The Patient Protection and Affordable Care Act (PPACA) otherwise known as ObamaCare is the law of the land and certain aspects have already been enacted back as early as 2010. And this year significant changes will start to unfold to the people in our area and continue to reveal more of its inner design on January 1st of 2014.

It is perhaps the greatest change to take place in American healthcare culture ever. Although many people identify the plan with the President by referring to it as ObamaCare, credit for its passage has to be given to the elected officials in our area who supported and voted for it, namely Senator Charles Schumer and Congressman Joseph Crowley.

These two representatives helped pave the way for ObamaCare and modesty has no place when an elected official endorses a plan that will affect his or her constituents in such a profound way as this plan does. So, on a local level at least, we could rightly co-name the new Act as Schumer Care or CrowleyCare in recognition for their efforts in helping the President’s plan pass and for all of the results that we will be seeing over the next few years.

The Tax Penalty

Under ObamaCare, individuals must purchase a government designed healthcare insurance policy or pay a tax. Businesses that employ 50 or more full time workers must provide employees with government designed healthcare coverage or face paying a tax. The estimated tax that individuals and businesses will have to pay will cost less than the cost of the insurance premiums they would have to pay so the young and the healthy as well as financially prudent businesses will most likely pay the tax penalty and avoid paying for insurance. Hence, the tax penalty works as an incentive for keeping young people out of purchasing insurance and motivates small companies to stay away from expanding. Previously, the downside for not purchasing insurance was the risk of getting a serious illness and not being covered. But that risk has been taken away from individuals since ObamaCare is an entitlement and covers pre-existing conditions.

This will leave an insurance pool comprised mainly of elderly and sick who will be forced to purchase a government approved health insurance policy at exorbitant premiums or, if they qualify, rely on a bankrupt Medicare program for health benefits. Before too long as insurance companies continue to pay out more in benefits than the premiums cover, many will simply go out of business eventually allowing the government to remain the only insurance game in town while leaving Medicare as a poor substitute for catastrophic illness.

Health “Coverage” and Health “Care”

Proponents of ObamaCare continually remind the elderly that ObamaCare does not change Medicare benefits to seniors even though ObamaCare takes 716 billion dollars out of the system over 10 years while millions of baby boomers turning 65 will enter the system. They forget to mention that there is a big difference between health “coverage” and health “care” and it is disingenuous to say the least not to point this out to seniors. It’s like the government says it’s giving away free metro cards but neglects to mention that there are no trains or buses to ride or that the government is handing out free movie theatre tickets but sidesteps the fact that there are no shows to be seen. Although the benefits offered with Medicare remain the same, receiving those benefits might be near impossible since there will be fewer doctors and hospitals accepting Medicare.

Doctor Elizabeth Lee, a prominent speaker on the new law states, “Medicare as you have known it is gone.” A 2012 survey conducted by The Physicians Foundation found that over 52% of physicians have limited the access Medicare patients have to their practices. Obama’s Medicare actuary, Richard Foster, believes ObamaCare Medicare cuts could negatively impact 15% of hospitals serving Medicare patients.

So what do doctors think about ObamaCare? Dr. Jane M. Orient, Executive Director of the Association of American Physicians and Surgeons (AAPS), stated that ObamaCare is a flawed 3rd party payment model health plan, which should not be confused with health insurance, and whose real aim is to “destroy private medicine.” Orient believes that many doctors will be forced to leave private practice and join large hospitals and be salaried government employees or be forced to leave medicine entirely. 59% of physicians from The Physicians Foundation agreed with Orient and stated that ObamaCare has made them less positive about the future of healthcare in America.

patient doctor relationship
Dr. Marcy Zwelling, a primary care physician said that ObamaCare, “Dismembers the very foundation of healthcare which is the patient doctor relationship.” She added that the government doesn’t belong in the exam room interfering with the doctor’s treatment of the patient. Patients’ private medical records will now be sent to the government said Zwelling who also fears ObamaCare’s Independent Payment Advisory Board (IPAB), a 15-member panel of unelected federal employees appointed by the president. IPAB was created to restrict payments to doctors and hospitals in order to achieve a reduction in Medicare spending. Unlike any coverage restrictions placed on a patient’s care by today’s insurance companies, where an individual can leave one insurance carrier for another, IPAB’s power is total and treatments regarding medication, and surgical procedures will be rationed in order to save money. Many doctors are planning on leaving medicine, a profession they love, not just because ObamaCare puts economic pressure on them but rather because of ethical and moral considerations. They stated that when they became doctors they took the Hippocratic oath that includes that they do no harm and that they could not abide by that oath under ObamaCare.

Many American doctors point to Britain’s version of IPAB, which is the National Institute of Health and Clinical Excellence (NICE) that severely restricts patient care. According to an October 2012 article in Forbes magazine, “ninety percent of England’s hospital trusts are now rationing care by following NICE’s long list of “recommendations” that includes stopping access to drugs that prolong life or cure breast cancer, stomach cancer, kidney cancer, macular degeneration (causing progressive blindness), multiple myeloma, rheumatoid arthritis, early Alzheimer’s disease, MS, and osteoporosis that causes hip fractures and premature death.” The Forbes article points to President Obama’s selection of Donald Berwick to be the Administrator of Medicare and Medicaid, who proclaimed in 2008 that individual choice is not appropriate in structuring healthcare – “that is for leaders to do.” 

**The views expressed in this column represent only those of the author and not the board or membership of the Juniper Park Civic Association.