Along with many other citizens, I have been affected by changes since adoption of the Affordable Care Act of 2010.  I am a practicing dentist and have studied medical economics.  Democrats provide personal vignettes to sell their federal programs, but Republicans rarely use this method.

I purchase health care for my family (which includes my wife and daughter) in the private sector and have simplified this analysis to avoid boring readers.  In 2009, I paid about $7,000 for premiums and carried about $5,000 deductible for all medical costs and co-pay up to $11,000 in drug expenses.  I had a primary care physician employed by a local hospital I found excellent, caring, and able to take the time necessary to perform a thorough history and physical prior to ordering any tests.  I routinely expected premium increases of 6% annually.  Referrals to specialists were determined by my physician in conjunction with me; insurance company interference did not occur, and procedures were not denied or delayed due to preauthorization.

Sadly, this is no longer the case.  About a year ago, I developed a condition that can be devastatingly difficult.  I developed vertigo (a condition of spinning) that makes one nauseated.  I had to be taken to the hospital in an ambulance as I passed out and had a weak pulse.  The care at the hospital emergency room was excellent, and many tests were performed to rule out a seizure, brain aneurism (expansion and leakage from blood vessels), cardiac event (skipped beat), stroke, or transient ischemic (low oxygen) event, which could be fatal.  After two days in the hospital, I went home with a diagnosis of positional vertigo (vertigo related to head position due to crystal abnormalities in the inner ear).  Several more events occurred; I underwent further tests to ensure that my heart was not the initiator of these incidents.  In the springtime, I again had to be taken by ambulance to the hospital.  After two additional separate hospitalizations, I decided to seek specialty care in New York City (as I live in a small upstate New York community), as my symptoms did not fit the profile of typical positional vertigo.

The neurologist (a professor at Columbia Medical Center) whom I saw ordered several tests that would further examine this diagnosis and also rule out more obscure issues.  Approval for some of these tests required almost two months – an unreasonable delay.  I am scheduled for my follow-up appointment late in November, the soonest appointment available.

During this time, I also experienced leg pain from spinal stenosis (narrowing of the spinal column nerves).  Twenty-four years ago, I had successful surgery to treat my lower back.  I attempted conservative treatment with physical therapy, chiropractic, and anti-inflammatory medications.  After over six months, I sought orthopedic care.  I had the necessary testing to diagnose the cause and had a spinal steroid injection, which was helpful.  As the benefit lessened, a second injection was indicated, but I now await insurance company approval.  The pain is severe and debilitating, but I have continued to work.  Unfortunately, when I offered to pay directly for the injection while waiting for the insurance approval, I was denied this opportunity.

What has happened to America?  I can’t pay to get care and must wait for some bureaucrat to determine my care while in pain.  Is this managed care under Obamacare regulations?

Now I pay almost $17,000 per year in premiums.  I now have $11,000 in deductibles and co-pays.  This is about a threefold increase in eight years.  Soon the increases for next year will be announced.  Since Obama took office, they have averaged over 12% per year.

How long will this continue before the private insurance system collapses?  Can the supporters of this government intrusion defend the care at the Veterans Administration?  Perhaps they feel that Medicaid is a great system with politicians and bureaucrats determining acceptable coverage and reimbursement rates below the cost of providing care?  Do the media recognize that the future of Medicare is threatened?

Obamacare has accelerated changes in the health care system.  More primary care is provided by nurse practitioners and physician assistants.  Excellent care is available in hospital emergency rooms without insurance preauthorization.  This is costly and inefficient.  Outpatient care and doctor office care are managed more closely and delay services requiring more paperwork and cost.  The addition of millions of new patients through Obamacare (subsidized by government funds) has overloaded the system and increased wait times for care.  Physicians increasingly see more patients per day (and are more rushed) as reimbursement rates have declined.  The unintended consequences of increased regulatory control have been to diminish quality and personal nature of care.  We have been transitioned from patients to clients.

The end result of such a diminished system will be increased calls for a single-payer system.  Can anyone believe that the government will do a better job than in the past?

The issue for us to consider is whether Obamacare is un-American.