This column by ACRU General Counsel Peter Ferrara was published on April 4, 2014 on Forbes.com.
The population of the U.S. is 314 million. On the day Obamacare was passed, the estimate of the uninsured was 60 million. So in this context, the supposed 7 million Americans signed up for insurance on the Obamacare Exchanges, even if that is a valid number, and all of those have actually started paying premiums, both of which are highly dubious, does not mean any significant success for Obamacare.
That is especially so since at least 6 million Americans have lost their health insurance due to Obamacare, so far, with more to come once the illegally and arbitrarily delayed employer mandate becomes effective, if it is ever allowed to do so. The estimate based on a new Rand Corporation study is that only 858,000 Americans signed up on the Obamacare Exchanges were previously uninsured. That is barely a dent of just over 1% in the original number of uninsured, from the historic Obamacare program that was supposed to provide “universal” coverage.
Yes, there are other sources of coverage under Obamacare. President Obama told us in his celebratory, hocus pocus, Obamacare address on April Fools’ Day that “more than 3 million young adults have gained insurance under this law by staying on their family’s plan.”
But that number is a publicly documented fabrication. It comes from a 2010 survey by the highly politicized Department of Health and Human Services estimating coverage for 19 to 25 year olds from all sources, including taxpayer financed Medicaid, and private insurance, which includes employer provided insurance and individually purchased plans, not just coverage from their parents’ health insurance, as David Hogberg explained at Spectator.org on April 2.
Moreover, that data is now outdated, as later HHS surveys show that health coverage for 18 to 25 year olds has since declined from 2010, Hogberg adds. That is why HHS has not released any new data on the point for almost two years now.
In addition, Hogberg further demonstrates based on 2012 data from the far less politicized Census Bureau, which breaks out data for Medicaid and employer provided health insurance, that the number of young adults gaining coverage on their parents’ health insurance under Obamacare totals at most 258,000.
In any event, the virtue of this young adult dependency on their parents’ health insurance is greatly exaggerated. That coverage is not free. The parents are paying more for it. Moreover, these young adults are not helpless, with no alternatives for health insurance. They can get their own jobs with employer provided health insurance. Or at least they could if Obama was not President. Or they could buy their own health insurance in the market, with help from their parents, if that is needed and desired. Young adults under 26 are the least in need of health insurance, and have the least trouble getting it. The healthiest population in America, they are targeted under Obamacare as lambs to be fleeced for funds to finance health care for others.
President Obama in his April Fools’ Day speech also cited “millions more who have gained access through Medicaid expansion….” But they cannot be included among the “millions of Americans [who] finally had the same chance to buy quality, affordable health care–and the peace of mind that comes with it–as everybody else.” That is because Medicaid is a taxpayer financed, welfare program, so those covered by it are not buying anything. Moreover, Medicaid does not provide “quality” health care, because it pays so little to the doctors and hospitals providing the actual health care for the poor, that many, especially the best, won’t take patients on Medicaid. Simply expanding Medicaid to cover ultimately 100 million Americans at taxpayer expense does not qualify as any sort of achievement.
But there were other howlers in Obama’s April Fools’ Day address. He told the American people that “Because of [Obamacare], 100 million Americans have gained free preventive care, like mammograms and contraceptive care, under their existing plans.” Here we have a President of the United States who does not understand that when the government requires health insurers to provide additional benefits, the cost of their health insurance has to go up, just to ensure the insurer has enough money to pay all the covered benefits. So there is nothing “free” about Obamacare’s required preventive care.
There are high school students who understand such basic economic reasoning better than the President. Of course, there are many adults who voted for him who cannot. Those are the people the President is counting on, and who are actually the ones who are most responsible for the long term, rapid decline America is now suffering.
Another more than dubious statement by the President on April Fools’ Day was that “a whole lot of families won’t be driven into bankruptcy by a serious illness, because [Obamacare] prevents your insurer from placing dollar limits on the coverage they provide.” A whole lot of families? Where is the documentation of that? I dispute that “a whole lot of families” were being driven into bankruptcy by the dollar limits on their health coverage before Obamacare.
