2013 was the year of Obamacare whoppers. But the nastiest truth about the health law is still to be exposed – the tightening hold the federal government will have over your doctor, even if you’re paying with private insurance. Obama said “you’re not going to have anybody getting in between you and your doctor in your decision making.” It was a lie from day one, just like the president’s other sales pitches.
President Obama’s often repeated claim that “if you like your health plan, you can keep your health plan” was the obvious whopper of 2013. Over six million people had their plans cancelled already.
Then, on December 20th, the president brushed aside reporters’ questions about the latest changes to Obamacare by brazenly claiming “the basic structure of the law is working.” That’s a lie too.
Premiums for Obamacare plans are 41% higher, on average, than what consumers paid in the individual market last year, with deductibles as high as double, and for all that, you generally won’t be able to use academic hospitals, top tier cancer hospitals for cancer, and the doctors who practice at these institutions.
But the truth is still to come out about the biggest whopper. Section 1311(h)(1) (B) of the health law gives the Secretary of Health and Human Services, a presidential appointee, blanket authority to dictate how doctors treat patients. Not just patients in government programs like Medicare and Medicaid. But also patients with private plans they pay for themselves.
On December 2, 2013 in the Federal Register, it was disclosed that the rules are in process of being written. Starting in 2015, insurance companies will be barred from doing business with doctors who fail to comply. Supposedly the rules are in the name of “quality,” but that could mean everything in medicine. “The powers given to the Secretary are so broad he or she could literally dictate how all physicians nationwide practice medicine,” warns Congressman Phil Gingrey (R. Georgia), himself a physician. Gingrey is sponsoring a bill to repeal Section 1311(h)(1)(B). He explains that otherwise, the HHS Secretary, a Washington bureaucrat with no medical training, could bar doctors from doing routine mammogram screenings until female patients turn 50, for example. The government will be calling the shots on what patients get.
The rules have not been announced, but the president’s key health advisor when the Affordable Care Act was written, Dr. Ezekiel Emanuel, early on discussed what government intervention was needed.
Emanuel said doctors take the Hippocratic Oath too seriously “as an imperative to do everything for the patient regardless of the cost or effects on others.” As long as doctors are in charge, cost control would not be possible. “Vague promises of savings from cutting waste enhancing prevention and wellness, installing electronic medical records and improving quality of care are merely ‘lipstick’ cost control,more for show and public relations than for true change.” Emanuel advocated for top down federal rules to allocate resources to patients based on what he called “social justice.”
Obama nominee to run the Centers for Medicare and Medicaid (CMS), Dr. Donald Berwick, was also insistent that the federal government must step in between doctors and their patients to curb and redistribute the use of medical resources. Berwick said resources should be allocated based on “important subgroups.” These groups, rather than the individual patient in the doctor’s office, should be the “unit of concern,” he said
Obama’s advisors would have these considerations override your doctor’s focus on your needs as a patient.
Right now states license and discipline doctors. And that’s plenty of oversight. In 2006, when the U.S. Attorney General tried to interfere in how Oregon doctors used controlled substances to treat patients, the U.S. Supreme Court struck down the federal intrusion. (Gonzalez v. Oregon, 2006) The Justices warned it would amount to a “radical shift of authority from the States to the Federal government to define general standards of medical practice in every locality.”
That is what Obamacare does. It puts the federal government between you and your doctor with an eye toward limiting your care—just what the president promised would not happen.
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