Are Dems abandoning healthcare?
By Jane Orient. The opinions expressed are her own.
One of the Obama Administration‚Äôs greatest legislative triumphs is already turning sour.
Before passage, Democrats were urged to vote for ObamaCare as a smart political move. In time, they thought, people would come to love the new benefits. ‚ÄúGood policy is good politics,‚ÄĚ Obama said.
But ‚ÄúHealthcare reform‚ÄĚ passed with zero Republican support and bipartisan opposition. And with midterm elections on the horizon, Democrats who voted ‚Äúno‚ÄĚ are posing as heroes.
Now that we can see what is in the bill ‚Äď we had to wait until it was passed — people are very unhappy. One of its key backers, Families USA, issued a new message: ‚ÄúThe bill isn‚Äôt perfect, but we‚Äôll improve it.‚ÄĚ
Nor are any of the left-wing groups that pushed for the passage of the bill doting on their healthcare baby. Its godfather, Sen. Max Baucus (D-MT), isn‚Äôt bragging about his authorship of ‚Äúhistoric‚ÄĚ legislation. He says he didn‚Äôt even ‚Äúwaste time‚ÄĚ reading it, but relied on ‚Äúexperts.‚ÄĚ
So why are Democrats trying to disown their ugly baby? Because they know they cannot keep their extravagant claims of reducing medical costs and the federal deficit.
At our Pima county medical society in Tucson, Arizona, there‚Äôs no applause for the American Medical Association‚Äôs endorsement of the bill. Instead, there‚Äôs a mood of resignation. The society‚Äôs leaders say that small medical practices won‚Äôt be able to afford the crushing new compliance requirements such as audits of billing practices.
For doctors who don‚Äôt want to close their doors or seek employment with a big group, they now have an added cost of paying an outsourced business entity to study the new rules, collect the right documentation, and file the necessary reports.
Patients have no cause to celebrate either. Sure, more people will be covered ‚ÄĒ by Medicaid. And by unemployment benefits. The cost of pricey ‚Äúminimum essential coverage‚ÄĚ or the penalties for not providing it ‚ÄĒ which could be as much as $3,000 per worker, depending on complex calculations ‚ÄĒ are job killers.
More onerous requirements kick in at thresholds of the 51st, 101st, or 201st employee. As businesses approach these levels, they may cancel plans for new hires, or simply pass out pink slips. This is the last kind of news we want to hear during a recession.
Small businesses may have been excited about the 35% 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 would have figured out that they probably don‚Äôt qualify for it.
States might be glad, too, that they got the ‚ÄúCornhusker Kickback‚ÄĚ — the federal government will foot the bill for the swollen Medicaid rolls until 2016‚ÄĒwhich was reportedly used to buy Nebraskan Senator Ben Nelson‚Äôs vote, but then expanded to all states because of the public outrage.
Meanwhile, states will lose the premium taxes on people crowded out of private plans and onto Medicaid ‚ÄĒ taxes that now fund up to one-third of that program. Yes, part of the premium you pay for private insurance is a tax paid to the state, rather like a sales tax. In some states it is an important source of revenue they cannot afford to lose. States will also have new demands on already strained or broken budgets, such as the requirement to monitor insurance premium increases or to set up insurance exchanges.
In reading the 906 pages of statutory language, in order to write an article entitled ‚ÄúObamaCare: What‚Äôs in It?‚ÄĚ for the fall 2010 issue of the Journal of American Physicians and Surgeons, I read a lot about the various features of the bill — taxes, regulations, punishments, favors to special-interest groups, social engineering ‚Äď but nothing about patient protections and nothing that makes care more affordable. The costs of the bill are simply shifted to other people or taxpayers.
Features of the bill that most Americans loathe include billions of new tax reporting forms (including 1099s for the sandwich shop), more crowded emergency rooms, fewer available doctors, loss of medical privacy, more marriage penalties, and lots of new taxes ‚ÄĒ either because you are defined as ‚Äúrich‚ÄĚ or because you are paying the taxes that ‚Äúrich‚ÄĚ businesses such as medical device manufacturers pass along to you.
Although there are certain things in the bill that some people will like: federally funded abortions, national servitude for doctors, thousands of new jobs for IRS agents and bureaucrats, millions of unwilling new customers for managed-care schemes, federally certified computer systems, and grants for developers of medical cookbooks, ineffective smoking cessation aids, or politically correct ‚Äúcounseling‚ÄĚ or ‚Äúeducation‚ÄĚ programs.
If ever an abortion of a misbegotten monster was warranted, to save the life of our country, this healthcare baby would qualify. It‚Äôs been conceived and implanted, but it has a lot of growing to do before it matures around 2014 ‚ÄĒ in the course of which it 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 level. The ideas and their purveyors need to be expelled from the halls of Congress and the palaces of the executive branch, and the society that harbored them needs to be immunized by this experience against future schemes for a government takeover of medicine.
Not everybody, though, is rolling over and planning to be a pawn in the massive new bureaucracy. By now, most people have heard of ‚Äúrepeal and replace‚ÄĚ in regard to the new law, and now there‚Äôs a third R ‚Äď resist, writes John Graham of the Pacific Research Institute. If we are fortunate, the resistance will restore the patient-physician relationship and remove the third-party dominance that brought us to this disaster. Otherwise, we‚Äôll continue down the path of destroying private medicine in America.
Dr. Orient, executive director of Association of American Physicians and Surgeons, is the author of “Sapira‚Äôs Art and Science of Bedside Diagnosis” and “YOUR Doctor Is Not In: Healthy Skepticism about National Health Care.” She is also a clinical lecturer in medicine at the University of Arizona College of Medicine.