Merits of PPACA debated at Denver Post panel discussion

Chief among her complaints is that PPACA shuts off promising healthcare reforms that are underway in the states; that the law fails to contain healthcare costs as promised; and that it unnecessarily limits healthcare choices available to patients.

“If you’re an Obamacare architect, your solution is to limit individual choice,” she said. “Obamacare limits the types of treatments that patients can access, the doctors they can see, and the demand for health care services generally.”

To illustrate PPACA’s constraints, Gorman (left) noted that policies like the one she’s owned for the past 15 years are (except for those grandfathered under the new law) no longer permitted. PPACA also prevents access to less costly alternative solutions.

“Under PPACA, you must have a certain deductible and you must buy your children’s eyeglasses through your insurance policy,” she said. “Why should I pay a premium to an insurance company to buy my kids’ eyeglasses when I can go to Lens Crafters and do it for less? Obamacare takes that freedom away.”

Gorman added that PPACA will end market innovations in the states that promise to reduce to healthcare costs and yield better care. Example: outpatient and assisted living services. PPACA regulations are “so crushing,” she said, that innovations in these areas are likely to come to end.

Based on the experience in Massachusetts, which implemented a health care plan similar to PPACA under then Governor Romney, a similar outcome awaits urgent care centers, she said.

“Urgent care centers not controlled by the federal government are blossoming all over Denver,” she said. “If you try to access an urgent care center in Massachusetts, which I attempted to do, good luck. What we have in Denver does not exist in Massachusetts.”

Gorman added that PPACA will also put an end to experiments underway in the states to limit health care costs by allowing patients greater latitude in how they spend their health care dollars. PPACA price controls that limit what health insurers can charge for coverage, she added, will also squelch market innovation and access to services.

Gorman also blasted PPACA’s individual mandate and requirement to cover pre-existing conditions, the latter of which, she noted, undermines undermines’ insurers’ long-standing pricing models.

“Health insurers need to be able to price risk,” she said. “The only time that you have a problem or failure of insurance pools is when you control price and say that everybody must join the pool, regardless of their health status, at the same price.

“There is a tremendous amount of data that suggests that it is much less expensive to let insurers price risk, quote premiums for policies, and then subsidize people who can’t afford the insurance, rather than implementing price controls,” she added.

Emanuel countered that PPACA is helping to reduce healthcare costs in part by encouraging market innovations and demonstration projects like “bundled pricing” of multiple services or procedures; and by encouraging health providers to shift from a costly fee-for-service model to one that rewards health care outcomes.

“Because of experiments around the country provided by PPACA, the private sector for the most part is very actively pursuing its own efforts to transition from a fee-for-service model to more global or bundled payments,” he said. “There is much in the healthcare law that is moving us off fee-for-service, not only in the federal program, but also incentivizing the private sector to do the same thing.”

Emanuel added that PPACA will also reducing healthcare costs by eliminating cost-shifting: charging people who are insured more for services to compensate for indigent, uninsured patients who cannot afford to pay for care out of pocket.

“One of the great things about PPACA is that it eliminate cost-shifting,” he said. “When you get everyone insured under the law, you’ll see an end to this practice.”