In the months leading up to the passage of the Affordable Care Act (ACA), President Barack Obama traveled across the country lauding the bill???s potential to fundamentally transform the U.S. health care system. Among his many promises was the insistence all Americans would eventually save money on health insurance because the nation as a whole would grow healthier from ACA???s various programs and mandates.
The theory went something like this: If uninsured Americans are given access to primary care physicians, healthy lifestyle changes would be quick to follow. If everyone is healthier, then the risk associated with insuring the nation would be reduced, thereby reducing expenses and, eventually, insurance rates.
The single greatest health problem facing the United States was and still is obesity and the various diseases and conditions that inevitably result from being severely overweight. Cardiovascular disease, diabetes, and high blood pressure cost the nation more than $720 billion annually, according to Todd Hixon, writing for Forbes. Astoundingly, that amounts to nearly one-quarter of all health care spending. Reducing obesity would almost certainly have a very positive effect on health care costs.
Available data show the Affordable Care Act has not dramatically changed the way the vast majority of people, especially impoverished Americans, receive health care. Obesity levels remain at incredibly high levels compared to the rest of the world. Health care costs continue to rise, and there???s no indication this vicious cycle is close to ending.
Various mandates and provisions in Obamacare force health insurance companies to offer programs and other initiatives intended to help obese patients lose weight, but these programs depend on the patient???s willingness to enroll in the offered programs and work regularly with primary care physicians to adopt healthier lifestyle routines.
For low-income Americans, who suffer from some of the highest obesity rates, having increased access to health insurance through the expansion of Medicaid has not, in many cases, created real access to primary care doctors. Many primary care doctors won???t accept new Medicaid patients due to low reimbursement rates, and there is a significant shortage of primary doctors. In other words, although Medicaid enrollment is expanding, access to primary care doctors is not.
This has pushed many people back into emergency rooms, where strategies to reduce obesity cannot be carried out. According to an important poll conducted by the American College of Emergency Physicians, 75 percent of the 2,099 emergency room doctors surveyed say they have witnessed increases in the number of people going to emergency rooms to receive basic medical care since the start of 2014. About 56 percent of the doctors polled say they have seen a higher number of Medicaid patients as well.
Emergency room doctors generally do not build lasting relationships with their patients. The goal is to get people in and out as fast and safely as possible, so America???s obesity crisis will never be solved if patients use emergency room physicians as though they are primary care doctors.
There is some evidence Americans??? daily caloric intake has started to decline, which could eventually help reduce obesity rates and total health care costs. According to a study in The American Journal of Clinical Nutrition (AJCN), the average number of calories the average American child takes in has been reduced by about 9 percent in recent years.
Some will be tempted to argue these moderate advancements are the result of various health initiatives by President Obama and First Lady Michelle Obama, but the study???s data show the average daily caloric intake began to decrease in 2003, long before the Obama family moved into the White House.
Even The New York Times, a notorious Obama apologist, acknowledges the calorie decrease is not attributable to Obama administration policies: ???The reversal appears to stem from people???s growing realization that they were harming their health by eating and drinking too much. The awareness began to build in the late 1990s, thanks to a burst of scientific research about the costs of obesity, and to public health campaigns in recent years.???
The most recently available data from the Journal of the American Medical Association show there has been ???no significant change??? in the overall prevalence of obesity in the United States since 2003???04, and no change at all from 2009???10 to 2011???12.
According to the Congressional Budget Office, the Affordable Care Act and its various programs are expected to cost more than $1.2 trillion between 2016 and 2025. What will the nation get for its tremendous investment? Millions of Americans remain uninsured and are expected to be uninsured in 2025. Health care costs continue to rise, along with health insurance prices. And more and more Americans become obese and develop the various problems associated with obesity, which will only add to the growing cost of Obamacare.
That means the vast majority of us are paying more to get the same coverage or worse coverage than what we had before, all so a relatively small number of people can be added to Medicaid or forced to buy expensive health insurance many of them cannot even afford to use.
What a bargain.