What ObamaCare Is All About

By Alieta Eck, M.D.

Now that Obamacare is the law of the land, we have been promised health care for all, higher quality, better access, lower premiums – all with a decrease in the deficit.  These promises defy common sense, but no matter, we are told, “Yes, we can.”

So what will Obamacare actually do? Consider Natoma Canfield, Obama’s poster patient, the woman from Ohio with cancer whose name was mentioned at the signing of this new law.  Natoma, a cancer survivor of 16 years, actually had health insurance despite her pre-existing condition. Trouble was, she voluntarily dropped it because she found it to be unaffordable.

Natoma could not attend the signing of Obama’s new law because she was in the hospital.  Like millions of Americans without insurance, she was receiving medical care, thanks to the kindness of physicians, communities, and local hospitals, as well as to Medicaid.

In the pre-reform world, if Natoma’s cancer had not come back, she would have had whatever she chose to buy with her money.  With ObamaCare, if she remained cancer-free, the insurance company would have had her money.  If the cancer did come back, the insurance company would still have had her money.  And it is possible that the insurance company would have refused to authorize her treatment – calling it “experimental” or “futile,” or deciding she was simply too old.

If reform had passed earlier, Natoma might not have been in the hospital—because the hospital might have closed. And she might not have been getting treatment from her doctor—because he may have retired early or changed occupations. Natoma would not have been allowed to just drop her insurance.  She would have been mandated to pay for it, no matter how great her other financial needs—or else pay money to the IRS and be without insurance.

Reform is going to clamp down on payments to hospitals, equipment suppliers, and doctors. Even if they stay in business, there will be more and more controls on what physicians can do for their patients. Having been a Medicare physician for many years, I have seen this happening already. I have already gotten a “report card.” The “pay for performance” grading system will punish physicians who do “too much” and go “over budget.”

Performance refers to “resource use” and “efficiency,” not to correct diagnosis and relief of the problems that ail you. Physicians will be punished if they spend in the top 10% of the computerized resource-use protocols. Caring for sicker patients will cost them dearly.

ObamaCare will unleash 17,000 new IRS agents on all of us, having us fill out complex forms to determine how much we are required to pay or how much we get subsidized by other taxpayers. There will be new agencies to dictate what treatments we are eligible to receive and what providers will be paid. These are bureaucrats, not the physicians, nurses and hospitals we really need.

So what kind of reform would have actually helped Natoma?  Allowing her to purchase low-cost, higher-deductible insurance would have enabled her to enjoy premium savings but still have coverage for big bills if the dreaded cancer returned.

Patients like Natoma need sound advice on affordable tests and treatments from doctors who are working for them, not for an HMO—or a bureaucracy based in Washington, D.C. They need to be able to find all the options, not just the ones the bureaucrats prefer. Sometimes it is worthwhile to spend more, even if help from family, church or community is needed. 

Reform will cause costs to escalate, and the iron hand of government to descend in an effort to control them. We are told that the rich will foot the bills for Obamacare but before long, anyone with a job will be considered “rich.”

This reform will have the same result as government intervention has repeatedly had throughout history: less efficiency, higher costs. And those who will be hurt the most are people like Natoma.


Alieta Eck, MD graduated from the Rutgers College of Pharmacy in NJ and the St. Louis School of Medicine in St. Louis, MO. She studied Internal Medicine at Robert Wood Johnson University Hospital in New Brunswick, NJ and has been in private practice with her husband, Dr. John Eck, MD in Piscataway, NJ since 1988. She has been involved in health care reform since residency and is convinced that the government is a poor provider of medical care. She testified before the Joint Economic Committee of the US Congress in 2004 about better ways to deliver health care in the United States. In 2003, she and her husband founded the Zarephath Health Center, a free clinic for the poor and uninsured that currently cares for 300-400 patients per month utilizing the donated services of volunteer physicians and nurses.  Dr. Eck is a long time member of the Christian Medical Dental Association and in 2009 joined the board of the Association of American Physicians and Surgeons. In addition, she serves on the advisory board of Christian Care Medi-Share, a faith based medical cost sharing Ministry. She is a member of Zarephath Christian Church and she and her husband have five children, one in medical school in NJ.

6 thoughts on “What ObamaCare Is All About

  1. I agree with those who suggest that physicians should start opting out of Medicaid and Medicare and even insurance plans. Patients could still have some form of insurance but let the patients submit the bill and get reimbursed. Save us the expense of having to pay a billing service and we can pass that savings on to patients. We shouldn’t have to settle for less than 50% of billed services being collected. This will also allow physicians and patients to set the fee schedule.

    I would like to have patients sign a waiver before they see us stating that they will not take us to court if they have a negative outcome. Any disputes could be handled through arbitration and the local state Medical Board.

  2. As a patient, I have been writing letters and making phone calls on behalf of myself and the nations doctors – but my efforts have been in vain.

    I ask, where do citizens such as myself opt-out? How do I afford concierge medical care? I am willing to pay for my healthcare and don’t expect to just hand over a $10.00 co-pay each time I see a physician. My health is worth much more than that. I witness on a daily basis older citizens shopping, dining out, driving brand new automobiles, playing golf and ordering $4.00 coffee drinks. Well enough, but just try and ask these same citizens to pay $200 for an annual check-up? Worse yet – $300 per month for perscription drugs that are non-invasive and which keep them alive. Unfortunately, at many of the “reform” rallies I attended I read signs deliverying the message to congress: “do what you want with healthcare, just dont’ mess with MY Medicare”.

    I want my physician to be well rewarded for his/her hard work and passion, but this so called reform will ensure that only the wealthy have access to this kind of care.

  3. No one has defined “health care.” It can mean dealing with whatever symptom a human can complain about (infinite possibilities), be it real, imagined, trivial, exagerated or deadly serious. With a guarantee of “health care” for all by the Government that will mean increased consumption since someone else is picking up the tab and people will naturallly gorge themselves on “health care” services (except for the stoics) as they have been doing with Medicare and Medicaid. It’s human nature. It can never work. It will increase costs, decrease access and promote rationing/euthanasia because of “limited resources.” If you can’t control the “input” i.e., the demand, you can’t control the costs.

  4. Robin Hood Medicine 2

    1. Is it possible to donate through a 501c3 or other IRS category to obtain a tax-deduction for paying to treat a patient? If so, can that patient be a random person, someone I do not know, but someone whom you treat?

    2. Can the organization be any 501c3 or appropriate IRS category? Can that donation be through a church or interfaith council?

    3. Can these transactions all be carried out with no Medicare involvement?
    No Medicaid involvement? No governmental involvement?

    H. Butler M.D., FACS
    HButler@post.Harvard.edu