The lead to a piece by Dr. Marc Siegel, physician and associate professor at NYU’s medical school, is worth quoting:

Last year, I ordered a CT scan of the chest on a 63-year-old patient whose chest X-ray had revealed a lung nodule. I had no problem getting the test approved by his private insurance company. The radiologist suggested that I repeat the CT scan this year to make sure the nodule hasn’t turned into cancer.

But this year, the same insurance company is denying the test, having clamped down on several elective services while also raising its premiums. This company now has to cover children with pre-existing conditions and can place no lifetime limits on care. It is struggling to preserve its profits as Obamacare kicks in – profits that, to begin with, are only approximately 4 percent of its total revenue.

Don’t get me wrong. I am not hard-hearted about children with preexisting condition (though when “children” reach their 20s, a time once widely designated as early adulthood, and their health care coverage on mom and dad’s policies is mandated by law, I do get a little put out). I am simply cognizant, as many in government apparently aren’t, that somebody has to pay for “free” medical benefits. It will come out of somebody’s hide.

Siegel says it will be older Americans like his63-year-old patient. Siegel’s patient will be on Medicare next year (a fate worse than death?) and can’t afford a supplementary policy. The patient had planned to buy Medicare Advantage, but the administration’s health care legislation pretty much doomed Medicare Advantage.  Siegel reports:

[I]n 2011, Medicare Advantage is due to be cut $140 billion by the new law, and it is doubtful that the plan he wants will still be available. Harvard Pilgrim, the second-largest insurer in Massachusetts, has just dropped 22,000 patients from its Medicare Advantage plan in anticipation of these cuts. Soon seniors everywhere will have the same problem. In fact, the Medicare actuary estimates that 7 million out of the 11 million people with Medicare Advantage will be set adrift over the next seven years.

Siegel’s report goes on:

My medical office is changing, and not for the better. As I write this, I have a patient waiting in the next room who has to pay cash to see me because his employer’s contribution to his plan has dropped this year, and his deductible has gone up. Many employers are getting ready to dump their employees on the state exchanges in 2014. They are adopting plans that won’t “grandfather in” under the draft regulations of the new law, which mandate low deductibles and low co-pays. I am treating my patient for high blood pressure, which may be due to his worrying over his medical bills. My bill is minor compared to the hundreds of dollars that the laboratory charges him for the routine blood tests his insurance no longer covers.

Next door to this man is a woman complaining about her premiums, which are up 20 percent from last year….