The Obamacare debacle ...
... has little to do with website rollout problems, never mind the hysteria that spread among TV talking heads. Sure, it’s easy to throw rocks at the flawed rollout, but it just isn’t what matters about Obamacare.
I’ll tell you what I think but I warn you this may not be an easy read.
New systems have had bumpy starts since before Democrats discovered entitlements, and we all know the hiccups and crashes of a new system. We also know websites, databases and complex systems can be fixed, or at worst can be scrapped and replaced.
So even though the Oct.1 Obamacare enrollment opening failed, and even though the new system clearly was not adequately tested, the marathon of criticism on Fox News is completely misplaced.
It is indeed interesting that Obama’s heretofore loyal mainstream media turned on him at long last on the rollout snags, joined by a wave of Democrats running for hotly contested seats in Congress who are publicly abandoning their Obamacare pom-poms.
Nevertheless, incompetence in the enrollment computer system pales in comparison to the real problems with Obamacare.
The current website controversy is mostly about appearances while more important substance lies ignored in a dark corner, overlooked. Go ahead and collect some heads as retribution for naive and unprofessional introduction of a major national system, and for spending truckloads of taxpayer money like a wastrel on a system that doesn’t work yet. But this aborted beginning is not at all central to the damage Obamacare is doing to America.
We all know Obamacare creates hundreds of new boards and commissions now in the process of creating volumes of new regulations to control every aspect of our health care lives.
We know the new law was crammed through by parliamentary maneuvers without a single Republican vote while half the country was adamantly opposed to it.
We know Obamacare covertly redistributes wealth from higher income to lower income individuals, and from the young to the old.
We know that government mandating every individual must purchase health insurance with their own money isn’t right, even if the Chief Justice of the U.S. Supreme Court twisted himself into an intellectual pretzel to declare the mandate’s penalty is constitutional, his reasoning that the payment is a tax and not a fee stretched like a dollar before payday.
We know Obamacare is the left’s strategic stepping stone to a single payer (government insurance) system.
Let me pause here to alarm my fellow conservatives by confessing that single payer might be a good fit in theory since insurance is the concept of spreading the small risk of catastrophic loss over large numbers of people, but the theory is trumped all to hell and back by our certain knowledge the federal government couldn’t lead a group of little old ladies through a pansy patch without serious consequences, and will surely screw up our healthcare to a fare-thee-well.
We don’t trust handing over one-sixth of the economy to our government whether the administration of the moment is Democrat or Republican, because we know government is an epic case study in human nature wherein every incremental dose of power seems to inflate an irrepressible urge to create more rules for other people to follow, overshadowing any notion that people should be left alone to control their own lives.
Chew on that thought long enough and you may see the irony since our country’s birth out of the love of liberty was induced by that very human weakness.
We know there are some good things in Obamacare, like doing away with pre-existing conditions, eliminating lifetime benefit caps, keeping children on our policy through age 26 and non-cancellation.
But it gets even better because the liberals in charge decided every policy must include coverage of prescription drugs like birth control pills, prenatal care, maternity, pediatric care including dental and vision, mental and behavioral care, and all 50 preventive and wellness screening procedures recommended by the U.S. Preventive Services Task Force.
And, of course, rehab is included since addictions of every stripe are considered diseases now instead of the misbehavior we all once knew them to be.
All that is before you even get to coverage of routine doctor visits and treatment for serious illness.
Who wouldn’t love policies packed with so many health safety hatches, with the federal government requiring many of them be “free” to the policyholder? One of the selling points is that now low-income drug addicts, alcoholics and mentally ill will for the first time have access to the services they need at no cost.
But because we weren’t born yesterday, we know — even while Obama’s dubious promise our premium cost will come down rings fresh in our ears – that every one of these coverage bells and whistles come at a cost that will eventually appear in our premiums.
We also know the medical care system will become overloaded with the newly-insured, inspired by their brand-new entitlement to “free” services.
And of course our government’s quest to take care of us all has consequences. Already, millions of Americans are receiving notice of policy cancellations because their existing policies don’t meet the new Obamacare requirements.
If that describes you, now you must choose a new policy, never mind that you may be a middle-aged male with no desire to pay for prenatal and maternity coverage, never mind that you are a young woman whose religion prohibits contraceptives, never mind that you want to pay for your own routine care and save premium dollars by purchasing a policy that only covers serious illness.
Nope. That old policy and its premiums might fit you like a glove but the geniuses in Washington know far better what is good for you.
