As a physician, I have often asked what I think of the Affordable Care Act, also known Obama Care. Make no mistake about it. Obama Care is purposely designed to lead directly to only one conclusion – a single payer system administered by the federal government and mandatory for everyone. The socialists in Washington are trying to sell this monstrosity to the American Public by claiming it will cost the government less than what is currently being spent on Medicare and Medicaid. I know they feel they are the elite who know what is good for the rest of us gun toting, bible clutching ignoranimi. What else do they think we are, nitwits?
It does not take a genius to figure out that with Medicare borrowing from Peter to pay Paul i.e. using current income to pay benefits instead of putting it into the currently nonexistent “Medicare trust fund.” How may I ask would it save money to add 30,000,000 new beneficiaries to Medicaid and by promising Medicare patients that their benefits will not be cut, despite a hoard of baby boomers soon to be admitted to its roles. Obama Care will gradually lead to bankruptcy. Medicaid is not much better off. The states are currently going broke trying to meet their financial obligations under this program.
How will this miracle be accomplished? There is only one answer. Despite all the protestations to the contrary it can only be done by decreasing access and services. The traditional method is to institute a “gatekeeper”, usually a primary care physician or his designee, to screen all patients prior to any referral to a specialist with their expensive procedures and treatments. This has been tried and has never worked. Bureaucrats have many excuses for this failure. When you come right down to it, the reason is that people are not dumb. So much medical information has been disseminated via the internal and the media that patients know what kind of a doctor they need to see. If patients are forced to consult a gatekeeper prior to referral, offices will be overwhelmed with the surplus going to hospital emergency rooms. This will lead to month long delays for doctor’s office appointments or a 12 to 24-hour wait in the emergency room. Unacceptable! Patients will not tolerate it and not being dumb will find ways to circumvent it. Other unpalatable methods will be tried i.e. denial of expensive tests, procedures and treatments to very elderly patients, patients with incurable diseases, and patients with severe incapacitating disabilities. Don’t think it can happen here? Check England and its committee, which reviews these cases.
If previous experience is of any value, what will happen is that the cost of the bureaucracy and administration of the program will exceed any savings that the Affordable Care Act produces. Insurance companies trying to provide private policies and groups plans for employees cannot complete with plans subsidized by the federal government and ultimately will fail, leaving the entire market place to a single payer – guess who? Thus the financial burden will become unbearable, leading to drastic cutbacks in services in order to retain solvency. Don’t believe the projections of the congressional budget office. Remember that in 1966, Medicare cost $3 billion dollars with projected cost of twelve billion dollars in 1990 when in fact by that year it was $107 billion dollars and is currently over three hundred billion dollars.
At the present time, only about 30% of practicing physicians accept Medicaid patients. Almost all still accept Medicare. This will change. Almost no one will take Medicaid and large numbers of good doctors will opt out in any participation in government healthcare, reverting to boutique or cash only practices. Many of the best specialists will be in this category. I am sure that attempts will be made to force all doctors to participate and if successful will lead to salaried physicians and loss of their ability to make those decisions which they feel are best for their patients.
I became a doctor because I wanted to be in a profession in which I could make meaningful decisions, which would be of immediate and long-term benefit to other people. Obama Care is taking this away from me and others who feel as I do, which will lead to a decline in the number of altruistic caring, compassionate, and intelligent young men and women entering the medical profession. The result can only be a decrease in quality and humanity in medical care. Perhaps the Affordable Care Act should be retitled the “Abominable Care Act”.