strip banner

new-logo25By  Dr. Marilyn Singleton,


The Affordable Care Act is like the television show Storage Wars, where unclaimed items in storage lockers are auctioned off after a quick peek through the door. People bid top dollar and hope for the best. Some find a goldmine, but the unseasoned bidders usually receive a Pandora’s Box.

Let’s look at some of the winners. The Center for Public Policy, a non-partisan public interest think tank in Washington D.C., estimated that $120 million was spent lobbying for health reform. Pharmaceutical Researchers and Manufacturers of America (PhRMA) alone spent $26 million lobbying for Obamacare in 2009. And PhRMA has spent well over $100 million on ad campaigns promoting healthcare reform legislation.

Upon passage of the bill, the stocks of some of the largest health insurers, including Cigna, UnitedHealth Group,WellPoint,and Aetna climbed. Major makers of electronic health records (EHR) systems lobbied hard, locking out smaller competitors. Chicago-based Allscripts Healthcare Solutions former CEO Glen Tullman, who had served as health technology adviser to Obama’s presidential campaign in 2008, made more than $200,000 in contributions to the campaign, and was frequent guest at the White House during 2009. With some nudging from the Stimulus mandate for EHRs, annual sales of Allscripts more than doubled from $548 million in 2009 to $1.44 billion in 2012. Cerner, another software purveyor, spent $400,000 lobbying for EHR. During the same three-year period, sales rose 60 percent.

Of course, AARP’s CEO, Barry Rand, wrote that the ACA was “vital” for the nation’s seniors. This makes no sense when the ACA in fact cut a half a trillion dollars from the popular Medicare Advantage program. It seems the ACA’s passage was vital to AARP’s insurance Medi-gap insurance products – which people with Medicare Advantage do not need.

The presumptive owners of the mystery storage locker – Congress – can change the contents at will. Congress, in a moment of bipartisan backbone or populist pandering, voted that their staff would be on the Exchange. Under the ACA, if an employee purchases a health plan through the Exchange, the employee will lose the employer contribution (if any) to any health plan.

When the chips were down as the moment of truth neared, Congress made a little adjustment: their staffers will keep their employer contributions of $5,000 to $11,000 – far and above those of ordinary Americans. For example, a single person in Washington, D.C., earning $35,000 per year (an average staffer’s salary) can find a Silver plan unsubsidized annual premium of $2,166. This everyday American is not eligible to receive a government tax credit subsidy, and can have up to $6,350 in co-pays and deductibles (not including the premium).

So we the proletariat get containers of empty promises. We all remember, “if you like your current health plan, you can keep it.” But the CBO estimates that up to 8 million people will lose their employer-sponsored insurance.

We get corporatized medicine, more bureaucracy, less choice, more likelihood of seeing a mid-level practitioner rather than a physician, shorter office visits, markedly higher premiums for young men that pay for those “free” preventive services, no catastrophic/major medical plan option unless you are under 30 years old, more IRS snooping, work hours decreased to 29 hours a week to avoid the threshold requiring a business to provide health insurance, risk of exposure of private medical and financial information, unelected bureaucrats making unilateral decisions by non-medical personnel, unvetted government customer service navigators who are privy to our personal financial information, and predictions of increased emergency room use because of the increased number of Medicaid patients who historically use the ER more due to the shortage of primary care physicians.

Our esteemed public servants claim to be advancing good government but are instead engaging all the while in cronyism to our detriment. We are on a slow descent into tyranny and dependence on government. We still have our voices. Insist that medical care be about you. Demand that medical care remain between you and your doctor – not the government’s highest bidder.

* * *

Marilyn M. Singleton, MD, JD is a board-certified anesthesiologist and sits on the Board of Directors of the Association of American Physicians and Surgeons (AAPS). Despite being told, “they don’t take Negroes at Stanford”, she graduated from Stanford and earned her MD at UCSF Medical School. Dr. Singleton completed 2 years of Surgery residency at UCSF, then her Anesthesia residency at Harvard’s Beth Israel Hospital. She was an instructor, then Assistant Professor of Anesthesiology and Critical Care Medicine at Johns Hopkins Hospital in Baltimore, Maryland before returning to California for private practice. While still working in the operating room, she attended UC Berkeley Law School, focusing on constitutional law and administrative law. She interned at the National Health Law Project and practiced insurance and health law. She teaches classes in the recognition of elder abuse and constitutional law for non-lawyers. Dr. Singleton recently returned from El Salvador where she conducted make-shift medical clinics in two rural villages. Her latest presentation to physicians was at the AAPS annual meeting about challenging the political elite.