So, how much will YOU pay for Obamacare?

The Supreme Court rendered it's decision on the legality of Obamacare this week. This post will not discuss that here. That's for another day and another column. Today is about the intended and unintended effects of this new far reaching federal legislation. But mostly, its about the massive cost of Obamacare. As the President and the Democrats envision it - Obamacare will add 30 million new people into the healthcare rolls. On the surface, that sounds great. 30 million people with medical coverage who didn't have it prior. But eventually someone will have to pay for it and that someone is... (Get ready. Here it comes) You. That's right. You will be the benevolent benefactor to most of these new enrollees. How? Will it is complicated and yet quite simple. Here goes.

We all now know that despite what Mr. Obama told you back in 2008 and 2009, his healthcare plan mandate is actually a tax, not a penalty. The Supreme Court just said so and this time, Obama didn't even flinch when they said it. Those who don't have insurance must buy it somewhere or pay a penal -  OOPS, tax. Many of these people can't afford coverage or else they already would have had it. So the government will subsidize their premiums through your taxes which will most certainly increase to cover the cost of the subsidies.  If you get your coverage through your employer as most people do, expect them to trim benefits to reduce costs. A Pew Research poll recently stated that 68% of employers are considering reducing benefits, deductables and yes, salaries as a way to keep their operating costs down. The same survey found that 71% of employers would consider hiring only part time workers instead of full time workers so as not to have to provide medical benefits. But it gets worse...

Pennsylvania for instance, will have to absorb as many as 700,000 new people enrolled in Medicare and Medicaid at a cost of $2 billion. Where do you think the Commonwealth is going to come up with that kind of scratch?  Hmmm. If you guessed you through increased taxes... Bingo! You win! Or do you?

The governments estimated number of new physicians that will be required to execute Obamacare is 160,000. As a member of the healthcare community, I hear all kinds of conversations. And I can tell you there is no way a number of new physicians even close to that figure will be coming anytime soon. In fact, at the rate that current physicians are choosing to retire because of this massive interference in medicine - that 160,000 number is probably way, way too low. Try doubling it. Medicare & Medicaid reimbursments have fallen so much that medical offices must see many more patients a day to break even. My Mother had two recent doctors visit. In both of those visits she saw a PA (Physician's Assistant) not a doctor. Even with a return visit to further investigate her problem, the PA mis-diagnosed her condition as "geriatric menapause" assuring her everything was normal. Only after she had a hospital stay for appendicitis did they catch the tumor she has growing near her Uterus. The doctors at the hospital couldn't believe that a simple ultra-sound wasn't performed. I'm sure there are fantastic PAs out there. It is not my intent here to maligne them. But a PA is not a substitute for a doctor anymore than a window is a suitable substitute for a door.
In any case - get used to seeing a lot of PAs in your future and a lot less doctors. As for specialists, you'll only get to see the ones you can afford. (They can afford to be pickier about who they see) And since they are even fewer in numbers, and since 30 million new potential patients will be coming their way - you may wait a long time to see the front of the line.

As with most government programs, this one is going to end up cost a lot more than originally envisioned. In 1965, Congress estimated that Medicare would cost about $5 billion by the year 1990. In 1990, the actual cost of Medicare was $95 billion. See where I'm goin' here?  When was the last time a government estimated cost of a program was actually correct? If the cost of Obamacare is even a fraction of the Medicare error ... well, you get the idea. And the bill.

I wish I lived in that fantasy world some do, who think that a major program like this wont cost much if anything. But I live in the real world. And I'm old enough to see the history and patterns of Washington's wild spending and it's dismal outcomes. While smaller more simple ajustments to the current healthcare situation would have been cheaper and easier to put into effect - like allowing insurance companies to compete against each other across state lines - we have been saddled against our wishes with this massive intrusion. Fortunately, we do have a method to undo this mess. Its called an "election". On November 6th I will be voting to elect the people who are commited to repealing Obamacare not to mention promote fiscal sanity and job creation.  However, if Barack Obama is re-elected and Obamacare is allowed to stand, we will have missed the one possible chance we had to return to sanity and reclaim the most fundemental rights our founders gave us.