Did you slip and fall into your garbage can? There’s a code for that!

The Affordable Care Act has forced insurance costs higher, encouraged many employers to bail out of providing health plans for their employees or cut employees or reduce hours to below the full-time threshold to avoid the higher costs, and has unleashed thousands of pages of new regulations. But intrepid federal bureaucrats charge ahead with even more requirements for providers, one of which is a revamping of the codes used to identify the medical services that providers use to bill insurers.

Currently, there about 18,000 such codes and one might be fooled into believing that is enough. But the devoted folks who get paid to generate new codes have been hard at work revamping the code system and the new list contains nearly 8 times the former number, checking in at 140,000 medical codes. The feds reason that more specific information is needed to adequately communicate what doctors and hospitals do for their patients, as well as what patients may have done to require a visit to a provider.

New codes describe precisely what bone was broken, or which eye was blackened, and tell insurers whether your injury occurred in, for example, an opera house, an art gallery, on a squash court, or in one of nine locations in and around a mobile home.

Some of them push the limits of propriety. Code R46.1 is for "bizarre personal appearance," while code R46.0 is for "very low level of personal hygiene." Others tell insurers whether an injury caused by walking into a lamppost was the "initial encounter," or a "subsequent encounter."

There is a group of codes that clarify whether you were injured while sewing, ironing, crocheting, doing handcrafts, knitting, or my personal favorite, playing a brass instrument. (Brass players are now churning out imaginative scenarios for how these injuries might have occurred.) There is also a code indicating that a patient's injury occurred in a chicken coup.

Speaking of birds, there are 72 codes for patients who have run afoul of these creatures, and being bitten by a parrot has a different code than if said parrot flies into you, or if you are bitten or flown into by a macaw or a goose. There are nine different codes for each of the six different species of bird.

The folks that developed the system—generally known as ICD-10, for International Classification of Diseases, 10th Revision—say "the codes will provide a more exact and up-to-date accounting of diagnoses and hospital inpatient procedures, which could improve payment strategies and care guidelines," and their use is scheduled to be required in two years. Pat Brooks, senior technical adviser at the Centers for Medicare and Medicaid Services explains that "It's for accuracy of data and quality of care."

As a side note, healthcare reform, known more commonly as Obamacare, is deemed so important that the furloughs that befell air traffic controllers did not extend to Obamacare regulators and code generators, according to Gary Cohen, director of the Center for Consumer Information and Insurance Oversight, who said that his office has not cut its workers’ hours and pay as a result of the automatic budget cuts that went into effect in March. This information should help convince doubters that the pain of the sequester is a conscious political choice of the administration, and not a requirement of the sequester.

While federal bureaucrats are busy, busy, busy improving the healthcare system with mountains of new regulations and charge codes, some of the people who actually provide care are taking different approaches, some of them good, and some not.

A recent Deloitte Center for Health Solutions survey of over 600 doctors reveals that 6 in 10 may retire earlier than they had planned, and will do so in the next three years, due to the effects of the Affordable Care Act on how they practice medicine.

Further, many providers will leave the private sector to work for hospitals or accountable care organizations, and others are fighting back against massive government interference in the doctor-patient relationship by reverting to an older direct primary care model that eschews health insurance in favor of fee-for-services, such as an office visit for $20 or a house call for $100. Some offer a membership plan where patients pay a set fee per month for physician services.

Getting away from health insurance, government regulations and other requirements reduces costs substantially, allowing doctors to provide services at affordable prices, and has the further advantage of allowing doctors to escape "assembly line medicine," all of which may benefit the relationship between providers and patients. In contrast to Obamacare, this is a real improvement in the system.

Finally, even supporters of this Rube Goldberg-like contrivance are starting to realize its boundless weaknesses. Senator Max Baucus, (D-Mon.), one of the Affordable Care Act’s designers and strong backers, told Health and Human Services Secretary Kathleen Sebelius during a Senate committee hearing that he sees "a huge train wreck coming down."

It's a shame Sen. Baucus and the other blind supporters didn't do their homework before the measure passed the Congress, and save the country much pain and suffering. But perhaps it’s not too late to reverse course.

