Americans have been anxiously awaiting the debut of the Affordable Care Act since the Democratic Congress passed it and President Obama signed it into law those long years ago. It held special significance for those with pre-existing conditions who were denied coverage, unless you were lucky enough to be included in a group plan at your place of work. The alternative was the emergency room, and that was only if the ailment had reached a critical stage demanding immediate attention. If you were in that neutral zone between wealth and poverty, it meant crippling medical bills that drove many into bankruptcy.
So any change was welcome, sort of. Watching politicians dissect the new law was like watching a pack of blind drunken plumbers performing brain surgery, and you could only hope the patient would survive with all his parts intact. There were so many deals cut to satisfy the needs of the politican-doctors and the insurance cartels that the end result was sewn-together abomination that even Dr. Frankenstien would have disowned.
But it was the best they could do, given that their majority was unlikely to survive the mid-term election of 2010. Nobody read the final draft. Nurse Nancy said we’d all find out what they had done after the bandages were removed.
There were immediate benefits, for my family in particular. PCIP probably saved my wife’s life, and for that I will be eternally grateful. I got to see how the system works up close and personal. The doctors were competent and professional.
Mercy Dignity Hospital is a well-run facility. The staff was helpful and compassionate. It really seemed that things were running smoothly for the new program.
Until we saw how much the ordeal had cost. Without getting into specific numbers, I calculate that it would take 900 healthy millennials paying the same high premiums just to break even. And that’s just one case out of the hundreds of thousands that will now flood the doctor’s offices and clinics across the land.
That’s the sticker shock that Americans woke up to after the new exchanges opened up in October. The botched computers are just the tip of the iceberg. The reality is that every working stiff will be subsidizing the sick and elderly, which they had been doing unconsciously before through inflated and inadequate insurance premiums. Obamacare just made it more obvious how broken the system really is.
John Roberts declared the the new insurance rates and subsidies are a tax, and he was correct. It’s a new tax passed through the hands of the insurance companies to the providers. And the public outrage is designed to force those providers into taking a smaller cut of the action, along with reams of new regulations.
There is already grumbling from the doctors and hospitals. Some will drop insurance and medicaid altogether and see patients on a cash-only basis. New arrivals will avoid general practice, opting for specialized services. More patients will never see a doctor, as the burden is shifted to nurse practitioners who are not as well versed on diagnosing serious conditions. Rationing, if you will.
The reluctant Republicans who refused to vote for the ACA said it was a ruse to move us into a single payer system, and they were right too. Perhaps that’s the only way to resolve the problem in the long run. There is no easy answer, and no free ride.