Of course, again the President doesn’t understand that removing dollar limits on the coverage means the cost of that coverage must be higher. And that is the more so the more families were reaching those dollar limits before. The actual effect of the Obamacare dollar limit ban is that consumers are denied the freedom of making the choice themselves of whether they want to pay more for coverage without any dollar limit. That is because Obama and his “Progressives” are so certain that they know better than everyone else what that choice should be.
But the biggest howler in Obama’s April Fools’ Day speech was that, “Under [Obamacare], the share of Americans with health insurance is up and the growth of health costs is down….” Whether the ultimate effect of Obamacare will be to reduce or increase the uninsured is highly uncertain at this time. The employer mandate has been delayed until after the elections because the President knows the effect in terminating current coverage is going to be ugly. What is certain now is that Obamacare won’t get America anywhere near universal coverage, as Obama led the Left to believe was the whole point of the exercise.
But more obviously false is the notion that Obamacare has driven the growth of health costs down. As I explained in a previous column, the decline in the growth of health costs started in 2003, when Health Savings Accounts were enacted, and Obama was still an Illinois state senator. As the number of people with HSA plans rose to 30 million over the years, the decline in health cost growth became sharper. Obamacare just went into effect, and here is our President taking credit for a health cost trend that started over a decade ago.
Unlike Obamacare, HSAs provide proven market incentives to reduce health costs. The only effect of Obamacare on health costs so far has been to increase them, due to costly overregulation. And contra Obama, that is not good for the middle class, or our fiscal future. Unless Obamacare actually reduces overall health coverage by increasing the uninsured, and the deductibles most covered people face, that cost increasing effect will become more obvious over time. But Obama will be gone by then, virulently opposing any change in his brilliant law from the private sector.
But Obama doesn’t get it. He said further on April Fools’ Day, Obamacare is “helping people from coast to coast, all of which makes the lengths to which some critics have gone to scare people or undermine the law, or try to repeal the law without offering any plausible alternative so hard to understand. I’ve got to admit, I don’t get it. Why are folks working so hard for people not to have health insurance?”
Many readers are not going to understand this. But my job here is to tell the truth, not to play politically correct footsie with you. What our President is telling us here, actually, is that he has so carefully avoided hearing any of the debate on this issue, that he actually does not understand the issue, on which he imagines himself as the historic founding father of American health care.
The plan I support to replace Obamacare, root and branch, is the reform proposal developed by John Goodman, President of the National Center for Policy Analysis. That proposal, unlike Obamacare, actually would ensure universal health care. But it would do so at far less cost. It would do so, again unlike Obamacare, while actually reducing health costs. That proposal is actually far more plausible than Obamacare, which has already proven itself implausible in the real world. That is why Obama has already acted to change the enacted Obamacare law without the approval of Congress, in violation of the Constitution and his own oath of office.
But Obama continued, “Many of the tall tales that have been told about this law have been debunked. There are still no death panels.” Mr. Obama, the death panel in the law is called the Independent Payment Advisory Board (IPAB). You have carefully avoided appointing members to this board and making it operative, until after the mid-term elections.
He knows what he is doing here, but not what he is talking about.
Obama added further,
“And those who have based their entire political agenda on repealing it should have to explain why Jeane should go back to being uninsured. They should explain why Sean and his family should go back to paying thousands and thousands of dollars more. They’ve got to explain why Marla doesn’t deserve to feel like she has value. They have to explain why we should go…back to the days when Americans with preexisting conditions were out of luck–they could be routinely denied the economic security of health insurance–because that is exactly what would happen if we repeal this law. Millions of people who now have health insurance would not have it.”
But none of that would happen under the Goodman/NCPA reform plan I support. I explained that reform plan in a previous column. Look that up, or go to ncpa.org to find it. Again, what this demonstrates is that Obama, so carefully cloistered his whole life in his own ideological cell, is so disconnected from reality that he does not actually understand health policy issues.
