Dr. Oran Smith

Obamacare is America’s Healthcare Trabant

November 4, 2016

Dr. Oran Smith

You’ve probably heard the old line about the difference between major surgery and minor surgery.

Minor surgery is an operation performed on you. Major surgery is when it is performed on me.

So it was (I humbly confess) on Obamacare, the Affordable Care Act. Since we released our study #UnaffordableCare three years ago, I have thought frequently about those unfortunate families who have been ensnared into Obamacare exchange plans or buried in the fallout that has hit all health insurance since the Affordable Care Act was rammed through a one-party controlled federal government—-those faceless Americans out there somewhere in the ether getting hammered.

And hammered they are. Nationally, it has been reported that premiums would be going up 22% and in South Carolina, the figure is to be more like 29%.

“There are South Carolinians in my circle of friends that are going to get hit!” I thought. “Thank goodness it won’t be me.”

Then, I got my letter.


It appears that the “Silver Z20 Plan” (not the real name) that cost my family $1,281 per month in 2016 (the one with an out-of-pocket maximum of $6,850 and a Co-insurance rate of 10%) is going away.

For 2017, I am being cheerfully offered the “Silver X50 Plan” for $1,705 per month with an out-of-pocket maximum of $7,150 and a co-insurance rate of 15%.

That’s less coverage for a 30% increase in premium…$5,000 more per year!

I also see that I am virtually banned from using Walgreens or Rite Aid pharmacies and that services outside my insurance company’s network are not covered unless they are “of an emergency nature” performed in urgent treatment centers or emergency rooms in its network.

It’s official. Obamacare has now gone from bad policy in distant Washington to an outrage—from a freak of Washington politics to an attack on my family and its livelihood. Obamacare is officially a major operation.

For comfort I turn to that great feeler of my pain, Bill Clinton, who told the people of Flint, Michigan: “…the people who are out there busting it sometimes 60 hours a week, wind up with their premiums doubled and their coverage cut in half. It’s the craziest thing in the world.”

Crazy indeed.

You may ask why I don’t just switch insurance companies. After all, if I had a bad experience at Bob’s Tire Service, I would try Bill. If the burger at Jane’s Diner tasted like horse, I’d switch to Sally’s. But guess what? The other legacy of Obamacare is there is very little competition.

Then it hit me. Obamacare is…the Trabant!

Have you ever heard of an automobile called the Trabant? It was the car East Germans loved to hate. Manufactured during the Communist era (1957-1991), the Trabant was unreliable, required a long wait for delivery, offered little or no choice in options, was slow and weak (two cylinders), was created by a one-party state, was the only game in town, and was the product of central planning.

The analogy with the Affordable Care Act is irresistible.

Robert Moffit of The Heritage Foundation could have been describing the Trabant when he recently said that Obamacare is “like a patient suffering from multi-organ failure [and] … central planning is the disease.”

I mentioned the wait to get a Trabant. The newest organ failure of the ACA is the wait is in the emergency room.

This represents an additional failure because with everyone insured, Obamacare was supposed to fix the emergency room clog. A few weeks after the ACA passed Congress, then-Speaker of the House of Representatives Nancy Pelosi said when those who were uninsured got coverage, they would be “no longer left to the emergency room for medical care.”oran-aca-quote

But, according to a report just released by the New England Journal of Medicine focusing on the state of Oregon, there has been a stark increase in that state in ER visits since the implementation of ACA. That means long lines for real emergencies and skyrocketing Medicaid costs for both the federal and state governments in that shared program. Those who ordered Trabants had to wait eleven to eighteen years. The Obamacare ER wait just may seem that long.

It is interesting to get the liberal take on the ACA crash. Most of them could see it coming. Young healthy people—absolutely essential as insurance enrollee—don’t want to spend money they don’t have to spend, and they sure don’t like being forced to enroll in anything. Say what you will about millennials, they usually ask “Why?,” and the “because I said so” answer from Washington doesn’t fly.

It was nearly two years ago, in a review of America’s Bitter Pill by Steven Brill in The New Yorker, Malcolm Gladwell said this:

“Brill’s intention is to point out how and why Obamacare fell short of true reform. It did heroic work in broadening coverage and redistributing wealth from the haves to the have nots. But, Brill says, it didn’t really restrain costs. It left incentives fundamentally misaligned. We needed major surgery. What we got was a Band-Aid.”

Well, OK. That is typical New Yorker with the marvelous wordsmith Malcolm Gladwell elegantly celebrating the “heroic” redistribution of wealth and calling for major surgery (single-payer British NHS style healthcare anyone?).

The fact checkers at The Washington Post have been less truthful in their reaction to new ACA problems, proclaiming “you can’t get something for nothing” and telling us not to worry, Uncle Sam would just pony up more subsidy money to prop up the insurance companies and the system. More government! That’s the answer!

But where I disagree with the more thoughtful on the Left is this: restraining costs isn’t a small task left undone in an otherwise successful whole. Cost reduction, along with increasing freedom, is the sine qua non of healthcare reform. Staying with our analogy, yes, the Trabant’s body was so substantial that it lasted an average of 28 years. But that’s small consolation for an automobile that won’t run. Broadening coverage sounds pretty good (maybe not “heroic”) until healthcare premiums increase 145% like they did in Arizona.

Obamacare is the Trabant: more East Germany than America. It is a betrayal of our values and like the Trabant, it time to shut down the assembly line for good.