare, they are blaming them for trying to sabotage the plan by spreading fear and misinformation and trying to dissuade people (especially the young and healthy) from enrolling in it. BTW, what is the Republikan health care reform plan?

Van, what exactly did I cherry pick? What part of my statement is wrong? 90% of Anthem's customers will be unaffected. Those that are, are free to switch health insurance companies to stay with their doctors.

The hospitals chose not to join the network because the payments would not cover payroll, services, the cost of new equipment and cover their costs. Let's be honest about that. IF and that is IF an employer decides to cover you and mine does, it will cost me an extra $3000-$5000 per year out of my household to cover my family. How is that "affordable"? You are incorrect, the poor get care at emergency rooms and according to progressives that was the major problem with health care as it cost all of us so much more.....now Obamacare is going to cost "so much more". Single payer historically has rationed care and it has to be paid for by someone, so it will cost all of us more. I like my provider, I like my doctors and I like my healthcare and in a free society YOU and a minority of high thinkers should not be able to "engineer" what I get. That is not a free market.

Hospitals chose not to join the network because there's easier pickin's out there with the other insurance plans (i.e. greater profit margins). Besides, as I said before, I support single-payer. And if you think single-payer will cost all of us more, how come every other country with single-payer spends way, way less in total cost and percentage of GDP, with comparable or even better results?

Hospitals are not "profit centers" as in Wal-Mart or other companies. Hospitals reinvest their earnings in new technology. Your "greater profit margins" argument is speculative at best and insulting at the worst. Single payer and % of GDP, etc. is all double speak. What matters is what happens on the ground. That means how it affects 1) the pocketbooks of the end user, the patient, 2) how rationed the care is in that certain things are not covered, 3) wait times, 4) end of life years and in Obama's words "maybe a pain killer makes more sense than expensive treatment" and 5) how much control faceless bureaucrats have over your life, choices and freedom. That canard about the United States is 37th and the rest of the world rocks is based on biased criteria in the first place. It is weighted on terms like "social fairness", etc. It has little to do with quality of care which is measured at just 12.5% of the analysis.

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