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Over the past several months, I’ve been silent on the subject of ObamaCare. But as the controversy has grown, I’ve received numerous requests for an update on this law. In this piece I will go beyond outlining the problems and will explain what is at the heart of the law, why the American people were deceived, and why this law will not survive.

Since October of 2013 when ObamaCare was launched, we have witnessed one disaster after another. First, there was the website debacle. Second, 6-million Americans lost their private health insurance. And now, people are suffering from sticker shock over the price of insurance on the ObamaCare exchanges.

As a result of this sticker shock, the Administration quietly announced its 14th change in the law on December 20, 2013. The 6-million Americans who have lost their insurance – as a direct result of ObamaCare – will have their individual mandate waived. They will receive a “hardship exemption” under the law. They can either buy a bare-bones, catastrophic insurance plan that was meant for the truly destitute or purchase no insurance at all! What this means is that the Administration has openly acknowledged that the increased cost of ObamaCare is a true hardship for many and it will be unaffordable for millions of Americans. ObamaCare is significantly more expensive than the private plans of the past. It turns out that this law will not result in “an average savings of $2,500 per year for a family of 4,” as Mr. Obama promised.

The Big Promise

To understand why ObamaCare is a Trojan horse, we must begin with the big promise. As everyone knows, there was an absolute and unequivocal assurance made by this president to the American people. This promise has come to redefine ObamaCare. It has exposed the true intent of the law. No less than 37 times, Mr. Obama said, “If you like your health plan, you can keep your health plan. Period!” He also promised that you could keep your doctor. Not only have these promises already been violated for millions of Americans, from what we now know about this law, these promises could never have been kept. And the White House knew this. Because of his deception, the nonpartisan, Pulitzer-Prize-winning website, PolitiFact has named President Obama’s promise its “Lie of the Year” for 2013.

In addition to the 6-million people who have already lost their private insurance, it is now clear that tens-of-millions-more will lose their healthcare plans in 2014. The reason for these inevitable cancellations is that the law was designed to force people off of their private plans and onto the ObamaCare exchanges. The canceling of private insurance policies was not some “unintended consequence” of the law. Doing away with millions of private insurance plans was necessary for the financial survival of ObamaCare. To provide coverage for 30-million uninsured Americans, and to have the sick pay no more for their health insurance than the well, young and healthy people had to be part of the ObamaCare pool. If only sick people signed up for the ObamaCare exchanges the system would collapse financially.

Furthermore, to provide the extra money required to take care of the “needy,” the law was structured so that the young and the healthy would be forced to buy services they neither wanted nor needed. This is why a plan for a 55-year-old couple must cover obstetrical care and pediatric dental care. This explains the sticker shock. When you analyze this law, you reach the inescapable conclusion that ObamaCare amounts to a massive transfer of wealth from the young and the healthy to the sick, the elderly and the uninsured. This law is a wealth redistribution program. It is a thinly-veiled, government-run, socialized medicine program.

ObamaCare - Trojan Horse

The Trojan Horse

The true intent and structure of the law was never shared with the public. Instead, ObamaCare was portrayed as a benevolent program for the less fortunate. The program would not be forced on those who were already happy with their insurance and their doctor. This deception is why ObamaCare was a Trojan horse. Private insurance companies were conscripted to pull the ropes of this Trojan horse through the gates of our healthcare system. This provided the illusion of maintaining private insurance. However, inside this horse were legions of government bureaucrats who would actually make all the rules that insurers and citizens must follow. Insurers went along with this ruse because they stood to gain millions of new customers.

However, unlike the Greeks – who constructed their Trojan horse of solid wood – the politicians in Washington made this horse from paper mache. This horse was constructed of thousands of pages of paper, held together with political rhetoric, lies, and platitudes. So poorly constructed was this horse that it is literally crumbling before our eyes – before the invading bureaucrats have even had the chance to exit the trap door and complete their deception.

Employer-Based Insurance

Still not convinced that the process was sinister? In 2014, millions more – those Americans who have insurance through their employers – will lose their private insurance. Dating back to 2010, Forbes Magazine reported that Obama officials projected 93-million Americans would be unable to keep their health plans after 2013. So the White House has known for at least 3 years – during the lead up to the 2012 presidential election and beyond – that almost 100 million Americans could potentially lose their private insurance under ObamaCare. And yet the lies continued. And if you think it is just PolitiFact that is calling Mr. Obama’s promise a “lie,” the Washington Post is using the “L-word” as well. Of their Top 10 Pinocchios for 2013, the Washington Post has given Mr. Obama’s healthcare promise “4 Pinnocchios” and has placed Mr. Obama’s promise at the top of their fib list for 2013.

