If you are paying $1000/mo in health insurance premiums now, that number will soon be much higher as a result of today’s court decision.  Premiums will increase because of the definition of “insurance” in this law.  The benefits that are mandated (breast cancer and pregnancy coverage for all, including males!) will result in these higher premiums, as none of these goodies will be free.  Mandated screening for bureaucrat approved procedures and other jewels will drive up the cost of insurance.  All of this is according to plan, as the statists know that unaffordable private insurance will necessarily usher in a single payer plan, their ultimate goal.  Once this goal has been attained, Uncle Sam will collect the money (on behalf of the 3 or 4 insurance companies that remain) and pay very little of it out, as care is denied on a widespread basis and profits of these companies go through the roof.  

Look for more and more physicians and medical facilities to post their prices.  As fewer and fewer deal with Medicare and Medicaid (due the price controls and costs and hassles of data reporting and electronic medical record keeping), this posting of prices will be less problematic and therefore more prevalent.  The low prices of care at physician-owned facilities will render the prospect of going without insurance much less scary, and will make payment of the FINE/TAX/WHATEVER? make more financial sense.  Patients who value their privacy, who don’t want every detail of their life sent electronically to Washington bureaucrats, will increasingly turn to these physicians and facilities that have shunned federal money.

Whatever you do, don’t count on the Republicans to overturn this any time soon.  Remember we got the Medicare, Part D legislation from the GOP when they were in control, the greatest gift to big pharma in history until the Unaffordable Care Act.  The insurance, pharmaceutical and big hospital lobbies will have even more profits to spread around Capitol Hill, making tough talking legislators, soft actors.  Also keep in mind that the GOP is hoping you’ll count on them to fight this rather than hold them accountable.  July 11th’s symbolic vote to repeal the Unaffordable Care Act is an attempt to prevent consequences from raining down on incumbent Republicans.  I predict that pleas for campaign contributions will be like never before the next several months.  If placed in power they probably won’t deal with this right away as removing a crisis deflates the pressure to send them more money.  

The free market will continue to work in medicine.  You will find it in the office of a physician who belongs to the Association of American Physicians and Surgeons.  You will find it in the office of a physician who has opted out of Medicare, providing care to the elderly but unwilling to deal with their government-issued insurance.  You will find it at surgery centers like ours and at physician-owned specialty hospitals, increasingly transparent with their pricing and unsurpassed in quality and patient satisfaction.  You will be able to find all of this but you will have to look a little harder after today.  Many of those who count today’s court ruling a victory will soon have a worthless insurance card in their pocket, one which certifies them as “insured,” but one which will gain them no access to a physician’s office.  They will, like the Canadians, have a right to hope for health care.  Solutions to the allocation of scarce resources never make sense or work unless they come from the unfettered and free market.  Some semblance of it will continue to operate and function, and will be responsible for the provision of the only care worth having.

G. Keith Smith, M.D.