Harris Conflates – Patients Lose

 In a blatant, poll-driven political maneuver, V.P. Harris’ campaign has released its interpretation of Trump’s “concept of a [healthcare] plan” hoping to frighten undecided voters with the threat of loss of medical care.

Harris and her Democrat confreres like Governor Walz conflate the word insurance with the phrase medical care, so people think they are the same. Keep in mind they are not (the same.)  

Using flawed logic, Harris builds on Trump’s stated intention to repeal the Patient Protection and Affordable Care Act of 2010 (ACA) warning that by so doing, Trump will take away care from millions of Americans. Furthermore, they say he will nullify protections for the medically vulnerable written into the ACA. 

The facts are as follows. 

Medically vulnerable Americans had effective, state-based programs to address their needs long before the ACA. Washington took control of state programs that were working and then claimed credit for filling a void that did not exist. If the ACA were repealed, states could once again do what they were doing before 2010. 

The ACA halved the U.S. uninsured rate from 15.5 percent in 2010 when the ACA was signed to the present record low level of 7.7 percent. More than 17 million Americans gained government health insurance, mostly through expansion of no-charge Medicaid and a small number via ACA subsidies. At its height in December 2022, Medicaid/CHIP covered 27.8 percent of the population, 92.3 million Americans. Since then, enrollment has declined somewhat. However, actual enrollment is likely to be much higher than officially stated as millions of illegal entrants are being enrolled in states like California and Oregon.

A healthcare system, any system no matter where, exists not to give its people insurance, but to provide care. Harris and her fellow progressives conflate insurance with care leading people to believe they are the same. They strongly imply that having insurance means one gets whatever medical care is needed when it is needed. This is false. Insurance and care work against each other, called the seesaw effect.

As the number of Americans with government-provided health insurance rises, access to medical care declines. Because Harris and the media have so frequently conflated care with insurance, common wisdom says they go together However, following the money trail proves the counter-intuitive notion that they behave inversely. 

In 2023, the U.S. spent $4.8 trillion on healthcare, the system, not on health care, the service, aka patient care. In fact, as much as half of that massive expenditure, $2.4 trillion, paid for activities unrelated to patient care called BARRCOME – bureaucracy, administration, rules, regulations, compliance, oversight, mandates, and enforcement. Those trillions were first-dollars-paid-out: only what was left was available to pay for patient care. 

BARRCOME dollars and patient care dollars are at opposite ends of the seesaw. As Washington passes more regulations, more money goes to BARRCOME and less is spent on patients. This is just as true of government insurance. 

As more money is spent giving no-charge (most definitely not “free”!) Medicaid/CHIP insurance to people, especially when making the huge influx of illegals eligible to enroll, fewer dollars are available to pay nurses, doctors, and facilities. 

Wait times for care get longer and longer until people start dying waiting for care that never comes. Such “death by queue,” documented in people with government insurance such as Medicaid and Tricare, exposes Harris’ falsehood that insurance equals care. 

Ironically, Trump’s intention to repeal the Affordable Care Act (ACA) will likely increase access to medical care, by making the seesaw reverse its direction. 

The ACA expanded Medicaid enrollment. It simultaneously increased maximum average wait times to as much as 132 days to see a primary care doctor by diverting more money to BARRCOME, taking it from patients. President Obama took $716 billion from the Medicare Trust and thus care for seniors to pay for ACA infrastructure.

As the ACA magnified the seesaw effect and reduced access to care, repealing it could flip the seesaw. As Medicaid rolls are culled to more appropriate levels and more money becomes available for patients, access to care will go UP. 

As long as the seesaw effect remains in force and patients get the leftovers after spending on BARRCOME, our healthcare system will fail in its primary duty to Americans: to provide medical care as needed. 

 

Deane Waldman, M.D., MBA is Professor Emeritus of Pediatrics, Pathology, and Decision Science; former Director of Center for Healthcare Policy at Texas Public Policy Foundation; former Director of New Mexico Health Insurance Exchange; and author of 12 books, including multi-award winning, Curing the Cancer in U.S. Healthcare: StatesCare and Market-Based Medicine

https://www.realclearhealth.com/blog/2024/10/02/harris_conflates__patients_lose_1062455.html