Financial Death by Deductible

What people are also discovering is that ObamaCare premiums are typically at least 30% higher than their old premiums. And even if people can afford these higher premiums, the deductibles are daunting. According to the WSJ, “The average individual deductible for what is called a bronze plan on the exchange—the lowest-priced coverage—is $5,081 a year.” For couples and families, deductibles can run as high as $12,000 per year. Millions of middle class Americans and young people simply cannot afford to pay these high deductibles. They cannot afford to pay the first $5,000 to $12,000 of their medical expenses out-of-pocket each year, on top of higher monthly premiums. After their private insurance plans were literally taken from them by the government, they are now being forced by the government to buy an inferior product at an unaffordable price.

Millennials Have Awakened

Millennials, those Americans age 18 to 29, have been reliable supporters of Mr. Obama. Idealism is normal in youth. Believing in slogans like “Hope & Change” and “Yes We Can” is like getting infectious mono. It just happens to young people. However, experience is the only real teacher in life. And young people have now learned the truth. Millennials now disapprove of ObamaCare by a large majority. The young have figured out that this law is a raw deal for them. Robust, young people will not use their limited discretionary funds to pay $175 per month in healthcare premiums, plus pay the first $5,000 in annual medical bills out-of-pocket for the good of others. It ain’t going to happen! And if the young fail to make this financial sacrifice in the name of “social justice,” the whole ObamaCare house of cards will fall. And it will. It turns out that Millennials are not socialists after all. A recent Harvard study showed that only 22% of the young plan to enroll in ObamaCare.

And if the insurance companies lose billions because not enough young people sign up, what happens then? In the law, there is a provision for the government (the tax payers) to bail out the insurers. This clause is disguised in typical Washington-speak called “risk corridors.”

The Individual Mandate

Won’t the majority of people be frightened by the threat of a government fine if they don’t buy health insurance? No. The fine has no teeth. The penalties for failing to enroll in ObamaCare for a young person start at $95 per year. And remember those threats of the IRS using strong-arm tactics to collect the fine? It turns out that the fine is not enforceable. Under the law, the IRS cannot even send you a letter demanding payment of the fine if you don’t buy health insurance. The only way that the IRS can collect the fine is if you overpay on your taxes. In that case, the IRS may withhold the amount of the penalty from your tax refund. That is all.

Top Hospitals are Excluded From ObamaCare

It turns out that not only can’t you keep your doctor or your health plan under ObamaCare, your choice of hospitals will be severely restricted. This means that when people and their families are most in need of life-saving medical care, the finest hospitals will no longer be available to them. The reason for these restrictions is that insurers have been mandated by the government to keep premiums as low as possible. The only tool left for the insurance companies to control premiums is to lower access to expensive doctors, hospitals, and to limit the use of expensive drugs. So the plans have cut-off access to the best doctors and the best hospitals.

The Financial Times and many other news outlets are reporting that the nation’s top hospitals will be excluded from almost all ObamaCare plans. When people get cancer under ObamaCare, their insurance will not cover a visit to the MD Anderson Cancer Center or the Memorial Sloan Kettering Hospital. ObamaCare plans will not cover the Cleveland Clinic. They will not cover Seattle Children’s Hospital for the children of Seattle and the surrounding states.

New Medicaid Patients Under ObamaCare Will Still Not Have Medical Care

The majority of people who have signed up for ObamaCare have been enrolled in Medicaid, not the exchanges. The Medicaid system is inadequate at best. I’ve recently done some pro bono work for Medicaid patients and I can tell you that this program is abominable. In fact, a recent study done on the Medicaid system in Oregon showed that people on Medicaid had no significant improvements in health outcomes as compared to those who were uninsured. If you have a new Medicaid card under ObamaCare, you will likely be no better off than you were without insurance. So the entire medical system was turned upside down to give the poor some of the worst medical care in the country, where most will have great difficulty finding a doctor.

It’s All Over

ObamaCare will ultimately collapse. This paper mache horse is coming apart at the seams. The law was written so poorly, it is so overreaching and it will be so devastating to the access of quality medical care that it simply cannot survive. And the death of this law will ultimately come at the hands of the bureaucrats who voted for it. They will set this beast on fire to save their own skins. The only thing these politicians care about is their own reelection and they are feeling the public outrage, which is only just beginning.

The Real Tragedies are Yet to Come

Unfortunately, as this law moves forward and finally collapses, people will be injured. Some will even die. This is not hyperbole. Some people with complicated medical problems will die as the result of losing their insurance, their doctors, and their specialty hospitals. Having taken care of many seriously-ill people in my career, I can tell you that there are critical times in a patient’s illness where continuity of care and the right subspecialty care can mean the difference between life and death.

You simply cannot disrupt the relationships of millions of Americans with their doctors and their hospitals and not have fatal outcomes. The real question is not if people will suffer and be harmed by this law, but how many casualties there will be? And when this begins to happen – when this law results in real people being hurt – the “Lie of 2013” could go down in history as the deception of the century.