Health Care Thoughts…Tom’s avalanche theory
by Tom aka Rusty Rustbelt
Health Care Thoughts: Knowns, Unknowns, Unknown Unknowns, Unintended Consequences
Tom’s Avalanche Theory– once an avalanche is started there is no controlling it
Some of the probable unintended consequences (?) of Obamacare are started to play out.
The convergence of 1) a mediocre economy, 2) a weak labor major and the 3) health reform avalanche are causing a sea change in the relationship between employers and employees.
Current higher deductibles and higher co-pays will eventually lead to much higher deductibles and co-pays and employers dumping employees into exchanges. HSAs will likely become more popular.
This risk** and financial shift will weigh heavy on the working middle class.
So what if Obamacare flops? Is repealed? The avalanche has started and cannot be stopped.
The consequences for the provider side of the equation in another post.
**Jacob Hacker’s book on risk shift is well worth the read. http://www.amazon.com/The-Great-Risk-Shift-Insecurity/dp/0195335341
What I wish Tom would do is broaden the context and time frame. Note this book is published 2008 and uses material prior to 2008 and well before the ACA. There were major changes underway to our system prior to ACA, including business divestment of health coverage as a benefit as coverage was decreased or eliminated by business for groups of people.
Rusty,
I have always maintained that Obamacare was designed to fail, a mere rest stop on the way to single payer. Witness the care in which it was crafted and implemented.
However the fact that it has failed so abysmally, so early, calls into serious public question the ability of this government to run a single payer system. This could be the big government Liberal Waterloo.
Dan:
Hacker would do us a great service if he did an updated edition, but for now it is still worth the read (on many topics).
that is labor market not labor major – gotta keep the brain focused
Dan:
I would love to write in more depth (although some of your writers get a little carried away) but there are a dozen major writing projects staring me in the face and more on the way (mostly for health providers in the “how to cope with __________” mode).