When the Affordable Care Act, also known as Obamacare, was signed into law in 2010, the American people were sold a bunch of empty promises. “You can keep your doctor; health care will be more affordable; Medicaid expansion will help individual states.” It didn’t take long for the dust to settle and for the American people to discover that they’d been sold a bill of goods — and noxious goods at that. Yet, here we are more than a decade later, and we’re still debating government-run health care. So, let’s quickly recap a few of Obamacare’s biggest failures.
First, despite multiple assurances from President Barack Obama that individuals could keep their health plans if they liked them, millions of Americans received cancellation notices when Obamacare took effect. New plans could not guarantee coverage of many patients' existing doctors, and as a result many individuals were forced to find new physicians. Working with families here in Alaska, I saw many of my patients struggle under these changes. New plans, with new networks, forced many families to change doctors or pay out-of-network costs. And while changing doctors in places like New York City may not be a significant challenge, in underserved and more remote areas of the country, we know it’s not that simple.
Second, Obamacare was supposed to drive down the cost of health care. But without any promotion of competition in the health care marketplace, premiums skyrocketed. Since 2013, health insurance premiums have more than doubled, and 29 million Americans are still uninsured. For many of my own patients, unless they qualified for a government subsidy or Medicaid expansion, health care is no more affordable or accessible to them. In fact, Alaskans have been particularly hard-hit by the continued rise in health care costs. Since 2014, the average annual cost of health care for an Alaskan is more than $11,000 — higher than per capita health care spending in any other state.
Finally, Medicaid expansion has proven to be a complete nightmare. Under Obamacare, states could choose to expand their existing Medicaid programs — which traditionally support the elderly, disabled, and low-income children and pregnant women — to include able-bodied, childless adults. The federal government pays a higher portion of Medicaid expenses for able-bodied childless adults compared to traditional enrollees' costs, and still, Medicaid expansion states are going broke. Nationwide, Medicaid now consumes 30% of states' budgets — almost one in every three state dollars — and states are being forced to make cuts elsewhere. Here in Alaska, Medicaid spending has increased by a whopping 379% since 2000.
Obamacare and its programs have failed us at every turn, yet I continue to hear politicians defend the law and push for even more government control through proposals like “Medicare for All.” Government-run health care is not the answer, and it’s time we start to explore more free-market health care choices.
We need proposals that put patients in charge — not government or insurance companies. We should give health care consumers more personalized care and control with more robust health savings accounts.
We must make health care more affordable by eliminating Certificates of Need in Alaska. We can increase competition nationwide by eliminating the moratorium on physician-owned hospitals and encouraging Association Health Plans, which allow groups of small businesses to band together to purchase insurance for their employees. And we must have more transparency in the health care market so that patients know in advance what costs they’ll be responsible for, and what insurers will pay.
When I opened my practice 22 years ago, my dream was — and still is — to care for the people of Alaska. I expected some battling with insurance companies to make sure patients' services were covered, and I even anticipated some level of frustration with government programs and red tape. But never, in all my years, could I have imagined the mess that is Obamacare. It’s time to get rid of it and enact free-market reforms that truly increase patient choice, increase competition and drive down health care costs.
Dr. John M. Nolte, M.D., has been practicing family medicine in Anchorage, Alaska, for 22 years.
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