A glimpse into our Kafkaesque future under Obamacare

Joesph Smith
Merriam-Webster defines "Kafkaesque" in part as "having a nightmarishly complex, bizarre, or illogical quality."

For a taste of the Kafkaesque under ObamaCare, consider the 159 new boards, panels and programs in the 2,733 page Senate Health bill, as compiled by Senate Republicans.  These panels would be the face of ObamaCare for every aspect of every medical need of every American.

Now consider one citizen's prolonged run-in with the Social Security Administration, as described in a Wall Street Journal account of  "the sometimes-Kafkaesque process debtors can face when challenging the validity of a claim."  Keep in mind that one can substitute any of the 159 ObamaCare panels for the role of the Social Security Administration in what follows.

According to the Journal account, Dr. Robert Steinberg spent six years and thousands in legal fees appealing a Social Security claim for overpayment of disability benefits related to a cancer condition that led to his eventual death.  A decade after the benefits were paid, the alleged debt was turned over to Treasury for collection:

In October 2002, administrative law judge Gary Lee found that the Social Security Administration never established the amount of the overpayment; had dismissed an earlier appeal "for spurious reasons"; had misinformed Dr. Steinberg and mishandled his later appeals; and had lost his file. He noted that Dr. Steinberg was "without fault" and told the agency to stop its collections efforts.

Dr. Steinberg died in 2008, at age 61. His lawyer, Peter Young, a former staff attorney for the Social Security Administration, has handled more than 100 overpayment cases, "very few of which were accurate," he says. "Most people can't find or afford help, and give up very quickly and end up with painful offsets on a fixed budget."

An agency spokeswoman says mistakes can happen, but "overall, the process works."

And now consider that the Senate Health bill gives "sweeping power" to the Centers for Medicare and Medicaid Services, and that, as the Journal earlier reported:

The Senate health-care bill also exempts Medicare's actions from judicial review , taking away the right of patients to sue the government. Unlike existing Medicare coverage laws, patients won't have the ability to appeal any of the decisions of this new Medicare Commission [emphasis added]...

The impact of these provisions won't be confined to Medicare. Private insurance sold in the federally regulated "exchanges" will take cues from Medicare, since they're both managed from the same bureaucracy. Medicare will set the standard for medical care across the entire marketplace.

The Kafkaesque process that confronted Dr. Steinberg will become a feature of everyday life if ObamaCare is pushed over the transom.  Dismissed appeals and inaccurate cases, misinformed and mishandled patients, spurious reasons and lost files, giving up and painful ends, will become the lingua franca of American health care. 

If it took Dr. Steinberg six years to appeal an overpayment case, imagine the possibilities for doubletalk, roadblocks and literal dead ends for patients and doctors in navigating the 159 ObamaCare panels.  Dr. Steinberg found belated relief from a judicial hearing, but judicial review is off the table for ObamaCare.  For sympathy and further review, appeal to the IRS.

Medical care can not wait six years, and sometimes not six hours, but what does it matter, if ObamaCare becomes the law of the land.

After all, "mistakes can happen, but overall the process works."

Merriam-Webster defines "Kafkaesque" in part as "having a nightmarishly complex, bizarre, or illogical quality."

For a taste of the Kafkaesque under ObamaCare, consider the 159 new boards, panels and programs in the 2,733 page Senate Health bill, as compiled by Senate Republicans.  These panels would be the face of ObamaCare for every aspect of every medical need of every American.

Now consider one citizen's prolonged run-in with the Social Security Administration, as described in a Wall Street Journal account of  "the sometimes-Kafkaesque process debtors can face when challenging the validity of a claim."  Keep in mind that one can substitute any of the 159 ObamaCare panels for the role of the Social Security Administration in what follows.

According to the Journal account, Dr. Robert Steinberg spent six years and thousands in legal fees appealing a Social Security claim for overpayment of disability benefits related to a cancer condition that led to his eventual death.  A decade after the benefits were paid, the alleged debt was turned over to Treasury for collection:

In October 2002, administrative law judge Gary Lee found that the Social Security Administration never established the amount of the overpayment; had dismissed an earlier appeal "for spurious reasons"; had misinformed Dr. Steinberg and mishandled his later appeals; and had lost his file. He noted that Dr. Steinberg was "without fault" and told the agency to stop its collections efforts.

Dr. Steinberg died in 2008, at age 61. His lawyer, Peter Young, a former staff attorney for the Social Security Administration, has handled more than 100 overpayment cases, "very few of which were accurate," he says. "Most people can't find or afford help, and give up very quickly and end up with painful offsets on a fixed budget."

An agency spokeswoman says mistakes can happen, but "overall, the process works."

And now consider that the Senate Health bill gives "sweeping power" to the Centers for Medicare and Medicaid Services, and that, as the Journal earlier reported:

The Senate health-care bill also exempts Medicare's actions from judicial review , taking away the right of patients to sue the government. Unlike existing Medicare coverage laws, patients won't have the ability to appeal any of the decisions of this new Medicare Commission [emphasis added]...

The impact of these provisions won't be confined to Medicare. Private insurance sold in the federally regulated "exchanges" will take cues from Medicare, since they're both managed from the same bureaucracy. Medicare will set the standard for medical care across the entire marketplace.

The Kafkaesque process that confronted Dr. Steinberg will become a feature of everyday life if ObamaCare is pushed over the transom.  Dismissed appeals and inaccurate cases, misinformed and mishandled patients, spurious reasons and lost files, giving up and painful ends, will become the lingua franca of American health care. 

If it took Dr. Steinberg six years to appeal an overpayment case, imagine the possibilities for doubletalk, roadblocks and literal dead ends for patients and doctors in navigating the 159 ObamaCare panels.  Dr. Steinberg found belated relief from a judicial hearing, but judicial review is off the table for ObamaCare.  For sympathy and further review, appeal to the IRS.

Medical care can not wait six years, and sometimes not six hours, but what does it matter, if ObamaCare becomes the law of the land.

After all, "mistakes can happen, but overall the process works."