This week, the US House of Representatives finally got the opportunity to question Secretary Kathleen Sebelius and examine the debacle that is the Affordable Care Act. Unfortunately, the Secretary of Health and Human Services spent most of the 3 hour session skirting around the issues and tossing blame to other government agency bureaucrats, government contractors and of course the GOP. When repeatedly pressed, she did in fact admit responsibility for the failed rollout but stopped short of admitting that the ultimate responsibility falls upon the Commander in Chief, President Barack Obama. Like any good soldier in a politically appointed job, she protected her boss from the fallout of the TRUTH. However, in spite of the Secretary’s claims of ignorance during her testimony, Lawmakers on the House committee as well as the American people were able to begin to better understand why the ACA has been such a disaster:
1. A complete lack of leadership on the part of the President and his appointees.
2. A complete lack of understanding of the law by the very people who drafted and now champion the legislation.
3. A complete lack of understanding of process of healthcare delivery in the US today
For example, numerous provisions have already been delayed and many more are likely to be postponed in the future. The mandates on some businesses, the out of pocket expense caps, and now the individual mandate–just to name a few. Throughout the process there have been many misleading statements made by the President and his political colleagues both in the White House and on Capitol Hill. No less than 6 different statements were made by Mr Obama forcefully claiming in 2009 while addressing the American Medical Association:
“If you like your doctor, you will be able to keep your doctor, period, If you like your health care plan, you’ll be able to keep your health care plan, period. No one will take it away, no matter what.”
Obviously the hundreds of thousands of insured that are now being dropped by their insurance plans and forced into the exchanges are proof that these statements are in fact not true. In addition, there is mounting evidence that the White House as well as Secretary Sebelius knew about these issues with potential coverage loss for quite some time. An IRS document from 2010 (during the time in which the President was making such bold statements about coverage) suggested that this may in fact not be the case. This document clearly states that an estimated 40-60% of individual policyholders would be dropped from their plans due to the ACA. An article in yesterday’s Washington Post awards the administration with “Four Pinocchios” for making untrue claims about his cherished ACA.
We are a nation built on certain guaranteed Freedoms–in particular freedom of choice, freedom of religion and freedom of speech–we are slowly losing our way in the healthcare debate. Those with a particularly stringent religious beliefs concerning premartial sex and birth control practices are now forced to purchase products that supply contraception. The Catholic Church–whose believers practice natural family planning–are being forced to provide their employees with funding for birth control. Our government has clearly overstepped its bounds. Those who are healthy and have little need of expensive insurance policies are now forced to pay for benefits they may not really need. The entire success of the ACA system requires that those who don’t need medical care pay for those who do–a unique system for transferring wealth.
Ultimately, costs will continue to rise. As evidenced by a report filed by Sebelius’s very own HHS in September 2013, most will see a significant premium increase. The average male in the US today who enters the exchange will see a 99% increase–the average female will see a 67% increase. In some states such as North Carolina where I reside, the average man will pay a 350% increase in premium. Rather than closing the wealth gap in the US, the ACA will actually result in the development of two divergent classes of Americans with respect to healthcare–Those with wealth will be able to pay out of pocket for concierge medicine–they will have access to whatever they need, whenever they need it as long as they can continue to pay. The rest of America will be lumped into the dysfunctional and bureaucratic Obamacare system.
I am sadly disappointed by my government–those in charge have slowly chipped away at my noble profession–Medicine is in jeopardy of no longer being a form of art–soon medical care will be an automated system carried out by a group of mindless lemmings. The doctor-patient relationship which has been the core of good medical care is in danger of extinction. I am a firm supporter of providing healthcare to those who cannot afford it–just not at the cost of Freedom. I can only hope that those in power in Washington will respect the basic tenets of our democracy and, most importantly, put legacy and ego aside and do what we do best as doctors–put patients first.