ObamaCare as Series BaseballBy Deane Waldman
Amidst Republican glee over healthcare.gov, Democrat excuses and finger pointing, the inevitable Washington blame game, and a host of "I told you so's," it is easy to lose sight of what really matters. We need to keep our eyes on the prize, not the ball (even if you were watching the World Series.) We must remember what the American people -- We The Patients -- want and expect from reform of our healthcare system.
Both major parties, the mainstream media, and online reporters and commentators are treating Obama's reform of healthcare just like a baseball game. They thrill when a pitcher strikes a batter out or when a hitter knocks one out of the park. But this more than one inning or even one game -- this is the World Series. We need to keep in mind much more than pitch count or the number of strikes on the man at the plate. The real prize is winning the Championship.
For healthcare reform, reducing costs and getting more people insured are laudable goals but they are merely interim ones. The true goal of reform is not signing up the "young invincibles." The healthcare equivalent of a World Series trophy is a fiscally healthy nation with healthy, long-lived individual Americans. While rooting for relief pitcher Koji Uehara, keep that in mind.
For those obsessed with scorekeeping, the latest tally shows twenty-eight States expanding their Medicaid programs under ObamaCare (PPAHCA). Does that mean the Obama team wins, 28-23 (DC makes 51)? Conversely, should it be scored as a Washington loss because thirty-three States refused to create State-based Health Exchanges? The real goal is health, so we should wait to see if ObamaCare makes individual Americans healthier. Recent studies suggest that it will not. As for health of our nation, ObamaCare is sickening the country fiscally: we are spending money that we don't have to create bureaucracy that we don't need.
Healthcare.gov was obviously a one-game blowout: the Feds lost 17 million to a number too low to count. The fatally flawed website doesn't work and when it does, the site gives erroneous data regarding the cost of insurance. Does this mean the series is over? No, but it does identify the real loser(s): America and Americans. We will be sicker while our nation is already fiscally weaker and less competitive due to Obama's "reform" of healthcare.
President Obama promised, "If you like your insurance, you can keep your insurance." The fact that hundreds of thousands of Americans are losing their present health insurance; that seven million will lose their health insurance next year; and that insurance is becoming less affordable does not bode well for his scorecard.
The president also famously promised, "If you like your doctor, you can keep your doctor." More and more doctors (including me) are quitting clinical medicine or refusing to accept government insured patients. This is likely to impact the health of We The Patients but apparently the president disagrees. His strategic plan (ObamaCare) takes money from the care providers to give it to bureaucrats.
Early in the game of healthcare reform, the manager (president) made a fateful strategic decision. Even as he proclaimed a compelling need to reduce the roster -- to cut spending -- he signed on hundreds of thousands of new players: rule-writers, administrative staff, actuaries, lawyers, managers, Directors, navigators and in-person assisters, regulators, IRS agents, overseers, and compliance officers. It was as though a big league manager cut the star batter (a doctor) and hired two thousand water boys (bureaucrats) to replace him.
To pay for the new hires, the manager took out a huge loan to pay all those water boys. The team cannot afford that loan so someone else -- our children -- will have to pay it. The price tag for ObamaCare -- over two trillion (!) dollars -- is being added on to an already overblown national deficit. The ObamaCare game plan is crushing our feeble economic recovery.
In most circumstances, one should wait until the desired outcome is achieved or fails to materialize before rendering judgment. For healthcare reform and the long-term health of Americans as well as America, this will be decades in the future.
However, in most circumstances a project of the magnitude of PPAHCA would have both proof-of-concept and evidence-of-effect established before implementation. ObamaCare had and has neither. Thus, when we see early results that are the exact opposite of what was promised, we can judge.
• National spending on healthcare is up, not down.
• Out-of-pocket spending is up, not down: insurance is even less affordable, not more.
• Millions are losing their insurance; millions cannot get insurance through healthcare.gov; the number of uninsured Americans is going up, not down.
• Medical care is becoming less available, not more: people cannot "keep their doctors."
• PPAHCA expands a Medicaid program that has worse outcomes than no insurance at all.
• The only part of our healthcare system that is doing well is the federal bureaucracy.
All of the above leads to a sicker U.S., not to better health. The prize we are getting from ObamaCare is the destruction of our "hope" for positive "change."
On Wednesday October 30, 2013, the Boston Red Sox won the World Series. Go BoSox!! Their manager, John Farrell, said that their historic victory was due to the team, its management, the City of Boston, and the fans all working together toward a common goal.
On the same day, President Obama accepted "full responsibility" for the failure of healthcare.gov while reaffirming the soundness of his game plan for healthcare. He does not seem to grasp that "his plan" can never win. The only plan that has a chance will be one We The Patients call our plan.
Maybe the president should ask John Farrell to reform healthcare.
Deane Waldman, MD MBA, is a regular contributor to AT, author of "The Cancer In Healthcare" and a member of the NM Health Insurance Exchange Board. He retired from clinical practice (pediatric cardiology) after ObamaCare was passed.
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