By Dr. Osmond Ekwueme
The Patient Protection and Affordable Care Act (ACA) “Obamacare” or the American Health Benefit Exchange Program is similar to the Federal Employee Health Benefits (FEHB) plan on which it is based.
Now, how the heck is affordable health care liberal or conservative, or republican or democrat? As a matter of fact, it is more conservative than liberal since ACA is the brainchild of the conservative Heritage Foundation. The trouble with calling it Obamacare instead of its proper name to me is a distraction, especially to those who dislike President Obama.
Exchange is not a centralized, government-controlled plan. It is a network of choices that are offered at lower cost due to the number of people enrolled. You can choose a plan with higher deductibles and co-pays but lower premiums. You can visit any doctor you like, including specialists. The specifics will vary according to the plan you choose. You will not be denied insurance, face higher premiums or be dropped from your plan due to pre-existing conditions, job changes or the onset of illness, nor will your premiums be increased when you get sick, forcing you to drop coverage. These are facts…go read the Act at the Government’s website. It is written in plain English. It is about affording health care. ACA doesn’t “fix” everything but does however provide some useful constraints on the insanity of our current system. The Truth shall set you free ….veritas vos liberabit.
Republicans keep saying “ I like this part of Obama care” or “ I like that part of Obama care” but what they keep doing is trying to totally eliminate it. What’s up with the “throw the baby out with the bathwater” approach? The remedy is worse than the disease….aegrescit medendo. Yes, Republicans come up with all kinds of lame excuses as to why the ACA should not go into effect. But they never mention anything about the 30 million people that would have to go without health insurance. What level of hypocrisy does it take for someone to be in the peoples’ House or Congress in Washinghton, receiving a federal paycheck and government-sponsored health care, and who will receive a fat federal pension on retiring, to devote his career to bad mouthing Washington and all it stands for?
Democracy doesn’t function if the people are fed lies consistently. I still remember the story I heard as a medical student in Europe and you probably know the story of German villages believing that they were winning the war until the Allied tanks rolled into their town. They got their information from propaganda radio and newspapers. We have exactly the same problem now. These Republican representatives know that Obamacare is the law of the land now and nothing can be done about it.
It is as the people want to be deceived, so let it be deceived! They know that it is unlikely that Obamacare would be repealed anytime soon, nor Medicare-for-all be adopted either, because of the self-imposed 60-vote super majority rule that is not even in the Constitution. 60-vote Senate caucuses are rare historical events. The law mandates that 80 percent of premiums must be spent on benefits, so the Health Insurance companies will only make profits by signing in more customers. Therefore, they will market Obamacare big-time. Though a greedy mind is satisfied with no amount of gain. The positive side is that their message only appeals to few percentage of the nation who chooses to live in the darkness. If people can turn off the hate and fear, the light comes up and you can start talking about the effect of insanity on the national psyche.
As a health care professional, who had lived in Europe and Africa, I know first hand that the US medical care as it is, is dysfunctional. Health care should never have been a profit making business. The ACA will at least ensure that more people will have access to healthcare. I don’t know how we can justify access of our quality medical care and educational opportunities for only those who can afford it. Justice is the highest moral good. Partisan passions aside, people want and need reliable health insurance. Doctors, hospitals and pharmaceutical companies need it as well.
It was obvious before this bill to BOTH parties that the system needed reform. The system put in place by ACA is a traditionally Republican idea, to make people choose between all current private health insurance companies, who are about to bring on about 30 million new members, and in return had to provide a little more protection to people, that sign up for health insurance. The ACA helps our seniors, the poor, the middle class and lowers health care costs for everyone. The disinformation about the “individual mandate” is amazing.
The individual mandate was a free-market-inspired creation of the ultra-conservative Heritage Foundation. Its policy wonks argued that individuals who could afford healthcare insurance should take responsibility for it and not push it onto others. Another fallacy being spouted out is that ACA “will send premium costs soaring”. Wait a second …Insurance by its very nature reduces risks and costs by pooling resources. The larger the pool the lower the cost of risk. We know that our insurance costs are so high right now, because we with insurance are covering those without it. We already are paying for all of the uninsured at the highest possible cost: Emergency care. The doctor in that emergency room is on a fixed income, the nurse is not getting rich, so, ask yourself, who is getting the lions share of that huge amount paid out? The reason Republicans want to kill the ACA has nothing to do with ACA, except that it was implemented by the opposition. Pure and simple! They fear ACA because it will be successful, not because it will be a failure.
