The Supreme Court has agreed to hear King v. Burwell - a case that could unravel the Patient Protection and Affordable Care Act - also known as Obamacare. This has caused considerable angst across the progressive mainstream media. At the heart of what is being argued before the court is language in the Act as to whether or not the government can legally subsidize healthcare insurance premiums in states that have not set up their own exchanges.

I wouldn’t pretend to know how the court will rule on the matter - I wouldn’t hazard a guess - but it does bring the PPACA and its ramifications back to front and center. Margaret Newkirk writing in Bloomberg News earlier this month opined, “Obamacare is both groused about and accepted, like taxes and the weather”. How glib. While acknowledging that the PPACA is “the reason enrollment has dropped at low-cost clinics” in two Georgia Counties and citing an example of one participant who signed up through an ACA “navigator” whose premium has already doubled, she makes the case that government subsidies keep costs down.

That’s upside-down logic. The costs are what they are - the premium is what it is. Government subsidies don’t lower costs, they simply shift where the money is coming from to pay them. Her reasoning is like saying that food stamps lower the cost of food. The fact is that the PPACA is causing costs to go up.

In her article Newkirk was writing about Gwinnett County in Georgia (and with relish she points out that all of its county commissioners are Republicans). The progressive media thinks stuff like that is important. She also sounds the alarm that “in Georgia, premiums would rise 381 percent without the credits, according to a June 3 analysis by Kaiser”. By the way, according to The Henry J Kaiser Family Foundation, West Virginia - an early adopter of its PPACA exchange - will see its premiums go up 5-10% this year. That’s more than double the rate of inflation in the best case scenario and could be more than 5 times the rate of inflation. No “lower cost healthcare” here.

The fact that premiums are going up as result of Obamacare is actually no surprise. An article appeared in the very same Bloomberg news service a year ago with the headline, “Obamacare Premiums Are Going Up—Here’s Why”. It provided 9 reasons - among them changes to the risk pool and cost of claims. (Another “non-surprise” - in the fourth quarter of last year according to the Bureau of Economic Analysis, Americans spent more on healthcare than on anything else with rent plus utilities a distant second).

And go up they have. How about that this from an article in the Daily Caller in March, “Obamacare health insurance premiums will grow faster than either private policies or the federal government in coming years, according to the Congressional Budget Office”. Or this headline in Forbes, “Now There Can Be No Doubt: Obamacare Has Increased Non-Group Premiums In Nearly All States”. So much for the promises of lowered costs.

And there are concerns that Obamacare could exacerbate an existing problem - a shortage of doctors. From the Atlantic this headline, “Why America’s Doctor Shortage Might Mean Trouble for Obamacare. ER visits were 40% higher for people who won Oregon’s Medicaid lottery—in part because there aren’t enough doctors to see them elsewhere”.

According to Michael Tanner writing in the National Review, a report from the nation’s medical colleges predicts a shortage of 130,000 doctors over the next decade. (Citing the same study, the Washington Post put the number at 90,000. Go figure). Even the Post’s “optimism” points to a significant problem. Says Tanner, “In 1970, the average income of general practitioners was $185,000 (in 2014 dollars). Today, even though doctors now see nearly twice as many patients as they did back then, average physician income has fallen to just $161,000. At the same time, the average medical-school graduate now begins his career with more than $170,000 in debt. Obamacare will squeeze physician incomes still further”. In other words, like the rest of us, doctors have lost ground over the last 45 years.

And then there’s this from Charles Krauthammer in a recent op-ed piece called “Why Doctors Quit”. Quoting one doctor, “My colleagues who have already left practice all say they still love patient care, being a doctor. They just couldn’t stand everything else.” That “everything else” being government intrusion on their work lives. Here’s another quote from a doctor, “The introduction of the electronic medical record into our office has created so much more need for documentation that I can only see about three-quarters of the patients I could before, and has prompted me to seriously consider leaving for the first time.”

My own doctor has complained to me about the electronic record mandate. He said that it necessitated that he work an extra day each week just to get into and stay in compliance. That’s a problem. Plus, what about the privacy concerns as we hear more reports of hackers breaking into sensitive databases and stealing data.

In addition, my doctor is getting up there in years and the American Medical Association has recently announced an initiative to get rid of older doctors. According to a recent article from the Associated Press, “With one out of four U.S. doctors older than 65, the American Medical Association adopted a plan…to help decide when it’s time for aging senior physicians to hang up the stethoscope”. It gets even more worrisome when you consider that 40% of all doctors are over 55.

So, we’re increasing the regulatory burden on doctors, cutting their pay - and - we’re trying to force as many as we can into early retirement, while we’re mandating that more people have health care coverage. Pure genius.

With all of this government interference in the market place, innovation is difficult. But that doesn’t stop people from trying. One of those innovators practices medicine right here in West Virginia. Dr. Vic Wood of Wheeling had a dream more than a decade ago. His innovative idea was for his patients to pre-pay for primary care services, those provided by General Practitioners like himself. According to the Wheeling Intelligencer, the local newspaper, “Wood, who operates Doctors Urgent Care walk-in clinics in Wheeling, Benwood and St. Clairsville, developed the innovative program in 2003 after his research revealed only one in 35 patients required hospitalization for health issues”. As of 2010, only 1% of his patients were “displeased with the value of the services” and only 7% chose not to renew.

He charges $83 per person or $125 per family per month. According to the article about Dr. Wood the cost of has his plan has never increased. “This works. I see no reason to raise prices,” he said.

Dr. Wood’s Primary Care One clinics almost didn’t get off the ground. There was, of course, a regulatory road block in his way. According to West Virginia state code, it could be interpreted that Dr. Wood was “acting as an insurance company” and would have to meet certain requirements imposed by the state insurance board. Fortunately, the legislature removed that obstacle and exempted pre-paid medical services from that designation and the rest, as they say, is history.

According to an article in Marketwatch which poses the question, “Is Obamacare driving doctors to refuse insurance?” It points out that by the end of 2013 there were 5500 so-called “concierge practices” (similar to Dr. Wood’s) nationwide, aimed primarily at serving the middle class. Amazing how entrepreneurs strive to meet a need - serve customers and clients when you get the government out of the way. Approximately two thirds of these plans cost less than $149 per month. The article goes on to say that cutting out the insurance company reduces overhead by 40%. Imagine that.

Further, with the PPACA forcing cancelations of many policies that aren’t “ACA compliant”, many folks are finding that their replacement policies have extremely high deductibles, leaving them feeling uninsured after all. Surprise! These concierge plans have the potential to fill that gap. I strongly suspect that the more we get government out of the medical business, the more good things could begin to happen.

But then again there are those who have a different perspective on things. Zachary Roth, writing on the Rachel Maddow Show Blog on the MSNBC website presents his take with this headline: “Right-wing doctors protest Obamacare by refusing to accept insurance”. He goes on to accuse “conservatives” of trying to “sabotage” Obamacare. I guess when you’re programmed to think a certain way, you’re going to come out with statements like that. You certainly can’t make this stuff up. It will be interesting to see how the Supreme Court Rules on King v. Burwell and what the reactions are going to be.