Obamacare: Still Killing People 13 Years In

On March 23, 2010, President Obama signed his namesake legislation, the Affordable Care Act (ACA) colloquially Obamacare, into law.  On March 23, 2023, the Biden-Harris administration celebrated the ACA's thirteenth anniversary.  They should be holding a funeral, not a celebration party. 

The ACA has caused countless avoidable American deaths.  They are due to Washington's conflation of a piece of paper (an insurance policy) with a professional service: medical care.

Xavier Becerra, the Health and Human Services secretary, astonishingly missing during the entire COVID health crisis, declared the following: "As we celebrate the anniversary of the Affordable Care Act today ... this law has lived up to its name, providing a way for Americans to access quality, affordable health coverage." 

The ACA did indeed expand medical insurance to more Americans.  In 2000, Medicaid enrollment was 15.6 percent of the U.S. population.  In 2022, that number has nearly doubled: 27.7 percent of Americans — 92,340,585 individuals — were enrolled in the taxpayer-funded, no-charge-to-enrollees program.  Thus, nearly one third of the country has medical insurance and, according to Secretary Becerra, "have the peace of mind that comes with high-quality health care." 

Note the conflation of care with insurance.  Washington wants you to think having the latter means you get the former, presumably when you need it.  Otherwise, what good is insurance?  Having insurance does not mean getting timely care.  In fact, there is a seesaw effect: as the number of people with government-provided insurance increases, access to care decreases.

Before the ACA, average maximum wait time to see a primary care physician was a unconscionable: 92 days.  With ACA expansion of government-provided, no-charge Medicaid insurance, maximum wait times increased to 120 days and produced death-by-queue.

Death by queue is a phrase coined in the United Kingdom, meaning dying while waiting in line for care that is technically possible but unavailable in time to save lives.  Death by queue has long been a feature of the vaunted British National Health Service (NHS) and has now become noticeable in the U.S.  

In Illinois over three years, 752 Medicaid enrollees died waiting for desperately needed medical treatment.  An internal Veterans' Affairs Department audit concluded that "47,000 veterans may have died" waiting in line for care that was technically possible but unavailable.  Veterans are covered by federal Tricare insurance.

An accurate estimate of death by queue in the U.S. is not available.  In Great Britain, at least "117,000 die[d] on waiting lists for NHS" in 2020 and 2021.

My wife may have been a victim of death-by-queue.  She waited seven months before she could see her primary physician for her abdominal pain.  The diagnosis was inoperable pancreatic cancer.  She died 22 months later.  Her case is certainly not unique.  Numerous studies prove that delay in diagnosis of life-threatening conditions such as cancer leads to deaths that could be prevented.  What is killing these patients is excessive wait times.

The reason for the long wait times and death-by-queue is Washington's repeated fixes applied to healthcare.  First there are federal regulations.  Physician time that should be spent on patients is consumed by regulatory and administrative burdens. 

Second, there is "bureaucratic diversion," when money is taken from clinical care to pay for bureaucracy, administration, rules, regulations, compliance, and oversight.  Each dollar spent on these non-clinical activities is a dollar that cannot be spent on patients.  Estimates of this outlay range from 31 percent to 50 percent of all U.S. healthcare spending.  In 2021, the U.S. expended $4.3 trillion on its healthcare system.  Thus, Washington took roughly $2 trillion away from patients to pay federal (and state) activities that provide no care.  Imagine how short wait times could be — can you say 48 hours?! — with an additional $2 trillion available to pay providers!  Possibly my wife would be alive today.

For decades, Washington has been fixing health care with federal programs such as Medicare and Medicaid (both created in 1965), the Emergency Medical Transport and Labor Act of 1986 (which created health care's unfunded mandate), the Health Insurance Portability and Accountability Act of 1996, and the ACA (2010).  Prior to 1965, the U.S. expended 6.5 percent of GDP on health care.  Last year, it was 19.7 percent

The end result of federal over-regulation and all that spending is what we have today: death-by-queue and impending bankruptcy of both Medicare and possibly the U.S. 

Biden's "celebration" of Washington's healthcare achievements is a travesty.  By constantly increasing government-provided insurance, Democrats increase the number of Americans who die waiting too long for life-saving care. 

If we want to shrink wait times, see the doctor before it's too late, and save American lives, kick Washington out of healthcare (the system), stop budget-focused bureaucrats from dictating our health (medical) care, and reconnect patients directly with their doctors with no third-party decision maker in between. 

Deane Waldman, M.D., MBA is professor emeritus of pediatrics, pathology, and decision science at the University of New Mexico.  He is the former director of the Center for Healthcare Policy at Texas Public Policy Foundation and author of multi-award-winning book Curing the Cancer in U.S. HealthcareStatesCare and Market-Based Medicine.

Image via Max Pixel.

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