Before its passage, politicians were urged to vote for Obamacare as a smart political move. In time, supporters claimed, people would come to love the new benefits. “Good policy is good politics,” President Obama said.
Today, as people find out what’s in the bill, they are coming to hate it. In a leaked PowerPoint presentation, Families USA advises a new message: “The bill isn’t perfect, but we’ll improve it.” Forget about the extravagant claims of reducing medical costs and the federal deficit, it says: “Keep claims small and credible.” A lead Wall Street Journal editorial queries: “Who’s Obamacare’s Daddy?”
Few of the groups that pushed for passage are crowing, and even fewer electioneering politicians are bragging about their authorship of the “historic” legislation.
At our county medical society, there’s a mood of impassive resignation. The society is making a deal with a business group to help doctors survive—and to help the society slow the loss of disenchanted members. There’s no applause for the AMA’s endorsement of the bill.
No Cause to Celebrate
Small medical practices won’t be able to afford the crushing new “compliance” requirements, say the society’s leaders. They have three years to figure out what they are going to do. The alternative to closing or merging is, in this view, to outsource responsibility for studying the new rules, collecting the documentation, and filing reports. Declaring independence from the system hasn’t occurred to them yet, but it will.
Patients have no cause to celebrate either. More people will be covered, but by Medicaid—and unemployment benefits. As employers look at the cost of “minimum essential coverage” or penalties such as $3,000 per employee if any worker qualifies for subsidies, there will be fewer hires and more pink slips—especially around the thresholds of the 201st, 101st, or 51st employee, where new requirements based on “bigness” kick in.
Small businesses may have been excited about the 35 percent tax credits touted on a postcard sent at taxpayer expense. But if they did the math or used the National Federation for Independent Business internet calculator, they probably figured out they didn’t qualify.
Massive Cost-Shifting, New Taxes
The federal government will foot the bill for the swollen Medicaid rolls until 2016. But states will lose the premium taxes on people crowded out of private plans and onto Medicaid—taxes that now fund up to one-third of that program. They’ll also have new demands on already strained or broken budgets, such as the requirements to monitor insurance premium increases and set up insurance exchanges.
In reading the 906 pages of statutory language, one finds no “patient protections” or anything that makes care more affordable. There are only ways of shifting the increased costs to other people or taxpayers.
Most Americans will hate hate features such as the billions of new tax reporting forms, more crowded emergency rooms, decrease in available doctors, loss of medical privacy, additional marriage penalties, and lots of new taxes either because you are defined as “rich” or because you are paying the taxes that “rich” businesses such as medical device manufacturers pass along to you.
There are things in the bill that some people will like: Federally funded abortions, lots of multiculturalism, national servitude for doctors, acceptance of death by dehydration or starvation, thousands of new jobs for IRS agents and bureaucrats, millions of unwilling new customers for managed-care schemes and federally certified computer systems, and grants for developers of medical cookbooks, ineffective smoking cessation aids, and politically correct “counseling” and “education” programs.
By 2014, Obamacare will suck the economy dry while displacing the professionals and institutions devoted to caring for the sick.
We need to starve it of funding, disown it, repeal it, enjoin it, and nullify it on the state and individual levels. The ideas and their purveyors have to be expelled from the halls of Congress and the palaces of the executive branch, and the society that harbored them must be immunized by this experience against future schemes for a government takeover of medicine.
Jane M. Orient, M.D. ([email protected]), is executive director of the Association of American Physicians and Surgeons.
Health Care News: Obamacare’s Broken Promise: One Company’s Experience by Charles Arp