As a physician trying to treat sick health care, I follow this critically ill patient closely. What do I see?
I see the "treating doctors" arguing about what the numbers mean on the patient monitor screen. They are fighting over which service should be listed as primary on the hospital chart: Internal Medicine, Critical Care, or Trauma, while the patient has difficulty breathing.
I watch the respiratory therapists trying to connect up the ventilator with hosing that doesn't fit the government-mandated machine. The proper endotracheal tube for this patient's throat is unfortunately not available in central supply because it was not ordered -- deemed "not cost effective."
Various hospital administrators are in and out of the room continuously. Some are telling the doctors what to do. Some are discussing how to keep the patient sick and thus have an 'occupied' bed for maximum facility utilization. Others are arranging discharge for today (!) because the patient may have reached his limit of insurance payment.
The maintenance people are working on the ventilation system all the time, constantly changing it as new regulations come out each day, so they have to keep altering the structure.
The nurses are the only ones trying to look at the patient, except they cannot get to him. They are being crowded out by people who argue loudly about the patient's condition, but never fix him. These are the same people who passionately proclaim their commitment to the patient, but have never even seen what he looks like and have no idea why he is sick.
If you are tired of 'analogy mode' and want me to write directly, I will. Our patient is a sick, in fact dying, system named health care. What are they doing about it?
As of Aug, 4, 2013, the Republican-controlled House of Representatives has voted forty times to repeal ACA. Of course, The Democrat-controlled Senate has cancelled out their attempts. It doesn't matter for poor sick health care. Repeal would merely remove the weights they have put on the patient's chest. He would still be critically ill, just dying a bit more slowly.
We read newspaper articles -- pro and con -- about how the 'reform' will get us care and make insurance more affordable. Meanwhile, doctors are leaving clinical medicine in droves and replacements are not forthcoming. How will reform get us care if there are no doctors? And as for affordable, between the rise in premiums already in place (30 percent so far) and the Cadillac tax that will hit most of us (not Cadillac owners), the ranks of the uninsured will rise, not fall. Here's proof.
A recent CBO report has revised upward the government's estimate of how many people who now have employer-supported insurance will lose it under Obamacare: seven million. The business community is responding any way it can to the huge increase in cost to their bottom lines that Obamacare represents.
Online pundits tell us the Exchanges will save us money by using free market forces: high-sounding rhetoric while the patient deteriorates. You cannot have a free market as long as there are price controls and mandated benefits. Meanwhile, ACA massively expands the bureaucracy, further 'bleeding' a patient (us) who had nothing to start with.
For the first time in U.S. history, our national debt (2012) exceeded our GDP. Even as we borrow more money -- to hire more ACA regulators and IRS agents -- we are producing less. How can that be good for the patient?
The government says ACA is good medicine for health care, in fact, for all of We, The Patients. Then, it exempts over 1,200 businesses and organizations, including Congress itself from this "good medicine." How is that helping the patient?
Deadlines are put off; rules and regs constantly pour out; we spend boatloads of money we do not have, and all the while patient health care just gets sicker.
With all of the partisan fighting, the bickering among experts, predictions and counter-predictions, and the frank disinformation, the patient is being ignored and is dying. When health care dies, so do we, and all the pettiness and irrelevancies will be as nothing. It will be too late.