A recent Fox News piece on uncompensated care got me thinking about health care efficiency again. If we really had a $5.7 billion drop in hospitals’ uncompensated care costs because of the Affordable Care Act, where did the money go? Since my health insurance premium went from $407 in 2014 to $479 in 2015, I definitely am not seeing any of this love coming my way! Did we just a get a much larger version of the Oregon Medicaid experiment in which the drop in uncompensated care is replaced with an even larger increase in Medicaid spending and no discernable change in health care outcomes? The reported drop in uncompensated care is sounding like another shell game and the middle class is still stuck with Affordable Care Act supporters who really do not care about health care reforms that matter to the middle class. This is pretty simple. If you are reforming health care in a responsible and sustainable manner then we should be seeing the results in lower health insurance premiums and better health care outcomes. If we do see improvements in both areas then reforming health care has become a façade for increased cronyism and gross incompetence.