Many Obamacare Supporters Want Silence, Not Debate

Reply to responses to Dr. Hurd’s commentary published in Cape Gazette (Lewes DE), 7/3/12

In my recent article criticizing Obamacare, a number of people said I didn’t have my facts straight. As a professional health care provider, the new laws affect me personally, so I will respond with facts and figures.

Fact: Starting in 2015, the ‘Patient Protection and Affordable Care Act’ provides that payments to doctors from federally funded programs such as Medicare be ‘modified to be based on the quality of care, not the volume.’ Based on my experience with HMOs and insurance companies over the last 24 years, this could mean doctor-fee ‘capitation,’ i.e., paying health care providers a set amount, each month or year, for all medical care provided. This would turn most doctors into 9-5 employees, rather than innovative, self-employed practitioners. Is this what patients really want?  The government may or may not force doctors into capitation, but my point is that the law gives government open-ended authority to do so. Suddenly politicians are authorities on doctoring? As a mental health provider, this worries me.

Fact: The law forbids insurance companies from denying coverage based on preexisting conditions. But an insurance company can’t survive as a business if they charge everybody the same, no matter their age or condition. So what will be the result? Because of this political stranglehold on business operations, insurance companies will either raise their premiums or go out of business, forcing even more people to accept one-size-fits-all government coverage. As a human being with an imperfect body that might need professional care, this worries me.

Many say such a requirement is ‘fair.’ But is it really fair to force people who have been paying premiums for years to shoulder the cost for those who choose health insurance at the eleventh hour?

One reader wrote, ‘What makes you such an expert on everything?’ With all due respect, that’s precisely my point. I’m not fit to make others’ health care decisions for them. And neither is the government. That is a matter between each of us and our doctors. Period.

Health care professionals are human beings who spent thousands of dollars learning to do what they do. We cannot treat them as faceless ‘resources.’ Doctors and nurses should be left to price their services as they see fit, based on the demand and supply for those services in the marketplace. It is that very marketplace that gave doctors and researchers the incentive to create the amazing advances that American medicine has enjoyed, up to now.

Fact: Nowhere in the available summaries of Obamacare (I’ve read them all) is there any mention of opening up the marketplace for medicine. Obamacare does not liberalize health savings accounts, nor does it allow individuals to purchase policies across state lines. So none of that has changed: That’s why so many people will end up on Medicaid.

Doctors buy their education in the free market; they buy their equipment and rent their offices in the free market; so why is a free market for health care so radical? And why does the very suggestion arouse such animosity? This response from a Cape Gazette reader goes to the core of the issue: ‘Dr. Hurd’s analogy to a government takeover of the car business omits mention that most Americans regard medical care as an entitlement, regardless of wealth or income. (If Dr. Hurd does not agree with this, let him stand up and say so.)’

This is me standing up and saying so.

Your or my need for medical care cannot be deemed an entitlement if our needs make the person providing it into a slave. If somebody has a talent from which I will benefit, it’s up to me and that person to work it out. Rational human beings do not deal with one another through force.

I recognize that Obamacare is a logical extension of other entitlement programs such as Medicare. But these programs have not worked out well. They were sold as voluntary and fiscally sustainable, but time has proven that to not be so.

One of the responses said I was angry. Of course I’m angry. I don’t want my doctor or hospital to be burdened even more than they already are. Obamacare does not liberalize; it tightens the noose of government over health care. This could someday cost you or me our lives.

I also received a hateful note accusing me of being hateful. Well, sometimes hate is rational. I hate the idea of government butting its bureaucratic head in where it doesn’t belong, and creating unintended life-or-death consequences in the process.

Several readers accused me of lying. For example, they say I lied when I blamed most of the national debt on entitlement spending. Here are some facts:

Fact: Obama’s own Treasury Secretary Tim Geithner told the U.S. Senate in February that President Obama’s budget entails an “unsustainable” course for entitlement spending and interest payments on the national debt.

Fact: In 2010, Federal Reserve Chairman Ben Bernanke warned Congress that ‘things will come apart’ if Congress fails to put federal entitlement programs on a sustainable path.

Fact: Just this year, the Government Accountability Office reported that federal spending will drive the national debt to ‘unsustainable’ levels in the coming decades, fueled by ever-rising health care costs and federal entitlement spending. Entitlement spending has everything to do with the national debt. It’s not just me saying so.

Obamacare is not the answer. Many people agreed with me, but some didn’t want me to reveal their positions. I don’t understand why there is such a taboo against disagreeing with Obamacare. At least one letter writer suggested the Cape Gazette shouldn’t publish my views at all. She equated my philosophical viewpoint with lying. Is this really the kind of world we’re living in, where diverse philosophical views are not tolerated? I applaud the Cape Gazette for continuing to publish varied points of view on an issue about which people have every right to feel passionate.

Today’s minority opinion sometimes becomes the conventional wisdom of tomorrow. Without free speech, none of us will ever have the opportunity to learn anything new.


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