By RICHARD E. RALSTON
Seven years in the Army provided me with a rather useful education. On one occasion, at age 19, a few minutes after being admitted to an Army hospital with strep throat and a fever of 104 degrees, I was told by a hospital orderly to get out of bed and sweep the floors. I came to learn that government medicine always serves another government agenda.
I also learned some unique turns of phrase from my sergeants that are apropos of such situations. I cannot repeat most of them here, but one term has immediate relevance: "Embrace the suck." An approximate translation would be: "At times you will find yourself in a miserable and dangerous situation with no way out. Deal with it."
With the reelection of Barack Obama, the Affordable Care Act will inexorably be implemented, and Americans will be forced to deal with its consequences on the cost, quality and availability of care. The few provisions that have bipartisan critics, such as the tax on the sale of medical equipment, might be adjusted. But there is no chance of major revisions in the next two or, probably, four years.
How will we deal with that?
As the government promises that the cost of insurance premiums will decline, we will be faced with, in fact, the opposite. Mandatory coverage of pre-existing conditions will increase all premiums, as will coverage of "children" up to age 26. As premiums for women are not allowed to cover their generally higher medical expenses, the premiums for men will increase to do so. The new taxes on medical equipment will increase premiums. Added federal coverage requirements, on top of existing state requirements, will increase premiums for millions of Americans forced to pay for services they do not want.
The only costs we will not have to deal with will be on whatever new life-saving drugs and equipment we will never see because they are forbidden by the Independent Payment Advisory Board. IPAB will begin to decree elimination of procedures and medications, as it was created to do.
Medicare patients will experience the reductions in care resulting from the $700-plus billion in Medicare cuts to finance Obamacare.
Medicaid patients will have to deal with the impact of adding up to 30 million people to that system.
Millions of employees promised by President Obama that "if they like their current insurance they will be able to keep it" will discover that the insurance they like does not comply with new coverage requirements. Millions will find that their employers, faced with soaring premiums, will drop insurance in favor of paying the less-expensive fines.
The way to begin to deal with these developments is to consistently articulate the only principle on which medical care must be based: individualism, protected by the limiting of government to the enumerated powers of the Constitution. This is the only way freedom in medicine can be restored, even if the president and Congress choose now to be oblivious to the idea.
We must make them deal with the consequences of Obamacare by diligently watching, documenting and reporting its effects on our rights, choices and lives.
The threat of Obamacare was not sufficient to stop it. We must be sure that the reality of Obamacare reveals the proper foundation for the liberation of American medicine.
Richard E. Ralston is executive director, Americans for Free Choice in Medicine, Newport Beach.
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