This commentary originally appeared in The Hill on December 5, 2016.
A report just released from President Obama’s home state has confirmed what doctors feared most about his namesake law: death of patients “by queueing.” If you are enamored with ObamaCare or any other form of government controlled healthcare — single payer, socialized medicine, universal health care, Medicaid, and Medicare — prepare yourself.
Following are three examples of government healthcare causing death by queueing. To quote Ian Fleming in his James Bond novel Goldfinger, “Once is happenstance. Twice is coincidence. Third time is enemy action.” You decide who the enemy is.
Here are some ways that death by queuing has occurred:
- In 2014, newspaper headlines in 72-point font were describing American veterans dying while waiting for their requests for medical care to be processed. An internal audit titled “Review of alleged mismanagement at the [VA] Health Eligibility Center” was released in 2015. It confirmed the allegations reporting, “As many as 307,000 veterans may have died [within the U.S.] waiting for medical care.”
- In 1998, a Canadian surgeon named Ciaran McNamee sued the Alberta Provincial government offering proof that Canadians were dying in their single payer healthcare system while waiting for desperately needed and approved surgical procedures. There were either too few nurses or doctors, or insufficient operating rooms to deliver lifesaving care in time.
- On Nov. 23, 2016, an Illinois Department of Human Services report confirmed that 752 Illinois Medicaid enrollees died while waiting for approved medical care. The state of Illinois expanded its Medicaid program in May 2013, which translates to 18 avoidable deaths per month just in the Prairie state due to the Affordable Care Act. That is death by queueing number three — enemy action.
Who is the enemy? Why is this happening?
When the government decides where healthcare dollars go, they pay the bureaucracy (themselves) first. Health care services—both people and facilities — must make do with the leftovers. ObamaCare reduced Medicare reimbursements to doctors (and thereby cut medical services to enrollees) by $716 billion in order to expand the federal healthcare bureaucracy.
Medicaid is worse and more obvious. Expansion of the program produced millions who were newly covered persons along with a massive increase in the cost of benefit packages. To pay all those bureaucratic costs, payments to care providers had to be slashed.
In New Mexico following Medicaid expansion, the Medicaid program had a 2017 shortfall of $416 million. To balance the program budget, they cut reimbursements to Medicaid doctors by an average of five percent. That decrease was imposed on already low Medicaid payments to doctors.
Thus in New Mexico, Illinois, and most likely each of the other 30 states that expanded Medicaid, the following unfolded. The federal government mandated “better” benefits to millions of newly insured persons and massively expanded the bureaucracy to verify and distribute those benefits. To pay all these new bureaucratic costs, money had to be taken away from care services.
While death by budget is also an accurate description, it is important to keep focus on who is being hurt — the patients — more than how. That is why we should call what is happening death by queueing: We the Patients are dying while standing and waiting in line.
Many analysts predicted these unfortunate consequences of the ill-conceived structure of ObamaCare. More people would demand care and would expect to get it. After all, the President Obama promised us, “all the care Americans deserve.” Meanwhile, there are fewer and fewer dollars to pay providers so there are fewer and fewer providers. More patients plus less doctors equals longer and longer wait times for care until you have death by queueing.
As long as a central authority called government has the power to allocate your healthcare spending, it will pay its bureaucracy before it pays for your medical needs.
The U.S. has spent trillions of dollars for new healthcare bureaucrats and to implement millions of pages of rules and regulations. There is not enough money remaining to build Burn Units or operating rooms; pediatricians are paid less than the driver who delivers the Enfamil; and rural hospitals have to cut nursing staff in order to cover payroll.
Death by queueing is the inevitable result of government control of healthcare spending.
Dr. Deane Waldman, MD MBA, is Director of the Center for Health Care Policy at the Texas Public Policy Foundation and author of The Cancer in the American Healthcare System. He can be reached at firstname.lastname@example.org.