By Paul Bremmer
The Affordable Care Act, or Obamacare, has created more dependency on government and perverted the capitalist foundations of America, according to a top surgeon.
“You just can’t keep giving everything away to people without them working for it,” said Dr. Lee Hieb, former president of the Association of American Physicians and Surgeons. “It’s not capitalism when you let people who are able-bodied not contribute to society but take the spoils. I mean, that’s just not capitalism. We have too many people that don’t work to eat.”
Obamacare appears to be worsening America’s dependency issue. The Associated Press reported food-stamp enrollment increased in 11 states between January 2013 and the end of 2014, the period during which Obamacare went into effect.
Ten of those 11 states expanded Medicaid under the ACA, and six of them used new online enrollment systems that made it easy for customers to sign up for both Medicaid and food stamps at the same time. Such streamlined application systems were built specifically for the health-care overhaul.
In total, nearly 632,000 people were added to the food-stamp rolls in those 11 states during that period, at an estimated cost of almost $79 million a month to the Supplemental Nutrition Assistance Program, the food-stamp program also known as SNAP. This came at a time when the national economy was improving and food-stamp enrollment declined nationwide.
Dr. Jane Orient, executive director of the Association of American Physicians and Surgeons, sees the phenomenon as part of a government attempt to place more Americans under its thumb.
“Self-reliant Americans are being crushed by taxation and regulation, directly and indirectly, and turned into government dependents,” Orient said. “How can you resist if government can cut off your food and medicine?”
In almost all of the 16 states that didn’t expand Medicaid, food-stamp rolls have been decreasing as the economy improves.
Hieb, author of “Surviving the Medical Meltdown: Your Guide to Living Through the Disaster of Obamacare,” said Obamacare’s Medicaid expansion damaged the American medical system by dropping people from their private insurance and putting them on Medicaid.
“People think that all these people getting on Medicaid through Obamacare were uninsured,” Hieb said. “That’s not true. A number of those people had private insurance, but now, because they qualify under these new guidelines, why not have somebody else pay for your health insurance? So instead of paying for health insurance, they’re taking Medicaid.”
She continued, “So you’ve turned paying patients into nonpaying patients. It’s absolutely, clearly a failing economic model, and I don’t understand how smart people believe it. I just don’t understand how they do not see that point.”
Hieb, an orthopedic surgeon, has observed firsthand the damage Medicaid expansion has done to hospitals. She recently reached the end of a contract to perform surgery two-and-a-half days a week at a small hospital, and she is now looking for a similar arrangement. However, she says she’s found hospitals are running scared from orthopedic surgeons like her because they fear they won’t make enough money to pay the surgeons’ salaries.
According to Hieb, the hospitals are struggling to bring in money because of the increase in Medicaid patients and corresponding decrease in private-pay patients. Medicaid does not reimburse hospitals as much as private insurance does. Hospitals have also struggled to cope with Medicare provider payment cuts and increased administrative paperwork.
But while Medicaid expansion has hurt hospitals, it has been a boon to health-care consumers. In states that expand Medicaid, adults with incomes up to 138 percent of the federal poverty level must qualify, and states are allowed to set even higher thresholds. Before the ACA took effect, the median Medicaid eligibility limit for parents was 106 percent of the federal poverty level. Medicaid expansion also made adults without dependent children eligible for the first time.
Hieb said she believes Americans are smart enough to act in their own financial self-interest, and, for many who hover just above the poverty level, that involves taking advantage of the welfare system. Hieb lives among the patients she serves in rural Iowa, and she says they know how to look out for themselves.
“It’s a mistake to think that all these poor people are children who cannot navigate this very complex medical system,” Hieb asserted. “These are the people who have figured out if you don’t make $35,000 a year working, it’s not worth working because you can do that well if you know how to work the system of welfare.”
If people can cobble together enough disability payments, unemployment payments and food stamps to earn a halfway decent living, Hieb argued, they are smart enough to hitch themselves to Medicaid, even if they might be able to afford health insurance on their own.
“People act in their own economic self-interest,” Hieb said. “If you can get things for free, why pay for them?”
She answered her own question: “One, because that’s ethical, and two, medical providers cannot be in business unless somebody actually pays the bill.”