Fine Piece On The Importance Of Ensuring The Imperfect ACA Moves Forward

[HuckleB]

Last edited Sat Jun 30, 2012, 01:15 PM - Edit history (1)

http://scienceblogs.com/denialism/2012/06/29/atul-gawande-on-resisting-health-care-reform-he-misses-a-tactic-lying/

"Even inexperienced physicians like me, still in my residency, have these kinds of stories to tell. They’re tragic. But worse, they’re just so stupid. Notice how, in each instance, the problem still ends up being taken care of, only now it’s emergent, farther along, more risky, and of course, more expensive to treat. This is part of the ludicrous nature of the opposition to health care reform. There is no way to get out of paying for these things. All we do by denying people coverage for necessary medical treatment is guarantee that in a few days, months, or years, they’ll be in the emergency room, only now it will cost ten times as much to fix, at greater risk to the patient. This is also backed up by the international experience of health care. Every other industrialized country has universal coverage, many have far superior care, not to mention superior service (France anyone?) to the United States. Yet every one of the countries pays far less per capita (most less than half) than we do on health care. Data from studies within our own country show it’s cheaper for the state to cover the uninsured than to let them stay uninsured. Because of EMTALA, passed by that notorious socialist Ronald Reagan, everybody gets emergency care whether they are insured or not, and fully 50% of emergency care is uncompensated, costs which get transferred to the insured and the tax payers.

For most of us in the healthcare system we see that universal coverage is necessary (unless you reverse EMTALA which will never happen), although we may disagree on how to accomplish it. If anything, the ACA/Obamacare is more of a free-market reform than many physicians would like. Many in my generation (though certainly not in the older generation) would have preferred single-payer, but for reasons I discussed yesterday this is actually not as important as merely guaranteeing universality. Mixed private/public and government payer/private insurance schemes are, if anything, the norm around the world and they work well while still costing less than 50% of what we pay per capita.

So why so much resistance to what should be obvious? There is no way to avoid paying for this stuff, so why don’t we do it more sensibly? Why don’t we move primary care out of the ER? Why not pay for problems when they’re cheap and not emergent?

...

In order to oppose a reform so obviously needed, so completely supported by the data from international experience and studies from within our own country, and in the face of the obvious gob-smacking experience of every physician in the country, one ultimately must rely on just lying. Politifact, both before and after the Supreme Court decision, has demonstrated this phenomenon. Many of the claims against the ACA have been so rabidly false as to deserve their “pants-on-fire” designation, including the fully debunked death panels nonsense (2009 lie of the year!), that it’s the largest tax increase ever, it’s rationing, or that it is some kind of Obama socialist plot. See the top five lies here. Immediately after the ruling Romney was apparently tripping over his own feet in order to be the first to lie about his own reform package saying it would increase the deficit by trillions, another lie, and Limbaugh reiterated the lie that it was the largest tax increase ever.

..."


This piece contains some great links that support why reform is needed, why it would save everyone money, why it would be positive for the economy, as well as being the right thing to do (even if there are better solutions that we should have pursued). It also offers links debunking GOP BS on ACA.

I offer this up as a hope that we will fight to keep this moving forward.

[annabanana]

1. EXCELLENT article. The majority of Doctors can see the

practicalities, and are on the front lines of "what's not working".

[HuckleB]

10. +1

[sabrina 1]

2. A very good article thank you.

His position is similar to many others. We didn't get what we needed but it's a step forward, and the best thing to do now is to continue to reform this system until we get the very costly middlemen out of the way, which would reduce the cost substantially, and those who oppose saving American lives, should simply be ignored. Sweep them out of the way, they are part of the problem.

[babylonsister]

3. Recommend with thanks. Read this, and recognize why we are on the right path. nt

[eridani]

4. What he forgot to mention about countries with mixed private/public systems

Their governments treat private insurers the way we regulate public utilities. None of this is in ACA.

These countries absolutely forbid denying any claim whatsoever.

These countries have fees directly set by the government for health care services.

These countries have just one universal benefit plan in which cost and items to be covered are specified by the government--no Platinum, Gold, Silver or Bronze people

These countries do not allow age rating.

These countries have no deductibles, though co-pays may be required.

[patrice]

7. Good points. I wonder how they compare to HR 676 Improved & Expanded Medicare for All. nt

[Honeycombe8]

5. K&R. nt

[patrice]

6. Going forward with the Patient Protection & Affordable Care Act is a good approach to healing the

fragmentation of the working- and lower- social economic classes, which fragmentation is essentially the result of what has ultimately come to be corporate-personhood and, thus, the cause of increasing oppression. Until there is CLASS solidarity, we will have little more than temporary "victories" against those who oppress us. Moving the PP & ACA forward is a good opportunity to address economic-class solidarity as a means of fighting the class warfare that is being waged against us.

Here are a couple of other good sources on the PP & ACA and also on HR 676 Improved and Expended Medicare for All:
http://www.pnhp.org/
- and -
http://medicinesocialjustice.blogspot.com/ (Dr. Freeman is chair of family practice at KU Medical School and he is my friend on FaceBook because I helped on some KU Med School student activities in support of HCR. He is on several other blogs than the one linked here, if you want to explore additional aspects of Medicine and Social Justice).

The Robert Woods Johnson Foundation also publishes on HCR, though it's more centrist than the two sources above:
http://www.rwjf.org/healthpolicy/

[annabanana]

11. Thanks for the links. . . . . n/t

[tblue37]

8. Such a rational argument in favor of universal healthcare

Last edited Sat Jun 30, 2012, 11:31 PM - Edit history (1)

and this particular reform, despite its flaws, can never convince RWers, even though the Affordable Care Act is largely a reform that RWers originated and have long championed.

The truth is that RWers are not opposed to Obamacare. They are opposed to Obama. Their purpose is to deny him a victory, and the ACA is simply the vehicle they are using against him, because it the signature accomplishment of his administration.

[HuckleB]

9. +1