A draft copy of the Health and Human Services Department form proposed for use to apply for low-cost insurance from Medicaid or the Childrenâ  s Health
A draft copy of the Health and Human Services Department form proposed for use to apply for low-cost insurance from Medicaid or the Childrenâ s Health Insurance Program is photographed in Washington on Tuesday March 12, 2013. (J. David Ake/The Associated Press) (J. David Ake)

According to the official sales spiel accompanying it, ObamaCare will:

Provide medical care to tens of millions who don't have it now. Will provide better medical care for all, including those who have access to medical care now. Will assure more extensive coverage for all. Will accomplish all of this while lowering medical costs.

If so, this would be the first time in economic history such expansive efforts didn't entail rising costs.

You'd think the breathlessness of the claims would be sufficient to warrant skepticism — that plus preliminary contrary indications.

But certain ardent defenders of ObamaCare have discovered what they insist is the one true reason some have doubts about ObamaCare: It's simply that they are loath to give credit to such a wondrous initiative because of the race of the initiative's namesake. (Let it be noted that Obama himself hasn't made such a claim regarding the motives of ObamaCare's detractors.)

Ironically, the defenders are as excited about the positive prospects of ObamaCare as the doubters are of the negative prospects — and just like the doubters, before the initative has had much of a chance to make a case for itself.


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Maybe ObamaCare will work the miracle cures its backers are pitching on its behalf. Or maybe, less grandly, it'll at least be an improvement on the status quo. But reasons for skepticism aren't entirely attributable to racial enmity or even political ideology.

One of the key ways ObamaCare claims it will cut medical costs is by penalizing hospitals and doctors whose patients are readmitted for treatment more than ObamaCare bureaucrats believe they should be.

Ask yourself: Who's more likely to require readmission? A. An affluent white patient who has had top-notch medical care leading up to his or her treatment and has had top-notch aftercare? Or B. a black patient of limited means who has had spotty medical care (if that) leading up to his or her treatment and spotty (if any) aftercare following the treatment?

Another question to ask yourself: Might not it be just conceivable that readmission penalties will tempt hospitals and doctors to err on the side of economics rather than medicine when confronted with readmission cases and possible penalties?

Another way ObamaCare proposes to cut costs is by limiting the network of hospital and doctors included in the so-called coverage exchanges, thus curtailing patients' options, contrary to ObamaCare sales spiels. (California already is discovering this unpleasant aspect of the ramrodded, epochal reform.) Care networks available through exchanges are likely to be weighted toward doctors who've agreed to accept cut-rate fees.

Who's more likely to suffer unintended negative consquences from such an arrangement: The white affluent patient, or the black patient of scarce means?

ObamaCare also allows, in fact encourages, employers to charge overweight and/or smoking emmployes more for their medical coverage. Who's this going to hit disproportionately?