Eight of the states that will determine the Senate majority in November are likely to see significant reductions in the number of insurers participating in ObamaCare marketplaces.
The likely departures of insurers in Illinois, Wisconsin, Florida, Pennsylvania, Ohio, North Carolina, Arizona and Missouri are pushing the healthcare law toward the center of some of the most competitive Senate races in the country.
GOP strategists say Obama-Care’s troubles this year are morphing into a perfect storm for their candidates, providing a boost in a year when the party is defending 24 Senate seats.
“It feels like there’s a sleeping giant that’s about to awaken on the campaign trail,” veteran Republican strategist Ron Bonjean said. “It really does seem like an easy target, an easy layup for Republicans to score points.”
Health insurers have been fleeing the marketplaces over the last year, citing steep financial losses. The departures, which have included industry leaders like UnitedHealth Group and Aetna Inc., are cutting into the choices people have when selecting ObamaCare plans.
Next year, exactly half of all states are expected to see fewer ObamaCare options in at least one county, according to data compiled by the Kaiser Family Foundation.
An analysis of the Kaiser data by The Hill found that the exits from ObamaCare align with some of the biggest battlegrounds for Senate Republicans this year.
Every county in Ohio, a crucial swing state, is on track to lose at least two insurers compared to last year. All of the counties in Pennsylvania, Indiana, Missouri, Arizona and Illinois are also expected to lose at least one option, according to Kaiser.
We were promised that the Patient Protection and Affordable Care Act would “bend the cost curve down”, and yet health insurance premiums are expected to rise by as much as 60% in 2016. What should be done to solve this dilemma? A common refrain is that since the “free market” has failed, the United States needs a Single Payer healthcare system like Canada’s.
Being a Canadian physician now living in the Minnesota, I assure you that Canada’s healthcare system is not Utopia. In my former life as Medical Director of Diagnostic Imaging for Thunder Bay Regional Hospital in Canada, for a while our wait time for an elective MRI was 13 months and for CT it was seven months. I managed to convince the hospital administration to increase MRI operational hours, and we reduced the wait to 4 months becoming the envy of the province. Doctors from other regions attempted to send us their patients. We said no. We could not accommodate the extra work because we only had one scanner for a radius of about 500 miles because that was all that the government would allow. As payer for the system, it is inevitable that the government controls the system. The incentive is to control costs, not necessarily to care for patients.
The Fraser Institute monitors wait times in Canada. As of 2014, the average wait time for medically necessary specialty care is 18.2 weeks. In the province of New Brunswick, the wait time averages 37.3 weeks. In my hometown of Sault Ste. Marie, where I still own property, the average wait for a newcomer to town to get established with a family doctor is five years, unless you have insider ties to the system.
The standard response by single payer advocates is that Canada’s healthcare system is underfunded. According to the Fraser Institute, the average Canadian family is spending 12,000 dollars per year for health coverage (buried in taxes). According to the Organization for Economic Co-operation and Development (OECD), Canada per capita healthcare expenses rank sixth highest amongst 192 ranked countries.
Another rejoinder of the single-payer advocates is that “outcomes” are better in Canada. For example, according to the World Health Organization, the average life expectancy in Canada is three years longer than in the US. Many factors affect life expectancy of which the health care system is only one. Racial background is very important. According to 1999 OECD data, an Asian-American male at birth can expect to live 80.9 years, a non-Hispanic white male can expect to live 74.4 years, and an African-American male has a life expectancy of 68.4 years. More homogeneously white, Canada is a less racially diverse country than the US contributing to a higher average life expectancy. According to Sally Pipes of the Pacific Research Institute, when allowing for deaths from violent crime and traffic accidents, Americans are the longest-lived people in the Western world. According to John Goodman in “Lives at Risk”, Americans fare better than any other country when looking at individual disease states such as myocardial infarction and various malignancies.
What happens in the doctor’s office or in the hospital pales in significance to the decisions that people make in their day-to-day lives. For example, Canadians are generally less obese than Americans and there is less gun-related crime. The relationship between health care systems and population outcomes is murky, and so we cannot conflate the efficacy of a health care system with average life expectancy.
Why is it that Canada’s single payer health care system is so constipated with an onslaught of patients waiting interminably for care? There are two basic reasons that are really two sides of the same coin. They are price controls and central planning.
