The Patient Protection and Affordable Care Act in Myth and Lore

I’ll admit to being conflicted about the PPACA. Part of my problem is that the law’s whole story has never been honestly told. We get selected facts: bits and pieces in news and opinion, both pro and con. But for the most part, everybody’s merely guessing or making bold predictions about it, and the PPACA—a mammoth manifesto that portends to rearrange life in these United States as we know it—remains shrouded in myth and lore. It’s as though the democrats foisting this dramatic life alteration on America want to do so, and believe they can do so, in secret: without telling anyone.

“By the way, you’re all socialists now.”

Why must they sneak? Why can’t they be forthright? Who are these people when they think nobody can see or hear?

But even republicans and conservatives campaigning against the PPACA don’t come clean about it: don’t tell us that the PPACA, or at least a law like it, is necessary because government healthcare costs are out of control. Mitt Romney tried to tell us that, and look where it got him.

Do we even want to know the truth about the PPACA, or are we content to rant about it, and . . .. What has happened to our news media?

Even the law’s common handle—“Obamacare”—is misleading because Obama neither conceived of nor wrote the PPACA and likely hasn’t even read it. So those who call the PPACA “Obamacare” are perpetuating the myth that it’s Obama’s work: his long hours of research and writing, “burning the midnight oil,” and “selflessly surrendering himself for the good of the American people,” and . . . oh no, I’m going to vomit again.

Who wrote the law? Senator Max Baucus (D-MT) gets a lot of the credit, but that’s inaccurate. Remember, Bill Clinton pushed his version of this law. He put his wife in charge, and the (typically) media-slickened term for it was “Hillarycare.” So the PPACA, at least in concept, is likely “pre-Baucus.”

Beyond that, who actually wrote the law? I mean, who set fingers to keyboards and transformed concepts to words? Even the Bible changed from translation to translation. Senators and representatives didn’t write the PPACA. Congressional aides and technical writers wrote it. They can tell us more about the law than anybody else: certainly more than Obama.

But the point is that this law, in some form, has been around for over 20 years, and a variety of congressional and executive bureaucrats and politicians have modified it.

More cynically, this law—the PPACA—has been a favorite beltway “party girl” for decades. Many politicos have had turns with her. She might be Obama’s date, but she’s not Obama’s gal.

My observation is that the DNC prematurely ushered Obama into office solely to sell this law to the democrat voters at whom it’s primarily aimed. Beyond that, congressional democrats don’t really accept him as one of them and haven’t much use for him—and he seems to reciprocate that sentiment—although he’s been well-compensated for his services: in the history books as America’s first African-American president, plus substantial royalties—several million dollars—for The Audacity of Hope and Dreams from My Father.

The democrats saw the opportunity to pass this law and went for it. They knew they’d have a congressional mandate, so they hired Obama to sell it and went for the gold.

Did they need Obama? Could Hillary have sold it?

I don’t know the genuine answers to those questions. Maybe they don’t even have clear answers. Many factors likely were at play in the DNC’s decision to hire Obama instead of Hillary.

Nancy Pelosi provided a clue, though. “We have to pass the law to find out what’s in it.”

She might as well have said, “The things Obama is saying about the law aren’t true.” It does not “provide free healthcare for 30 or 40 million Americans who don’t have it,” as Obama says. (Attention “media watchdogs”: this is something “the people have a right to know.”)

In fact, the law isn’t really about healthcare at all. It’s about health insurance, and the two are not the same. In fact, the two are often opposed. Healthcare givers and healthcare insurers are not on the same side of the fence. Anybody with health insurance knows this, although—ha-ha!—the PPACA is aimed at people who don’t have health insurance: people who don’t know much–who are perhaps deliberately ignorant–about its costs or how it works.

Could Hillary have sold the PPACA as “free healthcare”?

More is involved. In 1986, the democrat-controlled congress came up with the Emergency Medical Treatment and Active Labor Act (EMTALA), and Ronald Reagan signed it.

I urge readers to visit the EMTALA’s site and read about it because—I believe, anyway—the EMTALA’s passage at least partially set the stage for the PPACA.

To cut to the chase, this is from the first paragraph on the EMTALA’s site:

“EMTALA requires most hospitals to provide an examination and needed stabilizing treatment, without consideration of insurance or ability to pay, when a patient presents to an emergency room for attention to an emergency medical condition.”

Now, that is “free health care for 30 or 40 million Americans who don’t have it.” Reagan—if you want to give him credit—provided it over 25 years ago.

When hearing about this in 1986, I remember thinking, “Free health care? That doesn’t sound like Reagan. What’s going on?”

I also remember thinking, “Wow, I don’t have to buy health insurance. I can get free care.”

I bought it anyway, poor as I was in those days: major medical, as well as a supplemental plan for uncovered expenses. I was brought up that way. I don’t want “something for nothing.” I’m an American. I want to, and will, pay my own way. Obama’s PPACA spiel isn’t for me.