But the harsh reality of how Obamacare works, or actually doesn’t work, is demonstrated by the story of Frank Alfisi, who died on January 14, 2014, at age 73, a victim of Obamacare, as explained by Jeffrey Lord at Spectator.org on April 1. Frank lived in a seniors’ apartment complex in Wantagh, Long Island, near the family of his daughter Amy.
While he was successfully treated with chemotherapy for 8 years for multiple myeloma, the chemo caused kidney failure. But Frank was fine as long as he could receive kidney dialysis three times a week. The problem began when he missed a dialysis appointment one day because he was ill with a stomach virus.
The next day, he was feeling very ill because of the toxin buildup in his body missing just one day without the scheduled dialysis. He called an ambulance, which took him to the nearby hospital to get his treatment. But under a new Medicare regulation, required by Obamacare, Frank could not receive the dialysis unless he was admitted as an inpatient for at least two days. Dialysis, however, does not require even one overnight stay. After the treatment, which takes a few hours, the patient can go home.
The doctors knew Frank could not go home without his dialysis. So they kept running tests on him to find some reason to admit him, under Medicare regulations. Around 8:30 that night, Frank’s blood pressure was so high because of the lack of dialysis that he had a seizure, still in the hospital emergency room, still not admitted, so he still could not receive the dialysis. Later that night he had a second seizure, and was unconscious for two days in the ER, still without any dialysis. His doctor told his daughter Amy, “You can thank Mr. Obama for this.” The death by Obamacare has already begun.
After that second seizure, Frank was transferred for rehab in the hope he would recover well enough to get his dialysis, first to Gurwin Jewish medical center, and then to Parker Jewish. But Frank could never get his dialysis, and died while in that rehab. He was “covered,” by Medicare, but because of Obamacare, and its cuts to Medicare to finance Obamacare, Frank was denied the actual straightforward health care that would save his life. In my interpretation, Frank Alfisi was murdered by Obamacare. This was what Sarah Palin was talking about when she used the term “death panels.”
There are other examples of cancer patients losing their health insurance that was financing the doctors keeping them alive, because the insurance did not satisfy Obamacare requirements. Edie Littlefield Sundby had health insurance that spent $1.2 million on health care for her stage 4 gall bladder cancer, as she explained in the Wall Street Journal. That plan included first rate doctors from her hometown of San Diego, to Stanford University’s Cancer Institute, and the M.D. Anderson Cancer Center in Houston, that kept her alive for 7 years. But that plan was cancelled under Obamacare, forcing her insurer United Healthcare out of California altogether. So much for President Obama’s promise, “If you like your health insurance, you can keep it.”
Sundby and her health insurance consultants could not find another plan in the highly touted California Obamacare Exchange that includes those same doctors, at any price. So down went another Obamacare promise, “If you like your doctor, you can keep your doctor?” But Harry Reid tells us that all such examples of Obamacare failure are lies. Tell that to Frank’s daughter Amy. I dare you.
Further, similar examples have now been published as well. But the tragedy of Obamacare extends beyond health care.
Obamacare has been a major drag on the economy, preventing full recovery from the recession. Employers trying to avoid the costs of the employer mandate have reduced many full time jobs to part time jobs. Or they have frozen hiring, and the associated costs due to Obamacare. This is contributing to income stagnation and decline for the middle class, the working class, and the poor. And it is actually increasing inequality.
The new taxes of Obamacare are also deterring job creating investment, or capital investment that would increase worker productivity, and consequently wages and incomes. The costly regulatory burdens of Obamacare are increasing rather than reducing health insurance costs, which is a further drag on the economy.
The alternative, John Goodman, NCPA plan would achieve universal health care, with no employer mandate, no individual mandate, reduced taxes and spending, and sharply reduced regulatory burdens and costs as compared to Obamacare. All of that would be sharply pro-growth, and promote more jobs, and higher wages.
But Obama says that would not be a plausible alternative. The real problem is that he is not plausible as President. Only once he leaves the White House can the American economy be liberated to grow, and American health care be liberated to once again serve the sick, especially the most sick and in need of health care.