There are signs the Affordable Care Act
(Obamacare), enacted into law on March 23, 2010, is experiencing severe
problems. A recent revelation that three
major insurers—Aetna, United Health and Humana—are sharply reducing the number
of areas where they’ll sell individual health plans, doesn’t speak well for the
program’s future. The fact these
well-established and experienced firms all experienced major losses on their
plans is evidence of irreconcilable difficulties.
To add to the misfortunes, even more recently
three other major health insurers in Tennessee—Cigna Health, Humana and Blue
Cross Blue Shield—just received huge double-digit premium increases for 2017,
amid a warning from the state’s insurance commissioner of the Obamacare market’s
“very near collapse.” Although the 36 percent
boost in 2016 premiums caused consternation, the increases scheduled for the
coming year should prove cataclysmic: Humana 44.3%, Cigna 46%, and Blue Cross
Blue Shield a whopping 62%.
Perhaps you’re inclined to suggest these
firms are merely using their market dominance to take advantage of an
inexperienced bureaucracy. If so, note
that Blue Cross Blue Shield, which sold these health insurance policies
statewide over the past three years, estimates it lost nearly $500 million during
this time. Is it even questionable
whether they’d remain as participants in the system without a massive premium
increase?
One of the most knowledgeable persons in the
healthcare field is G. William Hoagland, a former executive of Cigna, who is
now vice president of the Bipartisan Policy Center, a nonprofit organization
which analyzes national problems in search of solutions. Included in his comments are the following:
“We’ve reached a point where the Affordable Care Act’s exchanges are not
working . . . [These] companies are simply saying we can’t realistically offer
plans that are required to meet ACA standards . . . and just admitting that
this is not a market they can participate in.”
The reality of Obamacare in serious trouble
is not lost on the person whose name the program bears, although his reason for
its malfunction is focused in a somewhat different direction. In a July 11, 2016 article published in the
Journal of the American Medical Association, President Obama accused the
Republicans of undermining the implementation of the healthcare law. Nonetheless, while asserting "the ACA has
succeeded in sharply increasing insurance coverage,” he acknowledged “too many
Americans still face challenges securing affordable and quality health care”
and admitted “the lessons enumerated may seem daunting.”
It’s probably accurate to say the “Patient
Protection and Affordable Care Act” signed into law by President Obama on March
23, 2010, is the least bipartisan legislation ever enacted in our nation’s
history. It passed the Senate with the
bare 60 votes required by prior congressional resolution: 59 Democratic and one
cooperating Independent. None of the 40
Republican senators approved the bill.
The final version approved by the House of Representatives on March 21,
2019, received not a single Republican vote.
Its approximately 2,700 pages of often undecipherable verbiage remained
scarcely glanced at during the two days between final congressional approval
and presidential enactment.
One of the more humorous episodes of the
whole charade is the comment made March 9, 2010, by California Congresswoman Nancy
Pelosi, then House Speaker, as she began her final windup by alluding to the controversies
concerning the transparency of the process which produced the bill. After saying “It’s going to be very, very
exciting,” she then blurted out to the assembled officials that Congress “[has]
to pass the bill so you can find out what’s in it…” This, of course, is the same Nancy Pelosi
who, weeks earlier, boasted about the transparency of the process creating the
bill.
It’s true, of course, from its inception the
Republicans in Congress have done everything in their power to destroy the
program. They came close on June 28, 2012
when the U.S. Supreme Court, in a five to four decision, rejected a challenge
to invalidate a key provision of the law specifying an “individual mandate” by
declaring it to be a “tax. Had Supreme
Court Chief Justice John Roberts not joined the four other justices
philosophically disposed to the law’s intent, and fabricated this contrivance,
Obamacare might well have ended then.
This gets us to what we may describe as the bottom line. With the financial problems regularly
experienced and the number of healthcare recipients to be covered, is it likely
Obamacare will survive and function as its originators intended? There’s an answer to this. No, it will not survive, and yes, it will
function exactly as its originators intended.
How is this possible, you may ask?
I don’t believe for a moment that Nancy
Pelosi, or then-Senate Majority Leader Harry Reid, or for that matter the
bill’s sponsor, New York Congressman Charles B. Rangel, as well as the many
members of the congressional staffs which assembled the 11,588,500 words which
comprise the law, had no idea what they created. That no one thought to do a cursory
feasibility analysis defies rationality.
I firmly believe it was understood from the onset by the participants
that the Affordable Care Act would be nothing more than a temporary expedient
en route to a permanent healthcare solution—a single payer system, devoid of health
insurance, regulated by the federal bureaucracy, in which all Americans would participate. In short: a U.S. government HMO mandated for
all. Medicare and Medicaid will be gone,
the medical insurance provider will be a thing of the past, physicians will be
government employees and hospitals will be operated as federal agencies. And best of all, no one will receive medical
care that’s inferior to what’s received by someone else, for we all will
receive equal care—third rate, of course, but most certainly, equal.
I’ll conclude with this final comment. If there’s one positive thing to be said, it’s
that America’s indigents will receive a boost in health services. Those persons who in the past suffered from
an almost complete absence of viable care will at last receive something. It’s also likely, unless enforceable laws
prevent it, the wealthy will be able to supplement their care by paying
out-of-pocket for what they may need or want.
The true losers will be the vast middle class of all ages who will find
themselves in much the same category as the current Medicaid patients. Lines will be long; waiting periods for all
sorts of services equally long; and a system of healthcare rationing, overseen
by appointed boards, will become the norm.
I can think of only one appropriate greeting to usher in our new system:
Welcome to the brave new world.
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If you enjoy this
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