But a lot of other people didn’t, and don’t, live by that rule.

I attended a university with one of the country’s best nursing colleges and knew nurses who, in turn, introduced me to other healthcare-industry professionals: respiratory therapists, anesthesiologists, medical assistants, et cetera. Confused, aghast and ultimately disgusted, they recited the stories.

Friday and Saturday nights—the “party nights”—were the worst: hundreds of drunken revelers who’d hurt themselves and each other, flooding emergency rooms expecting “free” healthcare. They wore nice clothes, hairstyles and jewelry. They’d been out in expensive nightclubs quaffing expensive cocktails. They had nice cars.

In other words, they obviously could afford health insurance or even to pay out of pocket, but they had no intention of doing so. Why should they? The EMTALA forced hospitals to treat them—what are those magic words again?—“without consideration of insurance or ability to pay.”

As horrendous as this is, it’s just a small part of a much bigger and very serious problem: the federal government is spending hundreds of billions of dollars a year for healthcare. Billions are wasted on people who can afford their own health insurance, and billions more are lost to out and out fraud.

For example, every hospital has a floor of geriatric patients who aren’t going to get well. They’re very old. But the hospitals can keep them alive for years, and to doctors and hospital administrators, each of those patients is worth thousands of dollars a day; and of course, the hard sell is, “If you love your mother and your father, you will carry the healthcare industry’s fight to the government and demand that Medicare and Medicaid pay the fees because”—hospital administrators and doctors ask this question with a gleam in their eyes—“you do love your mother and father, don’t you?”

Those are just two small examples: emergency rooms and geriatric floors. But the problem is much bigger. As P.J. O’Rourke famously noted, “free” healthcare costs are out of control.

Enter the PPACA, and I have to wonder if democrats deliberately set it up with the EMTALA because any fool can see that, once the democrats got the EMTALA—“free” healthcare—passed, something like the PPACA—comprehensive healthcare cost control via massive privacy intrusion, i.e. big-government control—was sure to follow. It was evitable.

Even Mitt Romney, the staunch republican and sensible businessman, saw the need for a similar law–after which the PPACA was at least partially modeled–in Massachusetts. Mitt Romney might be many things, but he’s not stupid, and he’s not a social leftist.

The country already had “free” healthcare via the EMTALA. The PPACA is the government-run insurance agency intended to control the costs. It’s all about government revenue. The government’s Internal Revenue Service is most suited to ensure that those who apply for “free” health insurance are those who are genuinely unable to pay.

Again: why did the democrats go to such great lengths to get this law passed? Why did they bring in Obama, and make him the freakin’ President, for crying out loud, just to get this law passed?


Cover the kids’ ears. This is where the story gets X-rated.

First of all, I feel safe asserting that a lot of the people who can afford their own health insurance or to pay for their own healthcare, but do not, are democrats. They’d never agree to this law unless it was peddled to them by somebody in whom they’d place irrational trust. That’d be Barack Obama: the cult of leftism’s walking, talking personification.

It helped a lot to “leak insider information” about Barack Obama. As the story goes, he’s Bill Ayers’ friend: an anti-establishment hero; a savagely pure-blooded revolutionary. More openly, he delightfully belittles “typical white people” and conservatives in general. He’s a Marxist Robin Hood.  He steals from the rich and gives all the poor, oppressed democrats “free” healthcare. They know it’s true because Obama said so and, ironically, the “conservative media” played a huge role in casting Obama as exactly the kind of person the democrat party needed to complete the sale.

Second of all, take a look at how health insurance companies do business. Yes, they’ll provide coverage. But, wait a minute. They won’t provide it blindly. They have conditions. If you, as a policy holder, get drunk and stoned and hurt yourself, you’re on your own. If you lead an unhealthy lifestyle, they’ll charge more for or deny coverage altogether. If you have a “pre-existing condition,” or a terminal illness, or if you’re very old and won’t recover, well . . .. Yeah, they’ll do what they can, but if you want the best care, they’ll charge you a lot: more than poor people can afford, and to which party do most poor people belong?

That’s right, and it also helps that not one republican voted for the PPACA. If even one republican had voted for it, the democrat voters at whom it’s primarily directed might’ve smelled the rat. The government, with the media’s help, played it up as a “good-democrat-versus-evil-republican” contest, and we all fell for that scam. Republican voters and activists know that all republicans aren’t “evil,” and all democrats aren’t “good.” But by arguing that point, we made it real; the appearance of republican opposition to this law, and the “angle” used to sell it, was an important part of selling it to democrat voters: again, many of those at whom the PPACA is primarily aimed.

The PPACA doesn’t provide “free healthcare for 30 to 40 million Americans who don’t have it,” because they already do have it, courtesy of the EMTALA, Medicare, and Medicaid.