Health insurance has gone up exponentially, periodically for decades, long before the ACA was passed. In 2010, UnitedHealthCare raised deductibles so high on individually held policies that many of the people with those policies either skipped medical care or paid out of pocket because it was cheaper. That was the year in which UnitedHealthCare CEO took home $200 million in compensation. You want to get angry? Get angry at that, because that is where America’s health care problem really is. Let’s do something about the excessive profiteering in the healthcare industry. When one looks at the profits of the health insurance industry and the compensation for the executives, you can see who is really behind this move to repeal the ACA, and why. These are the people who work to get these obstructionists elected. Reality becomes obscured when some see an opportunity to make a profit from the demise of others. That’s when rationalization becomes politically expedient.
The republican Representatives are stretching reality past the snapping point by saying breathtakingly craven things like “Everyday I serve in Congress I work to fight Washington…” Isn’t that exactly the same as a malignant, cancerous tumor blaming its host for being sick?
The GOP claims to be the party that supports business, right? Why should ANY business be saddled with the obligation of paying for their employees’ health insurance? What incentive does your employer have to provide GOOD insurance, instead of the cheapest allowed by law? Would they not relish the chance to do away with this expense and do away with all the compliance and paperwork? Would it not be a general boost to hiring if every company tomorrow was able to drop the cost of health care? So why would we not want a single payer system? The cost of doing business would immediately and dramatically drop like a rock. A business owner in most European countries and Canada doesn’t have the ‘tax’ of paying for employee health care nor do their citizens go bankrupt over health care. If you are not in the Healthcare business (an insurer or provider), why are you spending your valuable time thinking about your employees’ health care? Why should employees lose health care when they leave your employ? Employer paid health care often makes American companies noncompetitive because companies have to raise the price of their products to make back the cost of the high premiums.
A Natonal Health Insurance plan…everybody pays and everybody is covered. It’s simple, it’s efficient and it’s the way Health Insurance was DESIGNED to work. The largest, healthiest, risk pool possible, results in the lowest cost per individual policy holder. It is simple math; combined with a tad of social responsibilty. It works in many instances around the world and in the USA. We have the British model for our VA system. We have the Canadian model for Medicare. Medicare, already one of the most popular and successful government programs in US history along with Social Security. They are not a threat to freedom !!! Germany has private and public options, all are NONPROFIT. Some will call it socialism. It’s exactly like calling Switzerland, the banker/tax haven paradise, “socialist” because it has universal health care. We can see through all these that their arguments are both disingenous and faulty. One day, we will look back on this and smile….haec olim meminisse iuvabit.
The ACA palaver may be like a last shot from a duel by the fatally injured as Republicans are beginning to adopt nihilistic strategies as operating positions. As the saying goes,…a mortally wounded elephant is dangerous and can destroy an entire village. Republicans that perceive that they have been wronged are trying to destroy a good program. The difference between the two is that the elephant is actually wounded and actually uses reality checks to affirm that position. Republicans never bother to test reality because of the social/political pressure from the extremists in their party. I am not sure it’s a detachment from reality (at least for some), or that they are just that determined to hurt this administration thinking it will be their ticket back to power. Some are ideologues who believe in their nonsense. Others don’t want to buck the Party, and all are scared to death of their base. Over time, however, the Republican right is setting itself up for epic failure.
Finally, I have a suggestion for Republicans that seem fixated on the looming implementation of ACA “Obamacare”. Allow it to happen, as it was in fact passed into law by a majority of Congress and signed by the President. Then, once enacted, if it is the total disaster that you are certain that it is, use public indignation that such horrible legislation was ever passed to remove the Democrats that voted for it from office. It won’t possibly be that hard to do if in fact it is as bad as you say it is. That way we could move on to other issues and let the public decide if the legislation needs amending, over turning or continued implementation.
Osmond Ekwueme MD. PhD
Medical Professional and Policy analyst
