When Congress debated ObamaCare, pressure from critics forced lawmakers to include themselves under its mandates, rather than keep their current “Cadillac plans” that they proposed to tax out of existence for everyone else.  That decision will impact current members starting at the end of this year, as they have to find insurance on the ObamaCare markets just like everyone else.  Now, suddenly, ObamaCare looks a lot less attractive — and some of them may retire to avoid it (via Instapundit, who notes that this is doing what the term-limits movement couldn’t):

Dozens of lawmakers and aides are so afraid that their health insurance premiums will skyrocket next year thanks to Obamacare that they are thinking about retiring early or just quitting.

The fear: Government-subsidized premiums will disappear at the end of the year under a provision in the health care law that nudges aides and lawmakers onto the government health care exchanges, which could make their benefits exorbitantly expensive.

Democratic and Republican leaders are taking the issue seriously, but first they need more specifics from the Office of Personnel Management on how the new rule should take effect — a decision that Capitol Hill sources expect by fall, at the latest. The administration has clammed up in advance of a ruling, sources on both sides of the aisle said. …

The problem is far more acute in the House, where lawmakers and aides are generally younger and less wealthy. Sources said several aides have already given lawmakers notice that they’ll be leaving over concerns about Obamacare. Republican and Democratic lawmakers said the chatter about retiring now, to remain on the current health care plan, is constant.

Oh, the aching irony.  Remember when this was supposed to benefit all Americans?  How it was supposed to make you more secure in your line of work?  “If you like your plan, you can keep your plan”?  Those were promised made by some of the very same people that now want to flee after having their “solution” imposed on the rest of us.

They’re not the only people looking to flee, either.  Doctors want out of the system in both the private and public markets.  The AMA estimates that 17% of physicians are limiting Medicare patients in their practices now, and the number is expected to grow.  More physicians are also bailing out of the private insurance system as well, creating direct-payment businesses that not only lower costs rather than just prices, but also allows the doctor and patient to direct therapy rather than a bean-counter in an office far away.

My column this week for The Fiscal Times picks up on CNN’s report on this phenomenon, and argues that this is the true path for health-care reform:

Nunamaker and the increasing number of providers pursuing this option have to court aggressively a smaller market by competing with each other on price.  Fortunately, with the mandates and reimbursement headaches removed, that becomes much easier to accomplish.  Nunamaker structures his business on a membership model, where a flat monthly fee allows customers unlimited access to his clinic.  For most adults, the fee is $50; senior citizens pay $100, but membership for children costs only $10 per month.

Let’s say that an average family of four, with two adults and two children, sign up for this service.  That would cost $1,440 a year for complete coverage of any services that can be provided within the office.  The least expensive plan on eHealthInsurance.com all-plans for a family of four in Wichita costs $329 a month – and that has a $10,000 deductible. For a deductible of $1500 for the family – the same cost of the membership at Nunamaker’s clinic – the price would jump to $869 per month.

What happens when a patient needs services the clinic doesn’t provide? Nunamaker has created partnerships with providers at costs amounting to fractions of what insurance pays, CNN reports.  A $90 cholesterol test can be purchased for … three dollars. An MRI normally would cost an insurance company $2000, but Nunamaker’s patients can access one for $400.

Obviously, Nunamaker’s patients need hospitalization coverage in case something significant happens.  Normally, catastrophic coverage would be inexpensive, as hospital visits are relatively rare occurrences, especially for younger and healthier people.  Unfortunately, Obamacare outlaws such plans in the ACA “exchanges” by making them ineligible for subsidies.

Instead, Americans buying plans on the individual market have to spend much more than they’ll ever pay directly to market-based physicians like Nunamaker, essentially subsidizing the premiums of older and sicker Americans to make Obamacare politically palatable to those demographics who turn out more reliably to vote.  Americans purchasing plans through employers won’t have much more luck buying sensible insurance plans, either, thanks to other mandates within the ACA on employer-provided health insurance.

Doctors are fleeing ObamaCare, and some of those are showing the way to real reform.  Congress is fleeing the system that they created.  Why should the rest of us get stuck with it?