HEALTH POLITICS-Human nature being what it is, it's doubtful we can ever get past politics and focus more on what's needed to make health care affordable. I'm sure there are those--maybe most of us--who will never admit the truth, but President Obama and the Democratic leaders of Congress who passed the ACA (Affordable Care Act) were correct in that we had to do something, but those GOP leaders and others who opposed it were also right in that the ACA was not read or understood by those who passed it...and that bad surprises continue to vex us all.
Unaffordable care is still a BIG problem, and arguably the single-most threatening factor to achieving a sound economy, achieving the creation of "good" jobs with pay and benefits, and achieving a peace of mind to the average American family.
Many consider (or dare to presume) that a Supreme Court decision the Burwell vs. King will hurt the GOP if the ACA is ruled unconstitutional (LINK: http://www.wsj.com/articles/gop-split-on-possible-health-law-fixes-1432856435) point out that the ACA is doing great. They point out fewer Americans are uninsured and that "ObamaCare" is on its way to meetings its goals despite rapidly-rising premium prices (LINK: http://thehill.com/policy/healthcare/243513-early-clues-to-obamacares-impact).
Many others consider (or dare to presume) that the ACA is an ongoing train wreck that is dragging down the Democratic Party, cost the Party its control of Congress, and is an unaffordable nightmare that is preventing our economy from allowing employers to provide full-time work positions with benefits, and is unaffordable for a very large number of those who were supposed to benefit from "ObamaCare".
In my own experience, virtually all of my patients are unhappy with either the costs, the high deductibles, or the impacts of finding full-time work that the ACA now has in our present day.
The sole exception is the sort of patient I saw the other day: a middle-aged man who has not sought work or health care for years, has free health care because he now has Medi-Cal, and is able to have his skin cancers treated (and for which I saw him as a patient years ago, and I advised him to have these skin cancers treated) for free. He thinks that there is nothing wrong with the ACA.
Yet most of my patients WANT to work, but if they DO work they have to pay into their ACA/Covered California premiums with a prohibitively high deductible. They want health care, but want also to work and achieve self-reliance...while paying an affordable and sustainable prices for their care.
Aggravating the problem is that this is too much about "ObamaCare" and not enough about Affordability. Democrats crow about their success in sticking it to the GOP (while stubbornly refusing to acknowledge the ACA's limitations), while Republicans seethe about the "in your face" treatment they got from President Obama, former Senate Majority Leader Harry Reid and former Speaker of the House Nancy Pelosi (while stubbornly refusing to acknowledge the ACA's potential and ongoing benefits).
Sooner or later, the GOP (and, hopefully, the Democratic Party working with them) will have to confront the "fixing" and affordability of health care. President Obama will not be in office, so there will be no control issue on either the Democratic or Republican side of the aisle (and both are guilty of making this a control issue)...just a debate on how to do what's right.
The issues of focusing on prevention rather than reactive treatment whenever possible and the explosive rise in medication costs, even generics are just two examples of what always needed to be fixed, but which was unfortunately NOT fixed, by the ACA.
Do we go the "capitalist" route and allow a very large of competition to lower costs (and to encourage private health plans to continue the incentives to increase reimbursement based on preventive care and restrict formularies, and to create more generic companies), or do we go the "socialist/government-run" route and require price controls and government-mandated preventative approaches to health care and cost-containment?
It's hard not to conclude that BOTH the "capitalist" and "socialist/government-run" routes have their merits and their pitfalls.
But whether it's the upcoming court case, the departure of President Obama, the option of tearing down the ACA without an alternative, as well as the option of leaving the ACA as is, are BOTH non-starters.
Something will have to be done--as for the last several decades, the rising cost of health care is among the biggest (perhaps the single biggest) factors threatening our economy and the quality of life of the average American.
The greatest obstacle to achieving a better ACA will almost certainly be NOT an issue of cost, medicine, science or economics but one of politics...not only the politics in Washington or our state capitols, but the politics that exist in our own individual households.
Because it is in our own individual households that the deleterious effects of overpriced health care is most damaging to each and every one of us.
(Ken Alpern is a Westside Village Zone Director and Board member of the Mar Vista Community Council (MVCC), and has experience as a dermatologist treating patients in Los Angeles, Orange and Riverside Counties. He previously co-chaired its Planning and Outreach Committees, and currently is Co-Chair of its MVCC Transportation/Infrastructure Committee. He is co-chair of the CD11Transportation Advisory Committee and chairs the nonprofit Transit Coalition, and can be reached at [email protected] He also does regular commentary on the Mark Isler Radio Show on AM 870, and co-chairs the grassroots Friends of the Green Line at www.fogl.us. The views expressed in this article are solely those of Mr. Alpern.)
-cw
CityWatch
Vol 13 Issue 45
Pub: June 2, 2015
