Does the Affordable Care Act Work?

Today is Easter Sunday, which is a time of reflection and renewal for those of the Christian faith. Easter is also a time when we reaffirm family traditions and break bread with our friends and loved ones. I’m hoping that everyone had a wonderful Sunday no matter what your religious beliefs and what holidays you celebrate.

It brings to mind an article that Dr. Ben Carson wrote and appeared in today’s Opinion section of our local newspaper: Recovering America’s exceptionalism. He reflects on the famous French historian Alexis de Tocqueville, who came to America to study our nation. He concluded his American analysis by saying, “America is great because she is good. If America ever ceases to be good, she will cease to be great.” Interesting observation. Our we seeing the degradation of our greatness??

Dr. Carson delves into religion, slavery and history. He further discusses the wisdom and goodness of learning from our mistakes. He finds it “disturbing in the pursuit of goodness the turning of a blind eye toward corruption, much like the Romans did before the fall of their empire.” He is concerned regarding scandals that been characterized as “phony scandals” based on politics and “tells you a great deal about the loss of honesty in our society.”

So, how does this discussion fit our discussion of the Affordable Care Act? “The fact that one party is willing to use its majority status to cram a health care bill down the throats of the minority party and the American people and then refuses to acknowledge the obvious illegitimacy of a bill passed largely on the basis of false information provides a barometer on the lack of importance placed on virtue in our society today. How can such a society in any way claim to be good?”( The Sunday Star, April 20, 2017, Page A7).

My son this weekend, after a number of frustrating discussions with me, his mom and his friends, asked the question-What is really wrong with “Obamacare”? It really seems like such a great idea. My very intelligent wife then pointed out reality to the younger generation, who will soon see the obvious errors of the Bill. She realized the fallacy of the design when she was notified of her huge jump in our health insurance premium as well as the more than doubling of our deductible. She is now considering the delay in many of her doctor visits and diagnostic tests/exams.

Interesting and it brings up the major topic of discussion of this weeks blog. Read on.

Normally I appreciate and respect the opinion of Donna Brazile, appearing many times in our local opinion section of our and I’m sure many other newspapers.

In her article “Health care works on many levels” she tries to point how well the ACA works for the enrollees. As she ends her rant, she states “Numbers do not measure the ACA’s sign-up success. As a result of the Affordable Care Act- Obamacare- illnesses are prevented, people have a greater security in their lives, more money in their pockets (because insurance companies can’t make a profit higher than 20 percent), and families have a parent or child with them because a disease was cured. These are the true measures of success. And that is priceless” (The Star Democrat, April 9, 2014, Page A4).

My problem with these comments and the whole process is what we are really seeing in our medical practices. That Middle Class Americans are really being missed or made to bear the burden/cost again of the “real” health care solutions. Also, the numbers may really do measure the sign-up failure and the failure of the bill/law itself. We need to evaluate the breakdown of the enrollee numbers carefully.

Our President, when he first got into office, stated that he was going to protect the middle class of America. However, the middle class enrollees have had their insurance premiums increased by double digit percentages as well as have had huge increases in their deductibles, as I cited with my wife’s experience. They then are delaying their routine follow-ups for primary as well as specialty care as well as diagnostic tests and even surgeries. How does this prevent illnesses, give people a greater security in their lives or more importantly, keep more money in their pockets? In fact with the increase in deductibles, as seen by examples of $ 4,500 on average, they are now paying more out of pocket portions toward their health care bills. I was pulled aside by one of my”former”patients,who wanted to apologize for having to cancel his routine cancer post operative exams. He explained that his deductible of $5,000 made it very difficult to see me as well as his primary care doctor. Again, this is reality not media hype!

To the rich, this probably will never be a problem or a concern for this group. The poor, who is the only group that this program will help, are not going to contribute to the sustainability of the system. Paying $66-$110 toward their health care insurance coverage does little to cover the costs of health care. Unless health care system pays very little to the doctors and nurses who are given the job of caring for the increased numbers of patients that are going to seek care. Also, the statistics show the enrollees represent a sicker portion of the patient populations. This represents a more costly group of enrollees to treat. Yes, the government is going to subsidize this group of patients, but where are we going to see evidence of sustainability? We do need to see evidence of young, healthy enrollees who can afford the huge premiums and deductibles to assist in sustaining the health care system.

So, Chris, my son with the questions, read on as I attempt to point out the problems with the ACA. But unlike most of the people that object to the Bill and try to repeal the Bill, let us see if there is a way to make it work and provide what the President really wanted- a valuable health care program for all. Is there anything wrong with this goal? No, as long as the population for which it serves realizes the limitations and what is required by all of the enrollees. Look to the British health care system and their problems!

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