It's Been Five Years and We Still Can't Agree on Obamacare

On the five-year anniversary of the signing of Obamacare – March 23, 2015 – a number of articles were published about the president’s namesake domestic reform.

I reviewed 10 such analyses from sources that span the political spectrum – Cato Institute, Forbes, Fox News, MSNBC, National Journal, ThinkProgress, USA Today, Washington Examiner, and Washington Times.

My immediate and overwhelming impression is: Are they talking about the same thing?!

One writer calls Obamacare a profound “disappointment.” Another lauds it as a “fantastic success.” The president assures us that Obamacare is, “working better than even many of its supporters expected,” while Cato Institute warns that, “few Americas are cheering.”

Too often officialdom has proven the adage from the film "Michael Clayton," “The truth can be adjusted.” What is the true truth?

Photo credit: Shutterstock 

We know what we want from healthcare. Does our analysis of their so-called evidence lead us to conclude Obamacare is delivering on its promises?

Affordable Health Care Insurance

Though the official name is the Affordable Care Act, we cannot judge Obamacare on care. After the law was passed, the president admitted that his reform was aimed at health insurance, not health care.

Does Obamacare deliver affordable insurance?

One supporter defended Obamacare saying that there is "slower premium growth;" that “only 2.2 percent of Americans” have their policies canceled; and that 16.4 million Americans are newly insured, the “largest drop…[in the uninsured]…over the past four decades.”

Detractors counter with: a remarkable increase – 20-149 percent – in the cost of insurance; more than seven million cancelled policies; a “fail[ure] to cut healthcare costs;” and the fact that well over 75 percent of the newly insured are getting insurance for free through Medicaid expansion.

One author claimed that insurers are “eager to compete for Americans’ business” under Obamacare. Others point to a 20 percent drop in insurance carriers; the withdrawal of both Aetna and Anthem from the health insurance market in California; and the firing of over 4,000 physicians by UnitedHealth, the largest provider of Medicare services in the nation.

An objective analyst would conclude the following: Obamacare increased the cost of health insurance. Obamacare made health insurance more affordable for some. Obamacare made health insurance much, much more expensive for middle class Americans.

More in My Wallet

President Obama took over the reins of a country in recession. He assured the nation that his health care reform would help them. It would reduce their out-of-pocket costs by $2,500 a year. What has Obamacare done to your wallet?

Start with jobs.

Supporters claim that “employers haven’t cut work hours;” and that “2014 was the best year for job creation since the 1990’s.” Yet there are numerous reports of jobs lost; people dropping out of the labor force; reduced work hours; one in 10 employers cutting jobs; and 30 percent of businesses who dropped plans to hire new people.

Then there is your wallet.

While the insurance company is taking more money than ever before, it is the taxman who is really emptying your wallet: 12 new taxes and four existing taxes that go up.

Already on razor-thin profit margins during a recession, the government increases the costs to business and then expects employers not to respond? Employers large and small must cut their labor costs (reduce some jobs) or go out of business, eliminating jobs altogether.

Conclusion: Obamacare is hurting middle class wallets, not helping them.

Access to Medical Care

The president promised us, “all the [health] care that Americans deserve.” How much care do we deserve? Are we getting it?

Apparently, the answer to the first question is not much.

The cost saving provisions built into Obamacare cut our care. Obamacare slashes payments to doctors by over 20 percent and thereby eliminates medical services to patients. Though the House of Representatives has recently proposed a permanent “fix” to this nightmare, the Senate is balking.

The second cost cutting activity is medical rationing. Obamacare's Independent Payment Advisory Board will dictate what treatments are deemed Not Cost Effective even though they may be medically effective. Those are treatments you won’t get.

Less care with more insured is a recipe for the same kind of death-waiting-in-line-for-care experienced at our Veterans Affairs hospitals.

One magical thinker writes Obamacare will “allow previously uninsured people to go to the doctor.” Yet 30 percent of Medicaid doctors say that cannot afford to take Medicaid patients. Seventy percent of California physicians say they cannot afford to accept Obamacare-insured patients.

What does evidence show about Obamacare’s effect on access to care? It is too soon to tell. Obamacare was signed five years ago, but has only been in effect for 15 months. Nonetheless, you can do the math on access to medical care: more insured + fewer doctors = ?

Reduce National Spending

President Obama’s ostensible reason for healthcare reform was to reduce U.S. over-spending. Spending on healthcare has been crowding out other vital spending, such as infrastructure, education, and military, and adding to a ticking time bomb called the deficit.

The president promised that his reform of healthcare would “slow the growth of healthcare costs for our families, our businesses, and our government.” Obamacare has in fact harmed both our families’ budgets and our businesses. What has it done to national spending?

Obamacare supporters seek to divert our attention. They tout the announcement that the “price tag of Obamacare is now smaller than previously projected,” reported as $142 billion less than last estimate. One Kool-aid drinker had the gall to write the “law did not add to the budget deficit.” Do Obamacare acolytes believe, like Jonathan Gruber, that we are stupid?

Whether Washington’s latest estimate is higher or lower, even the administration admits that Obamacare will spend over $1 trillion! That is new spending of money we don’t have. Estimates more reliable than the Congressional Budget Office put the true cost of Obamacare closer to $2.6 trillion, an amount greater than the entire GDP of Great Britain, spent solely on the U.S. healthcare system, and mainly on its bureaucracy.

Objective Conclusions Regarding Obamacare

The president needs to take his own advice. “It’s time to embrace reality,” he said. The problem is that his “reality” is not our reality. Objective analysis shows that:

• Obamacare bends the U.S. spending curve upward.
• Obamacare increases the cost of health insurance.
• Obamacare reduces the availability of health care.

This is not what we were led to expect nor what we want. This is most definitely not a reality that improves our health – the true purpose of any healthcare system.

Dr. Deane Waldman MD MBA is author of award-winning “The Cancer In Healthcare;” Professor Emeritus of Pediatrics, Pathology and Decision Science; and Adjunct Scholar (Healthcare) for the Rio Grande Foundation, a public policy think tank. Dr. Deane also sits on the Board of Directors of the New Mexico Health Insurance Exchange, as Consumer Advocate. Opinions expressed here are solely his and do not necessarily reflect the opinions of the Board.

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