No: the PPACA is the American leftist’s dream. It’s the government’s insurance instrument for controlling healthcare costs and, judging from how other health insurance companies do business, the government proposes to control—read: decrease, in the long run—its healthcare costs the only way it can: by basically controlling people’s lives. To control its healthcare costs, the government—like any health insurance firm—needs a say in how much money you make, whether you can afford to pay for your own care, your age, your existing health condition, what you eat, what you drink, whether you exercise, how sick you really are, whether you really need the care you want, whether you’re going to live or die anyway, et cetera, et cetera.

This is all based on the decidedly fantastic idea that the US government is capable of paying for half the population’s healthcare while controlling the attendant costs.

Welcome to the human experience as a business decision. That sounds kind of cold, and it is. But when you have tens of millions–perhaps hundreds of millions–of people who are holding out their hands for “free” healthcare, well, you need a law like the PPACA; and when you know these people will never agree to an honest representation of a law like the PPACA, you need a “personality cult” like Obama’s to sell it to them via a massive ruse.

What else can we, as Americans, do with so many people who can’t or won’t buy health insurance? Some are genuinely and understandably in need and, from an American moral perspective, deserve free care, at least temporarily. But many are, to be blunt, slack dogs and confidence artists who either don’t want to take care of themselves, or who want to steal, and steal a lot, from the taxpayers.

From the politician’s perspective, these are voters and, more emphatically, contributors.

An Aside: low pay factors in, by the way. Employee compensation has decreased, in real terms, over the last 40 years. Moreover, the federal government wants to import an entire population of cheap labor that, at least in the short run, can’t afford its own healthcare. Most businesses, large and small, aggressively seek ways to decrease compensation among rank-and-file workers. Meanwhile, healthcare costs have gone through the roof. So many people simply can’t afford to go to the doctor, and 60 million “baby-boomers” are staring at old age. Many of them aren’t financially prepared for the attendant medical costs . . . and that’s the end of the aside.

So, to bring this windy missive back around: I’m conflicted about this law.

On one side I know that the PPACA, or a healthcare cost-controlling law like it, is necessary because government healthcare costs are massive and out of control.

On the other side I know that, in order to control its healthcare costs, the government will have to aggressively intrude on privacy and make some nasty decisions.

“Sorry, you’re going to die anyway, so you don’t get any care, and you aren’t really that sick, so get back to work, and the IRS has informed us that you earn enough to buy your own insurance, so pay up or we’ll take the money from you, and as for you, you Benz-driving slime ball, you have been billing Medicare and Medicaid fifteen thousand dollars a day for 25 years . . .” and so forth, and so on.

On one side I want the law repealed. On the other side, what about all the slack dogs who can afford their own health insurance or healthcare, but who refuse to pay? What about all these healthcare-industry fraudsters getting fat off the taxpayers’ dime? The PPACA is aimed primarily at them (and I feel safe asserting that many—not all, but many—are democrats).

On one side, I know this law is a metaphorical atomic bomb, and Obama has lied about it and, without skillful deception and complicit media propaganda, this law’s implementation will result in seriously bad blood between democrat voters and the party which, for most of them, has become a religious denomination; so I don’t want the law repealed. I want it enacted.

I want it shoved down democrat voters’ throats, right now. Pay for your medical care, you slack dogs. It’s the law, and it’s the law you supported. You didn’t bother checking the facts. You believed in your demi-god. You stupidly believed in “free” healthcare. You danced to the music, now you pay the piper.

Enact the law. Don’t delay it at all. Make them pay. Let the truth prevail.

But, no: on second thought, repeal the law, and keep out of my private life, especially given the IRS’ apparent propensity to favor democrats and harass conservatives.

Of course, if all Americans who are genuinely willing to work made $40,000 a year—and many employers can afford that (WAL-MART) without raising prices—schemes like this law and unethical salesmen like Obama wouldn’t find such easy purchase in American politics. Unfortunately, the government can’t make employers pay, and most employers lack the necessary morality.

It’s more complex than that, of course. We still have a huge, voting population within the population who don’t want to take care of themselves: who feel justified insisting that others take care of them. What an odd bunch, clamoring simultaneously for both freedom and a parent-like government. They seem unrealistic: perpetual teenagers.

In the end, the government’s healthcare costs are a huge problem, and no solution will solve it to everybody’s liking.

Senator Baucus, who’s rightly or not given credit for trying to provide a solution, isn’t retiring for nothing. As the story goes, he made the bomb. Now he’ll hide away while Obama gets credit for dropping it: “the nuclear warhead of love.”

But I think the whole US congress—democrats and republicans—and media leftists and conservatives have played their roles. This power-grab has been in the works for decades. It’s a business decision. It’s an ugly decision. It’s an ugly problem without a suitable solution.

Every democrat wants a part of it, but no politician wants to touch it in its unadulterated form: hence the myths and legends; the “Obamacare” misnomer and the greenhorn Obama’s “free healthcare” ruse.

It’s a big ruse with massive, far-reaching and long-term implications, the greatest of which are not even in the discussion yet.

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