Obama promised everybody they could keep their medical plans and doctors under Obamacare, but it isn't true

President Obama guaranteed Americans that after health reform became law they could keep their insurance plans and their doctors. It's clear that this promise cannot be kept. Insurers and physicians are already reshaping their businesses as a result of Mr. Obama's plan.

The health-reform law caps how much insurers can spend on expenses and take for profits. Starting next year, health plans will have a regulated "floor" on their medical-loss ratios, which is the amount of revenue they spend on medical claims. Insurers can only spend 20% of their premiums on running their plans if they offer policies directly to consumers or to small employers. The spending cap is 15% for policies sold to large employers.

This regulation is going to have its biggest impact on insurance sold directly to consumers—what's referred to as the "individual market." These policies cost more to market. They also have higher medical costs, owing partly to selection by less healthy consumers.

Finally, individual policies have high start-up costs. If insurers cannot spend more of their revenue getting plans on track, fewer new policies will be offered.

Under Obamacare the doctor-patient relationship "will be irreparably severed"

Much has been written about this bill’s “takeover” of American health care. But, the sad truth of the matter is that, for the past few decades, the federal and state governments have been in control of close to half of all health care resources, with Medicare, Medicaid, SCHIP, and other government health programs accounting for some 48 percent of all health care dollars spent in 2007. In addition, private health insurance is already heavily regulated by state and federal laws governing who must be covered and how. In a very meaningful sense, government took over health care long ago.

Still, despite copious amounts of government control, what kept American health care alive was the residue of market processes that enabled some semblance of choice, price signals, adaptability, and—perhaps most important—physician responsiveness to patients’ needs. The great tragedy of today’s health care legislation is not simply that it seeks to exert more control over the provision of health insurance and medical services per se, but that by doing so, it takes us farther and farther into a future in which the relationship between physician and patient will be irreparably severed.

Most of the problems in America’s health care system—high and rising prices, lack of consistent and reliable access for millions, rampant cost shifting, and an inability to distinguish between effective and ineffective services or between high and low quality, to name just a few—stem not from some supposed market failure, but primarily from existing government interventions in the market for health care and health insurance