ObamaCare, analysts, health care, and Brad and Angela
Americans aren’t ready to read, or believe, stories about the accomplishments of ObamaCare. We aren’t ready to think anything positive about health insurance. We become especially cranky when forced to read stories about whether Angelina Jolie and Brad Pitt are really divorced.
No one hates reading about health insurance more than those who have health insurance but have to wait months to see a doctor or travel hundreds of miles to find a proper hospital.
Health insurance is not health care. Health care is health care. An insurance policy simply pays bills you receive from doctors and hospitals. Sometimes health insurance pays nothing at all, which is why people hate thinking about it. Which is why government analysts are jumping the gun in their euphoria over the achievements of the 2010 Affordability Care Act (Obamacare). Government analysts reported last week that ObamaCare has reduced the number of uninsured Americans by 16 million; some say 9 million. The U.S. Census Bureau puts the figure closer to 5 million. Others are waiting for the numbers to be confirmed by Donald Trump, who prefers not to count undocumented citizens who have received ObamCare benefits until he first verifies their birthplace.
The problem is not the analysts but the analyses. Those who tally the “achievements” of government programs measure success not by people served but by management objectives completed. They do not count lives saved, sick people healed, or the number of communicable diseases prevented thanks to increased Medicaid benefits for the poor.
To be sure, ObamaCare has saved the day for millions of the country’s low-income, mentally ill, elderly, and disabled Americans. Even those who still don’t qualify for Obamacare’s subsidized insurance are fortunate to live in one of the 30 states that joined the Obamacare network and, thus, received hundreds of millions of dollars in new federal Medicaid dollars.
These lucky ones do not include residents of Kansas. When ObamaCare was launched, Brownback turned down nearly $1 billion in federal Medicaid dollars because he lacked the common sense God gave to gravel. His objection that receipt of the federal funds required him to kick in about $120 million in Kansas dollars and loosen up a few Medicaid eligibility rules. Think about it. $950 million v $120 million. Imagine that Brownback won the grand price on “The Price is Right.” Imagine that he was allowed to choose either a 2017 Mercedes-Benz S-Class Coupe (retail: $122,700) or a 1979 Ford Pinto with 360,000 miles on the engine. Imagine that he’d chosen the Pinto. Now imagine the likelihood that, upon hearing the news, Brownback’s wife and children would have beat him senselessly with a baseball bat.
It’s estimated that — insurance aside — 40 million Americans still not cannot get doctor appointments or hospital care. I have no idea how PEOPLE magazine calculated this number but I found it in my doctor’s waiting room while reading stories about Brat Pitt and Angelina Jolie. Americans are always being asked about “access” to health care. The findings are inconclusive because most people have no access to a working definition for “access to medical care.” Many consider “access” to mean availability of hospitals that doesn’t involve plane fare, or six-month wait. This is why public polls on health care are difficult to design and interpret. Pollsters often rely on a fallback research methodology known as “asking around.” Journalists use it all the time.
I typically survey a random sampling of average Americans about the difficulty of getting doctor appointments or prescriptions filled. Most are very grateful for the health insurance provided by ObamaCare but what they really want is their own family physician — someone who treats parents and kids over many years and develops a personal interest in their welfare. If hospitalized, they want to be visited by the same family physician, not “hospitalists” — hospital-employed doctors who cannot pronounce their lasts names. Lastly, a significant number of respondents threaten to go stark raving mad if they have to read another story about Brad Pitt and Angelina Jolie.
In short, the Affordability Health Care Act still has a couple hundred kinks to work out. We could start by renaming the law and lowering expectations. The law should be called Obama-Care. It should be called Obama-Insurance. Obama-Care implies an ample supply of hospitals and doctors for all, or a national pharmacy that dispenses Clonazepam and free strep throat tests on demand. A name change would clarify that ObamaCare’s accomplishments —which are are many — are merely the tip of a shifting iceberg