This past week the Obama administration provided another exemption or waiver to those individuals that recently lost their health insurance because of Obamacare.  Announced in the middle of the night and no doubt reinventing the law as they go, the exemption was meant to appease the constituents in states that have important upcoming elections.  As the article states: “Sebelius’s extension of the hardship exemption to Americans who lost their insurance this year creates just the kind of uneven playing field Obamacare was supposed to eliminate with a total reset of the individual insurance market in 2014.”

To read more on this and the political fall out, download this article from Time Magazine.  

But here is the rub: Obamacare has yet to treat a single patient yet.  Truth be told, I am a physician and I work in an environment that is heavily controlled by the government.  There are serious restrictions on tests that can be ordered and the types of medications that patients can receive.  These are not controlled by the physicians or nurses that see these patients but by the bureaucrats who sit in their offices.  Mr. Jones can’t have such and such medicine because he doesn’t meet the criteria.  However, if you are on the frontlines treating patients, patients rarely meet all of the criteria for any health problem.  As I like to say, “patients don’t read the text books.”  Government run health care is black boxing patient care.  If patient Smith has X,Y, Z criteria, then patient Smith gets drugs A, B, C.  Anything short of this, the patient and the doctor are looking for ways to patch the gaps.  It is medicine by inclusion, but most patients are excluded as they don’t fit the criteria perfectly.

What is clear is that there is always a way around these rules.  Patients can call their congressman or just make a lot of noise in general.  Better educated, courteous patients probably do better than the whiny, ignorant patient.  Obamacare was suppose to level the playing field and give everyone the same “cadillac” plan.  What we are seeing now — rewriting the law– is only a precursor of what is to come when we start treating patients.