False Promises in Health Care


The U.S. Supreme Court will shortly discuss the ACA, the latest abbreviation for the Patient Protection and Affordable Health Care Act of 2010, pejoratively named Obamacare.

In Monday’s Journal, State Sen. Dede Feldman, D-Albuquerque, defended the ACA, saying it is good for both New Mexico and the United States because it: a) brings lots of money into our state; b) creates new jobs; c) increases insurance coverage; and d) eliminates the exclusion for pre-existing conditions.

ACA may bring millions of federal dollars into New Mexico, but that money will be spent on bureaucracy, not on patients. ACA is likely to increase jobs – 38,000 to 47,000 new bureaucrats, regulators, insurance adjusters, IRS investigators and compliance officers, but not one new nurse or doctor.

In 2008, President Obama said that the U.S. health care cost spiral was unsupportable and was contributing significantly to our soaring national deficit. Then he pushed through a bill – ACA – that will spend an additional $1 trillion to $2.7 trillion, money we do not have and we will have to print or borrow.

Feldman applauded New Mexico’s “quiet implementation” of ACA, building a whole new IT system for insurance authorization and compliance, not for medical information and care. Isn’t that just what we need – a whole new layer of complex bureaucracy overlaying an already bloated, user-incomprehensible insurance system?

Feldman claims that ACA is good for us because it extends insurance coverage to people who currently do not have it. Insurance is not what patients want. What patients want is health care. Under ACA, they won’t get it.

If the doctor cannot afford to accept your insurance, such as Medicare, having insurance coverage is worthless. If the insurance carrier doesn’t authorize the care you need, when and where you need it, having insurance does you no good.

In day-to-day health care reality, government insurance is no different from private. First, they make money or stay within budget using the 3D strategy: Deny, Delay and Defer.

If by some miracle the procedure or drug that you need is covered, the insurance will contract for the cheapest they can find. This is generally not the level of quality that you need. As a pediatric cardiologist, I fight this battle every single day, and so do virtually all of my colleagues.

Then there is the ACA’s IPAB (Independent Payment Advisory Board). Just as in Great Britain, IPAB will say what is cost effective (meaning available) and what is not (not available.) In England, kidney dialysis and heart surgery are not considered cost effective over certain ages, so they are not available. If you need them, you die.

Even if you can keep your insurance with your pre-existing condition, you will wait and wait and wait, as they do in Canada, for a procedure that is approved but scheduled months or years in the future.

IPAB is even worse than you think. According to ACA, if Congress does not enact spending cuts in other areas – which are politically unpalatable and therefore will never happen – IPAB cuts in medical services automatically become law.

Is this what you would call “good” for New Mexicans or for Americans?

The ACA has been called magical thinking, snake oil, smoke and mirrors, a monstrous scam, and government takeover of health care. While all of these apply, the most appropriate terms are malpractice and exacerbation (the opposite of reform). ACA fails to treat the causes of health care illness. As a result, ACA makes both health care and us sicker.

Feldman called the Supreme Court challenge to ACA “more to do with politics than the Constitution.” Very clearly, the imposition of ACAon the American people had much more to do with partisan domestic politics than the health of either our health care system or We the Patients.

Dr. Deane Waldman is the author of “Uproot U.S. Healthcare” and a professor at the University of New Mexico. The New Mexico Rio Grande Foundation is an independent, nonpartisan, tax-exempt organization dedicated to promoting prosperity based on principles of limited government, economic freedom and individual responsibility.