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A national tragedy: We are learning what is really in Obamacare

Many thanks to former Speaker Nancy Pelosi for jamming the Patient Protection and Affordable Care Act through the House of Representatives so that finally the people could  "find out what is in it, away from the fog of controversy," as Ms. Pelosi so famously said two years ago. This unintentional revelation of what goes on in Ms. Pelosi's mind came in the heat of the battle between the liberal Congress and the American people, a majority of whom opposed this first step in a government takeover of our healthcare system. The American people lost that battle.

Of course, now that the odious gunk contained in the Affordable Care Act, now affectionately known as "Obamacare," has started oozing out, even the people who voted to approve the measure now realize how little they knew about it when the vote was taken.

Searching President Barack Obama's florid promises for a truthful statement about all the wonderful things the ACA would do for us is more challenging than Diogenes' trying to find an honest man.

Like your doctor? You can keep your doctor. Nope!

Like your insurance? You can keep your insurance. Nope!

It will lower costs. Nope!

After all the broken promises, there are also some new goodies in Obamacare:

There are 18 new taxes, estimated at about $800 billion, that will mostly affect America's middle class. And inflation, the cruelest tax on the poor, will increase as businesses find their operation burdened with added costs brought about by higher taxes and onerous government mandates, and pass those costs along to the consumer in the form of higher prices.

Obamacare will add $6.2 trillion (That's "trillion" with a "t"!) to the long-term deficit, according to the Government Accountability Office.

Medicare providers will be expected to continue to provide services despite a cut of $716 billion in payments. Added bureaucracy will make applying for health care even more burdensome than it already is; worse than that, an estimated 7 million people will lose their employer-provided health insurance; and worse yet, thousands of workers will find their hours cut or will lose their jobs entirely.

Just what we need: another government mandate that keeps unemployment unacceptably high.

Opponents of Obamacare warned that forcing companies employing 50 or more full-time workers to buy health insurance for their employees would result in a loss of jobs overall, and many full-time workers would have their hours reduced below the 30-hour weekly threshold. Even though the employer mandate does not go into effect until next January, employers are required to track worker's hours for up to 12 months prior to that, meaning that job and hours cuts have already begun so that employers can escape the $2,000 per-worker fine for uncovered employees, or have to bear the even higher costs of providing health insurance to full-time workers.

So, rather than increasing the number of employees getting insurance from their employers as advertised, Obamacare has instead caused employees to have their hours reduced, or cost them their jobs entirely.

These decisions are being made by more than a few businesses. The International Franchise Association finds that 31 percent of franchisees plan to cut staff to avoid Obamacare’s 50-employee mandate, and a study by Mercer consulting firm found that half of businesses that don’t presently offer health insurance plan to reduce employee hours to avoid Obamacare’s penalties.

The food industry has been particularly hard hit, including: Kroger, Wendy's, Red Lobster, Olive Garden, Burger King, McDonalds, KFC, Taco Bell, and Papa John's Pizza. Also affected are government workers across the nation, for the same reasons.

If not keeping your doctor or your insurance policy if you wanted to is not bad enough, or if thousands of Americans losing the jobs or having their hours reduced to less than 30 a week isn't bad enough, how about thousands of doctors taking down their shingles? According to a survey from the Deloitte Center for Health Solutions, 6 in 10 physicians said they expect many of their colleagues to retire earlier than planned in the next 1 to 3 years.

Another 55 percent of doctors surveyed believe many of their colleagues will cut back on their hours because of the way medicine is changing, and 75 percent believe the best and brightest may not consider a career in medicine, up from 69 percent in 2011.

How could the smartest man ever to inhabit the Oval Office have been so desperately wrong? Curious people want to know: Did Barack Obama just not have a clue about what the law that now bears his name would actually do, or did he deliberately deceive people about what it would do in order to gain their support for it?

There is a faction that firmly believes that if people lose their private sector insurance coverage, or can't afford it, that is precisely what Mr. Obama wants, thus making his dream of a single-payer government healthcare system a reality.

So, will our public servants act to relieve us of this Obomination? They should remember that there are Senate and House elections in 2014. And so should we.

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