Until now we have been underwritten by insurance carriers based on our personal risk profile – individual rating. Now under Obamacare, policies will be sold based on community rating in which you only need to answer three questions: age, sex and whether you smoke. You decide whether you believe cheerleader claims that your premium cost will be lower.
President Obama’s sales pitch had, at its core, his frequently repeated promise that we can keep our insurance policy and keep our doctor under Obamacare, and we know that was never even remotely true.
We know government-rationed care will become part of this mess.
We know the heavy hand of government’s one-size-fits-all rules is a blunt instrument, and that our deepest worries are not whether an enrollment website is broken, but what will happen in five years when your aging mom needs open heart surgery.
Will the boards and commissions of Obamacare step in to prioritize those scarce resources, allocating them to younger patients whose lifespan holds more promise, a rational decision that has nothing whatever to do with the value of your mother to you?
But there are other elements of the debacle that are more subtle.
With the advent of Obamacare, countless doctors nationwide have been throwing in the towel, scheduling their retirement from the practice of medicine because they’ve had enough red tape already and don’t want to become a red mummy.
Finding a doctor will become more difficult as the noose tightens, and as the years pass we will feel the effects that countless brilliant young men and women have already decided against a career in medicine, deterred by the repulsive notion of excessive government control.
The damage is already done in hardening America’s cultural shift to an entitlement mentality. For those who never learned in school the beauty of capitalism and self-reliance, for those who never pushed past the adolescent belief that government should take care of us, their worst ideals are being vindicated while the ideals of independence and personal responsibility that gave birth to this country are becoming passe.
Serious problems in our health care system not only remain but are aggravated by Obamacare. Republicans in Congress would do well to conserve the energy they squander on repeal efforts with no chance, and instead develop an alternative plan to actually solve some of the very real health care system problems. They should try to overlook their loathing for Obamacare to incorporate some of its ideas worth keeping.
A big part of the problem is you and me. By that I mean human nature, especially now that we live in a world that abhors risk of any sort, and our modern instinct that any problem or crisis we suffer means someone else must pay.
So, instead of gladly paying for routine doctor visits, and thereby making rational choices among competing costs, we have grown accustomed to ignoring healthcare costs because we expect someone else to pay every time we need surgery or get a scratchy throat.
Maybe you understand that health insurance paying for every little thing is actually a misapplication of insurance, which is the concept of spreading the risk of calamity over large numbers of people, each of whom pays a small regular sum into the kitty.
The better use of health insurance is to let you pay for your own routine doctor visits, while insurance covers your family against the financial catastrophe of a major illness.
Unless you are a socialist, of course, in which case your thought process eventually leads you to Obamacare and our mommy-state using other people’s money to pay for your smallest medical need, driving costs further into the stratosphere and allocating your mom’s open heart surgery to a younger person.
Obamacare does nothing whatever to encourage people to be responsible for their own routine doctor visits, or to pay careful attention to costs, which should be part of a rational healthcare system that protects against significant, unaffordable costs.
In fact, one advertised benefit is “free” preventive care, as if any covered service could possibly be free. The naive belief that someone else should pay for every medical service we seek, however large or small, is perpetuated and validated by Obamacare.
So long as patients ignore costs because they know “someone else pays,” some doctors will order unnecessary tests to cover their hiney and all medical providers are able to conceal their absurdly complex array of prices for services in which an aspirin tablet might billed from $2 to $50, depending on whether you are an insurance company with a specially negotiated deal.
As just one small example, when my daughter was suddenly seriously ill her summer before first grade while we were visiting grandma in Pensacola, the hospital bill was over $65,000 for her 10 days of care, reduced to just over $17,000 by the agreement with my insurance carrier, and my out-of-pocket cost was nearly nothing so what did I care what a second MRI cost when my kid is sick? Besides, if I had asked how much it cost the hospital would have taken hours at best to figure out the answer.
Hospitals play the inflated-billing game in an attempt to recover their losses on patients who don’t pay at all. This hidden-cost insanity will continue until patients have incentive to ask how much things cost and make decisions accordingly.
Obamacare makes it worse.
Those are some of the real problems with Obamacare, the things that matter far more than a broken enrollment website. That can be fixed, but the real damage to America caused by Obamacare just might be unfixable.
Think of it this way. When they get the enrollment flaws all smoothed out, America will be able to accelerate down the Obamacare highway, faster and faster, pell-mell toward perdition.
[Terry Garlock lives in Peachtree City and writes columns occasionally for The Citizen. He has authored a book, “Strength & Honor: America’s Best in Vietnam.” His email is firstname.lastname@example.org.]