Both policy experts and practicing doctors have been writing about the various ways that the Affordable Care Act (ACA), better known as "ObamaCare", hurts both We The Patients and our nation as a whole. Here are eighteen together in one listing. Each has solid evidentiary proof and thus is neither mere opinion nor personal bias.

The President knows all this or certainly should. If he doesn't, he is either the nation's most incompetent policymaker ever, or America's most creative magical thinker!

1. Unconstitutional #1: Government has no right to force We The People to purchase ... well, anything. Must we ask Congress and SCOTUS (Supreme Court of the United States) to reread the Bill of Rights? Have they forgotten the phrase that started this nation, "taxation without representation?"

2. Unconstitutional #2: President Obama promised the American people that ACA wasn't a tax. SCOTUS said it was (a tax), one that hits the middle class the hardest. Current estimates put the additional bill on the average family budget at $2500 more per year.

3. Unconstitutional #3: The Obama administration sold ACA under the "Commerce Clause." SCOTUS said it wasn't commerce.

4. Unconstitutional #4: ACA breaks down separation of Church and State. See how both Catholic & Muslim Americans are treated differently under ACA than other religious groups.

5. ACA was supposed to bend down the US "unsustainable healthcare spending curve." Instead, it will lift it into the stratosphere, expending $1-2.7 trillion over ten years. That is more than the US has spent in both the wars in Iraq and Afghanistan combined.

6. Because ACA spends money that we don't have, the government will have to either borrow it or print it. Either way, ACA adds to our already bloated national deficit and hands the bill-for-payment to our children.

7. Advocates of ACA promised it would reduce the costs of health insurance for the individual American family. Reality is otherwise. First, there is the $2500 new "tax" per year (see #2 above). Second, insurance premiums that were beyond reach before the ACA have risen 18-30% since the "Affordable" Care Act was passed.

8. ACA drives providers out of health care. This reduces access to care for all, but especially for Medicare and Medicaid patients -- our "most vulnerable." Over 30% of US doctors no longer can afford to accept Medicaid-covered patients. The number who cannot take Medicare patients is much higher. What good is having insurance coverage if you can't find a doctor?

9. IPAB (Independent Payment Advisory Board; an agency of the ACA) literally replaces your doctor. It makes your medical decisions. Worse,

10. Sarah Palin was right. IPAB really IS a "Death Panel." It decides what treatments will not be authorized and therefore will not be available. If you need such a non-approved treatment, you die -- by the decree of a government bureaucrat. This precise scenario just unfolded in Great Britain's NHS, on which the US IPAB was modeled.

11. Most ACA spending goes to the healthcare bureaucracy instead of patient care. At the same time as ACA expends money on new rules and regulations; new IT systems for authorization and verification; six whole new federal agencies; and bureaucrats from oversight officers to IRS agents, it cuts payments to doctors by over $700 billion to pay bureaucratic costs. Resources are literally taken from patient care and given to bureaucrats of all stripes.

12. ACA increases complexity. Complexity invariably increases the likelihood of errors. Errors hurt patients. Thus, ACA harms patients rather than "protecting" them.

13. ACA kills jobs. It suppresses creation of new ones and even destroys existing jobs. Part-time employees do not get benefits and therefore they are cheaper than full time. Guess what employers are doing to full time workers.

14. ACA was supposed to eliminate the problem of uninsured Americans. It will do exactly the opposite. An estimated 80 million Americans currently insured through their employer will lose their coverage. (Always remember, healthcare insurance isn't what we want. Health care is what we want and need. ACA makes care less available, see #8 above.)

15. The IRS has full access to our medical records. So much for the sanctity of the medical relationship and confidentiality of personal health information. The IRS agent can more easily access your medical records that the ER doctor can.

16. ACA continues, even expands, the "unfunded mandate:" the federal requirement to provide care "for free" for people who have no health insurance coverage. Of course, "for free" refers to the wallets of the uninsured. You and I pay for that care because of TANSTAAFL (there ain't no such thing as a free lunch.)

17. Illegal residents are exempt from ACA but still covered under the "unfunded mandate." You and I pay (excessively) for their care but never see the bill.

18. Finally, there is the one I should probably have put first: the way that President Obama imposed ACA on us. It was gangland-style politics at their worst: outright lies, bribery, chicanery, legal loopholes, partisan arm-twisting, and unsubtle threats, all to pass a Bill that most did not want and no one understood.

Some say the ACA is "a start; better than nothing; surely an improvement over what we have now." That is clearly not true, as you can see above. Kind of impressive, isn't it, when you see it all laid out line after line?

Is ACA what you call "Healthcare Reform" or is it exacerbation, the antithesis of reform?

Deane Waldman MD MBA is the author of Uproot US Healthcare, Cambio Radical al Sistema de Salud de los Estados Unidos, and Not Right! (January 2013), as well as Adjunct Scholar for the Rio Grande Foundation in New Mexico.