Calling Me Stupid

By Marc Siegel

Thursday, November 13, 2014

The arrogant remarks of Obamacare architect and MIT professor Jonathan Gruber should come as no surprise. He called the American people “stupid” and said that passage of the law relied on its “lack of transparency,”  which enabled it to slide through Congress and onto the public’s lap. Arrogance and condescension have too often characterized the attitudes of the current administration and their proponents. But the fact is, the American public is not stupid when it comes to Obamacare, and they are not deceived. Understanding this clunker and not liking it is precisely why this law has never been popular.

A health-care tracking poll from the Kaiser Family Foundation for this July showed that more than 50 percent of Americans viewed the Affordable Care Act unfavorably, the fifth time since the bill’s passage that more than half of Americans polled by Kaiser were found to be against the health-care law.

Americans know that having health insurance doesn’t automatically mean access to care. Trust me, patients were wary of the state exchanges long before they began to flounder and seize. The days of my patients proudly showing their shiny new insurance cards and demanding instant service are long gone. There isn’t a patient out in my waiting room these days who isn’t familiar with the red tape of denied tests, unobtainable referrals, narrow doctor networks. The problem preexisted Obamacare, but the Affordable Care Act made it worse, as most Americans knew it would.

Gruber bragged that the Cadillac tax that was levied on the top employer insurance policies (instead of repealing the tax advantage) led to higher premiums, as if the public wasn’t aware that the insurance companies would immediately transfer these costs to consumers. Employers and employees everywhere are miserable under the chafing impact of Obamacare, but employers anticipated this, and it is one of the reasons that there is a rise in part-time workers who don’t qualify for these policies.

What American didn’t always think of the individual mandate as a tax, given that it appears on his yearly tax form and the IRS is responsible for collecting it? We already feel overtaxed, which is one reason that Obamacare never had the slightest chance of bipartisan support.

Probably if you polled Americans from early childhood on you would discover that the only thing we trust less than a government proclamation is an insurance-company promise. Obamacare, which wraps both together in one neat package, is a perfect storm.

You don’t need a government-hired navigator to tell you that the real path to increased care is to be found in new doctors, nurses, hospitals, and clinics, not in new insurance.

My patient with a thyroid problem couldn’t afford the necessary ultrasound and antibody tests to better understand her condition before Obamacare, and she can’t afford them now, either, because of her large deductible. This gap between coverage and actual care is not a surprise to people who have struggled with the limitations of insurance of all kinds their entire lives. Most Americans do not believe in a free lunch these days – and certainly not when the government is pitching it.

Americans have always understood the Obamacare gap between insurance and actual care. What has sharpened our focus is time, not an injection of knowledge or supposed transparency from on high.