Monday, November 22, 2010

Health Care Reform Cannot be Stopped

Now that the Republicans have taken over the House, they are calling for repeal of The Patient Protection and Affordable Care Act (ACA).  They are calling it a "bad product" and a "monstrosity" and the airways are full of pundits telling the American people that they intend to "take back our country."  But what would repeal of the bill really do?

Overturning ACA would cause 32  million Americans to forgo insurance.  It would deregulate the insurance industry and cause those children that are on their parents plans (until age 26) to be dropped  like a hot stone.  The part that went into effect today about mandating that insurance companies spend 80-85% of your  premium money on the insured would be reversed.  Children would not be covered if they had preexisting conditions (active now) and the practice of denying coverage for adults with preexisting conditions would continue if the law is repealed.  Increased funding for primary care physicians and nurses would go away.  Preventive care is part of the bill.  That would be repealed along with insurance companies dropping people from coverage once they get sick or hit their lifetime limit.

Take away Health Care Reform and the deficits and health care costs will rise at higher rates.  Continuing to pay for  quantity and not quality got us into this mess.  Continuing the current system is the most expensive and irresponsible choice any politician could make.

 What are the Republicans planning on replacing ACA with?  They want to get rid of insurance exchanges (which preserves the current insurance system in America) and replace it with purchasing of insurance across state lines.  When people can't afford insurance in their own state, I don't see how buying it  from another state (that can't be regulated) adds anything.  They want expanded use of health care savings accounts.  Again, that works fine for high income people, but is that solving a problem?  Estimates from the Congressional Budget Office (CBO) report that similar principles would insure only an additional 3 million Americans.

The Democrats made a big mistake by delaying many provisions of ACA until 2014.  They also blew it by not getting the message out to Americans.  Many liberals are angry that Health Care Reform didn't go far enough.  It actually has many principles that were mouthed by Republicans a few years ago but are strongly opposed now that it came from Obama.

It is not a perfect law but unless I see an alternative that does as much for all Americans, I support "Obamacare"

25 comments:

Michael Kirsch, M.D. said...

Nice post, Toni. I was not an ACA supporter, and remain concerned about many of it's provisions. I see no cost control mechanisms, which the public would not tolerate. We will be adding about 30 million to the insurance rolls, without a primary care force to care for them. In addition, half of these will be in the Medicaid program, which many physicians will not welcome as the reimbursement is inadequate. There is no tort reform. There will be 'quality' measurements on physicians that have very little, if anything, to do with measuring real medical quality. Finally, I believe that the administration rammed the bill through, dissing the GOP, which strongly contributed to the recent election results. Keep in mind that the true objective of the political left, as articulated by candidate Obama, was for a single payer system, which would clearly be controlled by the government. Many of us are skeptical of this philosophy. Of course, the present health care system has many flaws and inequities, and we should address them. It's enormously complicated, and many of the players, including physicians, are contaminated with self-interest. Well, I'm not sure I solved anything, but I did express myself!

Cary said...

Interesting that the bill includes several provisions once supported by Republicans. But no matter--everything is politics anymore. It's not about what's right. It's about who wins. Issues be damned. If it comes from the other side, "whatever it is, I'm against it."

sunnydalai said...

Great post, which illustrates well how complicated the system is, and how hard it is to tweak it or change it completely. These discussions are not unique to this country. Several countries in Europe are facing the same challenges. As a society, we have to decide whether a community owes care for everyone, or only for those that can pay. And if we offer minimal care to everyone, what will that look like. The whole endeavour is made that much more difficult when the republican side has the defeat of the current president as their primary goal. Faced with that kind of attitude from the other partners in government, you cannot blame serious-minded elected officials for throwing up their arms in frustration.
If we decide that healthcare is not a right but a privilege, than we should at least admit that, even if we will move at an ever-increasing speed toward a society resembling the middle-ages.

BobbyG said...

I wrote the following thoughts in my first of five posts on U.S. health care policy on my policy blog:
___

'I will by no means be the first to note that our medical industry is not really a "system," nor is it predominantly about "health care." It is more aptly described as a patchwork post-hoc disease and injury management and remediation enterprise, one that is more or less "systematic" in any true sense only at the clinical level. Beyond that it comprises a confounding perplex of endlessly contending for-profit and not-for-profit entities acting far too often at ruinously expensive cross-purposes...'

See http://bgladd.blogspot.com/2009/05/us-health-care-policy-morass.html

Based on much of this study, I was invited to give a presentation on reform policy last week to the Nevada chapter of the Healthcare Financial Management Association. My informal subtitle for my talk was "If you're not confused, you haven't been paying attention."

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mandy said...

very interesting Ms. Toni. You made me aware of this. Well for me as a citizen there's a lot of flaws and unnecessary things that was happening in our health system. It sucks but what should i do I have only words to express but don't have power to be heard:(

Anonymous said...

I am an American living in Switzerland.

Here the health care answer is simple, straightforward, no drama.

The answer here is private insurance, regulated.

Everyone is required to have insurance.

Low earners have a portion of their premiums subsidized.

No one is turned down. There is no such thing as pre-existing conditions.

The insurance companies and government have set a reasonable standard of what is covered which the general population agrees with.

Everyone goes to whatever doctor they want. If they aren't happy, they choose another doctor.

People here believe that basic good health is every citizen's right and this is a higher value than any one group's interests.

And that is that.

Everyone is covered. Everyone is happy. No big discussion or drama.

Everyone gets on with their lives and spends their energy solving other problems.

The US is perfectly capable of giving each citizen basic health care.

At the moment, the US as a group doesn't value minimum standards of human welfare as highly as other countries who found it a no-brainer to solve these problems years ago.

Toni Brayer, MD said...

Anon Nov 30: I agree with you 100%.

abendkleid said...

It is one of the quality measurement in all these there are some of the things which is great to know about it.

Sunnydalai said...

Switzerland has a much stronger sense of unity and solidarity than the U.S. A more homogenous society as well as a much longer history of existence may account for that to some degree. Also, people generally understand that in order for insurance to work best, everybody will have to be forced to have insurance. While the rates are not much lower than in the U.S., the idea of "it takes a village" has not (yet) been compared to a communist manifesto like it has here in the U.S. I'm afraid it's going to get worse before it gets better

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If we decide that healthcare is not a right but a privilege, than we should at least admit that, even if we will move at an ever-increasing speed toward a society resembling the middle-ages.

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