By Jane M. Orient, M.D.
As Congress struggles to do something about the ObamaCare disaster, Senators may be getting calls pleading, “Don’t take my healthcare away!” But the more influential voices will be whispering, “Don’t take my ObamaCare dollars away!”
The American Medical Association (AMA), for example, is urging people to call about “cuts” (constrained growth) to Medicaid.
Let’s get the terminology straight: The government cannot “take away” or “give” you health care. Caring for your health is something you do—or don’t do—yourself. It costs practically nothing; in fact, it saves you money. Nonsmokers save thousands of dollars a year. Walking around the block every day is free—and maybe you’ll meet your neighbor. Healthy foods like fresh fruits and vegetables cost something, but less than Starbucks coffee-flavored milkshakes or fast-food lunches. Being faithful to your spouse pays huge dividends.
You can go to a “healthcare provider,” get counseled on smoking cessation, and have all your bad habits, risk factors, and soon probably your DNA and political views recorded in an electronic data base, accessible to the government and thousands of other entities. They will constantly score you—on your value to society, eligibility to own a self-defense tool, suitability for a loan or a job, and eventually perhaps your qualifications to have a child.
Your health depends on basic necessities not included in the $3 trillion poured into the “health care system” every year. Lacking a place to stay warm and dry, one homeless person lost his feet to frostbite, while Medicaid was paying someone $563 every month just to have him on a list of enrollees. Last year, Nevada Medicaid paid managed-care companies as much as $213 million for more than 30,000 people who received no care at all. Maybe that money was taken from housing or law enforcement.
Does the money given to Medicaid contractors perhaps pay safety-net hospitals to care for the needy who do need care during the year? We don’t really know where all the money goes. A preliminary look at publicly available documents of Arizona’s Medicaid system, allegedly the most efficient in the U.S., revealed that managed-care contractors made more than $225 million in pre-tax profits in just one year. And in 5 years, nearly $400 million of Medicaid funding was transferred to other state agencies.
From a basic economics standpoint, it is just absurd to use third-party payment schemes for routine, predictable (hence uninsurable) costs. It doubles or triples the costs, while making services look free or worth $5 at the time of service. It perpetuates the illusion that somebody else is paying, while managed-care stockholders, administrators, arbitrageurs, and purveyors of ridiculously overpriced drugs or procedures rake in profits.
Of course, there is the risk of a car crash, cancer, heart attack, or other true emergency. I’d like to buy catastrophic insurance to cover my risk for those things, without buying everybody else’s contraceptives, fertility treatments, smoking cessation counseling, drug abuse treatments, and blood pressure pills. Such insurance became very difficult to obtain years ago, and ObamaCare outlawed it.
We’re moving toward the end-game of single payer, which assures the continued diversion of funds to the Swamp. These funds are no longer available for people to choose to spend. And worse, the System will carefully control the funds that actually provide care, say by punishing doctors for deviating from government-dictated “best practices.” It will allow nothing it calls “snake oil” (things like vitamin D, hormone supplements for aging, or other generally benign items that people find worthwhile but that drain profits from government-approved treatments). Nothing “futile” like experimental treatment for Charlie Gard. Nothing experimental outside the control of the FDA (that might compete with lucrative drugs). Nothing that is not “value based” (such as life-sustaining treatment including food and water to patients not valuable enough to treat for pneumonia, heart failure, or a bleeding ulcer).
The system is also striving to eliminate nonadherence. Patients will take all their vaccines or lipid-control medicine, like it or not, because the benefit (to “society”) is claimed to outweigh the risk (to them personally).
The system wants Americans to trade their freedom for the illusion of “health care.” But Americans will soon learn that freedom is of the greatest importance when life is at stake.
Jane M. Orient, M.D. obtained her undergraduate degrees in chemistry and mathematics from the University of Arizona in Tucson, and her M.D. from Columbia University College of Physicians and Surgeons in 1974. She completed an internal medicine residency at Parkland Memorial Hospital and University of Arizona Affiliated Hospitals and then became an Instructor at the University of Arizona College of Medicine and a staff physician at the Tucson Veterans Administration Hospital. She has been in solo private practice since 1981 and has served as Executive Director of the Association of American Physicians and Surgeons (AAPS) since 1989. Dr. Orient is the 2017 recipient of The Edward Annis award for medical leadership.