In promoting the Affordable Care Act, or what has come to be known by friend and foe alike as "Obamacare," to the American public, President Obama spent at least four years making two fundamental guarantees: "If you like your health care plan, you can keep your health care plan," and "If you like your doctor, you can keep your doctor." It is quite well-known that the first guarantee has been proven untrue with private individual plans. Less known is that the guarantee is destined to become more untrue as employer-sponsored plans throughout 2014 decide whether to comply with Obamacare's costly plan design and compliance requirements and continue to cover their employees, or abandon that effort entirely and pay the related fines for not doing so.
On Fox News Sunday with Chris Wallace, Dr. Ezekiel Emanuel, one of Obamacare's chief architects, attempted to claim that the President's second guarantee was not a lie. Wait until you see his "reasoning." [See video after jump.]
Wallace, to his credit and unlike what we've generally seen from his other Sunday morning competitors, wouldn't let go of his questions until he got direct answers, deservedly annoying "Zeke the Bleak" (bolds are mine throughout this post; numbered tags are mine):
WALLACE: President Obama famously promised, if you like your doctor you can keep your doctor. Doesn't that turn out to be just as false, just as misleading, as his promise about if you like your plan, you can keep your plan? Isn't it a fact, sir, that a number, most, in fact, of the Obama care health plans that are being offered on the exchanges exclude a number of doctors and hospitals to lower costs?
EMANUEL: The president never said you were going to have unlimited choice of any doctor in the country you want to go to.
(CROSSTALK)
WALLACE: Wait, no. He asked a question. "If you like your doctor, you can keep your doctor." Did he not say that, sir?
EMANUEL: He didn't say you could have unlimited choice.
WALLACE: It's a simple yes or no question. Didn't he say, "If you like your doctor, you can keep your doctor"?
EMANUEL: Yes. If you want to pay more for an insurance company that covers your doctor, you can do that. [1] This is a matter of choice.
We know in all sorts of places, you pay more for certain -- for a wider range of choices or wider range of benefits.
The issue isn't the selective networks. People keep saying, oh, the problem is you're going to have a selective network.
WALLACE: Well, if you lose your doctor or lose your hospital.
EMANUEL: Let me just say something. People are going to have a choice as to whether they want to pay a certain amount for a selective network or pay more for a broader network. [2]
WALLACE: Which means your premiums would probably go up.
EMANUEL: They get that choice. That's a choice --
WALLACE: Which means your premium may go up over what you were paying so that, in other words --
EMANUEL: No one guaranteed you that your premium wouldn't increase. Premiums have been going up.
WALLACE: The president guaranteed me I could keep my doctor.
EMANUEL: Under president -- and if you want to, you can pay for it. [3]
(CROSSTALK)
EMANUEL: Under President Bush, premiums went up 80 percent after inflation. [5] We have actually seen a leveling off of health care costs and premiums in the last few years because of changes that have been made. [4]
WALLACE: Finally --
EMANUEL: As a matter of fact, choice is something we all understand and we all understand that for more choice, more benefits, you have to pay more.
Notes:
[1] – The problem is, thanks to geographic and other barriers, that many people are finding that they can't "pay more for an insurance company that covers your doctor," because there is no plan available which includes their current doctor. Quoting Stage-4 gallbladder cancer paient Edie Sundby in the Wall Street Journal on November 3:
You would think it would be simple to find a health-exchange plan that allows me, living in San Diego, to continue to see my primary oncologist at Stanford University and my primary care doctors at the University of California, San Diego. Not so. UCSD has agreed to accept only one Covered California plan—a very restrictive Anthem EPO Plan. EPO stands for exclusive provider organization, which means the plan has a small network of doctors and facilities and no out-of-network coverage (as in a preferred-provider organization plan) except for emergencies. Stanford accepts an Anthem PPO plan but it is not available for purchase in San Diego (only Anthem HMO and EPO plans are available in San Diego).
So if I go with a health-exchange plan, I must choose between Stanford and UCSD. Stanford has kept me alive—but UCSD has provided emergency and local treatment support during wretched periods of this disease, and it is where my primary-care doctors are.
Ms. Sundby can keep one of her doctors. She can't keep both, unless she's fabulously wealthy and can afford to pay one or the other out of her own pocket. The reason she can't keep both is because Obama's first guarantee, namely that she could keep her plan, was false. That irrevocably opened up the possibility that she couldn't keep her medical team intact, and that's exactly what has happened.
[2] – The fact that "People are going to have a choice as to whether they want to pay a certain amount for a selective network or pay more for a broader network" is a dodge. All of the networks are selective to a degree. The reason people like Edie Sundby are even in this position is because they couldn't keep their current plans. Once that occurred, the guarantee that people could keep their doctors evaporated.
[3] – There are many doctors who, because of awful reimbursement rates for services under Obamacare (e.g., California, as noted earlier today [at NewsBusters; at BizzyBlog]), are choosing not to participate in any Obamacare plan. People who lost their plans can only see their current doctors under these circumstances if they pay the full amounts involved for non-emergency services on their own. Obama's guarantee was not "you can keep your doctor, but you may have to bankrupt yourself to do so."
[4] – Emanuel, other Obama administration apologists, and press cheerleaders like Paul Krugman have been taking credit for health care costs leveling off with absolutely no evidence that any element of Obamacare has had anything to do with it.
[5] — The graph at the link in Item [4] shows that health care costs increased by 61% before inflation from 2002-2008. There's no way they increased 80% after inflation from 2001 to 2008.
Here's a related tweet (HT Twitchy) which gets to the heart of the matter:
Yes he is.
Cross-posted at BizzyBlog.com.
